NUR 513 Compare and contrast two nursing theories

NUR 513 Compare and contrast two nursing theories

Nursing continues to evolve in ways to better deliver quality care to patients and families in the community. Nursing theories contribute different nursing models and concepts to promote quality care in more ways than just science and medicine. Denis & Barker,(2016) stated that “Theories set the foundation model for nursing by contributing efficient and effective nursing practice thus enhancing nurse’s autonomy and accountability (Denisco & Barker, 2016). This means that caring can be used interchangeably with nursing.

There are multiple Nursing theories I believe align with me as an ICU RN. This is because every patient is unique and different theories can be applied and applicable to individual patient care. By assessing the patient holistically, the APRN selects the best approach to fit the patient’s and family’s needs to provide a positive outcome.

Nursing theories are the foundation of excellent patient care from the care provider that defines professional boundaries and decision-making. For this topic, I’ll discuss Florence Nighingales’s Environmental Theory and Kathrine Kolcaba’s Comfort Theory which I find significant in laying the framework of nursing practice as an ICU RN. These theories are essential in emphasizing the interpersonal relationships between patients, families, and care providers.

Florence stated that “The goal of the nurse profession is to lend assistance to patients in maintaining their vital capacity and satisfying their needs” (“Theory of Florence Nightingale,” 2015). Thus, Florence Nightingale’s Environmental Theory aims at humans as a member nature with natural defenses influenced by either healthy or unhealthy environments. This illustrates that nursing is a non-healing practice, in which a patient under natural conditions is placed back into the best position. As APRNs, we have a moral obligation to incite positive behavioral changes in patients by assessing the environment in which they live.

Florence’s Theory emphasizes environmental hygiene ( fresh air, warmth, light, quietness, cleanliness, and care in administering a healthy diet) and has both pros and cons to it. Its positive side is that a nurse can manipulate the patient’s environment to the advantage of restoring health. The negative issue is that the theory doesn’t define the actual procedures for handling dependent or extremely needy patients. This negativity deters the care delivery to these patients leading to psychological stress affecting other patients entrusted to their care. I understand that this negativity can be integrated into my future career as an APRN as patient care is inevitable. Accommodations for these environmental recommendations can positively or negatively impact overall patients outcome.

Katharine Kolcabas Theory of comfort emphasizes health practice, education, and research (Petiprin, 2016). The theory describes patients as individuals, communities, institutions, or families in need of healthcare. Petiprin stated that “the environment is an extension of a patient, family, or institutional surrounding that may be manipulated to enhance their comfort” (Petiprin, 2016).

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Comfort theory is the process of assessing a patient’s comfort needs, developing and implementing effective care, and evaluating the patient’s comfort level during and after patient interaction both objective and subjective assessment views. Objective assessment is visual and tangible, eg. patient observation and assessment of a wound healing while subjective assessment is evaluating the wounded patient to elicit a response eg, asking about the patient’s comfort level using an age-appropriate pain scale rating. The three forms of comfort used are Relief, Ease, and Transcendence to evaluate patients’ comfort in the sense of relief when needs are met and addressed (Petiprin, 2016). The pros to comfort theory example is administering pain medication to relieve patients’ pain creates a sense of calmness and contentment transcending a state of comfort where a patient rises above particular challenges (Kolcaba, 2016). Petiprin, (2016) identified four therapeutic contexts Psychospiritual, Physical, environmental, and sociocultural contexts. The cons to comfort theory are the concepts aren’t well defined suggesting the meaning should be universally understood (Oliveira, 2018).

Kolcaba described comfort measures as having evolved from physical focus to include multidimensional holistic care (Oliveira, 2018). Healthcare providers’ comfort measures can go unrecognized by the nurses performing the action. its significant importance to recognize and delineate the key attributes of comfort measures to acknowledge their work.

References

Denisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones and

Bartlett. https://www.gcumedia.com/digitalresources/2016/advanced-practice-nursing_essential-knowledge-for-the-

profession_3e.ph

Kolcaba. (2016). Encyclopedia of nursing research (21st ed.). New York Springer Publishing.

Oliveira, I. (2018). Comfort measures: A concept analysis. Research and Theory for Nursing Practice, 27(2), 95–113.

