The Mcgill Model of Nursing - Essay Example

?Annotated Bibliography on Nursing Theory/Practice Model (The Mcgill Model of Nursing) This paper considers the McGill model of nursing, in particular in two annotated texts, one concerned with how it is worked out in one nurse’s community practice, and the second with how it is being used in a school of nursing. Annotated Bibliography on Nursing Theory/Practice Model (The Mcgill Model of Nursing) Introduction The McGill model of nursing was developed in a university hospital in Quebec, Canada, over an extended period. It looked afresh at the role played by nurses within the health care systems. One model of nursing was that nurses would take on some task previously the domain of the medical profession. Another view was that health was strongly linked to such things as a person’s life style and health habits. This model, promoted by Dr Moyra Allen, ( Gottleib and Rowat 1987) sees nurses as active promoters of good health. It was a model that originated in a community situation, and so is rather different from other models such as ‘A model for nursing based on a model of living’ as put forward in the United Kingdom by Roper, Logan and Tierney (1995) which, although including some information from community districts and a psychiatric hospital, as well as a maternity unit, reads very much as if it were only general hospital based. The McGill model is one in which the nurse is not acting as a substitute for a doctor, as sometimes happens with modern day nurse practitioners , but is one where she plays a complementary role to other health workers in a variety of situations. This model can be generalized across all settings. It is concerned with coping with situations, but also making adaptions and developing new ways of dealing with things together with the individuals, the families, and the wider communities involved. This model is concerned with the family as the context for health and, just as families are all different and change from time to time, so this must be a dynamic model capable of adaptation in a variety of ways. This however may also be why it is often not used, as it does not present with a simple ‘first do this and then do that’ method which results in an agreed and expected result every time. Several articles on this topic were found. The web page ‘Nursing Theories , 2012, lists many other possible models such as the Betty Neuman’s System Model, Roy’s Adaption Model and ‘The Three C’s of Lydia Hall’ – Care, Cure and Core . Out of McGill model ideas Sharon Denham developed her book ‘Family Health’ based upon her community family based practice in Ohio. The article by Gottleib and Rowat ( 1987) points out how other models are concerned with dealing with the disabilities caused by illness or injury, whereas the McGill model is more concerned with seeing the possibilities of a situation , giving the vivid example of a boy who has injured his right hand, and how he took this on as a challenge as to how he could soon learn to become adept with his left hand. The writers see the process as being aimed at the achievement of life goals. It does however work from the view that individuals and their families have the inner strengths, the resources and the abilities, to come up with viable coping mechanisms. Denham, S., Family Health , 2003 http://www.diabetesfamily.net/family/family-health-model/textbook/ This was based upon the author’s own practice and research as a qualified nurse, and how families in the Appalachians ‘defined and practiced family health within their households.’ She looked at their routines and habits, including those bad habits which negatively affected family health. She also looked at how families altered their practices around health, and also identified the context in which these people lived. The audience is other nurses having to deal with families in their own diverse communities. The author presents her case very clearly, showing her fellow nurses how to identify a number of different strategies related to health interventions. The work, first published in 2003, is now out of print, but is available online, so presumably is still felt to have relevance for the modern situation. It is based upon a family model of health, especially perhaps in relation to the role of the mother, but this is discussed as part of the wider society, local and even global. This is because families, of whatever type, seek to care for and nourish their members ( Chapter 3 page 7). She looks in chapter 8 at how to produce a family which is healthy, and says that this involves genetics, the environment and relationships. In chapter 17 nurses are encouraged to identify useful strategies related to these ‘family related intervention’. This is a very pro-active way of learning and one which can be individualized to particular nurses and even to individual patients and their families. The family of a type two diabetic for instance might choose to change the whole family’s diet so that the individual does not see others eating things which are forbidden to him. In another family this might not be considered appropriate, and another strategy might need to be considered. A criticism of this work might conclude that it is based upon one person’s research among a particular group of people in Ohio. For some this would make it difficult for them to generalize the content, or to see how it would work in their particular, and perhaps very different situations. It does however include a list of what a reader might be expected to learn from each chapter and is designed as a text book, so would be good to use in a school of nursing. It