ERNESTINE WEIDENBACH

1. The Central Purpose defines the quality of health the nurse desires to effect on her
patient. It is a concept what the nurse puts into words, believes in, and accepts as a
standard against the value of her actions. Central purpose reflects the nurse’s
philosophy of care.
2. The Prescriptions are the appropriate nursing actions selected to create and
implement a care plan in accordance with the central purpose. These actions may
be voluntary (intended response) orinvoluntary (unintended response).

Voluntary actions include:

Mutually identified actions are understood and agreed upon by the practitioner
(nurse) and the recipient (patient). The recipient understands the implications of the
actions and is receptive to it.

Recipient-directed actions are in which the recipient directs the way the action is
carried out

Practitioner-directed actions are in which the practitioner carries out the action.

3. The Realities are aspects of the situation that influence the nursing outcome. After
the nurse determines the central purpose and has developed the prescription, she
considers the following realities:

 The agent or nurse practitioner who performs the nursing action.

 The recipient or patient who is vulnerable and is dependent on others for help.
 The goal or directed outcomes the nurse wishes to achieve.
 The means (actions, skills, experience) that empowers the nurse to achieve the
desired goals.
 The framework consists of the human, environmental, professional, and
organizational facilities.