Module 02: Nursing Theory Flashcards
These are described as the broad conceptual boundaries of the discipline of nursing.
Metaparadigm
The metaparadigm falls under what four (4) factors? (HEHN)
(1) Human Beings
(2) Environment
(3) Health
(4) Nursing
This sets forth the meaning of nursing phenomena through analysis, reasoning and logical presentation of concepts and ideas.
Philosophy
These are sets of concepts that address phenomena central to nursing in propositions that explain the relationship among them.
Conceptual Models
These are concepts that derive from a conceptual model and propose a testable proposition that tests the major premise of a model.
Grand Theory
These are testable propositions from philosophies, conceptual models, grand theories, abstract nursing theories, or theories from other disciplines.
Nursing Theory
These are theories that are less abstract than the grand theory but less specific than the middle-range theory.
Nursing Theory
These concepts are the most specific to practice that propose precise testable nursing practice questions and include details, such as patient age group, family situation, health condition, location of the patient, and action of the nurse.
Middle Range Theory
These are nursing theoretical systems that give direction and create understanding in practice, research, administration, and education.
The Future of Nursing Theory
These contribute to nursing knowledge with direction for the discipline, forming a basis for professional scholarship.
Nursing Philosophies
She is the founder of modern nursing.
Florence Nightingale
When and where was Florence Nightingale born?
May 12, 1820 (Florence, Italy)
When and where did Florence Nightingale complete her nursing training?
31 years old (1851 in Kaiserwerth, Germany)
What hospital did Florence Nightingale superintendent?
Hospital for Invalid Gentlewomen in London
What problems did Florence Nightingale address?
(1) Lack of sanitation (Victorian Era)
(2) Presence of Filth
What poem was she addressed as the Lady of the Lamp?
Santa Filomena
What did theories of modern nursing focus on?
(1) Environment
(2) Warmth, Light, Diet, Cleanliness and Noise
It was written not “as a manual to teach nurses to nurse” but assist millions of women who had charge of their families to “think how to nurse.”
Notes in Nursing
What is the most important practical lesson that nurses should learn?
Observation (what to observe and how to observe)
This is defined as the state of being well and using every power to the extent in living life.
Health
This is a reparative process and of the sufferings of diseases.
Disease
How does one maintain health and prevent disease?
(1) Environment Control
(2) Social Responsibility
for public health and health promotion, taking care of the well and the sick
It is ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet, all at the least expense of vital power to the patient.
Nursing
What is considered the most delicate test of sanitary conditions?
The life duration of tender babies
Where should nurses assist?
Reparative Process
How did Nightingale refer to the person?
Patient
What kind of patient is in the nurse-patient relationship?
Passive Patient as nurses are in control of and responsible for the patient’s environmental surroundings (we do not have any expectation to the patient and they are just there as recipients of care)
This major assumption pertains as to how nurses are assigned to assist the nature in healing the patient as well as the maintenance of a therapeutic or good physical living conditions.
Environment
This theory was developed when nightingale struggled to improve war-torn environment and workhouses.
Environmental Theory
What are the five essential components of the environment health?
(1) Pure Air
(2) Light
(3) Cleanliness
(4) Efficient Drainage
(5) Pure water
What is the focus of pure air?
(1) Ventilation - germ theory
(2) Warmth
“Keep the air he breathes as pure as of the external air, without chilling him”
Without this ventilation is comparatively useless?
Cleanliness
What are the effects of an inefficient drainage in a household?
(1) fever
(2) pyemia
In this, Nightingale advocated bathing patients on a frequent, even daily, basis at a time when this practice was not the norm. She required that nurses also bathe daily, that their clothing be clean, and that they wash their hands frequently.
Pure Water
This creates an expectation in the mind (status), which hurts the patient and has an effect upon the organ of the ear itself.
Unnecessary Noise or Noise
This sitting position is entailed for nurses so that the patient will not painfully turn his head to face you.
Sitting in front of a patient’s view
What kind of rules should nurses have regarding their patient’s diet?
(1) Rule of thought
(2) Rule of time
What did nightingale generated throughout her life time?
