NURSING GOALS AND THEORIES

Like most of my colleagues, choosing nursing as a career was as a result of past experiences which made me value the field and its intrinsic worth. I not only uphold a nurturing personality ,but I also have the endurance, strong grades, and have always conveyed the motto, ‘Don’t put off until tomorrow what you can do today’. This meant making the best out of my time and optimizing the workload as much as possible at any given moment. I have essential goals that I hope to undertake as long as am a nurse. One of my most important goals is to attain core characteristics that define a successful nurse. According to the American Nurses Association, nursing is defined as, “Protection, promotion, and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”  A nurse should also be able to explain in her own words what she believes demarcates success in her career. It is my belief that nursing deals with the whole person—body, mind, and soul. It is without a doubt a physically demanding job, but equally as important is the demand for emotional input. A core characteristic needed in the nursing field is teamwork and just as vital is the remembrance that nurses are the liaison between the patients and the doctors. Not only is it important to work well in a team, but it is also significant to seek out help when necessary. Another important quality is the understanding of diversity and the importance of acknowledging and honoring, rather than judging or ignoring, what makes people different. 
               My second and last goal is to provide ongoing community service to those in need of medical assistance and is less fortunate. It has always been a wish for me to give back to the community or even to travel to impoverished countries to lend a hand.  Not only am I providing others with comfort, but I am also enhancing my aptitude and preparation in the medical field. This allows me a chance to interact with various people from different backgrounds and provides me with assurance to why I do what I do.

I settled to choose module 2: Research and Nightingale and module 9: Benner, Theories of the 1980’s and 1990’s because they aligned with my goals and interested me the most.

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Module 2; Research and Nightingale

Nightingale was a passionate statician and a systemic thinker. Her work in nursing and social reform was informed by a religious faith or philosophy that privileged a universal approach: God created the world and governs it by laws, which we can discover by research in both the social and biophysical and spheres. For Nightingale, this entailed the most excellent possible research, access to the best accessible government statistics and know-how, and the compilation of new material where the existing stock was insufficient. Nightingale’s leadership style was very much knowledge based. ( Brockbank , July 16, 1958)

She was a pioneer developer of study instruments, at all times pretested by experts and vetted on appropriate cases. . Also, she was a pioneer in presenting data graphically. when research reports were only beginning to include tables, Nightingale was using bar and pie charts, that were colour coded to brought to light key points, for example, high mortality rates under certain conditions. She was fanatical not only to get the science precise but also to make it understandable to lay people, especially the senior civil servants and the politicians who administered and made laws. 

Nightngale’s Environmental Theory contains four metaparadigm nursing concepts which are;

  1. Health of houses: this principle is inclusive of five essentials which are; clean air, wholesome water, efficient drainage, light and cleanliness.
  2. Observation of the sick: this canon directions related to making observations and documenting remarks
  3. Ventilation and warmth: the patient and the patient room should be kept warm, well ventilated and free of odor. Definite order inclusive, ‘keep the air within as pure as the air without’.
  4. Food and food intake: instructions on patients’ food preferences have to be included. Also the amount of food and liquids ingested had to be documented.

Module 9: Benner, Theories of the 1980’s and 1990’s

Benner’s work has focused on the understanding of perceptual acuity, ethical comportment, skilled know-how, clinical judgment and ongoing experiential learning. Benners original domains and competencies of nursing practice were derived inductively from clinical situations and interviews and observations of nurses in actual practice. From these interviews and observations, 7 domains and 31 competencies were identified . the 7 domains are; the teaching-coaching function, the helping role, effective management of rapidly changing situations, the diagnostic and patient monitoring and ensuring quality of healthcare practices, administering and monitoring therapeutic interventions and regimens, monitoring and ensuring the quality of healthcare practices, and organizational work role competencies. These domains are diagnosing and managing life-sustaining physiologic functions in unstable patients, using skilled know-how to manage a crisis, providing comfort measures for the critically ill, caring for patients’ families, preventing hazards in a technological environment, facing death: end-of-life care and decision making, . In addition, the nine domains of critical care nursing practice are used as broad themes in data interpretation for the identification and description of six aspects of clinical judgment and skilled comportment. Here are the 6 aspects; 

