Nursing theories portray the views that scholars had of nursing at that time. These nursing theories have evolved over time. In this paper I will examine closely the nursing theories using the microscope approach. The microscope is an instrument that is used to assist an individual focus on a particular item and examine it fully.
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The nursing theories focused on the issue at hand fully and sought to bring certain changes to the individual. In order to get to a solution, the theorists highlighted the problem and the causes of the problem in the patient.
The nursing theories aimed to bring far away less understood issues closer for examination and observations in order to get a clearer understanding. At the end of the day, the theorists sought to achieve certain outcomes when their theories were applied by the nurses.
Nursing theories they can be classified into different categories according to the school of thought that was prevailing at that time. Under the three main categories of nursing theory, I will highlight the main focus of the nursing theory and the detail elements in nursing.
Care and Needs Theories
In the first classification of the nursing theories, the theorists showed that nurses were there to address the needs of the patients. A patient was an individual with unmet needs. He is unable to meet the needs therefore the nurse comes in to assist and equip the patient with the resources to be able to meet his needs. There were several scholars who contributed to the theory of care or needs. Jean Watson is famous for the theory of Human Caring which she put forward that
caring is a common and usual social behaviour in the world. This theorist felt that one could not take care of others unless the individual learnt to take care of himself. It was perceived that the people being treated have a need for provision of self-care in order to recover. The patient is taught how to nurture and intimately take care of his body. The nurse therefore came in to assist the patient take care of himself well. Non-provision of self-care services produces a deficit. In looking at humanness, love and care in the world were the most important things. Another theorist, Patricia Benner viewed caring as a process that created lasting human bonds in the world.
Virginia Henderson put forward the Development theory in 1961 stating the individual required a lot of help towards attaining independence (Lucille & Kelly, 2003, p 206). Nursing in detail consists of several stages where it is substitutive, the nurse doing for the patient, then supplementary where the nurse works with the patient. In the next stage, the nurse compliments the patient. The patient works with the nurse to take care of himself. Finally, the patient becomes fully independent. After hospitalisation, the rate of recovery in the patient is fast since he is independent in taking care of himself.
In taking care of himself, the nurse would in detail tell the patient how to take care of his needs. The patient should eat and drink adequately and ensure wastes are eliminated. Have adequate sleep and rest, select suitable clothes, keep the body clean and well-groomed and avoid dangers in the environment that would harm him. The patient was also expected to participate in recreational activities and have healthy and nurturing relationships.
It was also important to work and worship faithfully. The patient was to maintain healthy postures and modify clothing and change environment in different weather seasons in order to maintain acceptable body temperatures.
Humanistic or Interactive School of Nursing
The second classification focuses on the scholars from the humanistic school of nursing or the interaction school of nursing. The role of the nurse was to interact with the client
and help him or her set health promotion and maintenance goals and the means to achieve them. The patient and the nurse would have an interactive session and discuss the patient’s perceptions on the illness. The patient is an individual who is able to feel, think, choose and set goals. This goal oriented approach to nursing was put forward by Imogene King. She proposed that the nurse and the patient met as strangers in an environment where they interacted and set goals for development. Once the goals were achieved, there would be immense satisfaction experienced by both parties. If there was any role conflict then a lot of stress would be experienced in the nurse-patient relationship.
Ida Jean Orlando put forward the theory of Deliberative Nursing process theory which supported the use of goal-oriented behaviour (Roussel & Swansburg, 2005, p 16). The theorist wanted individuals to distinguish automatic actions from deliberative actions. The actions that were deliberate towards improving the health of individuals were what finally yielded solutions and change.
However automatic actions were just actions, nothing else. They did not cause the individual to learn much and meditate on their perceptions, thoughts and feelings concerning the disease that was affecting him. The role of the nurse was to help the
patient to learn lessons from his illness. This would be achieved through a therapeutic mutual relationship between the nurse and the patient. The patient should learn to accept that he is a human being who is prone to illness. If the patient is able to recover from their illness they will be able to function in their role. The focus of this school of thought is on both the individual and the nurse.
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It focuses on the interaction between the two and how the nurse assists the patient cope with his illness. The individual is a unique being who perceives illness in a specific way. The nurse assists the patient to perceive the illness in a positive light. There is growth in personality when the individual views the illness positively. There is actually self-actualisation of the individual. The individual ends up being creative, constructive
and able to function in the community well since he learns from his experiences.
Care should be observed to ensure that there are no hindrances to the nursing process. The patient should get support from the nurse and have his needs validated. The interaction time should be fruitful and not mechanical.
The nurse would therefore go into detail getting the patient’s status of growth and development and his perception on the health status. Once the patient has communicated all these details, the nurse would bring in his special skills and knowledge and set goals for health promotion.
