Nursing is no doubt the heart of every hospital. Through my own observations, I have noted that the nursing profession will most likely face increased challenges from clients’ demand for quality healthcare, increased client acuity, and complex disease processes. According to Andrist et al. (2006), Nursing science is “an identifiable, discrete body of knowledge, comprising paradigms, frameworks, and theories” (p. 165). The nursing discipline encompasses the daily activities that nurses have to undertake when providing care. Based on nursing science as the source of scholarly knowledge, nurse theorists across the world have developed their own formulations explaining the nursing profession over the years.
The theory posits that the nurse-patient relationship involves perceptions, judgments, and reactions, which are determined by how the two parties interact. Chitty and Black (2011) explain that nursing theory helps a nurse responds to a patient’s situation by asking, “what goals can we set together to restore [the patient] to health?” (p. 311). This paper will address two renowned nursing theorists, Neuman and King, as well as my own philosophy of nursing which is based on King’s nursing theory.
Imogene King’s theory of goal attainment indicates that, “nursing is a process that is interactional in nature” (330). According to the theorist, the interactions that occur between the nurse and the client lead lead transactions, which results in the attainment of goals. Like other nursing theories, King considers the interactions between the person, his or her environment, health, and nursing are elucidated in the four-meta paradigm concept. Simply defined, a person is made up of the physical body, the mind, and the spirit (Munhall, 2007). The environment on the other hand is the tangible area where the person lives in the physical or intangible area he or she encounters mentally.
Marriner-Tomey and Alligood (2006) define health as a “state and process of being and becoming an integrated and whole human being” (p. 201), while nursing is defined as the provision of care and compassion in order to support healing. As a profession, nursing helps people restore their autonomy. More this, nurses assist in restoring people’s full potential, which in turn leads to them attaining their goals (Munhall, 2007).
The Neuman systems model elucidated by Neuman and Fawcett (2011) regards the person as a combination of five variables, which include the physiological, mental, socio-sociocultural and developmental aspects of the person. The environment on the other hand is defined as the internal or external surroundings facing a client. Health in the Neuman model is viewed as the “optimal system stability” (Neuman and Fawcett, 2011, p.24), while nursing is perceived as the provision of prevention measures thus enhancing the client’s reaction to stressors.
Overall, the Neuman model proposes guidelines that nurses should use in order to provide optimal healthcare to patients based on holistic healthcare systems. According to Neuman and Fawcett (2011), every person has an open system that reciprocates how he or she interacts with the environment.
More so, the model argues that a person has defense lines as well as resistance structures that protect his or her psyche. However, the defense lines and resistance structures may be rendered ineffective by stressors in the environment thus leading to poor health. As such, the model proposes that the nurse’s role in such a scenario is to make the patient aware of the variables that affect his or her response to stressors. Specifically, the nurse should adopt actions that would assist patients, their families, and even groups to enhance their levels of wellness.
The King’ theory of goal attainment shares many similarities with the Neuman Systems model in viewing a patient with a dynamic combination of physical, emotional, sociocultural, spiritual, and developmental factors. Both theorists have some explicit and implicit assumptions, which may not always be accurate in all nurse-patient relationships. For example, not all patients are spiritual, and in some cases, not all patients are cognitively capable of participating in their healthcare plans. Although Neuman’s model is convincing stating that stabilizing stressors in a client ultimately lead to optimal health, King’s theory stresses the importance of interaction, communication, transactions, and attainment of goals as means through which the nurse can understand the client’s health needs thus placing him or her (the nurse) to provide comprehensive nursing solutions.
I base my nursing philosophy on a theory that will give me the greatest chance to use my reasoning abilities, as well as skills gained, to provide quality healthcare to my clients. The theory will not only help me in attaining clinical sound judgments but will also give me leverage to defend my actions should the need to do so ever arise. I believe that establishing a good nurse-client relationship will enable faster and more effective attainment of goals.
When goals are attained, it is axiomatic that my patients will be satisfied. I believe that the attainment of goals will encourage me to continue giving my patients effective nursing care. I like King’s theory of goal attainment. Based on King’s theory of goal attainment, I intend to ensure that the interactions that I establish with my clients will be based on mutual trust so that the perceptions developed between us are accurate.
King (1981, cited by Meleis, 2007) argues that transactions occur where perceptual accuracy in the nurse-client relationship exists. This is well reflected in my belief that my relations and interactions with the patients will determine how successful I will work with them in ensuring that they gain optimum health. The argument by King further reflects well on my belief that the most important focus of nursing should be on the patients’ well-being with their individual qualities, dignity, uniqueness, and self-worth. Observing all relevant ethics is very important for nursing as part of the healthcare team.
I realize that for my philosophy to become a reality, I will need to equip myself with appropriate communication skills, which will not only enable me explain all the necessary health information to the patients and their family, but will also enable me to set mutual goals with the patients regarding their healthcare. As a professional nurse, I want to collaborate with patients as well as other healthcare professionals to provide health for my patients. I belief that by doing this, I will not only be helping individual patients, but also the communities where the patients come from. I realize that in order to live out of this philosophy, I must remember that my patients need to be participants in the healthcare team. More so, their families need to be conjoined in the healthcare team, for as long as the patients feel comfortable.
As has been aptly stated by Meleis (2007), “philosophy focuses on providing the framework and a worldview for asking both ontological and epistemological questions about central values, assumptions, concepts, propositions and actions of the discipline” (p. 36). This means that philosophies can be scrutinized and challenged in order to evaluate their practicality and applicability in the real world. Nursing is a dynamic career that calls for constant learning. My philosophy is to establish good and lasting relationships with my professional colleagues. This will enable the team to learn from each other, and even help each other when needed.
I intend to keep evaluating this philosophy, specifically so that I can improve on it as time goes by. I am convinced that goal setting is an integral prerequisite in obtaining any desirable outcome in different careers. In my nursing career therefore, I will strive to remember to involve patients in goal setting always, so that together, we can attain the health outcomes most desired by the patient.
References
Andrist, L., Nicholas, P., & Wolf, K. (2006). A History of Nursing Ideas. Sudbury, MA: Jones & Bartlett Learning.
Chitty, K. K. & Black, B.P. (2011). Professional nursing: concepts & Challenges (6th ed.). Philadelphia: Saunders Publishing.
Marriner-Tomey, A. & Alligood, M.R. (2006). Nursing theorists and their work. St. Louis, Missouri: Elsevier Health Sciences.
Meleis, A. I. (2007). Theoretical nursing: development and progress. Baltimore, MD: Lippincott Williams & Wilkins.
Munhall, P. L. (2007). Nursing research: a qualitative perspective. Sudbury, MA: Jones & Bartlett Learning.
Neuman, B., & Fawcett, J. (2011). The Neuman systems model (5th ed.). Upper Saddle River, NJ: Pearson.