Applying Theory to a Practice Problem of Nursing - Essay Example

?Introduction and Problem of Practice Nursing is considered by the American Nurses Association (ANA) as the “protection, promotion, and optimization of health and abilities; the prevention of illness and injury; the alleviation of suffering through the diagnosis and treatment of human responses; and the advocacy in health care for individuals, families, communities, and populations” (2006, n.p.). This statement includes the development of nursing into something more than it being a domestic activity for women or punishment for criminals. Indeed, nursing is a unique, dynamic, and continuously changing vocation and profession for which theory can be used as a guide for practice (McCarthy & Aquino-Russell, 2009). Nursing has developed differently through the years, with the efforts of the theorists of the different nursing eras; they have helped turn it into a respectable and reputable profession. It cannot be questioned for it has been backed up the different nursing theories which helped carve what nursing practice is today. Providing care is one of the main responsibilities that a nurse has to give to a patient. In fact, nursing has almost come to be defined as synonymous to caring, because nurses include care into their daily interventions. Caring for people in the field of nursing involves the simplest of things. Indeed, listening attentively (and hearing the message between the words) to what patients say about themselves, about their environment, about their current situation, about matters concerning the mind, heart, and soul, and different other things are part of caring that is inherent in the nursing profession (Bernick, 2004). Caring in nursing also manifests itself in the simple aspects of therapeutic communication, in a touch that can transcend the barriers of age and race, and even in the nurse’s simple presence at the bedside, giving the patient the feeling of peace and security. This process of caring has been maintained for all these years by both contemporary and pioneer nurses. But with the appearance of technologies that can diagnose a patient without having to ask them any questions aother than their personal information and lessen the time of poking and proding, the idea of spending a quiet time with the patient has lost some touch to the nurses nowadays. The idea of saving time and alloting them to other chores rather than giving the patients the care that they needed runs within the nurse’s mind. Time spent with the patient decreases which means the care given to the patient also diminishes. The application of nursing theories actualy loses its touch on the nurse, without the nurse even noticing. Caring is one of the essential component of nursing, one they tend to overlook and disregard. To be unable to perform this task means that the nurse is not performing the responsibility placed upon their shoulders. The only time that nurses realize that providing more than the average activities and giving the caring needed not only improves the healing ability of the patient is through the presentation of evidences of improvement when they are given; one of which is presented by situations where the cases are treated with the application of the different theories developed through the years.This paper aims to determine the importance of application of theories on the everyday job of a nurse. How with the guidance of the theories developed years ago can improve the ability of a nurse to provide proper care for their patients. The application of nursing theories in practice has improved the nurse’s ability to provide for all the needs of the patient. Whether it be his physical, emotional, psychological or spiritual need; a nurse can help the patient with the proper application of a specific theory needed by the situation. The theories used in practice were identified and classified according to three general divisions: The grand theories, mid-range theories and the borrowed theories. Application of Grand theory to the Problem Nursing theory is an important aspect of nursing that nurses will become familiar with during their education, training and experience in the industry. Nursing theories are a body of knowledge that provides a framework of how to practice nursing. As explained, it is used to guide nursing research and actions, to predict practice outcomes, and to predict client response. There are a number of universal nursing theories developed by some of the best known nurses including Florence Nightingale, Helen Erickson, Dorothea Orem, and Callista Roy. McEwen and Wills classified ways by which the theories can be explained: human needs, interactive processes, and unitary processes. The early theorists' focus on human needs was motivated in great part to differentiate clearly nursing practice from the medical model with its focus on diagnosis and treatment of disease. It helped to clarify the autonomous work of nurses as separate from the dependent functions in the carrying out of medical regimens. With the emphasis on experimentation in artificial, controlled situations, there was justifiable concern expressed that the results could not be applied to naturalistic settings. All of the mentioned theories revolve around satisfying the need itself. Nightingale’s environmental theory discussed ways to be able to help the patient satisfy their physical need by improving their environment which would invariantly improve their ability to heal. The holistic view of nursing is a common denominator in the interactive process theorists. Additionally, they all are adaptations of systems theory where there is constant interaction between humans and their environment (McEwen & Wills). The biggest difference between the human needs theorists and the interactive theorists is the belief in the participation of clients in their own care. All of the theorists within the human needs and interactive processes have been classified by Parse (1995) into what she termed as the ‘totality paradigm’. Essentially, theorists in this paradigm define human beings as bio-psychosocial or spiritual beings who adapt to their environment. Though they are in constant interaction with the environment, they remain separate from the environment. Interactive process theorists include Levine, Artinian, King, Roy and Watson (McEwen & Wills, 2007). The final classification of theories has been termed the simultaneity paradigm. The idea of unitary needs is dissimilar from the other two classifications of grand nursing theories. Newman, Parse, and Rogers developed theories to express the worldview that