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Faye Glenn Abdellah is to date still considered as a researcher who contributed in the transformation of the nursing theory in addition to nursing education and care. Under the influence of the desire to promote a client-centered nursing care, she was able to describe nursing as a service to families, individuals and the society. This event occurred in the year 1960. She believes that nursing is generally based on science and art. These two disciplines are the ones which mould intellectual competencies, technical skills and attitudes of a nurse into the ability and desire to be of help to people whether sick or in good health.
In the light of comprehensive service, nursing encompasses a number of important elements. They include identifying the nursing issues or problems of the patient, settling on the suitable course of action according to principles of nursing, continuing to provide total care to the individual's needs, providing care to ease discomfort and pain and making sure that the care plan meets the patient's needs.
Other additional elements are assisting the individual to be more directing in terms of attaining a healthy state of mind, instructing the family and the responsible nursing personnel to let the patient do what he or she is capable to do in spite of the limitations, assisting the individual to adjust effectively to his or her limitations, working with health professions to plan for maximum health on all the necessary levels and finally administering evaluation on a continuous basis and research which will improve nursing techniques.
However, there are a number of philosophical underpinnings that relate to this particular theory. The first one is her approach which is patients centered which as generated from her practice. The theory commonly considered as a human needs theory, was created to help with nursing education. In addition to its intention to guide in the care of those in the hospitals, it is relevant in a community setting in terms of nursing care.
The twenty one nursing problems were developed by Abdellah and her colleagues in addition to the ten steps of identifying clients' problems and eleven nursing skills that are necessary to developing a typology for treatment. The nursing problems therefore fall under three distinct categories. The first one is sociological, physical and emotional needs of a client. The second one is kinds of interpersonal relations between the patient and the nurse. The final category is about the normal elements of client care.
In other words, the twenty one problems can also be divided into needs that are basic to all patients, remedial care needs, sustainable care needs and restorative care needs. Abdellah reckons that health is a dynamic world that is influenced by both internal and external factors which lead to use of resources in order to minimize the aspect of vulnerability.
A nursing problem that is put to the clients notice by the client is usually a situation that affects both the client and her or his family and it therefore calls for the nurse on duty to professionally assist them. The nursing problem is meant to assist the nurse attain the performance of her functions professionally. The nursing problem can also be described as a hidden circumstance which the nurse is expected to uncover and offer the necessary assistance as it relates to her profession.
In the process of offering an answer to the nursing problem at hand, the nurse is expected to be able to balance nursing and disease orientation and the affected client. It follows that the process of solving the problem involves identification, selection of data, hypothesis formulation, hypothesis testing by data collection and revision of the particular hypotheses.
Abdellah's theory is built around four main concepts. They are nursing, person, health, society and the environment. Nursing as a profession is all about helping out those who are in need. It is built around twenty one problem areas which necessitate nursing judgment and care. A person is necessary to provide the required emotional, sociological and physical needs that are to be acted upon by the nurse. It is viewed that a patient is what makes nursing to exist thus families and individuals are the direct recipients of nursing. In addition, the purpose of nursing services is achieving health.
A state of mutually exclusive sickness is what Abdellah describes as health. The state should therefore be of both body and mind when total health needs are attained. The various level in which nursing as a service operate, be it local, national, state or international all add up to a society. Kim & Kollak (2006) asserts that the environment offers a platform where the patient, his family and the nurse can interact.
The first characteristic which relates to the works of Abdellah states how her nursing problems, problems solving measures and concepts of health care are interrelated. A new way of looking at the nursing phenomenon emerges. Nursing was therefore considered as the use of the approach of problem solving towards nursing problems which relate to respective patients or clients. The second characteristic describes the idea of problem solving as a logical activity. The third characteristic describes how the main focus is laid upon individuals and the nursing practice in general. The fourth characteristic addresses the role of the client within the theory which is capable of raising a hypothesis.
The fifth characteristic depicts how the hypothesis that can be raised due to the fourth characteristic contributes to the nursing knowledge. The sixth characteristic shows how the problem solving approach can be utilized by medical practitioners as a guide. This situation is handy when specific needs relate to specific problems. The seventh and the final characteristic talks about the inconsistencies of the theory and how quite a good number of queries can still not be answered.
The twenty one problems can be used in the assessment stage of the nursing process in such a way that they guide in the way to collect data. A related principle stipulates that for every identified problem there is specific data that can be collected. The exact nature of the particular problem will determine the kind of approach.
Another area is in the nursing diagnosis. The data collected will definitely point towards the specific problems of the individual. The following step is grouping this problem under a single or several of the major nursing problems. Another stage that uses the twenty one problems is the planning phase. It follows that when the specific problem has been discovered, the corresponding goals have also been attained. The very goals can best be described as nursing goals.
The next stage is the implementation stage where a plan is developed using the nursing goals as a framework, followed by suitable nursing actions. The final phase is evaluation. A plan is evaluated on the basis of the progress of the patient according to the American Nurses' Association Standards of Nursing Practice. An idea that is not supported by the nursing problem approach. On the contrary, Abdellah suggests evaluation upon the progress of the nurse.
Another important concept is the progressive patient care which is better care to a patient by proper organization of facilities, staff and services in the hospital in question. It can also be described as a classification that is systematic in nature relating to the needs of the patient. The elements of this concept are intensive care, benefits to the patient, the physician, hospital, nursing personnel and the community.
Intensive care is meant for the seriously ill patients and therefore needs sufficiently skilled nursing care. This situation calls for thorough observation of the intensive care unit round the clock. The benefits of the progressive patient care are reduced problems, life saving care, steady medical and nursing care and better attention and adjustment.
The physician under this concept is charged with the responsibility of carrying out order effectively, ensuring better clinical service, assuring better nursing care and proper administration of drugs and use of suitable equipment at his or her disposal. The hospital is the field where the nursing services are offered. It is where the public image of that particular hospital can be improved.
The nursing personnel is concerned with job satisfaction, in-service education, solving medical problems, an avenue that offers time with the patient and where the individual skills of the nurse can be put into good use. The community contributes to the continuity of the services of a particular hospital within that particular community.
However, there are implications of progressive patient care for nursing education one of which is that a good number of nurse educators consider that progressive patient care is necessary especially in solving basic problems. Another point is that in such a setting, the three months assignment of nurses may be unrealistic. The seriously ill in the intensive care unit are concentrated irrespective of the diagnosis. The seriously ill patients are under close observation considering that they have life saving equipment and skills at their disposal.
Over a long period of time, this care unit will have a concentration of patients who will definitely require lengthened care. It follows that if grouping of these patients is put in place, then staffing patterns will be easier thus reducing costs. The hospital services are extended into the home in order to help the physician to take good care of the patients.
This should be recalled as the fifth element of the Progressive Patient care. This care unit takes care of patients who as much as they are self-sufficient (physically), they also require convalescent and diagnostic care in accommodations like in the hotel. It is evident how this unit is acting as a bridge between the home and the hospital. The needs of the patient influence the organization of the community and hospital services. An approach that is patient centered was established so that it can benefit the nursing practice in general.
Congruence of Faye Glenn Abdellah's theory and the rural nursing theory
To start with the rural nursing theory appreciates how the rural and the urban environment are different in terms of their health care issues as much as they are both geared towards improving the quality of a patient's life health wise. It is true that there will be preventive healthcare in the rural setting which will not interfere with the normal working schedule.
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