Nursing theories are useful in solving issues related to the nursing profession. This essay aims to describe the Comfort Theory of Nursing and the use of the theory in addressing problems encountered in nursing education. I have applied this theory in solving problems of this nature throughout my practice as a nurse. I also have a lot of experience through witnessing lecturers use the same principle in helping their nursing students. I will use a case study from one of the experiences to explain the applicability of the theory.
Overview of Nursing Theory in Nursing Practice
The profession of nursing has developed significantly over time. Initially, nurses used to depend wholly on medical directions from physicians to provide necessary medical assistance. However, the profession has now grown to have independent modalities of practice, with its theories that define its practice, its nursing models, as well as distinct nursing interventions. Nurses and researchers in the field of nursing have developed several theories over time due to the need for the development of policies that will shape the field of nursing. The theories have changed and shaped the current nursing profession (Sitzman & Eichelberger, 2011).
A theory projects a systematic, purposive view of a given subject. It is specially designed to explain, describe, predict, or prescribe a given analogy. All theories are made of models, concepts, propositions, definitions, and developed based on assumptions. They are drafted in two main ways; deductive and inductive reasoning. The theories are developed for various purposes. The main reason for developing them is the description, explanation, and prediction of the field of practice known as nursing. In this perspective, the theories help establish the basis for nursing practice, provide more information required in the same area, as well as predict the direction towards which the nursing profession is headed. The theories also help nurses to make decisions on what is known and determine what needs to be known (Sitzman & Eichelberger, 2011).
According to Sitzman and Eichelberger (2011), there are three main types of nursing theories, which are classified according to the scope of practice the theories cover. They include the Grand Nursing theories, Mid-Range Nursing theories, and the Nursing Practice theories. The nursing theories in the category of the Grand Nursing theories provide and the insights that are useful in the nursing profession, but they do not provide specific information for a particular intervention. Such broad coverage always limits the applicability of the theories in explaining, directing, and predicting nursing practice in particular circumstances.
The scope of practice of Mid-range theories is narrower compared to the Grand Nursing theories. They are designed to bridge the gap between the Grand Theories and the Nursing Practice theories. This category of nursing theories is research-oriented; thus, it the theories enhance evidence-based practice. The Nursing Practice theories have the narrowest scope of the three categories of theories, providing an abstraction level that is highly specific to a particular form of nursing intervention. They mainly direct the framework for the specific intervention to be used. In other words, they help to predict the actual outcome of the applied intervention, as well as the impact of the applied practice (Sitzman & Eichelberger, 2011).
Case Scenario
This is a case where a young lecturer in one of the nursing schools in the United States was expected to take Nursing class through the topic of cultural competency in nursing. It was a class composed of various students, in terms of age, social status, race, sex, and levels of education. The class had fresh students pursuing their first degree, as well as those seeking second degrees or advanced studies in nursing. The class had a broad range of cultural diversity due to the high diversity of the American residents; comprised of African Americans, Latin Americans, as well as American Whites, and a large influx of students from third world countries who travel to the US to advance their studies.
Cultural competency has emerged as one of the core units in nursing education required to be undertaken by all nurses. Each of the student nurses is expected to pass highly to be allowed to graduate from the Nursing School. However, the subject has become a nightmare for many students due to the complexity and diversity of cultures present in the US and across the globe; understanding all these cultures to provide care that respects the values and customs of all communities is challenging. The need for culturally competent nursing is heightened by the fact that even the working environment is now characterized by cultural diversity, with nurses working with people with diverse backgrounds (Lucero, Lake, & Aiken, 2010).
During the classes, there was one nursing student from the African continent who had a serious problem handling this subject. She told us how people had discouraged her by explaining the difficulties in the unit. Her condition worsened when she landed in the school and realized the unit was compulsory, and one had to pass highly to graduate from the school. Furthermore, it appeared to be a nightmare when the tutor took almost an hour of the first lesson describing to us the importance of the unit and the need to pass sufficiently. The student was so anxious that getting the concept of the unit became almost impossible. She failed terribly in the first year and was forced to retake the unit for another year. The next year proved to be worse, as her stress increased to include the fear of her scholarship being terminated.
The problems of the student seemed to grow day by day. The real challenge that almost made her drop out of the nursing school was when we visited a clinic during our usual clinic visits. Her first stumbling block came up when the white nurses gave her a cold welcome at the hospital. No hospital nurse was willing to develop a personal relationship with her and mentor her during the visits. Her concerns were also addressed poorly whenever she raised them. She came face to face with racial discrimination. The worst part was when we visited the wards and a white patient publicly declined to be examined by a black student nurse because the patient deemed her to be unqualified. Being her second year and with no hope of improving, she got frustrated day by day and attending classes became a problem. The situation changed when she met a school counselor who was familiar with the comfort theory of nursing. She listened to the student and addressed her concerns in line with the principles outlined in the comfort theory.
