NUR-513 APA Assignment GCU

Select one theory discussed during Topics 4 and 5. Describe how this theory applies to your future role in advanced nursing practice (individuals, families, communities, and special populations)? Why or why not? Use examples from your current practice to illustrate differences or similarities.

As a Nurse Educator in a college environment, guiding students and influencing their climb to success is an honor. The Nurse Educator must have strong clinical skills, effective communication techniques and sensitive awareness of different personalities. Everyone learns in a different way, and each person may have unique barriers to attaining knowledge that must be constructively addressed. Nursing school is a rigorous program, and making sure nobody feels left behind is important.

Imogene’s theory of goal attainment is a nursing model that defines the action, reaction and interaction that a nurse and patient have in response to a situation. This theory can also include that of a nurse educator and nursing student problem solving together. This theory utilizes key elements which includes roles, stress, space, and time. Meeting necessary standards can be difficult at times, and these four factors are heavily involved in possible hardships surrounding the achievement of desired goals (McQueen, 2017).

I found an article that addresses the millennial generation of students and graduates. This generation has many positive attributes associated with many areas including technology, confidence and ambitions. The article states that “In the last years, nurse educators have been introduced to and provided information on strategic teaching methodologies for millennial students in nursing programs in the United States (McQueen, 2017)”. Imogene’s theory helps provide a framework to guide and mentor the upcoming graduate nurse into their practice. Different types of learning modalities can be utilized to empower this generation to create change and become effective leaders within the profession. Health care delivery can be greatly improved and utilizing Imogene’s goal attainment theory can be highly beneficial in the success of this important generational movement (McQueen, 2017).

For roles, the nurse educator can establish an appropriate relationship with the students gaining respect and trust. Stress can be reduced by defining mutual appreciation and understanding between the educator and student. This can help create a safe and healthy learning environment. Space can define the educator’s ability to let the student experience learning opportunities in a constructive way, with criticism being delivered as guidance not reprimand. Time can involve the sharing of the educator’s knowledge and experience with the student. This, in turn, can help to identify weaknesses and strengths, and can help set reasonable goals for each unique individual eventually leading to goal attainment.

We have nursing students come in our unit often. I try my best to positively influence these student nurses’ confidence and provide as much as I can for them for the short amount of time I have. I not only teach about the daily nursing tasks, but also comfort them with my own experiences as a student nurse and practicing nurse. Reassuring them on their capabilities and letting them do things on their own while I stand by really means a lot to them.

NUR-513 APA Assignment GCU Reference:

McQueen, L, Cockroft, M, & Mullins, N. (2017). Imogene king’s theory of goal attainment and the millennial nurse: an important mentoring tool for nurse educators. 12(3): 223-225. Teaching and Learning in Nursing. https://doi.org/10.1016/j.teln.2017.03.003.

Nursing theories consist of concepts, perspectives, frameworks and hypotheses that guide nurses in care delivery. Theorists develop these models using inductive and deductive reasoning. The use of nursing theories is critical as it allows one to address issues in care provision and promote the attainment of positive patient outcomes (Watson & Woodward, 2020). The purpose of this essay is to explore the role and importance of nursing theories based on their purpose and significance to the current practice.

Purpose of Applying Nursing Theory to Patient Care

The use of nursing theories is critical to patient care because of the different purposes that they serve. Nursing theories assist in informing every interaction between nurses and patients. Through defining the features of the nurse-patient interaction, these theories shape how nurses develop relationships with patients (Wei et al., 2019). The purpose of most nursing theories is to help nurses identify care needs among patients, articulate what they can do for patients and why they do it, and determine the kind of information to collect to develop care plans. Through theories, nurses can comprehend and evaluate health situations, explain and anticipate certain responses from patients and map out objectives and anticipated outcomes (Bahabadi et al., 2020). These theories also help nurses determine the interventions to deliver, best practices, and selection of productive areas for research. The implication is that nursing theories are fundamental to quality care provision as they help nurses to possess background propositions to offer the best care.

