prelims Marciano 1
Profession: 4. Responsibility 4:
• A specialised field of practise, which is
founded upon the theoretical structure of the
science or knowledge of that discipline and
the accompanying practise abilities
Criteria of a Profession:
1. Utilises in its practise a well defined and well
organised body of specialised knowledge that
is on the intellectual level of higher learning.
2. Constantly enlarges the body of knowledge it
uses and improves its techniques of education
and service by the use of the scientific
method.
3. Entrusts the education of its practitioners to
institutions of higher education.
- University
4. Applies its body of knowledge in practical
services that are vital to human and social
welfare.
- esteem, prestige, power, altruism,
education
5. Functions autonomously in the formulation of
professional policy and in the control of
professional activity.
- Self-regulating, licensure,
membership
6. Attracts individuals of intellectual and
personal qualities who exalt service above
personal gain and who recognise their chosen
occupation as a life work.
7. Strives to compensate its practitioners by
providing freedom of action, opportunity for
continuous professional growth, and
economic security.
National Nursing Core
Competency Standards - 2012
A. Beginning Nurse’s Role on Client Care:
1. Responsibility 1:
• Practices in accordance with legal
principles and the code of ethics in
making personal and professional
judgement
2. Responsibility 2:
• Utilises the nursing process in the
interdisciplinary care of clients that
empowers the clients and promotes safe
quality care
3. Responsibility 3:
• Maintains complete and up to date
recording and reporting sytem
• Establishes collaborative relationship
with colleagues and other members of
the team to enhance nursing and other
health care services
5. Responsibility 5:
• Promotes professional and personal
growth and development
B. Beginning Nurse’s Role on Management
and Leadership:
1. Responsibility 1:
• Demonstrates management and
leadership skills to provide safe and
quality care
2. Responsibility 2:
• Demonstrates accountability for safe
nursing care
3. Responsibility 3:
• Demonstrates management and
leadership skills to deliver health
programs and services effectively to
specific client groups in the community.
4. Responsibility 4:
• Manages a community/village based
health facility/component.
5. Responsibility 5:
• Demonstrates ability to lead and
supervise nursing support staff.
6. Responsibility 6:
• Utilises appropriate mechanisms for
networking, linkage building and
referrals.
C. Beginning Nurse’s Role on Research:
1. Responsibility 1:
• Engages in nursing or health related
research with or under supervision of an
experienced researcher
2. Responsibility 2:
• Evaluates research study/report utilising
guidelines in the conduct of a written
research critique
3. Responsibility 3:
• Applies the research process in
improving client care in partnership
with a quality improvement/quality
assurance/nursing audit team
 prelims
Personal Qualities of the
Professional Nurse:
• Justice - the quality of being correct, righteous,
fair and impartial
• Honesty, loyalty, tolerance
• Prudence - the basis of the exercise of sound
judgement in practical matters
• Judgement, reliability
• Fortitude - courage; the control of responses
made to difficulties and dangers
• Motivation, resourcefulness
• Temperance - rational control of life’s essential
functions and basic emotional drives
• Moderation
Thomasian Core Values:
• Respect - we treat everyone with utmost dignity
in the light of catholic faith
• Excellence - we uphold the culture of
excellence and continuously commit to achieve
higher levels of quality
• Leadership - we empower students to become
productive, efficient and be of service to others.
• Innovation - we encourage creative and critical
thinking, new ideas and research
• Compassion - we are sensitive to the others
• SPIRITUALITY
St. Elizabeth of Hungary
(1207-1231): Patroness of Nurse
• Born in 1207
• Daughter of Alexander II, King of Hungary
• Studied @ the court of Landgraves of Thuringia
• Marries in 1221 to Ludwig IV of Thuringia
• Built a hospital in Wartburg to serve the sick
(bathing, feeding, dressing wounds and ulcers)
• Moved to Marburg after the death of her
husband (gave up her three kids)
• Renounced the world, became a tertiary of St.
Francis
• Died at the age of 24 on November 17, 1231
• Canonised four years later
St. Thomas Aquinas (1225-1274):
Patron of Catholic Universities,
Colleges and Schools
• Italian Catholic philosopher & theologian
• Doctor Angelicus and Doctor Universalis
• Born c. 1225 in Rome
Marciano 2
• Determined to join the Dominican order but
was kidnapped by his family
• prostitutes, temptations, etc.
• Pope Innocent IV intervened and Thomas
pronounced his vows to the church
• Died on March 7, 1274
• Canonised by Pope John XXII on July 18, 1323
St. Martin de Porres (1579-1639): Patron of
Public Health & Social Justice
• Born in Lima, Peru in 1579
• Mixed race (Spanish + coloured Panamanian)
• Lay brother at Dominican Friary at Lima
• Barber, farm laborer, infirmarian
• Gifts of God:
• Aerial flight and bilocation
• Died on November 3, 1639
• Canonised on May 6, 1962
• Feast day on November 3
Definitions:
1. Knowledge:
• an understanding acquired through learning
or investigation of what is known about a
discipline’s subject matter.
• May be based on fact or it may be
theoretical
2. Science:
• Unified body of knowledge about a
phenomenon that is supported by agreed-on
evidence. Includes disciplinary questions.
• Provides answers to questions that pertain
to the subject matter.
3. Phenomenon:
• An aspect of reality that can be consciously
sensed or experienced
• Subject matter of discipline
• An idea about an event, a situation, a
process, a group of events, or a group of
situations
4. Concept:
• An idea or complex mental image of a
phenomenon
• Term for a phenomenon or a group of
5. Theory:
• A supposition or system of ideas that is
proposed to explain a given phenomenon
• Used to describe, predict and control
6. Nursing Theory:
• Related nursing concepts derived from
nursing models
• Will lead to proper nursing care
 prelims Marciano 3