Petiprin, A. (2016). Kolcaba’s theory of comfort. Nursing Theory. https://nursingtheory.org/theories-and-models

Theory of Florence Nightingale. (2015). Nursing Theories, 3(1).

http://www.currentnursing.com/nursing_theory/attachment_theory.html

My supervisor and most of my colleagues know that after years of intending to take my master’s degree, I finally took the first step and enrolled. I had to keep telling myself that I can do this, and indeed, I am doing it. Whenever somebody asks me, “How is school?”, I did not expect that my answer would be, “I’m enjoying it.” I really am. I always liked being in school, I like learning new things and most of what I am learning in this course has been relevant to my current role. It has given me a broader insight of our healthcare system and the roles that APRNs play in advancing healthcare. It has inspired me to do little things that I can at this time to work towards that goal. Although employers provide training on cultural diversity, I enjoy reading the subject in the resources provided as well as researching on the subject.

So what have been my favorite learning experience so far? I want to say I liked learning about the different APRN roles and how each role can play a huge part in patient care and advancement of healthcare. It also made me realize what path I want to take moving forward. I also enjoy reading my classmates’ responses. Although I don’t get to read each and every response, I do enjoy reading through most of them. It makes me proud to be part of such a smart group of people.

The most challenging part of my learning experience so far is getting familiar with the APA format. I always make little mistakes here and there causing me to lose points, and I hate losing points. I try to double and triple-check my work, and yet I still end up missing something. Hopefully, by the end of this course, I will see a marked improvement in that area as we will continue to use the APA format in all our writing assignments in future courses as well.

Another valuable lesson that I learned so far is time management. I thought time management would be my biggest challenge but I am managing it pretty well so far. Between my very demanding work schedule, my family, my numerous doctor’s appointments, household chores, and attending work or family gatherings, I still find plenty of time to read some relevant school materials.

My goal is to complete my Master’s degree with no interruptions and I am definitely working hard to make that happen.

Introduction to advanced nursing has been a great and exciting course for the past four weeks. The weeks’ DQs, responses, and course assignments have given me a significant experience and have encouraged great interaction. It is from the interaction that I have gathered diverse insights on advanced nursing issues, specialties, and related nursing theories. The concepts I have learned have significantly impacted my practice experience and given me a broad view of the nursing profession. 

     The learning experience has been encouraging,particularly after reading about everyone’s ambitions and future goals in the advanced nursing practice. I have also learned to appreciate and recognize the impact of nursing theories in practice. Having looked into nursing care theories in week 4, I am encouraged to integrate every concept into practice. The foundational knowledge instilled by nursing theories encourages me to meet my professional duties and patients’ rights. As Younas and Quennell (2019) assert, regardless of the nursing specialization and our future goals, the theories discussed are crucial in guiding practice and enhancing positive outcomes.

     Besides, I am excited that most of the goals I set at the beginning of the class are being accomplished. First, I intended to gather as many insights from my peers, which has been made possible by the peer responses. I also looked forward to balancing school and other activities. The program has been highly favorable, and I look forward to interacting with the content in the coming weeks. I anticipate that the content will further guide and prepare me for my future role as a nurse leader. As a nurse leader, my role will encompass interaction with several other advanced practice nurses. Thus, the course is an excellent guide to a successful and fulfilling career.

References

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: an integrative review. Scandinavian journal of caring sciences, 33(3), 540-555.

The Goal Attainment Theory and the Roy Adaptation Model are the two theories of nursing that will be compared and contrasted here. The notion of goal attainment illustrates the reciprocal, interactive process through which a person sets and works to achieve defined objectives. The theory’s hypotheses explicate the elements that influence the realization of intended outcomes. These are divided into four categories: pressure, roles, geography, and chronology. Because of this problem, patients and caregivers must improve their ability to interact with one another.

While both Goal Attainment Theory and the Roy Adaptation Model place an emphasis on individualized goal-setting in nursing practice, they approach it differently. Goal Attainment Theory focuses primarily on setting goals and measuring progress with specific, quantifiable objectives (Gonzalo, 2021). The Roy Adaptation Model takes a more holistic approach that includes not just physiological adaptation, but also psychological and social factors. In terms of scope, Goal Attainment Theory is applicable to any setting or group while the Roy Adaptation Model mostly applies to individual patients within healthcare settings. Ultimately, the intentions and goals of these two theories differ as well; Goal Attainment Theory aims to assess and improve patient outcomes while the Roy Adaptation Model seeks to aid patients in adapting to their environment. Each theory offers valuable insight into nursing practice, but they should not be seen as inherently competing – rather, they can work together to support improved patient care.

On the other hand, the adaption paradigm states that adaptation occurs when there is a favorable reaction to environmental changes. The Roy Adaption Model views man as a bio-psycho-social being in harmony with the changing environment. The individual will use natural and acquired modalities in his quest for adaptation. It also includes people as individuals and groups such as organizations, networks, communities, and families. Both approaches pay close attention to the patient’s lifestyle and surroundings. Both emphasize the importance of nurses in their stories. The group or family as a whole serves as the “patient” under the adaptation hypothesis (Wayne, 2021).

