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Theorist

Patricia Benner

The person is a self-interpreting being, that is the person does not come into the world predefined but gets defined in the course of living a life

From Novice

To Expert (Patricia Benner)

Benner's Theory of Novice to Expert

categorizes nursing into 5 levels of capabilities:novice, advanced beginner, competent, proficient,and expert.

Novice stage

beginners learn through instruction.
Nurses in this stage have no experience with situation,they depend on rules to guide their actions. No rule can tell a nurse in this stage which tasks are most relevant in real life situations
A nurse in this stage will ask to be shown or told what to do.
What they know is generalized to simplify tasks.

Advanced Beginner Stage

I year experience,demonstrate marginally acceptable performance because the nurse has had prior experience in actual situations.Efficient and skillful in parts of the practice area, requiring occasional supportive cues.Knowledge is developing.
They now have some experience and they use this experience to assist them in their care.

Competence Stage

They usually have 2-3 years of experience in their area of care
They understand and think about future goals in the long term.
They are more aware of their own actions. They see faults in their own care sometimes and try to improve their methods for better efficiency.
Care is completed within a suitable time frame without supporting cues

Proficiency Stage

Situations are perceived as a whole rather than as unconnected and as different aspects, understand a situation as a whole because they perceive its meaning in terms of long-term goals. Learns from experience what typical events to expect in a given situation and how plans need to be modified in response to these events.
Can now recognize when the expected normal picture does not materialize.
This holistic understanding improves the decision making

Expertise Stage

not only the understanding of the task but also the decision of what to do next is intuitive and fluid. Given their deep understanding of the situation, they act naturally without explicitly making decisions and solving problems .The nurse has an instinctive grasp of each situation and zeroes in on the accurate region of the problem without wasting time on miscellaneous information.
In this stage nurses have more experience than other nurses in different stages. They have experienced situations that other nurses have not had to deal with yet.
His/her performance becomes fluid and flexible and highly proficient.
They no longer rely on rules, steps, guidelines, or instructions to provide care

What supports development and transition among the different stages in Benner`s Theory?

Use reflection, questioning, storytelling, feedback, experience and success to foster development.�Focus on concrete critical thinking development questions/discussion

Benners Theory

This theory changed the nursing professions idea of what it means to be an expert, placing this designation, not on the nurse that is most highly paid or with the most prestigious position, but on the nurse who provides the most competent nursing care. The underlying assumption of this theory is that the novice does not have the adequate skills needed in the nursing profession because he or she does not have the experience like that of an expert. Through reflection and experience the novice can transition and evolve into a expert.

Cheryl Beck(Sarah)

Postpartum Depression: "Teetering on the edge

Stages process of PPD

Encountering Terror
Dying of self
Struggling to survive
Regaining control

What is postpartum depression? (PPD)

moderate to severe depression in a woman after she has given birth; it may occur soon after delivery or up to a year later
occurs within the first 3 months but can occur up to a year after birth.

Topics prevalent throughout Beck's theory include

Maternity Blues Also known as "baby blues", maternity blues is a relatively transient and self-limited period of melancholy and mood swings during the early postpartum period. Maternity blues affects up to 75% of all women in all cultures,Postpartum Psychosis, Loss of Control, Life Stress, Loss of Self, and Socioeconomic Status are some of the major concepts.

Nightingale

The goal of nursing is "to put the patient in the best condition for nature to act upon him"

Florence Nightingale

had to deal with cholera Crimean War,outbreaks and unsanitary conditions contributing to the rapid spread of the disease.
She made it her mission to improve hygiene practices, and was successful in significantly lowering the death rate at the hospital in the process.

Major Concepts of Nightingale's

Nursing: The patient is to be put in the best condition for nature to act upon. Nightingale stated that nursing "ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet - all at the least expense of vital power to the patient."
Human Beings: Human beings are identified as how they are in their environment. Their environment affects them. How their environment is identifies them. Environment: The physical environment is stressed by Nightingale in her writing. Nightingale's writings reflect a community health model in which all that surrounds human beings is considered in relation to their state of health.
Health: She believed that nursing should provide care to the healthy as well as the ill and discussed health promotion as an activity in which nurses should engage.