7. Assumption: • Determines the nature of the concept

• A statement or view that is widely accepted definition, and structure of the theory
as true 3. Phenomenon: an aspect of reality that can be
• Something you think that is true without consciously sensed or experienced. The
proof subject matter of a discipline
8. Paradigm:
• Conceptual framework
• Pattern of shared understanding & Characteristics of Theories:
assumptions Evaluation of criteria
9. Metaparadigm: 1. Clarity:
• Most abstract level of knowledge • Must have consistency and structural clarity
• The core content of a discipline • Assed by identifying the theory’s major
10. Nursing Metaparadigm: concepts
• Person - the recipient of nursing care 2. Simplicity:
• Environment - internal & external • Simple theories to guide practise
surroundings that affect the person
• Sufficiently comprehensive at a level of
• Health - the degree of wellness or abstraction to provide guidance
wellbeing 3. Generality:
• Nursing - the attribute, characteristics, and • Examine the concepts and goals of the
actions of the nurse providing care theory
11. Principle: 4. Empirical Precision:
• Fundamental truth, doctrine, or law • Refers to the extent that the defined
• Scientific law that explains the method of a concepts are grounded in observable reality.
natural action
• Linked to the testability and the ultimate
use of the theory
Patterns of Knowing: • How well the evidence supports the theory
1. Empirics - the science of nursing 5. Derivable Consequences:
• Objective, abstract, generally quantifiable • How important? Nursing theory > research
• Verified through observation and proved by testing > practical knowledge >
hypothesis testing • Nursing theory generates new ideas
2. Esthetics - the art of nursing
• Expressive, creative subjective, unique, and
experimental
• No expressed in language
• Evident through actions, conducts, attitude,
and interactions
3. Personal Knowledge in Nursing
• Incorporates experiences, knowing, and
actualising the self within practise
• Expressed in personality
• Personal maturity and freed are components
4. Ethics - moral knowledge in nursing
• Moral code for nursing
• Based on obligation to service and respect
for human life.

Components of Theory:
1. Concepts: interrelated concepts abstract
2. Definitions: general meaning of the concepts
in a manner that fits the theory
3. Assumptions: statements that describe or
connects that are factual.
 Midterms Marciano 4

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 Midterms Marciano 5

Ludwig Von Bertalanffy:

Non-Nursing Theories 1. General System Theory
Abraham Maslow 1943: 2. Austrian biologist
1. Hierarchy of NEEDS & MOTIVATION 3. Open System & Closed System
2. American psychologist. 4. A person constantly receiving positive inputs
3. Universal and giving appropriate outputs is more likely
4. Deferred depending on the priority to achieve and maintain health.
5. Met in diff. Ways Kurt Lewin:
6. Needs are interrelated 1. German, Father of social psychology
7. Unmet needs lead to a problem then an 2. Field Theory
illness 3. Focuses on the subjective reality of an
8. Prioritisation of care individual.
9. Need to maintain life and physical 4. How the patient views the world
integrity is give top priority in nursing 5. Reality in the environment are moving
care. towards and against the patient’s goal.
6. Behaviour depends on
A. Home life
B. Professional and student life
C. Social life
7. Change Theory:
A. Unfreeze: ready for change
B. Change: executes intended change
C. Refreeze: change becomes
permanent
Erik Erikson: Psychosocial Development
1. Proponent of Psychosocial
Developmental Theory
2. People continue to develop throughout
life
3. 8 stages of developments/levels of
achievement.
AGE Stages of personality
development

Carl Rogers 1961: 0-18 months Trust vs mistrust

1. Humanistic American psychologist
2. Focused on THERAPEUTIC 18-3 yrs Autonomy Vs shame &
RELATIONSHIP & CLIENT- doubt
CENTRED
3. Each person experiences the world 3-5 yrs Initiative vs guilt
differently and knows what is best for
them 6-12 yrs Industry vs inferiority
4. Self Concept: thoughts, feelings &
beliefs 12-18 yrs Identity vs role
5. Client-centred approach confusion
6. Congruence > Empathy > Positive
7. Unconditional Positive Regard: Non- 18-25 yrs Intimacy vs isolation
judgemental attitude
8. Genuine: honesty & realness 25-65 yrs Generatively vs
9. Empathetic Understanding: Ability to stagnation
sense the feelings 65-death Integrity vs despair
 Midterms Marciano 6

Framework:
Florence 1. Manipulate the client’s env’t to include
appropriate noise, nutrition, hygiene, light,
Nightingale comfort, socialisation, and hope.

Characteristics of Nightingale’s Theory:

1. May 12, 1820 - August 13, 1910 1. Clear description of its concept
2. In 1827 in her diary, “God spoke to me and 2. Parsimony (simple, no jargon)
called me to his service.” 3. Concepts are testable
3. A unitarian who believed that action for the 4. Concerned with practical application.
benefit of others is primary was of serving
God.
4. Nursing is about environmental
manipulation and nutrition and conservation
of the patient’s energy.
5. Nursing is not limited to or defined by
medical arts.
6. Asserts the right of women and their role.

