Nursing Models Flashcards
what is the nursing process
It has 4 stages • Assess • Plan • Implement • Evaluate This is not a model of nursing, but a structure you can apply to a model.
what are nursing models
‘A systematically constructed, scientifically based and logically related set of concepts which identify the essential components of nursing practice, together with the theoretical bases of these concepts and the values required for their use by the practitioners’
describe the medical model
- Nature of people: complex set of anatomy and physiology, e.g. mental health problems are due to a problem in brain receptors
- Cause of problems: disease-orientated approach
- Nature of assessment: signs and symptoms
- Nature of planning and goal setting: work to change bodily system. Rarely person centred
- Focus of intervention: putting things right
- Nature of the evaluation: formative – how is physiological system working: summative – less common
- Linked with Maslow’s Hierarchy of Needs
- Role of the nurse: physicians’ assistant – changing nowadays with new roles e.g. ANP
- Used in critical care, A&E, surgical, etc
describe Orem’s Model
In this model, the nurse must identify what patients can and cannot do for themselves, and the how best to overcome the deficit between the 2. The cause of problems is an imbalance between self care and demands for care results in self care deficit, influenced by age, gender, environment, resources available, illness, etc- this is where nursing care is needed. The nurse must identify areas where patients need education, information, or support and advice to become more independent and address health and lifestyle problems
What are Orem’s Universal Self Care Requisites (there are 8)?
- Sufficient intake of air
- Sufficient intake of water
- Sufficient intake of food
- Satisfactory eliminative functions
- Activity balanced with rest
- Balance between solitude and social interaction
- Prevention of hazards to human life, human functioning and human well being
- Promotion of human functioning and development within social groups in accordance with human potential, known human limitations and the desire for ‘normalcy’ (note: what is normal for one person may be different for others)
what are the 5 steps of assessment in Orem’s model?
1) what are the demands being made on person for self-care
2) what is the person’s ability to meet these demands
3) If self-care deficit - establish reasons for it
4) what present state allows person to self-care
5) what is the potential of patient to re-establish self-care in the future, involve patient’s family and friends
how can the nurse evaluate care in Orem’s model
- Evaluate each goal in terms of self-care by patient and relatives
- Move from nursing in wholly compensatory state to interventions that are supportive
- ‘Recovery’ - patient’s increased capacity to perform self-care activities and any alterations in self-care demands
what are 5 roles of the nurse in Orem’s model
1) doing or acting for another (wholly compensatory)
2) guiding/ directing another (partly compensatory)
3) providing physical/ psychological support
4) provide environment that encourages development
5) Teaching (supportive-educative care)
what is Roy’s Adaption Model
The nurse is asked to see patients relative to their environment, and to assist them in adapting, in a positive way, to the circumstances in which they find themselves. Roy sees patients as people with biological, psychological, and social aspects. The patients must adapt to their environment: they do this through changes in their body, in their function, in the way they see themselves and in the level of dependence they have on other people. To protect themselves, they use different coping skills. It is up to the nurse to help the patient develop good coping skills, and help them identify and resolve any negative coping skills. when we cannot adapt, nurse intervention is needed.
what are Roy’s problems requiring intervention
Intervention needed where there is either a need deficit or a need excess within one of the four adaptive modes:
- Physiological adaptive mode
- Self-concept adaptive mode
- Role-function adaptive mode
- Interdependency adaptive mode
Describe the Roper, Logan, and Tierney Model of Nursing
The Roper, Logan, and Tierney Model of Nursing was developed from work by Nancy Roper in the 1970’s.
The Roper-Logan-Tierney Model of Nursing (Human needs model) assesses the level of independence and aims to provide individualised care for patients.
Nurses need to individualise their care and their care plans for their patients. Unique patients needunique nursing care plans. To do this: assess & evaluate each patient before and during care.
The model emphasises the patient’s ability to perform activities of daily living.
what are the 5 concepts of the RPL model of nursing?
Activities of living Lifespan Dependence / independence continuum Factors influencing the activities of living Individuality in living
what are the 12 ALs
- Maintaining a safe environment
- Communication
- Breathing
- Eating and Drinking
- Elimination
- Personal cleansing and dressing
- Controlling body temperature
- Mobilising
- Working and playing
- Expressing Sexuality
- Sleeping
- Dying
describe maintaining a safe environment
This can mean preventing accidents, driving carefully, food hygiene, washing hands.
But the model notes the effect of the environment:
External environment – effects of weather to wider environmental factors – it is reciprocal our influence on the environment :global warming, war
Internal environment – ‘Need to maintain balance (homeostasis)
Some variables need to be maintained within narrow limits: Blood pressure, pH, fluid/electrolytes, core temperature, blood & tissue O2 and CO2 levels, blood glucose
describe communication
Human beings are essentially social, therefore communication is a fundamental part of living Cultural sensitivity 'Sensory loss e.g. hearing, sight Body language/facial expressions Writing Alternative formats
