Nurses' Partiality in the Manner They Treat Outpatients and Patients Who Are Admitted - Essay Example

? THEORETICAL GAP Nursing is a scientific discipline which utilizes the fundamentals of a theoretical framework in actualizing the professional responsibility of caring for the patients and linking patients with the environment around them as well as their fellow members of family and community (“Jones & Bartlett Learning”, nd). Just as is the case with any other scientific discipline, nursing upholds theoretical guidance from research studies to adopt nursing practices that are coherent with research findings and in the process realizes effectiveness and efficiency. There are however variations in theoretical formulations which are applied differently in practice. For instance, in this paper, we focus on the postulation that there exists a gap in practice theories where nurses show partiality in the manner they treat outpatients as compared to the manner of treating the patients who are admitted. Introduction The study in the theoretical structures that govern nursing practices reveal that nurses care for patients holistically (patients as well as their family members) more when they are admitted than when they are on the outpatient setting. Therefore, there is the need to breech the gap in the holistic care of outpatients in order to restore effectiveness and efficiencies in the nursing profession. All patients, regardless of being admitted or treated under outpatient settings rely on the nursing services as advanced by the nursing practitioners. The nursing profession on the other hand has been shown to rely on the theoretical frameworks in order to actualize the effective delivery of caring services to patients. Therefore, nursing theories complement the nursing practice in servicing patients. From the previous literature review, a gap is established between the nursing practice and theory and this forms the basis of this paper. Synthesize the knowledge gained in the area you studied during this course The study of the interrelationship between theoretical and practical aspects in the nursing profession has revealed a lot of incites which form the basis of this paper. Among other features noted, nursing is purely a scientific discipline whose success wholly depends on the proper adoption and application of scientific theories (Swanson, 1991; Risjord, nd ). Scientific theories are frameworks that have been in application over decades in explaining scientific phenomena and are testable and universally accepted. Nursing as a profession is therefore based on scientific research and hence runs under the guidance of such defined theoretical frameworks. However, research studies have been used to reveal that there exists some gap between the existing theories and the actual practice by the nursing professionals. In often times, the inpatients enjoy higher attention and improved care by the nurses as compared to the patients receiving care in the outpatient department. This gap shows that there is inadequacy in the existing theories to guide the nursing professionals in attending to needs of patients; both at the customized care set up within hospitals inpatient programs as well as at the outpatient departments. We therefore note that there is great need to breach the gap existing between practice and the nursing theories. Our particular attention will be on breaching this gap by proposing and evaluating the provisions of a theory that addresses a patient as an entity, the family and community from which the patient hails as well as the nurse as most critical component in the recovery process. Though there lacks particular theories to address the disparity between nursing practices towards inpatients as and outpatients, there are some theoretical formulations which holistically empowers nurses to play a critical role in recovery process of patients; both admitted and the outpatients. Propose a component of a theoretical framework that addresses a gap following the theory development procedure you learned It is worth noting that the formulation of theories in the nursing discipline goes through stages such as from initial concepts into conceptual frameworks, then models and the ultimate formulation of theories (Wimpenny, 2002). However, formulated theories are never constant and they evolve because of research studies and innovations (Alligood, nd). I propose a theoretical framework that focuses on holistic nursing care for patients while admitted and even for those at the outpatient level. The theory proposes a continuous care for patients even after the initial encounter with a practicing nurse with the foundation being the initial encounter in any medical practice level. This postulation would borrow much from the system models theory developed by Margaret Newman, which has been widely used in management of stress at the admission level as well as at a domesticated set up for the outpatients. It was a formulation, whose focus was on how individual human beings relate and identify with stress, and the subsequent reconstruction factors which according to Newman, they are dynamic. However, bottom line to the theory is that the client system is quite dynamic and involves constant exchange of energy between the client and the environment while at the hospital or even at home. A client system according to this theory is the depiction of the interplay of the internal and environmental factors as variables to individual person. Theories in the nursing field, just as within other disciplines have undergone through tremendous evolutionary stages to be as they are in the modern day context. According to the systems theory, human beings has particular influence in the normal energy resources, that get surrounded by varying lines of resistance; the flexible lines as well as the normal lines of defense (“Neuman systems model”, 2011) . Defense lines as postulated by the theory are the internal factors with which a patient is able to fight the possible causes of stress with the normal line referring to the common state of equilibrium of a person while the flexible line referring to dynamic nature of man where the defense system can very easily alter. Therefore, according