Importance of Nursing Theory in Current Practice

The current practice trends implore nurses to offer innovative and patient-centered care to enhance outcomes. Models like the Quadruple Aim, evidence-based practice (EBP), and value-based care all urge nurses to be well-positioned to offer quality and cost effective care to patients and maintain their wellness in practice. Therefore, nursing theories are essential to the current practice as they offer nurses background approaches to the integration of these models. Nursing theories are essential because of the focus on patient-centered care. The use of nursing theories enhances values and goals of nursing practice implying that nursing models can only work when there are proper guidelines in care provision. These theories are interconnected and inextricably intertwined in nursing practice, irrespective of the nursing situation or circumstance. The application of nursing theories in any nursing situation means that nurses are keen on improving care outcomes, reducing the cost of care, and increasing accessibility.

The current practice environment emphasizes inter-professional collaboration and teamwork to deliver quality care. Therefore, through these theories like Nola Pender’s health promotion model, nurses understand their roles and the actions that they can initiate to improve public health (Bahabadi et al., 2020). Theories provide answers to complex nursing healthcare issues that emerge based on trends like increased use of technology to offer virtual health care services.

Application of a Nursing Theory

Planning and providing care in current practice are essential as they allow nurses to understand and use the most appropriate and effective interventions to deliver care. Nursing theories focus on the four main concepts in nursing metaparadigm. These include the person, the environment, health and nursing (Ortiz, 2018). The use of a nursing theory implies that one must focus on the metaparadigm when offering care. The planning should focus on patients, their environment, the need to attain healthy outcomes, and the role of nurses or nursing in this context.

Dorothea Orem’s self-care model entails three critical areas that include self-care, self-care deficit, and the nursing process. Similarly, Watson’s caring model emphasizes the significance of allowing patients to attain independence and understand their underlying conditions and what they can do to alleviate adverse outcomes (Watson & Woodward, 2020). Therefore, nurses can use a theory to plan care provision as it will help determine what they need to implement their care plans in consultation with the patient. Gathering information before the care provision is essential and requires nurses to leverage appropriate theories in nursing.

Theory Reflecting my Personal Perspective on the Essence of Nursing

Theories are essential in nursing because they offer guidelines and a framework, concepts and approaches that one can deploy to offer quality patient-centered care. Younas & Quennell (2019) assert that theory-guided practice in nursing leads to better quality of life, increased self-efficacy and self-care and reduces patient’s levels of stress, especially those with chronic conditions. The theory that aligns with personal perspective on nursing is Watson’s caring theory. Watson asserts that effective caring regenerates life energies and potentiates individual capability. Caring promotes self-actualization and mutually benefits both the patient and the nurse (Watson & Woodward, 2020). The theory advances that nursing is about health promotion, prevention of illness, caring for the sick and restoration of health. The theory captures my perspective on nursing since I believe that nursing is a selfless profession to help people attain the best outcomes from their health conditions. The theory has been effective in planning and providing care to patients as it focuses on health promotion and interventions that can guarantee better outcomes. Nurses must demonstrate the ten carative factors that Jean advances like willingness to learn to enhance one’s caring experience.

Conclusion

The use of nursing theories is critical as it offers guidelines on how nurses can implement different components of care provision and attain quality patient outcomes. Nursing theories are essential because they help nurses to generate interventions to improve care and understand their roles in care provision. Theories also help in shaping nurses’ personal perspectives on nursing and promotion of quality care.

NUR-513 APA Assignment GCU References

Bahabadi, F. J., Estebsari, F., Rohani, C., Kandi, Z. R. K., Sefidkar, R., & Mostafaei, D. (2020).

Predictors of health-promoting lifestyle in pregnant women based on Pender’s health promotion model. International Journal of Women’s health, 12, 71. DOI: 10.2147/IJWH.S235169.

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:

            Essential Knowledge for the Profession. Jones & Bartlett Learning.

Ortiz, M. R. (2018). Patient-centered care: Nursing knowledge and policy. Nursing science

quarterly, 31(3), 291-295. DOI: 10.1177/0894318418774906.