defines "humans as unitary beings, which are energy systems in simultaneous, continuous, mutual process with, and embedded in, the universal energy system" (McEwen & Wills, 2007, p. 122). These unitary beings, like a universe, are evolving, developing, and in a continuous state of flux with their surroundings. As with interactive theories, quantitative and qualitative research methodologies are considered appropriate to test hypotheses derived from the theories and advance the science (Parker, 2006). It allows the nurse to help the patient deal with their own situation in a mor systematic way. There is no consensus as to the classification of nursing grand theories. The grand theories described have been classified as theoretical frameworks, philosophies, as well as theories by various authors. McEwen and Wills' classification is based primarily on the way in which human beings are defined and nursing care determined. Theories in the human needs and interactive process classifications have an underlying similarity in terms of the definition of human being though they differ in the expectation of participation in the nurse-client relationship. In the human needs theories, clients play a more passive role. There is a major distinction between unitary process theories and the former regarding how human beings are defined. Each theory offers a unique lens through which nursing phenomena are examined and interpreted Application of Middle-Range Theory to Problem According to McEwen and Wills (2007, p.225), middle-range theories are "more specific, have fewer concepts, and encompass a more limited aspect of the real world." Middle-range theories may be derived from grand theories from nursing or other disciplines. They may also be constructed de novo—that is, their origins may be induced from real world experience. However, Meleis (2007) points out that highly abstract theories require many more steps to connect the theoretical concepts, and their real-world referents, or what is observed and expected in real life.  Patricia Benner's model of skill acquisition is considered to be a high middle-range theory. The said theorist introduced the idea that nurses considered as experts in their fields actually develop their understanding of patient conditions, as well as their skills, through a number of experiences that they go through over time. Benner also theorized that the development and cultivation of knowledge in several applied philosophies is made up of the extended use of scientific know how (or practical knowledge) through different channels such as nursing research and development, as well as the understanding and characterization of the practical side of the clinical experience. Leininger's Cultural Care Diversity and Universality Theory is another example. Though the focus of these two theories is narrower (skill acquisition and culture care respectively) than grand theories, both theories have been widely applied to nursing education, research, and practice. On the other hand, situation-specific theories, such as urine control theory and theory of chronic sorrow have a narrower focus, but are also more clearly connected to nursing interventions and expected outcomes.  Middle-range theory is aimed at describing, explaining, predicting, and prescribing phenomena, but at a narrower and more specific level than grand theory. It is more easily applied to practice situations. Middle-range theory may be derived from grand nursing theories or theories from other disciplines. It may also be developed by observations in real-life situations. Unlike grand theories, a number of middle-range theories may be applied simultaneously to inform specific problems or situations, thereby leading to a more accurate and comprehensive assessment of a situation and plan for intervention. Application of Borrowed Theory to Problem The term borrowed theory refers to the application of theories developed by other disciplines to nursing phenomena. The metaparadigm concepts of human being, health, environment, and nursing require a breadth of knowledge unlike any other profession. This is due to the definition of person as a holistic being affecting and affected by the environment. What constrains the type of knowledge required is the focus on health and the level of practice, basic or advanced. Knowledge from other disciplines is applied directly or indirectly; that is, it is used to develop theory that is unique to nursing practice. All of the borrowed theories summarized in the McEwen and Wills (2007) text are middle-range theories.  Borrowed theory is utilized for basic and advanced education, research, and theory development in nursing. It is helpful to understand the differences as to how borrowed theory fits at each level of professional nursing education: baccalaureate, master's, and doctoral programs, and therefore, affects the practice of nurses based on educational level. Borrowed theory is theory developed in other disciplines. Due to the breadth of the major concepts that underlie nursing practice, knowledge from other disciplines is critical to the practice of nursing. The way in which borrowed theories are used varies according to the educational level of the nurse. Borrowed theories are used directly to inform nursing practice and indirectly to develop theories unique for nursing practice.  Conclusion With the passing of the years, the more we are able to learn and understand of what it is that can be done to improve our way of life. Through the years comes the learned theorists and the advancements of their ability to know and develop what it is that is known. These advancements that are created helps us understand ourselves better and what it is that can help us in our everyday lives. The development of the different nursing theories whether it be a grand theory, mid-range, or a borrowed ones has made an impact in our ability to practice nursing today it helps us maintain the level of caring that is provided to the patient, in the different areas of the human need, interactive process and unitary processes. Nursing theories improved our ability to care and our chance to improve our ways of practice which invariable changed our way of life. References American Nurses Association (ANA). (2006). Definition of Nursing. Retrieved from Nurses Neighbourhood: http://www.nurses-neighborhood.com/definition-of-nursing.html American Association of Colleges of Nursing. (2001). Indicators of quality in research-focused doctoral programs in nursing. Position Paper.  American Association of Colleges of Nursing. (2008). 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