Five Essential Components of Environmental

Health:
1. Pure Air:
B. Keep the breathable
2. Pure Water:
A. Portable, clean water
B. Lack of access to clean water = possible
illness
3. Light:
C. Direct sunlight is needed by patients
4. Cleanliness
A. Dirty env’t was a source of infections
through the organic matter it can
contaminate
5. Efficient Drainage:
A. Proper handling of bodily secretions

Hierarchy:
1. Person:
B. The one whose well-being the nurse looks
after
2. Environment:
A. Stressed the importance of clean air &
water & decent housing.
3. Health:
A. Believed in a systematic approach to
health care with focus on prevention.
4. Nursing:
A. The care we give.
Goal of Nursing:
1. To facilitate “the body’s reparative process”
by manipulating the client’s env’t.
 Midterms Marciano 7

Faye Glenn
Remedial Care Needs:
12. Identify and accept positive and negative
emotions

Abdellah (13.03.1919 -
13. Identify and accept interrelatedness of
emotions and organic illness
24.02.2017 14. Facilitate the maintenance of effective
Key point: 21 nursing problems verbal and nonverbal communication.
15. Promote the developments of productive
Central Theme: Patient centred
interpersonal relationships.
16. To facilitate the progress towards
1. schools attended: Ann-may school of
achievement and personal spiritual goals.
nursing, Columbia university
17. Create or maintain a therapeutic
2. first nurse officer in the U.S to receive
environment.
the rank of a two-star rear admiral.
18. Facilitate awareness of self as an
3. Central Theme: Patient centred
individual w/ varying physical,
approach to nursing.
emotional, and developmental needs.
4. PATIENT:
19. Accept optimum possible goals with
• Nursing
limitations (physical & emotional).
• Clinical psychology
Restorative Care Needs:
• Speech & language therapy
20. Use community resources as aid in
• Creative arts therapy
resolving problems from illness.
• Physiotherapy
21. To understand the role of social problems
• Dietetics
as an influencing factor to health.
• Occupational therapy
• Psychiatry
Steps to identify the patient’s problem:
1. Learn to know the patient
On Nursing:
2. Sort out relevant and significant data
Broadly grouped into 21 nursing problems
3. Make generalisation about available data
which centers around
in relation to similar nursing problems
Basic:
presented by other patients.
1. Hygiene
4. Identify the therapeutic plan.
2. Comfort
5. Test generalisations with the patient.
3. Activity
6. Validate the patient’s conclusions.
4. Safety
7. Continue to observe and evaluate the
Sustenal Care Needs:
patient
5. Oxygen
8. Explore the patient and family reaction
6. Nutrition
9. Identify how other nurses feel about the
7. Elimination
patient’s nursing plan.
8. Hydration
10. Discuss and develop a comprehensible
9. Physical and emotional health problem
nursing care.
10. Interpersonal relationships
11. Development of self-awareness
 Midterms Marciano 8

11 Nursing Skills:
1. Observe health status
2. Skills of communication
3. Application of knowledge
4. Teaching of patients and families
5. Planning and organising of work
6. Use of resource materials
7. Use of personal resources
8. Problem-solving
9. Direction of work
10. Therapeutic use of the self
11. Nursing procedures

Problem Solving:
1. The process of identifying overt and
covert nursing problems and interpreting,
analysing, and selecting appropirate
courses of action to solve these problems
2. The nurse must be able to solve problems
to give the best professional nursing care
1. This is the final building block of
Abdellah’s writing.

Concepts:
1. Nursing problems:
• Condition faced by the patient or
patient’s family that the nurse can assist
them to meet.
• Consistent with nursing goals/functions.
• Problem solving
• I.D. the problems, select proper date,
formulate hypothesis, test hypothesis
and revise it.
• Practise: observing, reporting,
interpretation, analysis, implementation

Implications:
1. Nursing Practise
2. Nursing Education
3. Nursing Research
 Midterms
Virginia
Henderson
November 30, 1897 - march 19, 1996
Key point: patient independence
Bio:
1. Interest in nursing evolved around her
desire to help the sick and wound military
WW2
2. Enrolled at the Army School of Nursing
in Washington D.C.
3. MA in Nursing Education - Columbia Uni
4. Faculty at Yale Uni of Nursing
5. Helped issuance of licensure
6. Viewed practise of nursing as independent
from the practise of physicians.
7. Emphasised the art of nursing and
proposed 14 basic human needs on which
nursing care is based.
8. Made extraordinary contributions to
nursing during her 60 years of service as a
nurse, teacher, author & researcher.
14 Components of Basic Nursing Care:
1. Breathe normally
2. Eat & drink adequately
3. Eliminates body waste
4. Move & maintain posture
5. Sleep & rest
6. Wear suitable clothing: dress or undress
7. Maintain body temp.
8. Keep the body clean
9. Avoid dangers in environment
10. Communicate expressing emotion and
needs, fears
11. Worship according to faith
12. Have work accomplishment
13. Engage recreation
14. Learn, discover or satisfy curiosity
*first 9 components are physiological
*10th & 14th psychological
*11th spiritual & moral
*12th & 13th sociological
Marciano 9
Three levels of Nursing-Patient
relationship:
1. Nurse as a SUBSTITUTE for the patient
(your eyes become their eyes)
2. Supplementary:
• Serve as a helper (aid and assist)
3. Nurse as a PARTNER with the patient.
• Teach mother how to breastfeed
• Mother holds the stethoscope.
Central Theme: Nature of Nursing
Person:
• With biological, spiritual, sociological, and
psychological components (health)
Dignified death
Env’t:
• Conditions under which persons can
perform their activities unaided
Health:
• Ability to function independently
Nursing:
• Assisting the individual (sick or well) in
the performance of activities contributing
to health recovery or peaceful death.
“I say that the nurse does for others what
they would do for themselves if they had the
strength, the will, and the knowledge. But I
go on to say that the nurse makes the
patients independent of him or her as soon
as possible.
Postulation:
1. Henderson postulated that nurse functions
in relation with the patient, physician, and
other members of the health team and
each type of relationships gives nurses
specific responsibilities and roles.
2. Emphasised the need to view the patient
and his family as a single unit. For the
patient to achieve health, he must be able
to meet his needs (emotional needs)
which in many cases provided by the
family (support system).
 Midterms Marciano 10