The System Theories
Nursing was viewed in terms of adaptation and the systems theories. Sister Callister Roy put forward the adaptation theory where she believed that if the level of simulation in the environment was at a level that could not be handled by the individual then it gave rise to a negative reaction to stress.
The stress could be internal in that it relates to the patient’s emotions and feelings and the perception he has of himself. It could also come from the external environment, where the individual is stressed by financial problems, work-related problems or family problems. Betty Neuman contributed to the stress theory by putting forward that every individual had the mechanism on how they reacted to stress which is the usual line of defence. If what is stressing the individual got through the line of defence then the individual would put up a lot of resistance against the stressors. The outcome of nursing in this grand school is to reduce the stress factors and those adverse conditions that end up affecting the optimal operation and well-being of an individual. The nurse works to assist the individual or patient to identify the stress factors and to strengthen his line of defence. The nurse would therefore assess the patient’s capability of coping with his environment. The nurse would keep providing stimuli for the patient to beef up his defence till there is a positive response.
The nurse therefore helps in restoring and maintaining the stability of the individual. When an individual was not at par with his or her environment it led to loss of energy. The nursing process therefore was present to assist the individual conserve his energy and maintain his structural, personal and social integrity. The patient was encouraged to have a healthy relationship with his environment.
Nursing Theories Perception on Leadership
Nursing theories viewed leadership in terms of the relationship between the nurse and the patient. The nurse as the leader was to help the patient take care of his needs and take care of himself.
True leadership would only be achieved by the nurses when the patient attained independence and was able to take care of himself. The nurse had to interact with the client and get all his personal details on his illness and his perception on the illness. Adequate physiological information also had to be obtained from the client. The outcomes of nurse leadership would be wellness and the attainment of health promotion goals.
A nursing theory that has been adopted by nurses is the Orlando’s theory of nursing leadership. It has been used in nursing administration and leadership. The interaction and exchange between the nurse and the patient is important and vital for the success of the treatment (Swansburg, 2002, p 231). The theory is based on several concepts that assist a nurse to be a great leader. The first one is the concept of professional nursing. The theory states that the nurse’s role is to provide assistance to a patient and meet his needs.
It is to help the patient be empowered and stop feeling helpless about the situation he is in. The second concept is providing a solution to the problem. The nurse provides the appropriate solution to solve the patient’s problem. There has to be an internal response to the cues that the nurse gets from the patients. The nurse will have certain perceptions and thoughts about the behavior of the patient. The nurse should act on these. The nurse should carry out an investigation of her response or reaction to the patient’s cues to find out its validity. He should not just assume that his automatic reactions are correct. The effectiveness of the nursing process is evaluated by the
resolution of the patient’s problem. Since the nurse and the patient are unique human beings, the process has to be repeated every time the nurse is treating a different client. Each time the nurse goes through the process he learns a new thing.
Orlando’s theory of nursing is a good foundation for nursing leadership or administration. The nurse leader ensures that the nurses engage in clinical treatment and not automatic reactions. The nurse’s action should be motivated by the patient’s needs and not the nurse’s past experiences, organizational needs or the doctor’s prescriptions. Nursing is about focusing on the patient and the interaction between the patient and the nurse. When it comes to leadership in the nurse’s profession, leaders are those who motivate other nurses to do their work well. They assist others have a good positive attitude towards their work. They also treat other nurses and patients with respect and are able to work towards the fulfillment of their goals and vision. Nursing theories pave way for the dynamic leader-follower model of nursing leadership. They provide a common concept and framework for the nurses to use. Since it is an interactive model, it can be used in leadership and management. The main reason the theory’s model can be applied to leadership is that it encourages feedback in the whole interaction process (Marquis & Huston, 2008, p 7).
Examining the nursing through the microscope approach shows their development over time. It shows the expectations of the nursing process in detail. It helps one understand what the patient should take care of when it comes to body cleanliness and exercise. It shows the specific communication and interaction between nurses and patients and the relationship a patient has with the environment. Nursing leadership, administration or management should ensure that the patient is the main focus and professional nursing is being practiced at the hospital.
Lucille A. & Kelly, Y. (2003). Kelly’s Dimensions of Professional Nursing New York: McGraw-Hill Professional.
Marquis, B. & Huston, C. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application United States: Lippincott Williams & Wilkins.
Roussel, L. & Swansburg, C. (2005). Management and Leadership for Nurse Administrators, Massachusetts: Jones & Bartlett Publishers.
Swansburg, C. (2002). Management and leadership for Nurse Managers Massachusetts: Jones & Bartlett Publishers.