Varied subjects of healthcare, nursing and social reform (empirical evidence)
Nightingale highlighted the concurrent use of ___________________ and _____________ in the education of nurses.
Observation and Performance of tasks (Royalty - commission)
Nightingale often capitalized this word in her writings depicting as it was synonymous with God.
Nature
What kind of religious belief did Nightingale have to support the view of God as Nature?
Unitarian Religious Belief
This publication of Nightingale made a distinction between the role of the household servants and those trained specifically as nurses to provide care for the sick person.
Notes on Nursing (1969)
This pertains to being clear and easily understood.
Clarity Explains 3 major relationships: (1) Environment to patient, (2) Nurse to environment, and (3) Nurse to patient
Who developed the theory of transpersonal caring?
Margaret Jean Harman Watson
What school did Margaret Jean Harman Watson attended?
Lewis Gale School of Nursing and the University of Colorado
This program was established as the nation’s first interdisciplinary center using human caring knowledge.
Center of Human Caring (Watson Caring Science Institute)
What does the the caring point entail?
(1) Pausing
(2) Choosing to see
(3) Being present
How many books did Margaret Jean Harman Watson?
11 books
In this, it is an existential turning point wherein the nurse grasps the gestalt of the presenting moment and is able to read the field, beyond the outer appearance of the patient and the patient’s behavior.
Caring point
Watson described this as when the nurse is able to see and connect with the spirit of others, open to expanding possibilities of what can occur.
Being Transpersonal
Watson defined it as an imaginative grouping of knowledge, ideas, and experience that are represented symbolically and seek to illuminate a given phenomenon.
Theory
Watson acknowledges a ___________, ___________, and _______________ from the sciences and humanities.
Phenomenological, existential, and spiritual orientation.
Which transpersonal psychologist did Watson attributed her emphasis on the intrapersonal and transpersonal?
Carl Rogers
What was the definition of health by Watson which is associated with the degree of congruence between the self as perceived and the self as experienced?
unity and harmony within the mind, body and soul
This is defined as not necessarily a disease as it can be a subjective turmoil or disharmony within a person’s inner self or soul at some level of disharmony within the spheres of the person.
Illness
This process can result from genetic, constitutional vulnerabilities and manifest themselves when disharmony is present.
Disease (aggravates the illness)
These two phenomenon are not necessarily viewed on a continuum
illness and health (separate concepts)
This pertains to how Watson calls nurses to go beyond procedures, tasks, and techniques.
Trim
These are the aspects of nurse-patient relationship resulting to a therapeutic outcome
Core
This pertains to the elimination of a disease.
Curing
The person is a unity?
Mind, Body, Spirit, and Nature
This is tied to notices that one’s soul possesses a body and is not confined by objective time and space.
Personhood
According to Watson, these are healing spaces that can be used to transcend illness, pain and suffering and can be connected to the person itself.
Environment (Supportive, Corrective, Mental, Physical, Societal, and Spiritual)
This is the essence of nursing and the foundational disciplinary core of the profession.
Caring Science
These comprise caring as they are known to facilitate healing, honor wholeness, and contribute to the evolution of humanity.
Carative Factors or Caritas Processes
Where can a caring relationship be deemed as one?
(1) If it invites emergence of the human spirit
(2) Opens to authentic potential
(3) Becomes authentically present
(4) allows the person to explore options
What are the ten (10) carative factors?
- The formation of a humanistic-altruistic system of values
- The instillation of faith-hope
- The cultivation of sensitive to one’s self and to others
- Development of a helping-trusting, human caring relation
- The promotion and acceptance of the expression of positive and negative feelings
- Systematic use of a creative problem solving caring process
- The provision of supportive, protective and corrective mental, physical, societal, spiritual environment
- The assistance with gratification and human needs
- Allowance for existential, phenomenological and spiritual forces.
What are the ten (10) caritas processes?
(1) Cultivating the Practice of Loving-Kindness and Equanimity Toward Self and Other as Foundational to Caritas Consciousness
(2) Being Authentically Present: Enabling, Sustaining, and Honoring the Faith, Hope, and Deep Belief System and the Inner-Subjective World of Self/Other.