Dorothy Elizabeth Orem: 3. Self care agency:

• “the ability for engaging in self care”.
1914 - June 22, 2007 Conditioned by age, developmental
state, life experience, sociocultural
Key point: Self-reliant & patient orientation, health.
responsible for their care
Nursing Design:
Schools attended:
• These are professional functions that must
• Providence Hospital School of Nursing
be performed by a nurse in order to meet
• Catholic Uni of America (BSN and MSN-
client’s needs.
education)
Nursing Systems:
Central Theme: Nursing & Self-care
• these are series and sequences of deliberate
activity
practical actions of nurses performed at
A. Self-Care: Is an activity that promotes a
times in coordination with the actions of
person’s well-being. It is performed by
their patients.
persons who are aware of the time frames
on behalf of maintaining life, continuing
THREE THEORIES ASSOCIATED:
personal development, and functional
1. Theory of self-care
living.
2. Theory of self-care deficit
1. Self-care Requisites:

3. Theory of Nursing Systems
Are insights of actions or requirement
that a person must be able to meet and
Types of Systems:
perform in order to achieve well-
Partially compensatory System:
being.
Both nurse and patient perform care
• Universal self-care requisites
measures, either manipulation or ambulatory
• Developmental self-care requisites
task
• Health deviation self-care requisites
Supportive - educative System:
Able to perform or can and should learn to
B. Self-care Deficit:
perform self-care. (teach them how to take
• A relationship between the human
meds).
properties of therapeutic care demand
and self-care agency in which
constituent developed self care
capabilities within self care agency are
not operable or inadequate for knowing
and meeting a healthy life.
2. Nursing Agency:
• Is a set of established capabilities of a
nurse who can legitimately perform
activities of care for a client. It helps a
person achieve their health care
demand.
 Midterms
Jean Watson
June 10 1940 - present
Theory of human caring and ten caritas
processes
Central theme: human science and care &
transpersonal caring
Transpersonal Caring Relationship:
• Human to human connectedness occurring
in a nurse patient encounter
• Entails first and foremost a belief in the
value and dignity of each human being
“Caring in nursing conveys physical acts,
embraces the mind-body-spirit as it reclaims
the embodied spirit as its focus of attentions”
Major Assumptions:
1. Caring can be effectively demonstrated
and practise interpersonally.
2. Caring consists of curative factors that
result in the satisfaction of certain human
needs.
3. Effective caring promotes health &
individual or family growth.
4. Caring responses accept a person not as
what they are now but as what they may
become.
5. A caring env’t offers the development of
potential while allowing the person to
choose the best action for themselves at
the given time.
6. Caring is more “healthogenic” than is
curing; a science of caring is therefore
complementary to the science of curing.
7. The practise of caring is central to
nursing,
Marciano 11
Ten Carative Factors:
1. Formation of humanistic altruistic
system of value:
• defined as satisfaction through giving
and extension of the sense of self.
2. Instillation of Faith and Hope
• describes the nurse’s role in the
developing effective nurse-patient
interrelationships and in promoting
wellness by helping the patient adopt
health-seeking behaviours
3. Cultivation of sensitivity to self and
others:
• recognition of feelings to self
actualisation through self acceptance
for both the nurse and patient.
4. Development of hleping-helping-trust
relationship:
• promotes and accepts the expression
of both positive and negative feelings
5. Promotion and acceptance of the
expression of positive and negative
feelings:
• The sharing of feelings is a risk-
raking experience for both the nurse
and patient. The nurse must be
prepared for either positive and
negative feelings.
6. Systematic use of the scientific
problem-solving method for decision
making:
• Nursing process resembles research
process that is systematic and
organised.
7. Promotion of interpersonal teaching-
learning process:
• Enables the patient to provide self-
care, determine personal needs, and
provide opportunities for their
personal growth
 Midterms
8. Provision for supportive, protective,
and corrective mental physical,
sociocultural, and spiritual
environment:
• Nurse must recognise the influence
that internal and external
environments
9. Assistance with gratification of human
needs:
• Nurse recognises the biophysical and
psychophysical and interpersonal
needs of the self and patient
10. Allowance of existential -
phenomenological forces:
• Provides a thought provoking
experience leading to a better
understanding go self and others.
• moment to moment.
Anne Boykin
(1944-present)
Savina Schoenhofer
(1944-present)
A model for transforming practise
Central Theme: Nurturing persons, living,
caring, and growing in caring know persons
as caring person
Two perspectives:
1. Discipline:
• Nursing is a unity of science, art and
illness.
• Nursing is a response which involves
knowing, living, and valuing all at
once.
• Develops knowledge
2. Profession
• Based in everyday human experiences
and responses to one another.
Marciano 12
• Uses knowledge to respond to specific
human needs.
7 Major Assumptions:
1. Persons are carting by virtue due to their
humanness.
2. Persons are caring moment to moment.
3. Persons are whole or complete.
4. Personhood is a process of living
grounded in caring.
5. Personhood is enhanced through
participating in nurturing relationship
with caring others.
6. Nursing is both a discipline and a
profession.
7. Person viewed complete and continuously
growing in completeness, fully caring
Fundamental Assumptions:
1. Person-as-person
2. Person-as-whole
3. Person-as-caring
Dance of Caring Persons (model):
• Supports a way of being with others that
respects and explicitly values each person.
•
Lydia Elouise Hall
9/21/1906 - 2/27/1969
Advocate for the chronically-ill
Central Theme: Core, care, cure.
1. Core:
• Involves the therapeutic use of self and
emphasises the use of reflection.
2. Caring:
• nurse’s primary function.
• Hands-on bodily care represents
nurturance and exclusive to nursing.
3. Cure:
• focuses on nursing which relates to
medical knowledge
 Midterms Marciano 13

actions and decisions that help people of a

Madeleine particular culture adapt to, negotiate with
others a beneficial or satisfying health