Watson, J., & Woodward, T. (2020). Jean Watson’s theory of human caring. SAGE Publications

Limited.

Wei, H., Fazzone, P. A., Sitzman, K., & Hardin, S. R. (2019). The Current Intervention Studies

Based on Watson’s Theory of Human Caring: A Systematic Review. International Journal for Human Caring, 23(1). DOI: 10.1016/j.ijnss.2018.12.001

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: an integrative

review. Scandinavian Journal of Caring Sciences, 33(3), 540-555. DOI: 10.1111/scs.12670.

Topic 4 DQ 1

Nursing theories are essential components as they offer organized bodies of knowledge to help nurses define nursing, what they do and reasons for doing it. Nursing theories allow nurses to define the profession as a unique discipline which is different from others based on the concepts that it advances to help guide the nursing practice (DeNisco, 2019). Dorothea Orem’s self-care deficit nursing theory and Jean Watson’s caring theory are critical nursing theories used by nurses in their practice to help them deliver quality care.

Orem’s self-care deficit advances that all people have the ability to perform se3lf-care and maintain their health and life to meet the nursing paradigms of human, health, environment and nursing. The model has three components that include self-care, self-care deficit and the nursing process (Smith, 2019). The theory advances that individuals have self-care capabilities but when they lack due to certain deficits, the nursing process becomes critical to allow them overcome the challenges. The nursing process focuses on overcoming human limitations for needs and self-care. Nurses can help their patients to enhance self-care through acting and doing, guiding and supporting, promoting personal development and teaching.

Watson’s caring model advances that caring is core to nursing process and it should focus on holistic model aimed at health promotion and disease prevention (DeNisco, 2019). The theory has four ideas that include the value of human being, health being of essence for overall mental, physical, and social functioning, and society offering values and goals. Fourthly, the theory advances that nursing is a human science.

Both theories demonstrate that nursing is essential to overall quality outcomes for patients. Both Watson and Orem emphasizes the need for nursing process to be patient-centered. The two theories assert the role of nurses as assisting individuals maintain their health (Ortiz, 2018). They also agree that health should be holistic by embracing all components of care. However, while Watson’s focus is on holistic care, Orem’s focus is identification of gaps in the nursing process to improve overall outcomes. Further, Orem’s theory has three main parts while Watson’s model focuses on five critical areas in care provision (Smith, 2019). The intent of Orem’s theory is nursing process while Watson’s intent on personalized patient care. Watson’s theory is more relevant to my future role as a nurse leader since it focuses on provision of holistic care services to patients.

NUR-513 APA Assignment GCU References

DeNisco, S. M. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession:

            Essential Knowledge for the Profession. Jones & Bartlett Learning.

Ortiz, M. R. (2018). Patient-centered care: Nursing knowledge and policy. Nursing science

            quarterly, 31(3), 291-295. doi: 10.1177/0894318418774906.

Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.

The two different nursing theories that I am going to compare, and contrast are Hildegard Peplau’s Theory of Interpersonal Relations and Imogene King’s Theory of Goal Attainment. The main idea of Peplau’s theory is that the relationship between a nurse and patient is a substantial part of nursing practice and significantly affects patient outcomes (Gonzalo, 2021a). Peplau believed that nurses must clearly understand who they are as well as their different viewpoints to be able to help patients to their full potential because if we know ourselves, we avoid limiting patient choices (Gonzalo, 2021a). One of the most important skills a nurse must have to fulfill this theory is communication and interviewing skills (Gonzalo, 2021a). The main idea of King’s theory is the attainment of certain life goals by a nurse following the process of action, reaction, and interaction (Gonzalo, 2021b). The patient shares information with the nurse about their perception of what is happening and then goals are set together and achieved (Gonzalo, 2021b). King believes that the focus of nursing is the care of the patient and that humans are open systems that constantly interact with their environment (Gonzalo, 2021b). King really just follow’s the basics of the nursing process where a nurse and patient communicate, set goals, and act to achieve those goals (Gonzalo, 2021b). The one think they both have very much in common is that in the end their goal is to overall improve patient outcomes.