Application of the Comfort Theory in Resolving the Issue
It is crucial that the principles of the comfort theory are fully understood to know how the counselor applied the theory in helping the student improve her performance. Initially, comfort was considered one of the primary goals of the nursing profession and medicine, in general. However, comfort has been viewed as having a minor importance due to challenges such as increased workload in nursing institutions. It is now a reserve for patients who cannot be addressed through any other intervention. Comfort is highly neglected even in designing working and learning environments. Comfort is lowly viewed, despite the fact that studies have shown that attainment of comfort is associated with positive activities that promote positive thinking, while strengthening and nurturing the patient (Krinsky, Murillo, & Johnson, 2014). According to the comfort theory, three forms of comfort exist, namely; relief, ease, and transcendence (Holland, Gray, & Pierce, 2011).
As explained Holland et al. (2011), a person experiences relief whenever the particular needs of the individual are met. On the other hand, ease is experienced whenever the person achieves the state of satisfaction. For instance, someone having lots of anxiety over a particular issue will be at ease if the cause of the anxiety is addressed adequately. Finally, a state of transcendence is experienced when the affected person is made to overcome the challenge that is pinning them down and rise above it successfully. Although these concepts have been applied solely in patients who experience physical discomfort, it has been shown that addressing the individual needs of nurses or students, like the above case, addressing their sources of anxiety, and encouraging them to overcome the forces that affect their performance results in improved performance (Krinsky et al., 2014).
Comfort, according to this theory, can be experienced in four contexts; psychospiritual, physical, environmental, and sociocultural. Psycho-spiritual comfort mainly entails the realization of self, such as personal identity, self-esteem, sexuality, relationship with higher beings, and meaning of life to oneself. The physical context entails addressing the needs of one’s body, while the environmental context refers to the external factors surrounding the person. Lastly, the sociocultural context involves family, interpersonal, and societal relationships (Holland et al., 2011).
A thorough understanding of this theory was the basis for the effective management of the student’s problems in the study subject. The primary strategy applied by the counselor was skillful listening to the student to understand why her performance in the subject was so dismal that it threatened the continuation of her studies. This gave the student an opportunity to feel cared for, which made her express her needs to the counselor; none of which had been addressed by the teacher or the nurses in the hospitals she visited. The fact that she received a discouragement from home meant that she needed somebody to deal with this need. Consequently, the systematic explanation from the counselor brought a sense of relief to the student.
However, the bigger burden was the elevated anxiety that grew when she was supposed to retake the unit and the fear of losing the scholarship. To help out, the counselor, having understood the need for a sense of ease as explained in the comfort theory, reassured the student that a retake does not mean failure. Instead, the retake was an opportunity for her to better her grades. The counselor also managed to intervene and ensured that her scholarship was not canceled. As a result, the anxiety disappeared and the student felt satisfied and contented with the situation.
Finally, the counselor addressed the feeling of racial discrimination to reinstate comfort fully in the student. To address the concern, the counselor used the situation as an appropriate opportunity to emphasize the need for cultural competence and the training of culturally competent nurses. In explaining the behavior of the nurses who discriminated the student, the counselor insisted that the use of that subject of study was to ensure that such incompetent nurses are not released to practice. Moreover, such behaviors should encourage her to work harder to eradicate the vice in the society.
The counselor equipped the student with tactics of handling such challenges, where the main tactic was to condemn the act boldly and inform the offending nurse and the patient the need for respecting every person, irrespective of gender or race. At last, the student was able to overcome the challenges and developed a sense of transcendence. The student emerged the best in the unit by the end of the academic year. She also received university recognition, which raised her self-esteem further and shaped her future; thanks to the Kolcaba’s Comfort theory of nursing.
Conclusion
Nursing theories are necessary tools in the nursing profession, as they help in shaping the type of nursing services and interventions provided, as well as predicting the future direction in the field of nursing. Among the different theories formulated, the Kolcaba’s Comfort theory of nursing is one of the best in ensuring full patient recovery, including nurturing and strengthening the affected person. Though applied mainly in physically discomforted patients, the above student case study shows that proper application of this theory in the field of nursing education can improve the learning outcome of different nursing students, as well as medical students. It is mandatory that the students experience relief, ease, and transcendence in physical, sociocultural, environmental, and psycho-spiritual comfort. It ensures the students are nurtured sufficiently and strengthened in their line of study.
References
Holland, B. E., Gray, J., & Pierce, T. G. (2011). The client experience model: Synthesis and application to African Americans with multiple sclerosis. Journal of Theory Construction & Testing, 15(2), 36-40.
Krinsky, R., Murillo, I., & Johnson, J. (2014). A practical application of Katharine Kolcaba’s comfort theory to cardiac patients. Applied Nursing Research, 27(2), 147-50.
Lucero, R. J., Lake, E. T., & Aiken, L. H. (2010). Nursing care quality and adverse events in US hospitals. Journal of Clinical Nursing, 19(15-16), 2185–2195.
Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists: A creative beginning. (2nd Ed.). Sudbury, MA: Jones and Bartlett.