Leininger outcome.
3. Culture Care Restructuring or
Repatterining:
(july 13, 1925 - August 10, 2012)
• Refers to those assistive, supportive,
facilitative, or enabling professional
Theory of Culture Care Diversity and actions and decisions that help people
Universality change or modify their life ways to
accommodate new or different health care
Central Theme: transcultural care patterns that are culturally meaningful
1. Enic: and satisfying to them.
• Knowledge gained directly from the
experience of the person (person-centred)
2. Etic:
• Knowledge in the professional’s
perspectives

Leininger’s Premise:
• People of each culture not only know and
define their ways of experiencing and
perceiving their nursing care but also relate
them to their general health beliefs and
practises.
• Nursing care is derived and developed from
the cultural context in which it is provided.

Concepts:
1. Culture:
• “learned, shared, and belief transmitted
knowledge of values, beliefs, norms, and life
ways of a [articular group that guides an
individual’s or group’s thinking, decisions
2. Culture care diversity and culture care
universality.
3. Person:
• Caring beings are capable of being
concerned about, holding interest in, or
having personal regard for other people’s
needs, well-being, and survival.

Three Models of Actions and Decisions:

1. Cultural Care Preservation or
Maintenance:
• Refers to those assistive, supportive,
facilitative, or enabling professional
actions and decisions that help individuals
preserve or maintain favourable health
and caring life ways.
2. Cultural Care Accommodation or
Negotiation:
• Refers to those culturally assistive,
supporting, or enabling professional
Midterms Marciano 14
 Midterms Marciano 15

FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
FINALS FINALS
 Finals
PROCESS
THEORIES
Ida Jean Orlando
Palletier
• Aug. 12, 1926 - Nov. 28, 2007
• 1917 - diploma in nursing
• 1951 BS Public Health Nursing
• 1954 MA in Mental Health Nursing
• Research: Integration of mental health
• First psychiatric nurse in the US
• Program: Two Systems of Nursing in a
Psychiatric nursing
Five Major Interrelated Concepts:
1. The function of professional nursing
2. Presenting behaviour of the patient
3. The immediate or internal response of the
nurse
4. The nursing process discipline
• Starts from communication
• Patient perception
5. Improvement
“The dynamic nurse-patient relationship:
Function, process and principles”
• based on the interaction between the
patient and the nurse.
Orlando’s Process Discipline:
1. Nurse reaction (explored with patient)
2. Need for help
3. Nurse action
Nursing Process:
1. Evaluation
2. Assessment
3. Nursing Diagnosis
4. Planning
5. Implementation
Marciano 16
Assessment:
• Nurse sharing of reaction to the patient’s
behaviour
• Gathering of data about the patient’s needs
through the 5 senses
Nursing Diagnosis:
• The product of analysis of the patient’s
needs and problems
• Prioritisation
• Immediate resolution of the problem
• Given attention one at a time
Metapadigrims:
Health:
• Did not define health but assumed that
freedom from mental or physical
discomfort and feelings of adequate and
weed-being contribute to health
Nursing:
• Finding out and meeting the client’s
immediate need for help.
Environment:
• not fully defined
Person:
• A unique individual behaving verbally and
non verbally
Verbal & Non-verbal Behaviour:
• Inconsistency between these two types of
behaviour should alert the nurse that the
client needs help.
• All patient behaviour, no matter how
insignificant, must be considered an
expression of need for help unto its
meaning is understood.
• Improvement in patient’s behaviour
indicating resolution of the need is the
desired result.
 Finals Marciano 17

PATRICIA Ernestine
BENNER Wiedenbach:
Aug. 1962- Present Aug. 18, 1900 - march 8, 1998
• 1964 BS Degree
• 1922 BA Wellesley College
• 1970 Master’s
• 1982 Doctorates • 1925 RN Johns Hopkins
- Researcher: nature of nursing practising and • 1934 MA Teacher’s College
how nurses gain expertise • 1946 Certificate in nurse-midwifery
- Living legend of the American Academy of
Nursing 2011 • Clinical Nursing, A Helping Art - book
1964
Central Theme: how nurses learn to do • Family-Centred Maternity Nursing
(1958)
nursing (stages of clinical competence)

“my thesis is that nursing art is not

Five Stages:
compromised of rational nor reactionary
1. Novice
actions but rather of deliberative action.”
2. Advanced Beginner
3. Competent
Central theme: quality of health that the
4. Proficient
nurse desires to sustain in her patient and
5. Expert
specifies what she recognises to be her
responsibility in caring
Metaprigim:
Person:
The Prescriptive Theory of Nursing:
• a self-interpreting being. They do not come
situation producing theory
into the world predefined but gets defined
through experiences.
Conceptual model of nursing: The Helping
Environment:
Art of Clinical Nursing
• Used the term situation rather than
environment. Situation conveys a social
Need for help:
environment with social definition and
meaningfulness. • any measure desired by the patient that has
the potential to restore or extend the ability
Health:
to cope with various life situations that
• Based on the lived experience or being
affect the health and wellness
healthy or ill.
Nursing:
Prescription:
• A caring relationship, an enabling condition
of connection and concern. • A directive to activity which specifies the
nature of action and the thinking process.