Although I think both theories are very important and should be implemented in all nursing careers the one that I think may be more relevant to my future role is Peplau’s Theory of Interpersonal Relations. I really believe that if I go into nursing leadership and management, I need to have a big focus on communication and interviewing skills. I also believe that Peplau’s theory can work towards patients as well as nurses. If you are a manager being able to effectively communicate with nurses under your supervision can really improve their outcomes as a nurse which in turn positively impacts patient outcomes. I think it is very important that we all understand ourselves on a very deep level to prevent bias actions.

NUR-513 APA Assignment GCU References

Gonzalo, A. B. (2021a, March 5). Hildegard peplau: Interpersonal relations theory. Nurseslabs. https://nurseslabs.com/hildegard-peplaus-interpersonal-relations-theory/

Gonzalo, A. B. (2021b, March 5). Imogene king: Theory of goal attainment. Nurseslabs. https://nurseslabs.com/imogene-m-kings-theory-goal-attainment/

TOPIC 4 DQ 2

The two different nursing theories I am going to describe are Faye Abdellah’s Typology of 21 Nursing Problems and Dorothea Orem’s theory. Faye Abdellah had a very unique nursing theory as she complied 21 nursing problems that fall into specific categories such as basic human needs, interpersonal relationships, and other common patient care elements. She then created a ten-step problem-solving method and eleven nursing skills to fix these nursing/patient problems. Abdellah viewed nursing as a comprehensive service. As you can imagine her theory is very lengthy with many parts but has great content. I would recommend checking it out. Abdellah uses a patient-centered approach to nursing and the theory is considered a human needs theory (Gonzalo, 2021b). Some pros to Abdellah’s theory are that she create the model to guide care in all settings not just to hospitals as well as the model was created in a way that healthcare providers and practitioners can use it as well (Gonzalo, 2021b). The language Abdellah uses is simple and very logical making it easy to use (Gonzalo, 2021b). Some of the cons of her theory is that it is inconsistent with the concept of holism because of this, patients may be diagnosed with numerous problems causing care to be spread across many different teams leading to the possibility of certain things being overlooked or forgotten about (Gonzalo, 2021b).  Overall, her theory can definitely be used for successfully enticing behavioral change since it is so patient centered and has steps that are needed for this success. 

Dorthea Orem’s theory is a Self-Care Deficit Nursing Theory. One interesting fact is that it is considered a grand nursing theory, which means it is broad and can be applicable to all nursing (Gonzalo, 2021a). The general idea of Orem’s theory is to assist others in management of self-care to maintain human functioning and to be able to perform activities of daily living to maintain life, health, and well-being (Gonzalo, 2021a). Some of the key points are to stay alive people must participate in constant communication among themselves and their environment, mature humans are able to perform all actions of self-care, in times of incapacity humans with structured relationships can delegate care to those willing to help them (Gonzalo, 2021a). I really love Orem’s theory because I think that it needs to be practiced by all and I think that everyone at some point in their lives has struggled with self-care. A great definition of self-care agency was provided and states that, “Self-care agency is the human’s ability or power to engage in self-care and is affected by basic conditioning factors” (Gonzalo, 2021a). Some pros of Orem’s theory are that it is applicable to all healthcare providers, that it provides a comprehensive basis for nursing practice, ad that is specifically defines when nursing is needed (Gonzalo, 2021a). Some of the cons are that although her theory seems simple it is actually really complex, and not as simple to follow as Abdellah’s. Also, there is limited acknowledgement of the patient emotional needs (Gonzalo, 2021a). Overall, her theory can also be used for successfully enticing behavioral change as the main idea is literally changing a patient’s behavior of self-care. This theory focuses on patient’s independence and really tries to show that all patients want to care for themselves. Patients can recover more quickly by performing their own self-care as much as they’re able (Gonzalo, 2021a). 