to the theory, a practicing nurse has distinct roles in management of the stress in patients through maintaining the defense system. He/she is required to maintain and strengthen the internal defense line through increasing resistance factors while at the same time reducing reactions in a patient. Moreover, the nurse is empowered to empower the patient to readapt and return to wellness after the treatment while at the same time guiding the patient against reconstitution or return of the stress. In the like manner, my proposal will guide nurses in the practice to adopt the view that patients are not only dependent on them while at the hospital but more so when discharged. In such an instance, the practicing professionals in nursing would seek to establish links with patients that would transcend the patient’s conditions at the moment but care for the eventualities that would arise after the encounter. This has been noted as the major gap that exists where the theories propose continued interaction between the nurses and the patients during and after such an encounter that has not been fully realized up to date. The formulation of the theory by Neumann had basic influences from other theoretical works by various other theorists. She first derived her motivation by philosophic writings by deChardin and Cornu concerning wholeness in system. General system theory by Bertalanfy and Lazlo, stress theory by Selye as well as Lararus writing on coping and stress are all great inspirations, which influenced the birth of the theory of systems by Neuman. It was based on many assumptions, which include that every individual client’s system is distinct and unique. There exist very many stressors, which are universal while other universally known while others are still unknown. Particular interrelationships by variables in a client determine the level of defense that a patient enjoys from a particular line of defense. Environmental factors are major influences to the evolution of the lines of defense as described previously. Lines of resistance explain the uniqueness of individual client’s capacity to challenge and take defense against the stressors. Primary prevention strategies define the possible or the actual risk factors that are associated to individual client condition. The secondary factors provide the practitioner with direction to address the outcome of a particular treatment administered to a particular client concerning stress. The tertiary level on the other hand explains reconstitution adjustive processes to be adopted for addressing the stress and factor causes. Discuss how the developed theoretical framework component reflects the metaparadigm of nursing The development of this theoretical framework for discussion in this paper has been influenced by various factors. First, nursing as a profession is based on many paradigms, which explains the practices and theories adopted in the discipline. Just as the theory by Newman has been in application in nursing discipline in the understanding that an individual client is a person as at the bottom line and then as a multidimensional structured individual, this postulation would be based on the various paradigms in application within the discipline. In the later, the theory understands a person to be comprising of various variables or subsystems that are psychological, physiological, social cultural, developmental as well as spiritual dimensions. Environment in this regard refers to the internal and external physical environment as well as the created environment, which is dependent on the client and is often developed unconsciously. According to Newman, health is equated to wellness and a person moves into a state of death when the energy requirement is higher than the capacity available. Wellness on the other hand is realized in the event that more energy than required is produced. She also brings about the interaction of nursing as a discipline and the theory in that nursing concerns all the variable factors that influence personal reaction towards a stressor. A nurse is also the feature that has the capacity to address a client as a whole system concerning stress, which would have effects advanced to an individual person, family, community as well as a society. The theory therefore is acknowledged of having simple and straightforward approach to nursing as a discipline and the client as a system. It is thus a holistic, comprehensive and flexible of approaching nursing. It can be summarized as a theory that evaluates and acknowledges the response of an individual client as a system to the environmental stressors and then the application of various lines of defense to address the stress (“Nursing theories”, 2012). This would equally form the basis of my proposal concerning the approach that nurses should uphold towards the patients in the hospitalized setup as well as at the discharged state. The postulated theory as illustrated is a universally relevant theory which is open to creative interpretation and which can lead to in-depth application especially in research studies in nursing as a discipline, research, education as well as administration. According to Glennister, Neuman has had great significance in the development of nursing theories because of her development of the systems/stress theory. He observes that the theory has received great evolution especially in influencing development of other theories of general systems in the discipline of nursing. He echoes that human beings represent compositions of various subsystems of developmental, physical, psychological, physiological as well as spiritual subsystems. It explains how self tries to defend himself from possible attack by external as well as internal stressors through definite lines of defense. Therefore, there is the distinct specialization of responsibility as defined by what a nurse is supposed to do and what a patient is to do in the process of mitigating stress. This has brought a new dimension in understanding the distinct roles that the two; patients and nurses play as compared to what was in previous theories (Glennister, nd). It is in this regard that I would develop such a theoretical to bridge the gap in existence between