NURSING THEORY MAJOR PROJECT 2 YARYLENN MAYOR THE NURSING ROLE
The nursing role is rapidly changing and evolving as we are taking care of a wider health care responsibilities. The public perception of nurses just at bedside has changed drastically and now we see nurses involved and collaborating in scientific research, pursuing advanced specializations, involved in changing health care policies, or in the media raising awareness about health and illnesses. The independence, flexibility, and authority to treat patients and to be the link between the patients and primary care providers are some of the many incentives that continue to motivate numerous nurses to pursue this career nowadays. NURSING THEORY
Despite all these changes in the healthcare system throughout the years, one thing has remained constant: The positive impact that nursing theorists and theories have in our profession. Theories provide a framework to guide our profession and provide patient care that is culturally specific and empathetic. As nursing students we studied Florence Nightingales theory of () manipulation and the environment for the benefit of the patient (George, 2010 page. 9 ). THEORY AND CONCEPTS
It is necessary, in order to comprehend these theories, to review the elements used
to generate these theories and the definitions of the concepts.
Nursing theories are composed of concepts (and their definitions) and propositions that explain the relationships between the concepts. For example, Nightingale proposed a beneficial relationship between fresh air and health. Theories are based on stated assumptions that are presented as givens (George, 2010. p. 3) THEORY AND CONCEPTS
The term metaparadigm is defined as the core content of a discipline, stated in the most global or abstract of terms. () the metaparadigm of the discipline of nursing consisted of four major concepts: person, health, environment, and nursing. (George, 2010. p. 3) Person may represent an individual, a family, a community, or all humankind. Health represents a state of well being Environment represents the persons physical surroundings, the community, or the universe and all it contains. Nursing is the practice of the science and art of the discipline. (George, 2010. p. 3) NURSING THEORISTS
Jen Watson theory of Transpersonal Care promoting healing while preserving the dignity of the patient or one of my favorites theorists Madeleine M. Leininger and her theory of Transcultural Nursing, recognizing that the concept of caring was elemental in our nursing profession. Leininger defined Culture care as the synthesized and culturally constituted assistive, supportive and, facilitative, caring act towards self or others focused on evident or anticipated needs for the clients health or well being or to face disabilities, death, or other human conditions (Leininger and McFarland, 2002, p.47) NURSING THEORISTS
Leiningers theory of culture, care, and diversity is useful as it calls on healthcare
providers to take a different approach to health care delivery. Nurses strive to deliver quality health services when handling patients. Similarly, patients intend to receive quality patient care and recover from the illness. The theory thus advocates for the development of an effective nurse-patient relationship that is driven by the desire to design an effect treatment or management plan in the face of ill-health. NURSING THEORY IN PRACTICE
Nursing theories enhance professional nursing practice in the roles of advocate, provider, teacher, manager, researcher, and leader. Nursing theories not only educate the novice nurse but also gives them the opportunity to shape the doctrines that will help evaluate patient care and develop the nursing interventions based on the evaluation findings. They serve to guide the nursing process and to stablish criteria to evaluate the quality of nursing care rendered. They have helped our profession to become more autonomous by clearly defining its independent functions. NURSING THEORY AT UNIVERSITY OF MIAMI HOSPITAL. It is easier to apply a nursing theory to a specific cultural group or patient, but when it comes to a hospital, a nursing home, or any other facility in the healthcare system, I always wondered how these institutions could adapt it and take it successfully into practice. While working at University of Miami Hospital I realized these theories, concepts and metaparadigms are flexible and adaptable to any healthcare arena. In this institution not one but three nursing theorists form part of the the hospital mission and vision: Florence Nightingale Dorothea Dix and Lillian Wald. NURSING THEORY AT UNIVERSITY OF MIAMI HOSPITAL. In the words of the hospitals CNO: At UMH we are leading our nurses to follow in the steps of Florence Nightingale, Dorothea Dix and Lillian Wald. These nursing icons responded to a health care delivery system need- for soldiers on the battlefield (Nightingale), for the mentally ill (Dix) and for immigrants coming to New York City (Wald). At UMH nurses have the opportunity to follow in the path of Nightingale, Dix and Wald as we rethink our nursing care delivery system What is the role of a nurse? Whether the nurse approaches each patient with a caring attitude (Jean Watson), puts them in the best environment for healing to occur (Florence Nightingale), or modifies the stimuli to facilitate their successful adaptation to their physiological and social challenges (Sr. Calista Roy) at UMH, we believe the nurse is practicing a time honored art and science. (University of Miami Hospital , 2017) DEVELOPING A NURSING PHILOSOPHY
As nursing students these theories gave us a structure and helped us identify and eventually form our own beliefs about nursing and values regarding patient care. I believe it is crucial to clarify our beliefs because these are the ones that are going to guide our professional choices and how we care for our patients on our daily practice. Creating a nursing philosophy and metaparadigms are difficult since Im still trying to understand the complexities of nursing profession, and at the same time creating my own philosophy and beliefs. DEVELOPING A NURSING PHILOSOPHY
When I asked my coworkers about their nursing philosophy and values they all mention Florence Nightingale as an inspiration but they couldn't offer a clear statement of what their personal philosophy is. Some nurses are more aware than others of the beliefs and values that influences their actions. Even though many of my coworkers stated that nursing interventions, patient care, nursing skills and hands on experience is what nursing is all about in a hospital setting. That there is no time in between doctors calls, tests, social services meetings and patient care for philosophy, these set of actions is the philosophy that currently guides them. Even they recognize it or not, this is a philosophy as well. I would say action over reflection is what guides their profession at this moment. DEVELOPING A NURSING PHILOSOPHY
There is no right or wrong while developing a nursing philosophy and metaparadigm
Based on my 6 month nursing experience at UMH, and according to the patients cultural group, I feel more identified with Madeleine M. Leiningers Theory of Culture Care Diversity and Universality. Madeleine Leininger's Theory of Culture Care Diversity and Universality is more relevant today than ever. Her concepts about patients, their family and the community cultural needs are testable and applicable in all the different healthcare settings. The core of our job consists on being sensitive to patients cultural needs in order to provide excellent customer care and improve patient health outcomes. REFERENCES
George, J. B. (2010). Historical Perspective. In J. B. George, Nursing Theories: The Base for Professional Nursing Practice. (6th ed., p. 9). Fullerton , CA: Pearson. Leininger, M., and McFarland, M. R. (2002). Transcultural nursing: Concepts, theories, research and practice (3rd ed., p. 47). New York: McGraw-Hill. University of Miami Hospital . (2017). University of Miami Hospital . Retrieved 2017, from Nursing at University of Miami Hospital: http://www.umiamihospital.com/nursing
