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Lecture 1

NURS 341 Lecture Notes - Lecture 1: Nursing Theory, Integrative Thinking, Independent Community And Health Concern


Department
Nursing
Course Code
NURS 341
Professor
jantzen
Lecture
1

Page:
of 6
Nurs 341: Week 2
Email: pg. 1-12
The focus of the discipline revisited
Caring as the human health experience
Unitary transformative
oA meeting place for holistic thinking and problem solving
oMay include deterministic and integrative thinking
oA nurse sees the whole while attending to the part
oThe nurse enters the whole person through the part
The caring, knowing presence of a nurse taps into what is meaningful for the patient and opens the way for relevant action
The process of knowledge development
The worldviews that have guided our exploration of knowledge include a traditional scientific approach, a multidimensional
evaluation of interactive milleu and more recently a unitary perspective.
oThe unitary perspective represents a shift form looking at the whole as a sum of parts to looking at the whole as
primary, from seeking to solve a problem to seeking to know the pattern and from embracing an action-relation
casual approach to realizing the mutuality of the unfolding rhythmic process through which insight into action arises
Two phases (nursing hx)
oReceptive phase- nursing knowledge derived from other disciplines
oTransformative phase- nursing knowledge significantly influences other disciplines as well as nursing practice
Unitary concept of health
oPathology is relevant but not separate and dominant
oPatterning is the identifying process of a while- allows the relationship to emerge as the central focus of the
discipline
It is the nature of the nurse-patient relationship that unites the practice of nursing
That commitment is to a caring relationship focused on understanding the meaning of the current situation for the people
involved and appreciating the pattern of evolving forces shaping health so that appropriate actions can be realized
Nurses bring to the situation their personal knowledge and expertise as well as the background of liberal and professional
education and experience
Patients bring to the situation their personal history and life experience as well as the health concern that often is the
precipitant for the nurse-patient meeting
The nurses responsibility is to be fully present, seeking to know what is meaningful to the patient and allowing the pattern of
unfold
Many in the UT paradigm suggest that knowledge develops as nursing praxis, a synthesis of theory, research and praxis
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Theory guides and informs the practice experience and research process and the generation of knowledge
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 and beliefs of the discipline, creating a structure to organize knowledge and illuminate
nursing practice
The essence of nursing practice is the nurse-patient relationship
The concepts of health, caring, consciousness, mutual process, patterning, presence and meaning have been selected to
address the essence and dimensions of the nursing relationship
Concepts central to the discipline
Health: The intent of the relationship
Health is central to the focus of the discipline of nursing
The absence of disease, A continuum from wellness to illness, Optimal wellness
Integration of the body, mind and spirit- a holistic phenomenon
Health as the ability to function independently and adapt to life’s stressors
Health is a dynamic life experience and a way to achieve potential
A state and process of being and becoming
From a unitary perspective- the concepts of health and illness are seen as manifestations of rhythmic fluctuations of the life
process
oOne can no longer think of health and illness as separate- that is health as the absence of disease or health as a
continuum from wellness to illness
Newman- health is a transforming process to higher levels of consciousness
oHealth and the evolving pattern of consciousness are the same
Health in the face of illness derives meaning through a caring nurse-patient relationship
Caring: the nature of the relationship
Caring is the quality of relating that potentiates a transformative connection between nurse and patient
Leininger- the first to describe caring as the distinguishing focus of the discipline
oArgued that caring and care were basic needs essential for human growth and development
Watson- defined nursing as the art and science of human caring and focused on the relational dimensions of caring and its
connections to healing
Boykin/ schoenhofer- caring as an altruistic, active expression of love, the intentional and embodied recognition of value and
connectedness
A fundamental human attribute lived out in a relationship
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A moral ideal that compels right action, an ethic of practice, an interpersonal process, a therapeutic intervention and a process
of nurturing
Smith identified 5 constituents of caring when viewed within the unitary paradigm- manifesting intention, attuning to
dynamic flow, appreciating pattern, experiencing the infinite, and inviting creative emergence
From a unitary perspective- caring is a quality of participative patterning
oThis way of being is characterized by holding the best intentions for the other and expressing them in thoughts,
words and actions
Caring is seeing the other and self as interconnected to something more extensive than both
Consciousness: the informational pattern of the relationship
Experience of consciousness
Life is a process of expanding consciousness,
oNewman- incorporated this shift in an understanding of the nurse relationship by asserting that health is the
expansion of consciousness
Consciousness, the information of the pattern of the whole, includes all forms of information, sensation and physiology as
well as intellect, emotion and intention
A person is identified by a pattern of consciousness which includes awareness of self within a large system of consciousness
A deeper experience of their lives
The essence of consciousness is information- the essence of information is resonancy, resonancy is the way information is
shared
Mutual Process: the way in which the relationship unfolds
Nurses are central to creating an environment that fosters relationship and health
Mutual process occurs in the movement of being fully present with the individual, family or community
In mutual process- the pt is invited to participate and through reflection to find opportunities for new awareness, action,
movement and transformation
In mutuality the focus is on wholeness, being with and in relationship
Outcome- intentional presence as the nurse and the pt reflect on the meaning in the moment
Each interaction with the nurse and pt offers in mutual process the potential for discovery and choice
The mutual process with another is enhanced by the nurses authentic presence
In mutual process the self and other are engaged in an experience that promotes awareness of self and other, and potentiates
insight with new choices and actions
Human becoming- is described as a rhythmical process lived in relationship, expressed through values and transcending with
the possible
There is no predetermined health outcome that is preferable for each person
The preferred outcome emerges in the person-environment mutual process through choice
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