To me, the goal-attainment theory is more applicable out of the two. The notion highlights the advantages of health information and the significance of communication between patients and nurses. As I will be a nursing instructor in the future, and my goal will be to give the appropriate information about different illnesses like HIV/AIDS and prevention and testing for STI/STDS, communication with patients will be my main objective in becoming the nurse instructor. It also has a secondary use to help people overcome technologically-induced communication difficulties. Nurses can better meet their patients’ varying requirements using technologies like vocera. When the patient and the nurse cannot communicate, technologies are used for interpretation.

References:

Angelo Gonzalo, B. R. (2021). Jean Watson’s Theory of Human Caring. Nurseslabs.

Gil Wayne, B. R. (2021). Nursing Theories and Theorists. Nurseslabs.

Virginia Henderson defines nursing as: “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.” (Alligood,2014).

Henderson’s Principles and Practice of Nursing is a grand theory that best describes the principles of advanced practice nursing roles and principles. As a nurse, I view a patient as an individual needing assistance to achieve health and independence or a peaceful death. I work in the ICU, and most of our patients come into the hospital on the brink of death. They are in cardiogenic, septic, distributive shock, or cardiac arrest. Their lives are hanging by a thread. Depending on their code status, we worked to achieve a certain level of stability to get them back to life or to give them at least a peaceful death. Depending on their beliefs, spirituality, or culture, there could be some tension formed between the medical and the nursing team and their families. There are so many times that we already know that the patient will not make it, but we still rely on the family’s decision to guide us on what direction to take or base our care on the patient’s wishes.I hope everyone will have an advance directive ahead of time. It is a respectful way to fulfill a patient’s wishes to receive medical care if that person cannot make medical decisions because of a severe illness or injury. Despite this, sometimes, their family overrides the patient’s advance directives. Respecting patients’ wishes before their death is essential because it is their effort to maintain their independence and dignity at the end of life. The simplicity of Henderson’s nursing theory defines the basic need of a man in a holistic approach that to achieve wholeness, it is essential to maintain physiological and emotional balance. The Henderson nursing theory is easy to understand and applicable to any branch of nursing practice. The flexible nursing theory can be used by nurses in multiple care settings and adapt to the patient’s situation individually. I always advocate for patients’ autonomy and to gain independence as they recover from illness because you give them the freedom to engage in meeting their own needs. It provides them with the pride of being able to fulfill the meaning of self-actualization, and as a result, they regain their health and strength. The principle of Virginia Henderson applies to my preferred advanced nursing role as a nurse leader because the nursing role is ever-changing and expanding with new technology, leadership opportunities, and scientific approaches. Still, the core sentiment of nursing provided by Virginia Henderson is relevant today. This makes nursing more diverse and critical to improving the lives of individuals across their lifespans. I would use the nursing need theory in advanced practice to base the approach on the individual’s needs and empathetically establish necessary interventions to promote disease prevention and health maintenance to improve health outcomes.

Hildegard Peplau’s nursing theory is a core definition of nursing because, according to the Interpersonal theory, nursing is a “significant, therapeutic, interpersonal process.” She defines it as a “human relationship between an individual who is sick, or in need of health services, and a nurse specially educated to recognize and to respond to the need for help.” (Alligood,2014) The professional scope of nursing practice is multidimensional and comprehensive because it plays a central role in transforming the healthcare system to create a more accessible, high-quality, and value-driven patient environment (Hagert et al., 2017). Patients’ interpersonal relationship with the nursing team influenced their overall hospital experience and health outcomes. It is also important to note that nurses should be given enough resources to provide the utmost nursing experience to improve patient satisfaction and healthcare outcomes. If the unit or hospital lacks the tools to be effective partners in healthcare, it will overwhelm the nurses and, therefore, affect how they interact with patients. Building rapport is essential to breaking communication barriers as a relationship is established. The weakness of Peplau’s nursing theory is lack of focus on disease prevention and health maintenance. As a nurse leader in the future, my goal would be to promote nurse driven care focusing on disease prevention and health maintenance to lessen patient’s hospital admission and to improve their health outcome and survival rate. Thank you.

Reference:

Alligood, M. R. (2014). Areas for further development of theory-based nursing practice. Nursing theory: Utilization & application. Elsevier.

Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017, March 24). Peplau’s Theory of Interpersonal Relations. Nursing Science Quarterly, 30(2), 160–167. https://doi.org/10.1177/0894318417693286