nursing practice and the already existing theoretical frameworks. Discuss how your component demonstrates leadership principles Following the already identified gap that exists between the ways outpatients are treated by nurses compared to inpatients, it is inevitably necessary that such a theoretical framework be formulated to bridge this gap. As a nursing theory, it is important that it exhibit some principles of leadership and effects to foster nurses as leaders in the profession of medicine. Leadership is the art of imparting influence to people and making them willingly cooperate enthusiastically towards realizing an organizations purpose or a strategic goal. A leader therefore mobilizes the efforts of persons through ‘leadership’ towards achieving a common goal. Strategic leadership entails the capability of a leader to shape decisions, deliver high value over time through not only his/her own efforts but by inspiring and guiding other people in the organization too (Wong, 2003). There are specific guiding principles, which govern effective leadership. These are ‘defining and delivering to stakeholders’, ‘sustaining competitive advantage over time’, ‘developing and communicating the organization’s purpose’, ‘setting ethical standards’ and ‘managing human resource and organizational decisions’ (Hitt et al, n.d). These are therefore very relevant and necessary in nursing profession and as such, any theory formulation should consider them. In my proposed theoretical framework, nurses have the strategic role to play in ‘leading’ out patients, as is our focus towards full recovery. This is possible through showing no partiality while handling these patients as compared to those in admission. As the Lynch model illustrates, this theory will empower nurses to define and deliver to the stakeholders (in this case the patients), sustain competitive advantage in handling the patients as well as in setting ethical standards to emulated. Furthermore, the theoretical framework supports the principles of management of nurses as human resource as well as developing and communicating overall vision in the nursing discipline. Discuss how the developed component could be tested The processes entailed in testing scientific theories may at times be strenuous and technical. They may be strenuous in the fact that it will take many tests and takes time in order to ascertain the authenticity of such a postulation. In other instances, there may lack a straightforward mechanism of testing a theoretical framework and thus necessitate other indirect tests which would be associated with the theory. In our case, this theory may lack direct testing tools but through related tests, we would test it. We can carry out a number of tests regarding the effects of the partiality shown by nurses to patients at the outpatient scope while compared to those under admission. In our test, we could compare the recovery period and cases of recurrence of medical conditions attended to within the varying set-ups (with keen interest towards the inpatients as compared to the outpatients). The outcome of the tests would be instrumental in confirming the authority of such a theoretical projection as this one. The most likely outcome to the tests would show that poor care offered to the outpatient clients lead to slow recovery and increased cases of recurrent medical conditions while compared to the cases where the nurses took keen observation and monitoring programs. The testing would therefore involve many customized tests involving patients and nurse care at the two statuses. Conclusion In sum, we have noted the existing gap between the theoretical structures governing the nursing profession and the practice itself. Theories exist to explain the system models involving the critical role played by nursing practices and the individual patients towards the effectiveness and efficiency in nursing discipline. Our postulation towards the bridging of the gap existing because of partiality in handling inpatients as well as outpatients was majorly influenced by the systems model theory in management of stress developed by Margaret Newman. In the conclusion, we support that such a theoretical framework would contribute immensely towards efficiency in addressing medical cases at the outpatient level as well as at the inpatient levels. It is necessary that in professional practice, nurses show no partiality towards handling either of the patients in order to realize the efficiency aimed at. Moreover, the theory would support establishment and maintenance of lifelong ties between nurses and the clients attended to in order to minimize cases of recurrence and uncontrolled complications. As Newman puts it, health is a summation of effects of both internal factors as well as external factors in a patient. References Alligood M. R., (nd). Introduction to Nursing Theory: Its History, Significance and Analysis. Retrieved from < http://www.elsevieradvantage.com/samplechapters/9780323091947/AlligoodCh1-9780323091947.pdf> Glennister D., (nd). Towards a general systems theory of nursing: a literature Review. Retrieved from < http://journals.isss.org/index.php/proceedings55th/article/viewFile/1717/569> Hitt et al. (n.d). Strategic Leadership: The Good, the Bad, and the Guilty. Retrieved from < http://www.slideshare.net/Jack78/strategic-leadership-4367579> “Jones & Bartlett Learning”, (nd). The Essence of Nursing: Knowledge and Caring. Retrieved from < http://samples.jbpub.com/9781449649029/46066_CH02_6031.pdf> “Nursing theories”, (2012). Betty Neuman's System Model. Retrieved from < http://currentnursing.com/nursing_theory/Neuman.html> “Neuman systems model”, (2011). 2011 Symposium. Retrieved from < http://www.neumansystemsmodel.org/> Risjord M., (nd). Nursing Science. Retrieved from < http://userwww.service.emory.edu/~mrisjor/documents/Nursing_Science.pdf> Swanson K. M., (1991). Empirical development of a middle range theory of caring. Nursing research, 40(3): 161-166 Wimpenny P., (2002). The meaning of models of nursing to practicing nurses. Journal of Advanced Nursing 40(3), 346–354 Wong L., et al. (2003). Strategic leadership competencies. Retrieved from < http://www.au.af.mil/au/awc/awcgate/ssi/wong.pdf> Read More