NUR-513 APA Assignment GCU References 

Gonzalo, A. B. (2021a, March 5). Dorothea orem: Self-care deficit theory. Nurseslabs. https://nurseslabs.com/dorothea-orems-self-care-theory/ 

Gonzalo, A. B. (2021b, March 5). Faye abdellah: 21 nursing problems theory. Nurseslabs. https://nurseslabs.com/faye-g-abdellahs-21-nursing-problems-theory/ 

Watson’s Theory of Human Caring is the first theory that I would like to examine. Watson’s approach incorporated elements from the fields of nursing, therapeutic, educational, and social psychology. Caring relationships between patient and caregiver, carative circumstances, and caring occasion/moment are the primary conceptual parts of the approach. This philosophy encourages, on a broader scale, self-awareness and connectivity with humanity and the universe (Gunawan et al, 2022). The purpose of Watson’s Theory of Human Caring is to identify the beneficial characteristics of caring nursing and their effect on patients. Watson eventually used the term caritas for carative. This changed theory nomenclature from a medical antonym to a nursing-specific patient care theory. The fundamental caritas processes are accept, inspire, nurture, trust, forgive, balance, humanity, deepen, co-create, and infinity. This caritas theory approach is seen as a set of nursing competencies for caring for others (Gunawan et al, 2022). Watson’s Theory of Human Caring applies to all nursing personnel. As they should demonstrate caritas as a competency for caring for others. This applies to the highest levels of administration as well as the nursing personnel. Watson’s Theory of Human Caring has as its ultimate objective the protection, preservation, and enhancement of human dignity.

The second nursing theory I will discuss is Orem’s Self-Care Deficit Theory (OSCDT). People-centered care and population health, which specifically addresses social determinants of health, are two OSCDNT concepts that continue to be relevant (SDOHs). In order for nurses to play a role in empowering and engaging individuals in their healthcare, reducing health inequities, and enhancing healthcare outcomes, these are important (Hartweg & Metcalfe, 2022). OSCDT aims to structurally and functionally include self-care into the scope of nursing practice by increasing the personal, health, and sociocultural aspects of self-care. According to Hartweg and Metcalfe (2022), the OSCDT defines self-care as “the practice of actions that individuals initiate and undertake on their own behalf for the purpose of maintaining life, health, and well-being.” The scope of this theory is to empower patients and their families to take on a greater and more ongoing role in their own care. The objective of OSCDT is to enable nurses to collaborate with their patients in order to support them in attaining better outcomes.

Watson’s Theory of Human Caring and Orem’s Self-Care Deficit Nursing Theory both employ the themes of caring for and preserving human dignity. While Watson’s Theory is more focused on nursing practices throughout the healthcare system, Orems’ theory is more concerned with enabling the patient to improve their health through a strong collaborative relationship with the nurses providing assistance. I believe Watson’s Theory of Human Caring will be more applicable to my future position because it focuses more on nursing behaviors and influences all levels of nursing positions.

References

Gunawan, J., Aungsuroch, Y., Watson, J., & Marzilli, C. (2022). Nursing Administration: Watson’s theory of human caring. Nursing Science Quarterly, 35(2), 235–243. https://doi-org.lopes.idm.oclc.org/10.1177/08943184211070582

Hartweg, D. L., & Metcalfe, S. A. (2022). Orem’s self-care deficit nursing theory: Relevance and need for refinement. Nursing Science Quarterly, 35(1), 70–76. https://doi-org.lopes.idm.oclc.org/10.1177/08943184211051369

