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Lecture 3

NURS 341 Lecture Notes - Lecture 3: Model Theory, Nursing Theory, Nursing Process


Department
Nursing
Course Code
NURS 341
Professor
jantzen
Lecture
3

Page:
of 5
Nurs 341: Week 2
Nursing Theories and Nursing Practice: pg. 1-14
Nursing Theory and the Discipline of Nursing
Nurses assess, plan, implement and evaluate the patient
Defining nursing in terms of the nursing process or by functions is problematic
Multiple professionals and non-professionals perform the same tasks as nurses, and persons with the ability and authority to
perform certain tasks change based on time and setting
Nightingale- differentiates nursing from medicine saying that they are two distinct practices
oDefined nursing as putting the person in the best condition for nature to act, insisting that the focus of nursing was
on the health and natural healing process and not on the disease and compensation/ financial context
oCreating an environment that provided the conditions for natural healing to occur was the focus of nursing
The Discipline of Nursing
Each discipline has a unique focus that directs the inquiry within it and distinguishes it from other fields of study
Nursing knowledge guides its professional practice, thus it is classified as a professional discipline
A discipline offers a unique perspective, a distinct way of viewing which ultimately defines the limits and nature of its
inquiry
A discipline incl. networks of philosophies, theories, concepts, approaches of inquiry, research findings and practices that
reflect its distinct perspective
Expression of Human Imagination
Members of any discipline imagine and create structures that offer descriptions and explanations of the experiences that are
of concern to that discipline
oThese structures are theories of that discipline
Domain
A professional discipline must be clearly defined by a statement of its domain- the boundaries or focus of that discipline
The domain of nursing incl. the experiences/ facts of interest, problems to be addressed, main content, methods used and
roles required of the disciplines members
Donaldson and Crowley identified the following as the domain of the discipline of nursing
oConcern with principles and laws that govern life processes, well-being and optimum functioning of human beings,
sick or well
oConcern with the patterning of human behavior in interactions with the environment in critical life situations
oConcern with the processes by which positive changes in health status are affected
Fawcett: Metaparadigm: 4 concepts
oPersons
oEnvironment
oHealth
oNursing
Kim: 4 domains
oClient
oClient-nurse encounters
oPractice
oEnvironment
Nursing can also be defined as the study of the health or wholeness of human beings as they interact with the environment
Nursing is the study of caring in the human health experience
The human being is characterized by wholeness, complexity, and consciousness
The essence of nursing involves the nurses true presence in the process of human to human engagement
Nursing theory expresses the values of the discipline, creating a structure to organize knowledge and illuminate nursing
practice
The essence of nursing is the nurse-patient relationship
Newman/smith/dexheimer-pharris and jones: 7 concepts
oHealth, consciousness, caring, mutual process, presence, patterning, and meaning
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Smith- nursing knowledge focuses on the wholeness of human life and experience and the processes that support relationship,
integration, and transformation
Syntactical and Conceptual Structures
Conceptual structures- defines the proper concerns of nursing, guides what is to be studied, clarifies accepted ways of
knowing and using content of the discipline
oRelates concepts within nursing theories
Syntactical structures- help nurses and other professionals to understand the talents, skills and abilities that must be
developed within the community
oDirects the description of data needed from research as well as evidence required to demonstrate the impact on
nursing practice
oguides nursing’s use of knowledge in research and practice approaches developed by related disciplines
Specialized language and symbols
the language of nursing theory facilitates communication among members of the discipline
Tradition
Nursing’s practical experience and knowledge have been shared and transformed as the content of the discipline and are
evident in many nursing theories
Values and beliefs
Fundamental nursing values and beliefs include a holistic view of the person, the dignity and the uniqueness of persons and
the call to care
There are both shared and differing values and beliefs within the discipline
Systems of Education
Nursing theories should provide the basis for nursing education and the framework for organizing nursing curriculum
Definitions of Nursing Theories
A theory- is a notion or idea that explains experience, interprets observation, describes relationships and projects outcomes
Theories- mental patterns or frameworks created to help understand and create meaning from our experience, organize and
articulate our knowing and ask questions leading to new insights