(3) Cultivation of one’s own spiritual practices, transpersonal self, and going beyond ego self
(4) Development and Sustaining a Helping- Trust Caring Relationship.
(5) Being Present to and Supportive of the Expression of Positive and Negative feelings
(6) Creative Use of Self and All ways of Knowing as Part of the Caring Process and Engange in Artistry of Caritas Nursing
(7) Engage in Genuine Teaching-Learning Experience that Attends to Unity of Being and Subjective Meaning— Attempting to Stay Within the Other’s Frame of Reference.
(8) Creating a Healing Environment at All Levels.
(9) Administering Sacred Nursing Acts of Caring- Healing by Tending to Basic Human Needs.
(10) Opening and Attending to Spiritual/Mysterious and Existential Unknowns of Life- Death.
This involves being real, honest, genuine, and authentic.
Congruence
This is the ability to experience and thereby understand the other person’s perceptions and feelings and to communicate those understandings.
Empathy
This is demonstrated by a moderate speaking volume, a relaxed open posture, and facial expressions that are congruent with other communications.
Non-possessive warmth
This has cognitive, affective, and behavior response components
Effective communication
This acknowledges the evolving nature of theory.
Empirical precision
This is the metaphysical orientation for the delivery of nursing care.
Derivable Consequences
Who developed the Theory of Bureaucratic Caring?
Marilyn Anne Ray
Who was Marilyn Anne (Dee) Ray’s Professor?
Professor Emerita at Florida Atlantic University
What was Ray’s original profession?
Retired colonel after 30 years of service under US Air Force Reserve Nurses Corps
This work of Ray used ethnographic methods in combination with phenomenology and grounded theory which focuses on nursing in complex organizations such as hospitals
Theoretical Sources
These two factors synthesized and reconciled to form the unitive force of bureaucratic caring.
(1) The thesis of caring
(2) The antithesis of bureaucracy
The theoretical sources of Ray was stimulated by her work with __________
Leininger in 1968
This theory describes simultaneous order and disorder along with order within disorder. Ray compares change in complex organizations and challengers nurses to step back and renew their perception of everyday events and discover embedded meanings.
Chaos Theory
According to Ray, what is nursing?
Nursing is a holistic, relational, spiritual, and ethical caring that seeks the good of self and others.
According to Ray, what is caring?
Caring is cultural and social able to establish social and functional relationships
How did Ray perceive people?
As spiritual and cultural beings that engage co-creatively in human organization and transcultural relationships to find meaning and value
How does Ray perceive Health?
a pattern of meaning for individuals
This embodies knowledge and conscience about the beauty of life forms and symbolic (representational) systems or patterns of meaning.
Environment (spiritual, ethical, ecological, and cultural phenomenon)
They play a role in facilitating understanding of the meaning of caring, cooperation, and conflict in human cultural groups and complex organizational environments
Functional forms identified in the social structure or bureaucracy
What does theory (theoretical assertions) imply?
(1) Dialectal Relationship (thesis, antithesis, and synthesis)
(2) Dimension of spiritual-ethical and structural caring
(3) Structural Dimensions of bureaucracy or organizational culture
This is the synthetic margin between the human and structural dimensions where nurses, patients, and administrators integrate person, nursing, health and environment.
Bureaucratic Nursing
This is a primoradial construct of consciousness of nursing and is highly differential depending on its structures.
Caring
This form of caring is described to be whole and operate by conscious choice.
Spiritual-ethical caring
This means that everything is a whole in one context and part of one another, with each part being in the whole and the whole being in the part.
Holography
This is a relationship between charity and right action, between love as compassion in response to suffering and need and justice or fairness in terms of what ought to be done.
Caring
This involves creativity and revealed in attachment, love and community
Spirituality
This is related to the moral obligation towards others.
Ethical
This involves formal and information programs to convey information and other teaching and sharing information regarding caring.
