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Fundamentals of Nursing

Fundamentals of Nursing

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1
Fundamentals of Nursing
1.
THEORETICAL
F
RAMEWORK
of NU
RSI
NG P
RACTICE
 1.
Nursing 
  As by the INTERNATIONAL COUNCIL OF NURSES (ICN, 1973) as written by VirginiaHenderson: The unique function of the nurse is to assist the individual, sick or well, inthe performance of those activities contributing to health. It¶s recovery, or to a peacefuldeath that the client would perform unaided if he had the necessary strength, will or knowledge. Help the client gain independence as rapidly as possible.
1.
 
CO
N
CE
P
T
U
AL
 
A
ND
THEORETICAL
 
MO
D
ELS
 
O
F NU
RSI
NG P
RACTICE
 
Th
eorist
 
Description
 
F
LORE
N
CE
 N
I
G
HTI
NG
ALE
 
· Developed the first theory of nursing. · Focused on changingand manipulating the
environment
in order to put the patient inthe best possible conditions for nature to act.
HIL
D
E
G
AR
DP
E
P
LA
U
· Introduced the Interpersonal Model. · She defined nursing asa therapeutic, interpersonal process which strives to develop a
nurse-patient relations
h
ip
in which the nurse serves as aresource person, counselor and surrogate.
 
F
AYE
 
AB
D
ELLAH
 
· Defined nursing as having a
problem-solving approac
h
,with key nursing problems related to health needs of people;developed list 21 nursing problem areas
 
I
D
A
J
EA
N
ORLA
ND
O
 
· Developed the three elements ± client behavior, nursereaction and nurse action ± compose the nursing situation. Sheobserved that the nurse provide direct assistance to meet animmediate need for help in order to avoid or to alleviatedistress or helplessness.
MYRA
 
LEVI
N
E
 
· Described the
Four 
C
onservation Principles
.1. conservation of energy2. conservation of structured integrity3. conservation of personal integrity4. conservation of social integrity
 
D
OROTHY
 J
OH
N
SO
N
· Developed the
B
e
h
avioral
Sy
stem
M
odel
.1. Patient¶s behavior as a system that is a whole withinteracting parts2. how the client adapts to illness3. goal of nursing is to reduce so that the client can movemore easily through recovery.
 
MARTHA
 
RO
G
ERS
 
Conceptualized the
S
cience of Unitar 
y
 
H
uman
B
eings
. Sheasserted that human beings are more than different from thesum of their parts; the distinctive properties of the whole aresignificantly different from those of its parts.
 
D
OROTHEA
 
OREM
 
Emphasizes the client¶s
self care needs
; nursing carebecomes necessary when client is unable to fulfill biological,psychological, developmental or social needs.
IMO
G
E
N
E
 
KI
NG
Nursing process is defined as dynamic
interpersonal process
 between nurse, client and health care system.
 
BETTY
N
E
U
MA
N
S
tress reduction
is a goal of system model of nursingpractice. Nursing actions are in primary, secondary or tertiarylevel of prevention
SISTER
 
CALLISTA
 
ROY
 
Presented the
A
daptation
M
odel
. She viewed each person as
a unified bio-ps
y
c
h
osocial s
y
stem
in constant interaction
 
2
with a changing environment. The goal of nursing is to help theperson adapt to changes in physiological needs, self-concept,role function and interdependent relations during health andillness.
LY
D
IA
 
HALL
 
Introduced the notion that nursing centers around threecomponents:
person(core), pat
h
ologic state andtreatment(cure) and bod
y
(care)
.
 
 
J
EA
N
WATSO
N
Conceptualized the
H
uman
C
aring
M
odel
. She emphasizedthat nursing is the application of the art and human sciencethrough transpersonal caring transactions to help personsachieve mind-body-soul harmony, which generates self-knowledge, self-control, self-care and self-healing.
 
ROSEMARIE
 
RIZZO
 P
ARSE
 
Introduced the
Th
eor 
y
of 
H
uman
B
ecoming
. She emphasizedfree choice of personal meaning in relating to value priorities,co-creating of rhythmical patterns, in exchange with theenvironment and contranscending in many dimensions aspossibilities unfold.
 
MA
D
ELEI
N
E
 
LE
N
I
NG
ER
 
Developed the
T
ranscultural Nursing
M
odel
. She advocatedthat nursing is a humanistic and scientific mode of helping aclient through specific cultural caring processes (culturalvalues, beliefs and practices) to improve or maintain a healthcondition
2
.
 
