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1.

THEORETICAL FRAMEWORK of NURSING PRACTICE

A. Nursing

As by the INTERNATIONAL COUNCIL OF NURSES (ICN, 1973) as written by


Virginia Henderson: The unique function of the nurse is to assist the
individual, sick or well, in the performance of those activities contributing to
health. It’s recovery, or to a peaceful death that the client would perform
unaided if he had the necessary strength, will or knowledge.

Help the client gain independence as rapidly as possible.

1. CONCEPTUAL AND THEORETICAL MODELS OF NURSING PRACTICE

Theorist Description

FLORENCE • Developed the first theory of nursing.


NIGHTINGALE • Focused on changing and manipulating the environment in order to
put the patient in the best possible conditions for nature to act.

HILDEGARD PEPLAU • Introduced the Interpersonal Model.


• She defined nursing as a therapeutic, interpersonal process which
strives to develop a nurse-patient relationship in which the nurse
serves as a resource person, counselor and surrogate.

FAYE ABDELLAH • Defined nursing as having a problem-solving approach, with key


nursing problems related to health needs of people; developed list 21
nursing problem areas

IDA JEAN ORLANDO • Developed the three elements – client behavior, nurse reaction and
nurse action – compose the nursing situation. She observed that the
nurse provide direct assistance to meet an immediate need for help in
order to avoid or to alleviate distress or helplessness.

MYRA LEVINE • Described the Four Conservation Principles.


1. conservation of energy
2. conservation of structured integrity
3. conservation of personal integrity
4. conservation of social integrity

DOROTHY JOHNSON • Developed the Behavioral System Model.


1. Patient’s behavior as a system that is a whole with interacting parts
2. how the client adapts to illness
3. goal of nursing is to reduce so that the client can move more easily
through recovery.

MARTHA ROGERS Conceptualized the Science of Unitary Human Beings. She asserted
that human beings are more than different from the sum of their parts; the
distinctive properties of the whole are significantly different from those of
its parts.

DOROTHEA OREM Emphasizes the client’s self care needs; nursing care becomes necessary
when client is unable to fulfill biological, psychological, developmental or
social needs.

IMOGENE KING Nursing process is defined as dynamic interpersonal process between


nurse, client and health care system.

BETTY NEUMAN Stress reduction is a goal of system model of nursing practice. Nursing
actions are in primary, secondary or tertiary level of prevention

SISTER CALLISTA ROY Presented the Adaptation Model. She viewed each person as a unified
bio-psychosocial system in constant interaction with a changing
environment. The goal of nursing is to help the person adapt to changes in
physiological needs, self-concept, role function and interdependent
relations during health and illness.

LYDIA HALL Introduced the notion that nursing centers around three components:
person(core), pathologic state and treatment(cure) and
body(care).

JEAN WATSON Conceptualized the Human Caring Model. She emphasized that nursing
is the application of the art and human science through transpersonal
caring transactions to help persons achieve mind-body-soul harmony,
which generates self-knowledge, self-control, self-care and self-healing.

ROSEMARIE RIZZO Introduced the Theory of Human Becoming. She emphasized free choice
PARSE of personal meaning in relating to value priorities, co-creating of rhythmical
patterns, in exchange with the environment and contranscending in many
dimensions as possibilities unfold.

MADELEINE LENINGER Developed the Transcultural Nursing Model. She advocated that
nursing is a humanistic and scientific mode of helping a client through
specific cultural caring processes (cultural values, beliefs and practices) to
improve or maintain a health condition

2. ROLES AND FUNCTION OF A NURSE

a. Caregiver – the caregiver role has traditionally included those activities that
assist the client physically and psychologically while preserving the client’s
dignity. Caregiving encompasses the physical, psychosocial, developmental,
cultural and spiritual levels.
b. Communicator – communication is an integral to all nursing roles. Nurses
communicate with the client, support persons, other health professionals, and
people in the community. In the role of communicator, nurses identify client
problems and then communicate these verbally or in writing to other
members of the health team. The quality of a nurse’s communication is an
important factor in nursing care.
c. Teacher – as a teacher, the nurse helps clients learn about their health and
the health care procedures they need to perform to restore or maintain their
health. The nurse assesses the client’s learning needs and readiness to learn,
sets specific learning goals in conjunction with the client, enacts teaching
strategies and measures learning.
d. Client advocate – a client advocate acts to protect the client. In this role the
nurse may represent the client’s needs and wishes to other health
professionals, such as relaying the client’s wishes for information to the
physician. They also assist clients in exercising their rights and help them
speak up for themselves.
e. Counselor – counseling is a process of helping a client to recognize and cope
with stressful psychologic or social problems, to developed improved
interpersonal relationships, and to promote personal growth. It involves
providing emotional, intellectual, and psychologic support.
f. Change agent – the nurse acts as a change agent when assisting others,
that is, clients, to make modifications in their own behavior. Nurses also often
act to make changes in a system such as clinical care, if it is not helping a
client return to health.
g. Leader – a leader influences others to work together to accomplish a specific
goal. The leader role can be employed at different levels; individual client,
family, groups of clients, colleagues, or the community. Effective leadership is
a learned process requiring an understanding of the needs and goals that
motivate people, the knowledge to apply the leadership skills, and the
interpersonal skills to influence others.
h. Manager – the nurse manages the nursing care of individuals, families, and
communities. The nurse-manager also delegates nursing activities to ancillary
workers and other nurses, and supervises and evaluates their performance.
i. Case manager – nurse case managers work with the multidisciplinary health
care team to measure the effectiveness of the case management plan and to
monitor outcomes.
j. Research consumer – nurses often use research to improve client care. In a
clinical area nurses need to:
• Have some awareness of the process and language of
research
Be sensitive to issues related to protecting the rights of human
subjects
• Participate in identification of significant researchable
problems
• Be a discriminating consumer of research findings

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