Education
This state involves biological and mental patterns
Physical
This includes ethnicity and family structures, intimacy with friends, and family communication, societal interaction and support as well ass structures of cultural groups, community, and society.
Socio Cultural
This includes nonhuman resources, such as machinery, to maintain the physiological well being of the patient.
Technological
This pertains to the meaning of caring including money, budget, insurance systems, limitations and guidelines imposed by managed care organizations along with the allocation of scarce human and material resources.
Economic
This was the mentor of Marilyn Anne Ray?
Madilyn Leininger 1968 which is the proponent of transcultural nursing
This type of caring encompasses a dynamic and complex cultural contexts of relationships, organizations, and communities.
Bureaucratic caring
This pertains to the power structure within an administration and how it influences nursing. This includes pattern of communication, decision making, role and gender, stratification, union activities, government, and insurance company negotiations.
Politics
This theory is a theory of level of skill acquisition. A novice to expert theory.
Caring, Clinical Wisdom, and Ethics in Nursing Practice
Where was Patricia Benner born?
Hampton Virginia
What are some of Patricia benners’ famous publication?
PhD in stress, coping, and health was
conferred in 1982 at the University of California
What is Patricia Benner’s current job
Currently the Chief Development Officer with Dr.
Pat-Hooper-Kyriakakis on continued development
of the textbook replacement learning program,
NovEx, which was publish in 1984 and garnered many awards.
Who is influenced Patricia Benner’s philosophy?
Virginia Henderson (21 Human Needs)
This is defined as describing, illustrating and giving language to taken-for-granted areas of practical wisdom skilled know-how, and notions of good practice
Articulation Research
What can be explained further by Benner’s philosophical source?
Theory is derived from practice and practice is extended by theory. (Distinction between practical knowledge and theoretic knowledge)
How does Benner define nursing?
Nursing is viewed as caring practice whose science is guided by the moral art and ethics of care and responsibility
How does Benner define person?
Benner defined a person as a self-interpreting being and gets defined in the course of living a life
What are the roles a person must deal with?
- The role of the situation
- The role of the body
- The role of personal concerns
- The role of temporality
Benner defined this as something that can be assessed or entails self expression.
Health
This is the human experience of health or wholeness
Well being
This is defined by the person’s engaged interaction, interpretation and understanding of a matter and can be s influenced by each person’s past, present and future and includes their own personal meanings, habits and perspectives.
Situation
The person has no background experience of the
situation. They have context -free rules and objective attributes must be given to guide performance. They also have difficulty discerning relevant vs irrelevant aspects
Novice
The person can demonstrate marginally acceptable performance. He has enough experience to grasp aspects of the situation and is guided by rules and oriented by task completion. Clinical situations are viewed as a test of their
abilities and demands rather than in terms/
Advanced Beginner
They are defined by conscious and deliberate planning which aspects of current and future situations are important and which can be ignored. They display hyper-responsibility for the patient and exhibit an ever-present and critical view of self. The learner begins to recognize patterns and determine which element warrant attention
Competent
They perceive the situation as whole rather than in terms of aspects and the performance is guided by maxims. They recognize the most salient aspects and has an intuitive grasp of the situation. They have the ability to see changing relevance in a situation including recognition and implementation of skilled responses
Proficient
They have an intuitive grasp of the situation and being able to identify the region of the problem without losing time considering.
Expert
What are the characteristics of an expert
Demonstrating a clinical grasp and resource-based practice
Possessing embodied know-how
Seeing the big picture
Seeing the unexpected
She developed the philosophy of caring.
Kari Mari Martinsen
Where was Kari Mari Martinsen born?
Born in Oslo, Norway in 1943 during WWII
What was the focus of her theory?
Moral and sociopolitical discussions dominated home life
According to Martinsen. this is based upon caring. Caring does not merely from the value foundation of nursing; it is a fundamental precondition of our life..
Moral practices
According to Martinsen, this demands emotional involvement and the capacity for situational analysis in order to assess alternatives for action.
Discernment
According to Martinsen, where is performing nursing directed?
