Running Head: RA2: ACTIVITY II

RA2: ACTIVITY II
Enzo Miguel T. Villoria
Saint Louis University

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1. Can wellness and illness co-exist? If not, why? If they can, explain your answer. Use
relevant theoretical frameworks to explain your answer. Give practical examples of
your view.
Wellness is a non-problematic state (van Manen, 1990) which entails the acceptance of
symptoms or illness as part of a normal condition, where the body functions in its optimum
(Dunn, 1961), taken-for-granted (Leonard, 1989; Fassett& Gallagher, 1998), and fades into the
background (Heidegger, 1982). A well individual is at a continued high level of functioning or
optimum health that does not feel or recognize any disruption from his day-to-day life. More so,
when a person is well, his physical body becomes the least of his concerns and is taken-forgranted because of its non-problematic condition. Perception of wellness varies and changes as
the age progresses. A child may consider himself or herself unwell if he or she easily succumbs
to the signs and symptoms which he or she are perceives as problematizing. On the contrary, a
geriatric patient, albeit bestowed with chronic illnesses, may still consider himself or herself well
because the presence of the signs and symptoms do not interfere with his or her activities of daily
living and has simply learned to live with it as a normal condition. Wellness may still be
experienced by individuals with chronic illness for as long as the signs and symptoms do not
restrict their functioning and their body remains unnoticed in the background. Furthermore, in
the experience of being well, the person is not directed towards their own state of wellnessillness because other experiences take up position in the foreground awareness. Instead, the
person dwells on other things which are of significance to them (Macke, 2009). However, a
person becomes unwell if he is inflicted with an illness with signs and symptoms which are
perceived as problematizing. The physical body is forced in to consciousness, and the body
becomes part of the individuals concerns if he is unwell. The taken-for-granted-ness of the body

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also disappears, making the easy and laidback physiologic tasks and functions (such as
breathing, walking, chewing, etc.) difficult and challenging. With this, the continuity of
experience is disturbed, and the body is forced to emerge in the foreground.
My father is a 52-year old hard-working man. He decided to retire early as a policeman
so that he can spend more time with his family. My father has been diagnosed Cholelithiasis and
has been recommended for surgery. Despite the doctors advice, my father opted not to undergo
Cholecystectomy because he claims that he does not feel anything painful and that he considers
the operation unnecessary. I know for a fact that my father sometimes feel stabbing pain on his
abdomen, but I cannot force him to go under the knife if he does not want to. His situation is a
concrete example that illness and wellness can both coexist in an individual. Even if a person is
afflicted with a chronic disease, as long as he does not find it problematizing, he can still be
considered well. His chronic illness does not restrict his activities of daily living and his body
remains unnoticed in the background.
As a son and as a nurse, I play an immense role in the promotion of health and wellness
not only to my father but also to the general populace. Health promotion initiatives which are
individualistic or behaviourally-oriented such as encouraging people to become more health
conscious, to get fit, eat a more healthy diet, lose weight, develop a health-enhancing lifestyle, or
participate in screening programs may be done by nurses. In addition, radical health promotion
advocacies involving citizen empowerment, collective community based actions, formulation of
integrated health strategies and political activism may also be undertaken by nurses to serve the
greater population. Nurses must learn to accept the challenge of influencing health behaviours of
individuals and the community to act upon their health before a negative health event occurs.

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2. What worldview would a nursing leader need to have in order to become an effective
transformational leader? Explain your answer.
A good leader must possess a worldview which gives merit to understanding past
experience and reflection. Reflection involves looking both inward and outward at experience to
develop an understanding and create meaning (Newman et al. 1991, Johns & Freshwater, 1998).
Inculcating reflective practice among nurses is difficult but doable. Nurse Leaders must be
Modernistic, cutting-edge, current and avant-garde in spurring reflective practices among their
staff. Leaders need to include an aesthetic approach to open up doors for reflection, awareness
and understanding from a different perspective. For them nurses to become transformational
leaders, they need to understand that knowing is a form of knowledge gained through
experience and shaped by the unique perspective of the individual (Artinian 1993, Antrobus
1997, William &Inurita 2004 as cited by Bonis, 2008). Furthermore, leaders must learn to master
and understand various patterns of knowing in nursing, and be resourceful in devising activities
which makes use of reflective practices. Awareness and reflection on experience enhances the
dynamic process of knowledge development in nursing (Bonis, 2008).
Drawing from the above statements, nurse leaders must capitalize in the use of reflection
and reflective practices. Reflecting on experiences may allow nurses to tap the more personal,
creative side of knowledge development (Ingram, 1994). Nurses are able to be more consistent
and reliable with regards to the conduct of their duties because they are able to refer back to
knowledge gained from previous patients. The combination and interweaving of empirical
knowledge, experience, intuition and aesthetics allow nurses to bring fresh insight to a situation.
According to Bonis (2008), knowing is shaped through personal perspective. The unique nature
of an individual, coupled with their personal knowledge and experience of each nurse promotes

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modification and fine-tuning of professional practice by providing a different vantage point at

any given situation.
Professional knowledge is built through research and reflective practice. Statistical data,
scientific evidence and research generate empirical knowledge, but only through reflective
practice and experience can this empirical knowledge be refined.