Voluntary action:
• Mutually understood and agreed upon
• Recipient-directed
• Practitioner-directed
 Finals Marciano 18

Prescriptive Theory: Three Components for a nursing

• The conceptualisation of a desired situation philosophy:
and the prescription by which it is brought 1. A reverence for the gift of life
about. 2. Respect for the dignity, worth, autonomy,
• Directs action toward an explicit goal and individuality of each human being.
3. A resolution to act dynamically in relation
Three (3) factors: to one’s beliefs.
• Central purpose
• Prescription Metaparadigm:
• Realities Person:
• posses unique potential, strives towards
Assumptions: self-direction, and needs stimulation.
• nurse identifies her own philosophy and Health:
recognises that the patient has autonomy • not defined but supports WHO definition of
and individuality. Nurse will work with the health as the state if complete physical,
patient to develop a prescription or plan for mental, and social well-being and not
his/her care. merely the absence of a disease and
infirmity.
Key Concepts: Elements in clinical nursing Environment:
1. Philosophy • Incorporated within the realities
2. Purpose Nursing:
3. Art of nursing • Goal-directed activity requiring the
4. Practise application of knowledge and skill toward
meeting a need for help experienced by a
Five Realities: patient.
1. Agent: • A helping process that restores patient’s
practising nurse who is committed and ability to cope with demands.
competent in nursing Nursing Act:
2. Recipient: • Based on thought through the kind of
patients has the ability to cope with problems results nurse wants, executes action to
3. Goal: obtain the results and accepts responsibility
desired outcome; what the nurse wishes to for acts and the outcome of action(s).
achieve
4. Means:
activities and devices used to attain goal
5. Framework: the context in which
nursing is practised and constitutes
currently existing limits
 Finals
Joyce Fitzpatrick:
• Known for advancing the science of
nursing education at universities and health
ministries around the world.
• HIV prevention
Life Perspective Rhythm Model:
Main Theme: Classification of nursing
diagnoses, interventions & outcomes
Assumptions:
• The process of human development is
characterised by rhythms that occur
within the context of continuous person-
environment interaction.
• Nursing activity focuses on enhancing the
developmental process toward health.
• A central concern of nursing science and
the nursing profession is the meaning
attributed to life as the basic
understanding of human existence.
• The identification and labelling of
concepts allows for the recognitions and
communication with others, and the rules
for combining those concepts permits
thoughts to be shared through language.
Metaparadigm:
Person:
• Concept of both self and others having
unique biological, psychological,
emotiona, social, cultural, and spiritual
attitude.
Thriving on honour, dignity, self-evaluation
and growth and development.
Development happens within the social
setting interacting with the environment.
Health:
• A dynamic state of being resulting form
interaction of the person to the
environment.
Marciano 19
Optimum health:
• Actualisation of innate and obtained human
potential as a result of rewarding
relationships with others. It is goal directed.
• Health is “adjustment” as a need basis
Environment:
• Not clearly defined, assumed to be in the
setting on the patient.
Nursing:
• A practise of discipline and profession that
is based upon a synthesised body of
knowledge, which is derived from inquiry
and clinical evaluation promoting wellness
and diminishing illness.
NOLA J. PENDER
• aug. 16. 1941
• Educator >40yrs.
• Book: Health Promotions in Nursing
Practise, 1982
• >>Preventive care<<
Major Concepts:
• Health promoting behaviour
Personal Factors:
1. Biological Factors - age, gender,
BMI
2. Physiological Factors - self-esteem,
self-motivation, perceived health
status
3. Sociocultural Factors - race,
ethnicity, education, socioeconomic
status
• Perceived benefits of action
• Anticipated positive outcome
• Perceived barriers to action
• Anticipated/imagined/real
• Perceived self efficacy
• Judgement of personal capability to
organise and execute a health
promoting behaviour
 Finals Marciano 20

Major Assumptions:
• Person seek to create conditions of living
through which they can express their
unique human potential
• Person have the capicity for reflective self
awareness, including assessment of their
own competency

Metaparadigm:
Health:
• An outcome of health promoting
behaviour
• Enhanced well-being and actualised
potential
Environment:
• Bio-psycho-social situations
• Interacting with persons
 Finals Marciano 21

Environment:
THEORETICAL
WORKS ON
Client System:
SYSTEM
BETTY NEUMAN
THE SYSTEMS MODEL
BSN: public health & psychology
• Proponent: von Bertalanfy
• Concept: Wholeness in systems
• Recognition of the whole while valuing
the importance of the parts
Central Theme: a health systems model for
a total person approach to client problems
The NEUMAN SYSTEM MODEL FOR
HEALTHCARE SYSTEM MODEL
• Made up of internal and external forces
that surround humans and with which
they constantly interact
• Open system
• Individual, family, group or community
• Achieving optimal system stability
• Lines of resistance:
• Protect basic structure
• Activation of immune system
• Flexible line of defense:
• Initial response or protection
• Prevent stressors from invading
• Normal line of defense:
• Usual level of stability, normalcy and
wellness; stability overtime
• Baseline for determination of wellness
• Basic structure

Five Variables: Mode of Prevention in Nursing:

1. Physical • Interventions used by nurses to retain attain
2. Psychological and maintain system balance for the client
3. Socia-cultural Primary:
4. Developmental • Promotion before symptoms sets in
5. Spiritual • Prevention (vaccination)
Secondary:
Metaparadigm: • Occurs after the system reacts to stressor
Health: and there is existing symptoms
• Levels of wellness or stable lines of • Straightening the internal lines of
defense. Health and wellness exist if all resistance
parts and subpart are in harmony with the • To regain optiman system stability
whole person. Tertiary:
Nursing: • After the system has been treated through
• Unique profession in that it is concerned secondary prevention
with all the variables affecting an • Protect the client system reconstitution
individual’s response to stressors. by supporting existing strength and
Person: continuing to conserve energy
• Each is a total person and as a client • May begin after constitution (return to
system it is a composite of biologic, system stability) began
psychologic, sociocultural, and • Participation in rehabilitation system
developmental variables.
 Finals Marciano 22