• Reasoning-in-transition: Practical reasoning in an ongoing clinical situation

• Skilled know-how: Also known as embodied intelligent performance; knowing what to do, when to do it, and how to do it

• Response-based practice: Adapting interventions to meet the changing needs and expectations of patients

• Agency: One’s sense of and ability to act on or influence a situation

• Perceptual acuity and the skill of involvement: The ability to tune into a situation and hone in on the salient issues by engaging with the problem and the person

• Links between clinical and ethical reasoning: The understanding that good clinical practice cannot be separated from ethical notions of good outcomes for patients and families.

However, there were two other modules that interested me the least which are, module 5: Levine, King Rogers and module 7: Leninges, Newman and Watson.

Module 5: Levine, King Rogers

King, in her Interacting Systems Framework, conceptualizes three levels of dynamic interacting systems that include personal systems (individuals), interpersonal systems (groups), and social systems (society). Individuals exist within personal systems, and concepts relevant to this system include body image, growth and development, perception, self, space, and time. Interpersonal systems are formed when two or more individuals interact. The concepts important to understanding this system include communication, interaction, role, stress, and transaction. Examples of social systems include religious systems, educational systems, and healthcare systems. Concepts important to understanding the social system include authority, decision making, organization, power, and status (King, 1981; Sieloff, 2006).

King’s Theory of Goal Attainment was derived from her Interacting Systems Framework (Sieloff, 2006) and addresses nursing as a process of human interaction (Norris &Frey,2006). The theory focuses on the interpersonal system interactions in the nurse–client relationship 

The propositions of King’s Theory of Goal Attainment are as follows (King, 1981):

• If perceptual accuracy is present in nurse–client interactions, transactions will occur.

• If the nurse and client make transactions, goals will be attained.

• If goals are attained, satisfactions will occur.

• If goals are attained, effective nursing care will occur.

• If transactions are made in the nurse–client interactions, growth and development will be enhanced.

• If role expectations and role performance as perceived by the nurse and client are congruent, transactions will occur.

• If role conflict is experienced by nurse or client or both, stress in nurse–client interactions will occur.

• If nurses with special knowledge and skills communicate appropriate information to clients, mutual goal setting and goal attainment will occur.

Module 7: Leininger, Newman and Watson

Leininger identified the main features of the cultural diversity and universality theory:

Transcultural nursing is a substantive area of study and practice focused on comparative cultural caring values, beliefs, and practices of individual or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people face unfavorable human conditions, illness, or death in culturally meaningful ways.

According to Watson’s theory, the goal of nursing is to help persons attain a higher level of harmony within the mind-body and spirit. Attainment of that goal can potentiate caring guided by curative factors and corresponding caritas processes.

REFERENCES

Brockbank, W. (July 16, 1958). Florence Nightngale and the Doctors. Zacharyp Cope. London: Museum Press Ltd., 1958; pp. 163. Illustrated. 2Is. Medical History, 2, 3, 234.

George, J. B. (2011). Nursing theories: The base for professional nursing practice. Upper Saddle River, N.J: Pearson Education-

Meleis, A. I. (2007). Theoretical nursing: Development and progress. Philadelphia: Lippincott Williams & Wilkins.

Killeen, M. B., & King, I. M. (April 01, 2007). Viewpoint: Use of King’s Conceptual System, Nursing Informatics, and Nursing Classification Systems for Global Communication. International Journal of Nursing Terminologies and Classifications, 18, 2, 51-57.

Alligood, M. R., & Tomey, A. M. (2006). Nursing Theory: Utilization and application. St. Louis, Missouri: Mosby

Parker, M. E. (2006). Nursing theories and nursing practice. Philadelphia: F.A. Davis. 

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