Theory for doctoral Nursing Practice

Full Answer Section

       

• • • rect sunlight.
    • Cleanliness: Of the patient, the nurse, the room, and the surroundings.
    • Health of Houses: Proper drainage and sanitation.
    • Quiet: Minimizing noise to promote rest.
    • Diet: Ensuring adequate nutrition and clean water.
  • Health: Nightingale viewed health as not merely the absence of disease, but "the state of being well and using every power to the fullest extent in living life." She believed that nature heals, and the nurse's role is to place the patient in the best possible condition for nature to act.
  • Nursing: She defined nursing as distinct from medicine. It involved "putting the patient in the best condition for nature to act upon him." This meant manipulating the patient's environment to facilitate their natural healing processes through meticulous observation and direct care.
  • Person: Implicitly, the person was seen as a passive recipient of care, possessing inherent reparative capabilities, but profoundly influenced by their surrounding environment.
• Significance of Their Work in Nursing: Nightingale's contributions were revolutionary. She transformed nursing from a low-status, often disreputable occupation into a respected profession. Her emphasis on sanitation, hygiene, and empirical observation laid the groundwork for evidence-based practice and public health nursing. Her theory continues to influence hospital design, infection control protocols, and the recognition of environmental factors as determinants of health.

 

Theorist 2: Jean Watson

 

• Historical Context: Jean Watson, an American nurse theorist, emerged in the late 20th century, particularly from the 1970s onwards. This period saw a growing critique of the purely biomedical model of care and a desire to re-emphasize the humanistic and holistic aspects of nursing. Watson's work at the University of Colorado Health Sciences Center focused on integrating caring science into nursing education and practice, advocating for a return to the moral and philosophical foundations of nursing.
• Main Concepts: Watson's theory is known as the Philosophy and Theory of Transpersonal Caring, or simply the Theory of Human Caring. Its core concepts revolve around the "Caritas Processes" (originally Carative Factors):
  • Caring-Healing Consciousness/Caritas Processes: These are the moral and ethical foundations of nursing, guiding the nurse's intentionality and actions. The 10 Caritas Processes include:
    1. Formation of a humanistic-altruistic system of values.
    2. Instillation of faith-hope.
    3. Cultivation of sensitivity to self and others.
    4. Developing a helping-trusting, human caring relationship.
    5. Promotion and acceptance of the expression of positive and negative feelings.
    6. Systematic use of the scientific problem-solving method for decision-making.
    7. Promotion of transpersonal teaching-learning.
    8. Provision for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment.
    9. Assistance with the gratification of human needs.
    10. Allowance for existential-phenomenological-spiritual forces.
  • Transpersonal Caring Relationship: A reciprocal relationship where both nurse and patient transcend their individual selves to connect on a deeper, spiritual level, facilitating healing for both.
  • Caring Moment/Caring Occasion: The focal point in space and time when the nurse and patient meet, forming a connection for human-to-human caring.
  • Health: Viewed as harmony, wholeness, and comfort. It involves unity of mind, body, and soul.
  • Person (Human Being): A unitary being of mind, body, spirit, and environment, who is interconnected with others and nature. Humans are inherently valuable and deserving of care.
  • Environment: Watson acknowledges the internal and external environment but emphasizes the "caring-healing environment," which involves creating a space that supports well-being, peace, and spiritual growth.
  • Nursing: A human science and art that extends caring to others, aiming to promote health and prevent illness, restore health, and care for the sick. It is primarily a moral ideal rather than a task-oriented approach.
• Significance of Their Work in Nursing: Watson's theory brought the focus back to the humanistic and spiritual dimensions of nursing, counteracting the increasing medicalization and technological emphasis in healthcare. It provides a moral and ethical framework for nursing practice, emphasizing compassion, empathy, and the intentional use of self in the caring relationship. It is widely applied in holistic nursing, palliative care, and chronic disease management, reminding nurses of their core purpose: genuine human caring.

 

Theorist 3: Betty Neuman

 

• Historical Context: Betty Neuman, an American nurse theorist, developed her Systems Model in the early 1970s. This period was characterized by a growing interest in systems theory across various disciplines, recognizing the interconnectedness of elements within complex systems. Neuman, a mental health nurse, sought to create a holistic framework that integrated physiological, psychological, socio-cultural, developmental, and spiritual variables when considering a patient's response to stress.
• Main Concepts: Neuman's model is a systems-based approach focused on prevention and how individuals respond to stress.
  • Client System (Person): The core concept. A client system is a dynamic composite of the five client variables (Physiological, Psychological, Socio-cultural, Developmental, and Spiritual) existing in constant interaction with the internal and external environment.
  • Lines of Defense and Resistance:
    • Flexible Line of Defense: The outermost protective buffer, rapidly changing in response to stress. It's the client's immediate response to stressors.
    • Normal Line of Defense: Represents the client's usual or customary state of health and stability. It's their normal coping patterns.
    • Lines of Resistance: Internal factors that help the client system resist stressors and restore stability (e.g., immune response, coping mechanisms).
  • Stressors: Stimuli that produce tension and have the potential to cause disequilibrium within the client system. They can be:
    • Intrapersonal: Originating within the individual (e.g., infection, anxiety).
    • Interpersonal: Occurring between individuals (e.g., role expectations, conflict).
    • Extrapersonal: Arising outside the individual (e.g., financial problems, pollution).
  • Reconstitution: The state of adaptation to stressors, which may be at a higher, lower, or same level of wellness as before the stressor.
  • Prevention: Neuman emphasizes three levels of nursing intervention based on prevention:
    • Primary Prevention: Actions to strengthen the flexible line of defense and prevent exposure to stressors (e.g., health promotion, education, stress reduction techniques).
    • Secondary Prevention: Early diagnosis and treatment of symptoms to strengthen internal lines of resistance (e.g., screening, early intervention).
    • Tertiary Prevention: Actions taken after treatment to maintain adaptation, promote reconstitution, and prevent recurrence (e.g., rehabilitation, follow-up care).
  • Health: A state of dynamic equilibrium or stability, reflecting the level of wellness a client system maintains. Illness is a state of instability or disequilibrium.
  • Environment: All internal and external factors affecting the client system. It includes the created environment (developed symbolically by the client) and the existing environment.

 

Sample Answer

          Part 1: Chosen Theorists and Overviews For this assessment, I will analyze and compare the contributions of Florence Nightingale, Jean Watson, and Betty Neuman. These theorists offer a diverse range of perspectives, from the foundational environmental focus to the humanistic caring approach and the systems-based stress and adaptation model, all of which are highly relevant to contemporary nursing practice.  

Theorist 1: Florence Nightingale

 

• Historical Context: Florence Nightingale (1820-1910) is revered as the founder of modern nursing. Her seminal work took place in the mid-19th century, most notably during the Crimean War (1853-1856). Witnessing the horrific conditions in military hospitals – rampant disease due to poor sanitation, lack of hygiene, and inadequate nutrition – she meticulously documented her observations and implemented reforms. Her efforts drastically reduced mortality rates. Post-war, she established the Nightingale Training School for Nurses at St.