Nursing Development and Progress - Essay Example

The greater concerns for consumer confidence, quality graduate education, and clear outcomes mandate that a more coherent and consistent set of standards are articulated.
GRAND THEORIES AND THEIR DEVELOPMENT:
Grand Theory emphasizes a global viewpoint with a broad perspective of nursing practice, and a distinct nursing perspective of nursing phenomenon. Grand Theories as to the broadest in scope, less abstract than conceptual models but composed of general concepts still relatively abstract, and the relationships cannot be tested empirically. Every nurse must possess strong critical thinking and decision-making skills. The ability to critically and accurately assess, plan, intervene, and evaluate the health and illness experiences of clients (individuals, families, and communities) should be a primary goal of nursing. Skills of this level are mandatory in order to improve health care delivery and outcomes of patient care. The ability to communicate effectively, both orally and in writing, is also essential to transmit the outcomes of these processes.

THE MIDDLE RANGE THEORIES:
Middle Range Theory is defined as less abstract than grand theories, more accessible to researchers and technicians. Mid-range theories are particularly important for practice disciplines. Mid-range theories balance the specificity with the conceptual economy normally seen in grand theories. As a result, mid-range theories provide nurses with the “best of both worlds”---easy applicability in practice and abstract enough to be scientifically interesting. Mid-range theories focus on concepts of interest to nurses and include pain, empathy, grief, self-esteem, hope, comfort, dignity, and quality of life.

ORGANISATION OF THE HEALTH CARE SYSTEM
These theories are developed in an effort to understand the ways in which health care is organized and delivered in order for the nurses to function effectively and assume a leadership role in the health care system. An understanding of the totality of health care systems, including managed care and integrated systems of delivery, must be obtained. As an increasing emphasis is placed on the delivery of care within integrated care systems or on the continuum of health care, all nurses, even those with a more acute or specialized focus, must have a clear understanding of community and the organization of community-based systems of care; therefore, concepts of community, community assessment, and community health care systems are essential components of the nursing life. Likewise, those nurses practicing in community-based systems of care must have an understanding of the acute care delivery system, its organization, and its functioning. Ethical decision-making should be the focus of content as evidenced in research, evaluation, clinical practice, and management. This specific focus of nursing is emphasized in mid-range theories.

Hence there is strong emphasis from the researchers for transition to mid-range theories for better health care. Nursing is a human science that is based on the experiences and responses to health and illness which lends itself far better to the development and use of less abstract, situation-specific mid-range theories.
The advanced mid-range practice nurse should possess a well-grounded understanding of normal physiologic and pathologic mechanisms of disease that serves as one primary component of the foundation for clinical assessment, decision making, and management. They should be able to relate this knowledge “to interpreting changes in normal function that result in symptoms indicative of illness and in assessing an individual’s response to pharmacologic management of illnesses.

INFERENCE
Implementation of a differentiated mid-range practice clinical learning model does not require major curricular change. Instead, the process for teaching the content and the environment in which it is taught are the elements that must change. Implementation must include collaboration between practicing administrators.
The advancement of medical science and technology has changed the landscape of health and illness. Not only are people living much longer, but they are also living with chronic illnesses that would have been fatal twenty years ago. This is true in adults and children, resulting in the need for providers who can manage the ongoing health needs of persons of all ages. The necessity for practitioners who focus on the promotion of health and wellness and the prevention of disease has emerged as not only a good and wholesome thing to do in our society but also as a means of addressing escalating medical costs.