5 Essential Components of Environmental Health

PURE AIR : Focus on the architectural aspect of the hospital
"Keep the air he breathes as pure as the external air, without chilling him"
PURE WATER : Dirty water. "well water of a very impure kind is used for domestic purposes. When epidemic disease shows itself, persons using such water are almost sure to suffer."
EFFICIENT DRAINAGE : Inappropriate sewage disposal. "All the while the sewer maybe nothing but a laboratory from which epidemic disease and ill health is being installed into the house."
CLEANLINESS :She noted that a dirty environment (such as floors, carpets, walls, and bed linens) was a source of infection through the organic matter if contained.
LIGHT: Direct sunlight as a particular need of patients. The beneficial effects of sunlight, nurses were instructed to move and position patients to expose them to sunlight.

Dorothea Orem

Self-Care Deficit Theory of Nursing

What is Self-Care?

Compromises those activities performed independently by an individual to promote and maintain personal well-being throughout life

Orem's general theory of nursing in three related parts

Theory of self care
Theory of self care deficit
Theory of nursing system

Wholly Compensatory System

Nurse's actions:
Accomplishes patients therapeutic self-care
Compensates for patient's inability to engage in self-care
Supports and protects patient

Partly Compensatory

Nurse's actions:
Performs some self-care measures for patient
Compensates for self-care limitations of patient
Assists patient as required
Patient's actions:
Regulates self care agency
Perform some self-care measures
Accepts care and assistance from nurse

Major Assumptions Self Care Model

People should be self-reliant and responsible for their own care and others in their family needing care,People are distinct individuals,Nursing is a form of action - interaction between two or more persons,Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health,A person's knowledge of potential health problems is necessary for promoting self-care behaviors,Self care and dependent care are behaviors learned within a socio-cultural context

Universal self care requisites

life processes and the maintenance of the integrity of human structure and functioning,Maintenance of sufficient intake of air ,water, food

Developmental self care requisites

Associated with developmental processes/ derived from a condition.... Or associated with an event
E.g. adjusting to a new job
adjusting to body changes

Health deviation self care

Required in conditions of illness, injury, or disease .these includes
Seeking and securing appropriate medical assistance
Being aware of and attending to the effects and results of pathologic conditions

Self care requisites

Action directed towards provision of self care.
Universal self care requisites
Developmental self care requisites
Health deviation self care requisites

HILDEGARD PEPLAU

first published nursing theorist since Florence Nightingale and created the middle-range nursing theory of Interpersonal Relationships

Theory of Interpersonal Relationships

emphasizes on nurse-client relationship.The main purpose of this theory is to achieve a common goal between two or more individuals
Framework for psychodynamic nursing

Stage 1: Orientation(Pepula)

When the client and nurse first meet Occurs shortly after being administered to a medical settingThis allows the client to get accustomed to a new environment and new people
Client seeks assistance ,expresses needs ,asks questions, shares preconceptions and expectations of past experiences
Nurse responds, explains roles to client, helps to identify problems and to use available resources and services

Stage 2: Identification

The client begins to identify problems to be worked on within relationship
The patient identifies with those who can help him/ her.
The nurse permits exploration of feelings to aid the patient in undergoing illness as an experience that reorients feelings and strengthens positive forces in the personality and provides needed satisfaction.
The goal of the nurse: help the patient to recognize his/her own interdependent/participation role and promote responsibility for self

Stage 3: Exploitation / Working

Client's trust of nurse reached full potential ,Client making full use of nursing services
Solving immediate problems
Identifying and orienting self to set goals. The patient attempts to derive full value from what he/ she are offered through the relationship.The nurse can project new goals to be achieved through personal effort and power shifts from the nurse to the patient as the patient delays gratification to achieve the newly formed goals

Stage 4: Resolution / Termination

Final phase of nurse-patient relationship Sense of security is found as patient has less reliance and identification upon nurse helper Client has increased self-reliance to deal with his/her problem.The patient gradually puts aside old goals and adopts new goals. This is a process in which the patient frees himself from identification with the nurse.