3. Explain the purpose of a theory in nursing practice.

As defined by Chinn and Kramer (2010), nursing theory is a creative and rigorous
structuring of ideas that project a tentative, purposeful, and systematic view of phenomena.
It is the association of related theories that introduce action that model practice. More so,
Theory refers to a coherent group of general propositions used as principles of explanation.
Chinn and Jacobs (1978) posit that nursing theories provide the foundations of nursing
practice, help to generate further knowledge and indicate in which direction nursing should
develop in the future.
Having attained the status of independent profession by the middle of the 20th century
where nursing education started to transition from the hospital to academia (Brukley, 2012),
nursing is still a young profession.

In early part of nursings history, knowledge was

dreadfully lacking, and there was a thirst and need to categorize knowledge, so people could
evaluate client care situations in order to connect in comprehensible and essential ways
(Nursing Theories: An Overview, n.d.). Nursing theories provide nursing practice with a
framework which supports nursing as an independent profession solidly grounding the
profession in nursing (Brukley, 2012). Similarly, Kuhn (1970) identified that any subject
undergoing the early stages of scientific development, or the pre-paradigm stage, would be

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subject to a number of schools of thought relating to a single phenomenon. Nursing remains

in the pre-paradigm stage as it is still subject to many theories and has yet to reach the
paradigm stage when one theory is deemed absolute (Kuhn, 1970 as cited by Colley, 2015).
Theory is important because it helps us to decide what we know and what we need to
know (Parsons 1949 as cited by Colley, 2015). It helps to distinguish what should form the
basis of practice by explicitly describing nursing. The benefits of having a defined body of
theory in nursing include better patient care, enhanced professional status for nurses,
improved communication between nurses, and guidance for research and education (Nolan
1996). In addition, caring cannot be measured, it is vital to have the theory to analyse and
explain what nurses do. By providing nurses with a sense of identity, nursing theory can help
patients, managers and other healthcare professionals to recognise the unique contribution
nurses make to the healthcare service (Draper 1990, as cited by Colley, 2015). A formal
definition of nursing theory also provides nurses with an understanding of their purpose and
role in health care.
4. Choose a Nursing Theory that underpins your clinical practice or if youre in
education, your teaching practices. Using a philosophical discourse, explain why you
have chosen this theory. Explain the epistemological, axiological teleological and
ontological views.
The Roy Adaptation Model is a rich source of knowledge for improving nursing praxis for
individuals and groups (Roy & Zhan, n.d.). The Roy Adaptation Model advocates the use of a
six-tiered nursing process that is on-going and simultaneous (Roy, 2009, p.57). It can be
deciphered in her values-based concepts of adaptation that Sister Callista Roy\has a deep spirit of

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faith, hope, love, commitment to God, and service to others (Roy &Zhin, n.d.). Moreover, Roys
introduction of the concept of Veritivity in the year 1988 proves that she has a strong faith in
humanity. Offering the notion of rootedness of all knowledge being one, Veritivity is the
principle of human nature that affirms a common purposefulness of human existence. The
concept views people in the society in the context of the purposefulness of human existence,
unity of purpose of humankind, activity and creativity for the common good, and the value of
meaning of life (Roy & Zhan, n.d.). With her close religious affinity and her concept of Veritivity
sprung her assumptions that: 1) Persons have mutual relationship with the world and the Godfigure; 2) Human meaning is rooted in an omega-point convergence of the universe; 3) God is
intimately revealed in the diversity of creation and is the common destiny of creation; 4) Persons
use human creative abilities of awareness, enlightenment and faith; and finally, 5) persons are
accountable for entering the process of deriving, sustaining, and transforming the universe (Roy
& Andrew, 1999, p.35 as cited by Roy & Zhan, n.d.). Human beings and groups are perceived as
holistic, adaptive systems that constantly change and interact with their environment. According
to Roy, the overall goal of nursing is to focus on promoting health of the individual and group by
promoting adaptation in each of four adaptive modes: physiological-physical, self-concept, role
function, and interdependence (Roy & Andrew, 1999, p.35 as cited by Roy & Zhan, n.d.).
To bridge the Roy Adaptation Model into the academia, the nurse educator should gather
data about the behaviour of the student as an adaptive system in each of the adaptive modes. The
next step is to identify of internal and external stimuli that are influencing the students adaptive
behaviours. These stimuli can be classified as either Focal (those most immediately confronting
the person),Contextual (all other stimuli present that are affecting the situation), and/or
Residual(those stimuli whose effect on the situation are unclear). The third step is to formulate

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of statements that interpret data about the adaptation status of the student, including the
behaviour and most relevant stimuli. Setting of goals is the fourth step, wherein clear statements
of the students behavioural outcomes are set. The fifth step of the nursing process involves the
determination of how best to assist the student in attaining the established goals. The final step of
the nursing process involves judging the effectiveness of the nursing intervention in relation to
the behaviour of the student after the nursing intervention in comparison with the goal
established.

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