The first theory I’d like to discuss is, Watson’s Theory of Human Caring. Watson’s theory combined components from nursing, clinical, educational, and social psychology. The major conceptual elements of the theory consist of caring relationships between patient and caregiver, carative factors, and caring occasion/caring moment. On a larger level this theory encourages self-awareness and interconnection with humankind and the universe (Gunawan et al, 2022). The intent of Watson’s Theory of Human Caring is to define the valuable aspects carative nursing and recognize the impact they have on patients. Watson eventually replaced the term carative was caritas. This moved theory terminology away from being a medical antonym to a nursing specific theory of patient care. The caritas processes consist of embrace, inspire, nurture, trust, forgive, balance, humanity, deepen, co-create, and infinity as essential to the theory. This caritas theory process is considered a set of competencies for nurses to take care of others (Gunawan et al, 2022). The scope of Watson’s Theory of Human Caring extends to all nursing staff. As they should display the described caritas as a competency to care for others. This extends from the highest levels of management to staff nursing. Ultimately, the goal of Watson’s Theory of Human Caring is to protect, preserve and enhance human dignity.

The second nursing theory I’d like to cover is, Orem’s Self-Care Deficit Nursing Theory (OSCDT). Two particular constructs OSCDNT has that hold continued relevance: people-centered care and population health specifically addressing social determinants of health (SDOHs). These are necessary if nurses are to have a role in empowering and engaging people in their healthcare, reducing health disparities, and improving healthcare outcomes (Hartweg & Metcalfe, 2022). The intent of OSCDT is to place self-care structurally and functionally within the scope of nursing practice by expanding the personal, health, and sociocultural features of self-care. As Hartweg and Metcalfe state, OSCDT defines self-care as “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being.” The scope of this theory seeks to empower patients and their families to care for themselves on an increased and ongoing level. The goal of OSCDT is to empower nurses to form collaborative care with their patient to assist them with achieving improved outcomes for themselves.

Both Watson’s Theory of Human Caring and Orem’s Self-Care Deficit Nursing Theory utilize the concepts of caring and protecting human dignity. While Watson’s Theory is directed more towards nursing behaviors throughout the healthcare system, Orems’ theory focuses more on empowering the patient to improve their wellbeing by having a strong collaborative relations ship with nurses providing support. I think Watson’s Theory of Human Caring will be more relevant to my future role because it is more directed at nursing behaviors and impacts all levels of nursing roles.

Culture Care Diversity and Universality Theory, also known as Culture Care Theory (CCT), developed after World War II due to Dr. Madeleine M. Leininger’s realization that nurses caring for immigrants would need to understand different cultures. This would require nurses to learn transcultural nursing practices. At the time, Leininger cared for children of different cultures and recognized that she struggled because each child’s behaviors, needs, and responses were unique due to cultural differences. Furthermore, it was clear that each parent had a different expectation of care depending on their cultural background. One consideration that I had while researching this theory was that social media, not yet the norm in Leininger’s time, may help to provide a better foundation for today’s nurses to understand cultural diversity.

This theory is still very relevant in today’s clinical settings. As a leader, I can use the fundamentals of this theory to reinforce the importance of understanding cultural differences more entirely in order to provide culturally congruent care to all patients. The difficulty with this theory is that one cannot immerse themselves into every culture as suggested. Leininger does offer that understanding the philosophy of transcultural nursing and the CCT is a foundation for inciting behavioral changes in nursing. (293-298)

Dr. Pamela G. Reed’s Theory of Self-Transcendence gave birth to two widely used research instruments: The Spiritual Perspective Scale and the Self-Transcendence Scale. She focused on spiritual perspective, self-transcendence, mental health, and well-being among older adults at the end of life. According to Reed, during difficult health-related experiences, individuals expand and refine self-boundaries. One becomes more aware of beliefs, values, personal relationships with people, nature, and their past and future. The difficulty or barrier with this theory could be that people could misunderstand its intent to be that of separation from self or others instead of its intention, the connection to everyday aspects of the environment.

Understanding this theory is very helpful when caring for cancer patients. People deal with their diagnosis differently, but anxiety is one commonality among all cancer patients. Perhaps if nurses understood and could articulate this in a particular way to their patients, it would be a source of comfort. Nurses could use the tools and understanding of self-transcendence as a predictor of well-being and use that finding to guide their patient care.

In conclusion, I found no ethical issues related to either theory. I believe both views hold ethical value and can be used practically by nurses to enhance their understanding of their patients and their patient’s needs.