could be very useful alongside case studies compiled by students. A group for instance might consider a particular case study and come up with a number of strategies to bring the person back into a better state of health. Usually there has been a stress in modern nursing upon holistic care of an individual, but the McGill model sees a much wider picture based upon the context and relationships that person exists within. This has huge implications for nursing practice. Years ago a patient was seen as ‘The diabetic in bed 2’. Over time they became known as ‘Mr Smith who has diabetes’. Now, according to this model, they must be seen as Mr Smith who has a family history of diabetes, and whose wife thinks she is doing him a favour by giving him ‘treats’ in the form of highly sweetened puddings, or who perhaps is struggling to come up with palatable family meals suitable for a diabetic. Nurses cannot adopt this model without getting to know their patients, their families and their contexts very well and that cannot be a bad thing. Keily, S., The McGill Model , 30 years in, The McGill Daily, Health and Ed., http://www.mcgilldaily.com/2009/03/the_mcgill_model_30_years_in/, This relatively recent article is about the way in which the McGill model of nursing is taught at the time it was written . It does not give an overview of how the model has been developed over time, but rather gives in considerable detail a description of a particular class given in the school of nursing dealing with the model as now taught. It does give opinions, but they are not directly those of the writer. It is impossible to tell what authority or status the author has. Is she a nurse, a member of the faculty or a professional journalist? She seems to be rather actually reporting what she has seen. It claims that nurse are encouraged to look at their patients and the way they behave , rather than having their heads down in paperwork. It describes how nurses are encouraged to build relationships with families, and to encourage families to participate in the treatment for a family member. The intended audience is not clear apart from those having an interest in the McGill model of nursing. The model encourages a strong belief in using the power of support from families to be involved in bringing about healing, a system described as a ‘ family-centric ideology’. The article is very vivid in the way it centres upon one particular patient, a 12 year old boy who has an ulcerative condition of the colon, and the way in which he presented his case history to a class of nurses. The writer goes on to say how nurses were moved by his presentation, especially the way in which he revealed his inner thinking including his fear of a death sentence and had lots of questions . The aim, as described in the article by Professor Catherine Gros who was taking the lesson and who teaches in the school of nursing, was to produce nurses who would be more effective in their nursing practice. It is pointed out that getting this model of nursing widely accepted has been a very slow process over many years, but no reasons are given for this. It is even said the McGill Hospital itself originally was very reluctant to allow a PhD program which would allow nurses to develop and further research the McGill model, but this was eventually achieved. Professor Gros is quoted as having said:- The biggest hurdle is still society’s view of women. Unfortunately, nursing has not always been valued by society – it’s related to women’s work, mothering and nurturing……Under the hierarchy of the health-care system, nurses were always seen as assistants who carried out the doctor’s orders, handmaids for the doctors, mini-doctors. But we are doing something completely different. This statement makes a very good summary of the article. Nurses are increasing seen as being capable of making their own decisions, rather than always relying on orders from doctors. This article serves to stress how this should be not because they want to be autonomous for its own sake, but in order to allow their patient’s to move towards a better state of health because of family based interventions. Summary Unlike the model of nursing based upon a model of the activities of daily living (Roper et al., 1995), this model does not have carefully defined, step by step guidelines in the article and book above. The second article can be considered as a taster. Prospective students would need to obtain a prospectus or ask a lot of questions in order to find out what was actually involved in working with this model. The majority of people still think of nurses as very much in a hospital setting, handing out medicines or tidying up wounds. I have found it quite difficult to find details about how the McGill model of nursing has been developed and tweaked to suit particular situations. Is it perhaps not as widely used as McGill hospitals would like to think? Perhaps it is that nurses are simply getting on with the task and not writing about it as Sharon Denham has done. References Denham, S., (2003) Family Health , reprinted on line 2012 , retrieved from http://www.diabetesfamily.net/family/family-health-model/textbook/ Gottleib, L.and Rowat, K., (July 1987) The McGill Model of Nursing : A practice derived model, Advances in Nursing Science, Keily, S., ( 12th March 2009) The McGill Model , 30 years in, The McGill Daily, Health and Ed , retrieved from http://www.mcgilldaily.com/2009/03/the_mcgill_model_30_years_in/, Roper, N., Logan, W. and Tierney, A., (1995), The Elements of Nursing : A model for nursing based on a model of living, Edinburgh, Churchill Livingstone, Read More