Performing nursing is essentially directed towards persons not capable of self-help, who are ill and in need of care. To encounter the ill person with caring through nursing involves a set of pre-conditions such as knowledge, skills, and organization
This form of caring requires at least 2 people
Relational
This form of caring is about concrete and practical action
Practical
This form of caring is a n acknowledgement of the other in light of his situation
Moral
How did Martinsen view the person?
The person cannot be torn away from the social milieu and the community of persons. In one way, there is a parallel between the person and the body. It is as bodies that individuals relate to ourselves, to others, and to the world
According to Martinsen, this does not only reflect the condition of the organism, it is also an expression of the current level of competence in medicine.
Health
According to Martinsen, these factors all set the tone and color the situation and the space.
Architecture, interactions among individuals, use of objects, words, knowledge, one’s being in the room
This is important as a physical, material and constructed place, but it is also a place we share with other people
Sick room
This is the positive development of the person through the good
care
Through its exercise in practical living contexts that nurses learn clinical observation. Training not only to see, listen and touch clinically but to see, listen and touch clinically in a good way
Professional Judgment
This is when empathy and reflection work together in such a way that caring can be expressed in nursing. It is present in concrete situations and individual actions need to be accounted for
Moral Practice
In this, demand professional knowledge which affords the view of the patient as a suffering person, and which protects his integrity
Person-Orientated Professionalism
In this, phenomenon that are beyond human control and influence and therefore sovereign. It includes openness, mercy, trust, hope and love
Sovereign Life Utterances
This are boundaries for which individuals must have respect
Untouchable Zone
Given as a law of life concerning neighborly love which is foundationally human
Vocation
Being Touched or moved by the suffering of the other and the situation the other experiences. Moreover, this is a participatory event based on the reciprocation that unifies perception and understanding
Eye of the Heart
These concerned with findings connections, and analyzing it into a system. Alliance with modern natural science and technology
Registering Eye
She was one of the pioneers of caring science in the Nordic countries
Katie Erikson
Where and when was Katie Erikson born?
Born in November 18, 1943 in Finland
Katie Erikson was honored as a what?
Honored as a Knight, First Class, of the Order of the White Rose
According to Erikson, these are the two basic motive of caring
Love And charity (caritas)
This pertains to the visible motive of caritas
Caritative Outlook
According to Erikson, what is nursing?
Caring Nursing represents a kind of caring without prejudice that emphasizes the patient and his/her suffering and desire
According to Erikson, this implies being whole in body, soul and spirit. This is the pure concept of wholeness and holiness
Health
How did Erikson perceive health?
Health is both a movement and integration
1. Implies a change, between actual and potential
2. Dependent on vital forces
What are the three (3) dimensions?
(1) Doing
(2) Being
(3) Becoming
In relation to the major assumption of Erikson’s theory, how did Erikson perceive the environment>
It is related to the concepts of Ethos in accordance with Aristotle which consists of the idea of love, charity, respect, honor of holiness and dignity of the human being. Ethos originally refers to home, representing a person’s innermost space
This pertains to eros and agape are united, constitutes the motive for all caring
Caritas
This structure that determines caring reality
Caring Communication
This pertains to the caring elements (faith, hope, love, tending, playing and learning) and invites to deep communion
Acts of Caring
This deals with the basic relationship between the patient and the nurse
Caritative Caring Ethics
These are ethical principles and rules that guide one’s work or decisions
Nursing Ethics
This form of dignity is granted the human being through creation
Absolute Dignity
This form of dignity is influences and formed through culture and external context
Relative dignity
The act that occurs when the career welcomes the patient to the caring communication
Invitation
This pertains to human being’s struggle between good and evil in a state of becoming
Suffering
This implies a change through which a new wholeness is formed of the life the human being has lost in suffering
Reconciliation
This is the total caring reality and is based on cultural elements such as tradition, rituals and basic values
Caring Culture
This is the suffering experience in connection with illness and treatment
Suffering related to illness
This is the suffering where the patient is expose to suffering caused by care or absence of care (not be be taken seriously, not to be welcomed, being blamed)
Suffering related to care
This is the suffering situation of being a patient
Suffering related to life