Theories are organizing structures of our reflections, observations, projections and inferences
A theory is a set of concepts and their relationships to each other that offers descriptions, explanations and predictions about
experiences
Nursing theory provides a framework, gives meaning to and helps explain specific aspects of nursing, research and practice
The Purpose of Theory in a Professional Discipline
All professional disciplines have a body of knowledge consisting of theories, research and methods of inquiry and practice
They organize knowledge, guide practice, enhance the care of patients and guide inquiry to advance science
Theories are patterns that guide the thinking about, being and doing of nursing
Theories provide structures for making sense of the complexities of reality for both practice and research
Theory-based research is needed in order to explain and predict nursing outcomes essential to the delivery of nursing care
Theories must also provide structure and substance to ground the practice and scholarship of nursing and must also be
flexible and dynamic to keep pace with the growth and changes in the discipline and the practice of nursing
The primary purpose of nursing theories is to further the development and understanding of nursing practice
Nursing theory exists to improve practice, the test of nursing theory is a test of its usefulness in professional practice
Theory provides nurses with different ways of looking at and assessing experiences, rationale for their practice and criteria
for evaluating outcomes
Empirical indications provide specific examples of how the theory is experienced in reality
Empirical indicators- tools and instruments to determine the impact of nursing practice
oProvide clear demonstration of the utility of nursing theory in practice, research and administration
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Nurses must know what they are doing, why they are doing it, what the range of outcomes of nursing may be, and indicators
for documenting nursing’s impact
Nursing theory is simulated by questions and curiosities arising from nursing practice
The structure of knowledge in the discipline of nursing
The domain of inquiry, Metaparadigm, or focus of the discipline is the foundation of the structure
The knowledge of the discipline is related to its general domain or focus
Theoretical work in nursing must be dynamic, that is must be continually in process and useful for the purposes and work of
that discipline
Theoretical work in nursing must be dynamic- continually in process and useful for the purposes of the discipline
oMust be open to adapting and extending in order to guide nursing endeavors and to reflect development within
nursing
Paradigm
Paradigm- a global, general framework made up of assumptions about aspects of the discipline held by members to be
essential in development of the discipline
Kuhn- used paradigms as a term to guide scientific activity and knowledge development in disciplines
Paradigms- are broad, shared perspectives held by members of the discipline- often called world views
Before any discipline engages in the development of theory and research to advance its knowledge, it is in a pre-paradigmatic
period of development
oTypically followed by a period of time when a single paradigm emerges to guide knowledge development
Kuhn- recognized that science is the work of a community of scholars in the context of a society
Paradigms/ worldviews reflect different values and beliefs about the nature of human beings, human-environment
relationships, health, and caring
As we continue to move away from the historical conception of nursing as part of biomedical science, developments in the
nursing discipline are directed by at least two paradigms or worldviews outside of the medical model
Parse
oTwo paradigms: totality and simultaneity
Totality
Reflects the worldview that humans are integrated beings with biological, psychological,
sociocultural and spiritual dimensions
Humans adapt to their environments and health and illness are states on a continuum
Simultaneity
Humans are unitary, irreducible (can’t be broken into parts) and in continuous mutual process with
the environment
Health is subjectively defined- reflects a process of revolving or becoming
Newman
oThree paradigms: particulate-deterministic, interactive-integrative, unitary-transformative
Particulate deterministic
Humans are known through parts
Health is the absence of disease
Predictability and control are essential for its management
Interactive integrative
Humans are viewed as systems with interrelated dimensions interacting with the environment
Change is probabilistic
Unitary transformative
Describes humans as patterned, self-organizing fields within larger patterned-self organizing fields
Change characterized by fluctuating rhythms of organization-disorganization toward more
complex organization
oHealth is a reflection of this continuous change
Fawcett
oReaction, reciprocal interaction and simultaneous action
Reaction
Humans are the sum of their parts
Reaction is casual and stability is valued
Reciprocal
Parts are seen within the context of a larger whole
There is reciprocal nature to the relationship with the environment
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