DOROTHY JOHNSON
aug 21. 1919 - feb 1999

Central Theme: The Human as a Behavioural

System

Seven Behavioural Subsystems

1. Attachement or affiliative
2. Dependency
3. Ingestive
4. Eliminative
5. Sexual
6. Aggressive
7. Achievement

Metaparadigm:
Person:
• Persons have two major systems, biologic
and behavioural (with patterned repetitive
and purposeful)
Environment:
• Society is the environment in which and
individual exists thereby influencing the
individuals behaviour
Health:
• Dynamic state influenced by biologic,
psychologic, and social factors.
Nursing:
• An art and science whose primary goal is to
foster balance within an individual by
providing external care
• Nursing care is directed towards
maintenance of equilibrium
• Returning the client to a state of
equilibrium & maintaining and supporting
the client’s natural defense and adaptive
process.

Assumptions:
• Patters if behaviour of man reflect what goal
he is attempting to achieve
• Each subsystem has a tendency to achieve
one unified goal and that is to achieve balance
within
 Finals Marciano 23

THEORIES ON ROSEMARIE RIZZO

HUMAN PARSE
Central theme:
• humans are intentional beings involved with
DEVELOPMENT their world, having a fundamental nature of
knowing, being present, and spent to their
world
MARGARET • The unitary human is one who coparticipates
in the universe in creating becoming and who
NEWMAN is whole, free to choose ways of becoming

Theory: Health as Expanding Symbol of human becoming theory

Consciousness
Metaparadigm:
Health:
Concepts and Assumptions: • A way of being in the world; it is not a
• Health encompasses conditions known continuum of healthy to ill, nor is it a
as diseases dichotomy of health or illness, rather it is
the living day-to-day ways of being
Metaparadigm: • A synthesis of values, a way of living
Nursing: • A personal commitment
• The role of the nurse is to help clients • A process of changing life’s meaning as a
get in touch with the meaning of their result of the collective relationships with
the others and the universe
lives by identification of the meanings Environment:
• Is a process of caring through pattern • The work, the universe and those who
recognition occupy spaces along with others who freely
Environment: choose to be in the situation
Nursing:
• Not explicitly defined but is being • A basic science, the practise of which is
described by the larger whole performing art.
Person: • The knowledge base of nursing is science
• Client patient individual human being of the art and the performance of the art is
the creative living of the knowledge
• Including family and community
• Participants in the transformative
process
Health:
• A fusion disease and non-disease create
a synthesis that is regarded as health
• Interaction patter of a person with the
environment
A Paradigm Shift
• To see health as the pattern of the
whole, one needs to see disease but as a
separate entity but manifestation of the
evolving pattern of person-environment
interaction
 Finals Marciano 24

Clinical Application of Humanistic Nursing

LORETTA ZDERAD & Theory;
• Encourages reflection; reflection being a
JOSEPHINE G. learned process that can help enhance the
experience of the nurse and prepare the
PATERSON
Central Theme: Humanistic Nursing
• Humanistic nursing is a responsible MARTHA ROGERS
searching, transactional relationship whose May 12, 1914-march 13, 1994
meaningful demands conceptualisation • Public Health nurse
founded on a nurse’e existential awareness of Central Theme: Science of Unitary Human
self and of the other Beings
• Nursing is concerned with the individual’s • A unified whole having its own distinctive
unique being and striving towards characteristics
becomings , nurtured in relationships Basic assumptions:
• Concerned with the phenomenological 1. Wholeness
experience of individuals and the exploration 2. Opens
of human experiences 3. Uni-directionality
4. Pattern
Five phases of humanistic nursing inquiry: 5. Organisation
1. Preparation of the nurse knower for 6. Sentience
coming to know 7. Though
2. Nurse knowing the other intuitively
3. Nurse knowing the other scientifically Metaparadigm:
4. Nurse complimentarily synthesising Person:
known others • Humans who are unified beings with
5. Succession with the nurse from the many individuality, in continuous exchange of
to the paradoxical one energy with the environment
Environment:
Metaparadigm: • An wnergy field
Person: • all of the patterns that exists external to the
• man is an individual being necessarily related to individual
other men in time Health:
Nursing: • Not specifically addressed but emerges out
• A nurturing response of one person to another of interaction between human and
in a time of need that aims toward the environment, moves forward and
development of well-being (nurturing) and maximises human potential
more being (human potential) Nursing:
• Nursing helps increase the possibility of • An art and a science directed toward the
making responsible choices, since this is how unitary human and concerned with the
human beings are able to become. nature and direction of human development
Environment:
• The phenomenon of society or environment is Application:
the the community • Nursing burnout -> compromised safety of
• Community is defined as 2 or more persons patient
striving together. Implication:
Health: 1. Seeing the results of what nurses do as
• Is a matter of personal survival, a process of being greater than the sum of their parts
experiencing one’s potential for well-being and having a rippling effect out in the
and more-beng, a quality of living and dying. environment can help them remain
It is more than the absence of disease/illness focused even during mental fatigue.
2. Help management see the need to allow
nurses to rest
 Finals Marciano 25

Theory of Goal Attainment:

THEORETICAL WORKS • In the context of interpersonal systems
ON INTERACTION & • What nurses do with and for the individuals
• interaction, communication, transaction, role,
INTERPERSONAL stress, growth and development, time,
personal space
RELATIONSHIP • Transaction - a series of exchange between
IMOGENE KING human beings and their environment that seek
to reach goals of worth to the participants
Theory of Goal Attainment and Transactional
Procces

Central Theme: The process of human

JOYCE TRAVELHEE
interaction Central Theme: a sick person finding meaning
in illness and suffering and human to human
Assumptions: relationship
Original encounter > stages of emerging
• Human beings are open systems in constant
interaction with their environment identities > feelings of empathy > feelings of
sympathy > rapport building
• The nursing focus is human being interacting
with the environment
Metaparadigm:
• The nursing goal is to help individuals and
groups maintain health Person:
• A unique irreplaceable individual who is in
Metaparadigm: a continuous process of becoming,
Person: evolving, and changing.
Environment:
• Humans are open system who are social,
rational, perceiving, controlling, purposeful, • Not defined
action, and time oriented • Human conditions and life experiences
Health:
• three interacting system:
• Social • Includes the individuals perceptions of
health and the absence of disease.
• Personal
Nursing:
• Interpersonal
Environment: • The critical work of psychiatric nursing is
to help people develop a sense of self
• Internal and external environment
continually interacts to assist in adjustment through a healing interpersonal relationship
to change • The instrument for the delivery of
Health: interpersonal nursing is the therapeutic use
of self
• A purposeful, adaptive response to internal
and external stimuli to maintain balance and Human to Human Relationship:
comfort • Original Encounter:
Nursing: • First impression by the nurse and the ill
person
• perceiving, thinking, relating, judging and
acting with an individual. • Emerging Identities:
• Together they explore and agree on means • Nurse and patient perceiving each other
to achieve goals as a unique person. Bond begins to form
Propositions: • Empathy:
• Perceptual accuracy, role congruency, and • Ability to share in the other person’s
communication in a nurse-client interaction experience
leads to transactions • Sympathy:
• Transaction > goal attainment and growth and • The nurse has the desire to alleviate the
development cause of the patient’s illness or suffering
• Goal attainment > satisfaction and to effective • Rapport:
nursing care • Nursing actions are being done to relieve
the patient’s distress
 Finals Marciano 26

HILDEGARD PEPLAU
Interpersonal Relations in Nursing

Central Theme: described the dynamic

relationship between the nurse and the patient

Metaparadigm:
Person:
• Man is an organism that lives in an unstable
equilibrium, psychological, physiological, and
social fluidity
• Striving to reduce tension generated by needs
Environment:
• Fluid context of the nurse-client relationship
• Consider culture and moral values when
hospitalised
• Today nurses consider cultural + home +
work background.
Health:
• Life is the process of striving in the direction
of stable equilibrium, i.e., a fixed pattern that
is never reached except in death. It is the
forward movement of the personality.
Nursing:
• The therapeutic interpersonal process carried
out through the relationship between the
person and the nurse
• Identified six nursing roles:
1. Counseling: aids another in
recognising, facing, accepting and
resolving problems
2. Leadership: initiate and maintain
group goals
3. Surrogate: nurturing care
4. Stranger/Technician: physical care
through clinical skills and operating
machine
5. Resource: specific, needed info -
understanding a problem or new
situation
6. teaching: imparts knowledge (need
or interest)

Three Phases of the Nurse-Client Relationship:

1. Orientation:
• Nurse needs to be aware of her personal
reactions to the patient.
2. Working:
• Nurse mostly uses communication tools
to explore and deal with clients problem
3. Termination:
• Patient’s needs have been met
 Finals Marciano 27

THEORETICAL MYRA ESTRIN

WORKS ON LEVINE
“The Conservation Principle: A Model for
ADAPTION Health”

Central Theme: Adaption, Conservation, and

Integrity
SISTER CALLISATA Adaption:
ROY • The life process by which, over time, people
maintain their wholeness or integrity as they
Adaption Theory respond to environmental challenges.
• The consequence of interaction between
Central Theme: The person is in constant person and environment
interaction with the changing environment Conservation:
• Product of adaption = wholeness and integrity
Adaption Level: • Ensuring the ability of the system to continue
• Integrated - adaption level working as a to function in the face of severe challenges
whole • Provides the current survival but also future
• Compensatory - human response system is vitality in facing challenges in the most
activated economical way possible.
• Compromised - when integrated and Four Principles of Conservation (core of
compensatory process are not providing for Levine’s Theory):
adaption 1. Conservation of energy of the individual
2. Conservation of the structural integrity
Metaparadigm: 3. Conservation of the personal integrity
Person: 4. Conservation of the social integrity
• As an adaptive system that is in constant
interaction with the environment Metaparadigm:
Health: Person:
• Is a state or process of being or becoming an • Should be on person’s wholeness
integrated and whole person • Continually adapts interactions with
Nursing: environment which results in conservation
• Theoretical system of knowledge that • In need of nursing when suffering arise
prescribes a process of analysis and action • Independence are set aside and accepts
related to the care of the ill or potentially ill services of another
persons. Health:
• goal: the promotion of adaptive responses • Goal of conservation
in relation to the four adaptive modes • Health and disease are patterns of adaptive
• Adaptive responses - activities that changes
positively affect health Environment:
• through human interaction w the environment
Four Adaptive Modes: • Social context is an important consideration
1. Physiological of the wholeness of an individual
2. Self-concept-group Identity • Three aspects :
3. Role Function 1. Operational
4. Interdependence 2. Perceptual
3. Conceptual
Nursing:
• To take care of others when they need to be
taken care of
Finals Marciano 28
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