ROLES
 
A
ND FUN
CTIO
N
O
F
A
NU
RSE
 a.
C
aregiver 
± the caregiver role has traditionally included those activities that assistthe client physically and psychologically while preserving the client¶s dignity. Caregivingencompasses the physical, psychosocial, developmental, cultural and spiritual levels.b.
C
ommunicator 
 ± communication is an integral to all nursing roles. Nursescommunicate with the client, support persons, other health professionals, and people inthe community. In the role of communicator, nurses identify client problems and thencommunicate these verbally or in writing to other members of the health team. Thequality of a nurse¶s communication is an important factor in nursing care.c.
T
eac
h
er 
 ± as a teacher, the nurse helps clients learn about their health and thehealth care procedures they need to perform to restore or maintain their health. Thenurse assesses the client¶s learning needs and readiness to learn, sets specific learninggoals in conjunction with the client, enacts teaching strategies and measures learning.d.
C
lient advocate
± a client advocate acts to protect the client. In this role the nursemay represent the client¶s needs and wishes to other health professionals, such asrelaying the client¶s wishes for information to the physician. They also assist clients inexercising their rights and help them speak up for themselves.e.
C
ounselor 
± counseling is a process of helping a client to recognize and cope withstressful psychologic or social problems, to developed improved interpersonalrelationships, and to promote personal growth. It involves providing emotional,intellectual, and psychologic support.f.
Ch
ange agent
± the nurse acts as a change agent when assisting others, that is,clients, to make modifications in their own behavior. Nurses also often act to makechanges in a system such as clinical care, if it is not helping a client return to health.g.
L
eader 
± a leader influences others to work together to accomplish a specific goal.The leader role can be employed at different levels; individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned processrequiring an understanding of the needs and goals that motivate people, the knowledgeto apply the leadership skills, and the interpersonal skills to influence others.h.
M
anager 
± the nurse manages the nursing care of individuals, families, andcommunities. The nurse-manager also delegates nursing activities to ancillary workersand other nurses, and supervises and evaluates their performance.i.
C
ase manager 
± nurse case managers work with the multidisciplinary health careteam to measure the effectiveness of the case management plan and to monitor 
 
3
outcomes. j.
R
esearc
h
consumer 
± nurses often use research to improve client care. In a clinicalarea nurses need to: · Have some awareness of the process and language of research ·Be sensitive to issues related to protecting the rights of human subjects · Participate inidentification of significant researchable problems · Be a discriminating consumer of research findings2.
Co
ncepts
of 
Health and Illness
 I.
H
ealt
h
± As defined by the World Health Organization (WHO): state of completephysical, mental and social well-being, not merely the absence of disease or infirmity.
a.
haracteristics
 i. A concern for the individual as a total systemii. A view of health that identifies internal and external environmentiii. An acknowledgment of the importance of an individual¶s role in life A dynamic state inwhich the individual adapts to changes in internal and external environment to maintaina state of well being
b. M 
o
dels
of 
Health and Illness
 i. Health-Illness Continuum (Neuman
)
± Degree of client wellness that exist at any pointin time, ranging from an optimal wellness condition, with available energy at itsmaximum, to death which represents total energy depletion.ii. High ± Level Wellness Model (Halbert Dunn) ± It is oriented toward maximizing thehealth potential of an individual. This model requires the individual to maintain acontinuum of balance and purposeful direction within the environment.iii. Agent ± Host ± environment Model (Leavell) ± The level of health of an individual or group depends on the dynamic relationship of the agent, host and environmentØ Agent ± any internal or external factor that disease or illness.Ø Host ± the person or persons who may be susceptible to a particular illness or diseaseØ Environment ± consists of all factors outside of the hostiv. Health ± Belief Model ± Addresses the relationship between a person¶s belief andbehaviors. It provides a way of understanding and predicting how clients will behave inrelation to their health and how they will comply with health care therapies.Four ComponentsØ The individual is perception of susceptibility to an illnessØ The individual¶s perception of the seriousness of the illnessØ The perceived threat of a diseaseØ The perceived benefits of taking the necessary preventive measuresv. Evolutionary ± Based Model ± Illness and death serves as a evolutionary function.Evolutionary viability reflects the extent to which individual¶s function to promote survivaland well-being.The model interrelates the following elements:Ø Life eventsØ Life style determinantsØ Evolutionary viability within the social contextØ Control perceptionsØ Viability emotionsØ Health outcomesvi. Health Promotion Model ± A ³complimentary counterpart models of health protection´.Directed at increasing a client¶s level of well being. Explain the reason for client¶sparticipation health-promotion behaviors.

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