Peplau's Seven Nursing Roles

Stranger - receives the client in the same way one meets a stranger in other life situations provides an accepting climate that builds trust.
Teacher-who imparts knowledge in reference to a need or interest
A Person of Resource : one who provides a specific needed information that aids in the understanding of a problem or new situation
Counselors : helps to understand and integrate the meaning of current life circumstances ,provides guidance and encouragement to make changes
Surrogate: helps to clarify domains of dependence interdependence and independence and acts on clients behalf as an advocate.
Leader : helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way
Technical Expert: providing physical care for the patient and operates equipment

Major Concepts of Theory of interpersonal relationships

Peplau viewed nursing as a therapeutic because nursing is a healing art
Viewed nursing as an educative instrument designed to help individuals and communities use their capacities in living more productively;
Helping patients make positive changes; illness is an opportunity for experiential learning, personal growth, improved coping strategies and psychiatric nurses play a role in facilitating this growth.
The theory explains the purpose of nursing is to help others identify their felt difficulties.

Phil Barker Tidal model

a mental health recovery model that focus on helping the individuel make their own discovery
It takes mental problems from a medical setting into a nursing setting and uses the metaphor of water to describe the patients' state of health.
"It emphasizes helping people reclaim the personal story of mental distress, by recovering their voice. By using their own language, metaphors, and personal stories, people begin to express something of meaning of their lives. This is the first step towards helping recover control over their lives."

The Ten Tidal Commitments: Essential Values of the Tidal Model

Value the voice
Respect the language
Develop genuine curiosity
Become the apprentice
Use the available toolkit
Craft the step beyond
Give the gift of time
Reveal personal wisdom
Know that change is constant
Be transparent

Three Domains: A Model of the Person Phil Barker

Self - The private place where the person lives
World - The focus of the efforts to understand the person and the person's problem of living
Others - Place where the person acts out everyday life with other people- family, friends, neighbors, work colleagues, professionals, etc.

Ramona T. Mercer

theory of maternal role attainment in the 1960's

Microsystem(Mercer)

immediate environment in which maternal role attainment occurs. It is the most influential on maternal role attainment.

Mesosystem(Mercer)

Encompasses, influences, and interacts with the people in the Microsystem.

Macrosystem(Mercer)

refers to the general prototypes existing in a particular culture or the transmitted cultural consistencies.

1.)Anticipatory Stage in Maternal Role Attainment

begins during pregnancy and includes the initial social/psychological adjustments to pregnancy. Mother learns the expectations of the role.

2.) Formal Stage in Maternal Role Attainment

begins with the birth of the infant and includes learning and taking from the mother. Role behaviors are guided by consensual expectations of others in the mother's social system.

3.) Informal Stage in Maternal Role Attainment

begins as the mother develops unique ways of dealing with the role not conveyed by the social system.

4.) Personal Stage in Maternal Role Attainment

the mother experiences a sense of harmony, confidence, and competence in the way she performs the role, thus the maternal role is achieved.

Nola Pender

Health Promotion Model

According to the World Health Organization (WHO) Health promotion

is the process of
enabling people to increase control over and/or improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions

Major Concepts of Penders Model

1. Personal Factor
Categorized as biological, psychological, and sociocultural. These factors are predictive of a given behavior and are shaped by the nature of the target behavior being considered.
2. Perceived Benefits of Action
Perceived benefits of action are anticipated positive outcomes that will result from health benefits.
3.Activity- Related Affect
An activity- related affect describes subjective positive and negative feelings that occur before, during, and following behavior based on the stimulations properties of the behavior itself. Activity- related affect influences perceived self efficacy. In turn, increased feelings of efficacy can generate further positive affect. 4. Interpersonal Influences
These influences are cognitions concerning behavior s,beliefs,or attitudes of others. Primary sources of interpersonal influences are families, peers, and health care provider.
5. Situational Influences
Personal perceptions and cognitions on any given situation that can facilitate or impede behavior. They include perceptions of available options, demands for characteristics and aesthetic features. Situational influences may have a direct or in direct influences on health behavior.
6.Health Promotion
A health- promoting behavior is an end point or action outcome that is directed toward attaining positive health outcomes such as optimal well being, personal fulfillment, and productive living. Example s of health-promoting behavior are eating a healthy diet , exercising regularly, managing stress, gaining adequate rest and spiritual growth, and building positive relationships.

Swanson

Theory of Caring with a focus on miscarriages.

The Caring Model consists of five basic processes:

Knowing, Being with, doing for, enabling, and maintaining belief.

Kolcaba

Described comfort as existing in 3 forms: relief, ease, and transcendence. Also, Kolcaba described 4 contexts in which patient comfort can occur: physical, psychospiritual, environmental, and sociocultural.

References: https://healtheappointments.com/hershey-medical-center-essays/