DEFINITIONS OF NURSING

1) American Nurses Association

 Nursing is the diagnosis and treatment of human responses to illness (to actual and protentional health
problems).

2) Canadian Nurses Association

 The same definition as that of the American Nurses Association.
 However, it includes the supervision of functions and services in collaboration with others to promote
health.
NURSING THEORIES
1) Florence Nightingale – Environmental Nursing Theory
 Often considered as the First Nursing Theorist
 Defined Nursing as:
 The act of utilizing the environment of the patient to assist him in his recovery.
 Nightingale’s theory remains an integral part of Nursing and Healthcare today.

5 Environmental Factors General Concepts

1. Pure or Fresh Air 1. Ventilation
2. Pure Water 2. Cleanliness
3. Efficient Drainage 3. Quiet
4. Cleanliness 4. Warmth
5. Light, especially direct sunlight. 5. Diet

2) Dorothy Johnson – Behavioral Systems Model

 Defined Nursing as:
 Nursing is an external regulatory force that regulates the action or behavior of a person when
such behavior constitutes a threat, in order to preserve his organization.

7 Subsystems
1. Attachment and Affiliative 5. Sexual
2. Dependency 6. Aggressive
3. Ingestive 7. Achievement
4. Eliminative

3) Virginia Henderson – Fourteen Fundamental Needs

 14 Fundamental Needs focusing on Physiologic Social Recreation.
 Defined Nursing as:
 The unique function of the nurse is to assist individuals, sick or well, with the activities towards
health that he would do unaided, if with strength and knowledge.
 If that is not possible, towards a peaceful death.

14 Fundamental Needs
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body waste
4. Moving and maintaining a desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range by adjusting clothing and modifying environment.
8. Keeping the body clean and well groomed to protect the integument.
9. Avoiding dangers in the environment and avoiding injuring others.
10. Communicating with others in expressing emotions, needs, fears, or opinions.
11. Worshipping according to one’s faith.
12. Working in a such way that one feels a sense of accomplishment.
13. Playing or participating in various forms of recreation.
14. Learning, discovering, or satisfying the curiosity that leads to normal development and health, and
using available facilities.

4) Faye Abdella – Problem Solving Approach to 21 Nursing Problems

 Focus is on proper identification of the problem.
 Particularly about the proper nursing diagnosis.
 Defined Nursing as:
 Nursing is a service to individuals, families, and therefore, to society.
 Conceptualized nursing as an art and science of molding the intellect, attitude, and skills of the
nurse.

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  Nursing in terms of providing education.
21 Nursing Problems
1. To maintain good hygiene.
2. To promote optimal activity: exercise, rest, and sleep.
3. To promote safety.
4. To maintain good body mechanics.
5. To facilitate the maintenance of supply of oxygen,
6. To facilitate maintenance of nutrition.
7. To facilitate maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolytes balance.
9. To recognize the physiologic response of the body to disease conditions.
10. To facilitate the maintenance of regulatory mechanisms and functions.
11. To facilitate the maintenance of sensory function.
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept the interrelatedness of emotions and illness.
14. To facilitate the maintenance of effective verbal and non-verbal communication.
15. To promote the development of productive interpersonal relationship.
16. To facilitate progress toward achievement of personal spiritual goals.
17. To create and maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying needs.
19. To accept the optimum possible goals.
20. To use community resources as an aid in resolving problems arising from illness.
21. To understand the tole of social problems as influencing factors.

5) Marjorie Gordon – Human Functional Health Patterns

 Focus is on 11 Health Patterns
 Advantage to the Nurse
 It enables the nurse to determine the client’s response as functional or dysfunctional.

11 Functional Health Patterns

1. Health Perception 7. Self-Perception and Self-Concept
2. Nutritional/Metabolic 8. Role Relationship Pattern
3. Elimination 9. Sexuality or Reproductive
4. Activity and Exercise Pattern 10. Coping-Stress-Tolerance
5. Cognitive Perceptual Pattern 11. Value Belief Patterns
6. Sleep and Rest

6) Imogene King – Goal Attainment Theory

 Patient has 3 Interacting Systems
1. Individual’s or Personal System
2. Group Systems or Interpersonal Systems Fraternity
3. Social Systems

7) Madeleine Lehninger – Transcultural Nursing Theory

 Defined Nursing as:
 Nursing is a humanistic and scientific mode of helping through culture-specific process.

8) Myra Levine – Four Conservation Principles of Nursing

 Involves the following:
1. Conservation of Energy
o Example: Complete bed rest without bathroom privileges.
2. Conservation of Structural Integrity.
o Example: Turn patient from side to side every 2 hours to avoid bed sores.
3. Conservation of Personal Integrity
o Example: Maintain Patient’s Privacy
4. Conservation of Social Integrity
o Example: Maintenance of Patient’s Relationships

9) Betty Neuman – Health Care Systems Model

 The concern of Nursing is to prevent stress invasion.

10) Dorothea Orem – Self Care and Self Care Deficit Theory
 3 Nursing Systems based on Art of Care of Patient Needs
 Defines Nursing as:
 Nursing is a helping service to any individual who is sick.
o Sick – Comprises of wholly dependent or partly dependent care when the person is
unable to do so.

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  Defines Nursing in terms of a need.
1. Partial Compensatory
 Patient performs some of nursing care needs.

2. Wholly Compensatory or Total Compensatory

 For paralyzed patients, for ICU patients.

3. Supportive-Educative
 For up and about patient.

11) Hildegard Peplau – Interpersonal Model

 More on a therapeutic process.
 Therapeutically, you will communicate with them in a nicer way and like putting yourself in their shoes.
 4 Phases of Nurse-Patient Interaction

4 Phases of Nurse-Patient Interaction

1. Orientation
 Usually initiated by the nurse.
 You will already start treatment process and provide information; start answering questions that bothers
the patient.
 During this phase, your patient will still consider you as a stranger; no rapport and trust.
 Thus, you must interact and communicate well.
 They will only answer questions that you ask.
 
2. Identification Phase
 She will be comfortable with you.
 This time, she can express their feelings and those feelings will become stronger.
 
3. Exploitation Phase
 Clients makes full use of the services.
 Best time for nurses to maximize all resources to benefit the patient.
 Benefit of this would be that you can perform all treatments and procedures with full understanding of
the patient.
 
4. Resolution and Termination Phase
 Client does not need your help anymore.
 Relationship ends already.
 Your responsibility also ends here.

12) Martha Rogers – Science of Unitary Human Beings

 Man is composed of energy fields, which are in constant interaction with the environment.
 Defined Nursing as:
 Nursing is a humanistic science dedicated to compassionate concern for the promotion of
health, prevention of illness, and rehabilitation of the sick.
 You handle everything or your environment according to your energy.

13) Sister Calista Roy – Adaptation Model

 Man is a Biopsychosocial Being.
 Defined Nursing as:
 Nursing is a Theoretical System of Knowledge that prescribes analysis and action related to the
care of the sick or ill.
 It is a set of knowledge.
4 Modes of Adaptation
1. Physiologic Mode
 Compatible with Hans Selye
 Elimination, activity, rest, etc.
 Once patient's adaptation is okay with the treatment provided by the nurse or the doctor, there's a great
chance of recovering.

2. Self-Concept
 
3. Role Function
 They have to act based on their role.

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  Once the patient gets sick, especially if they're a breadwinner, somebody must take on their role so that
they can fully recover.
 Check with the patient if they have a good interpersonal relationship as well with the family.
 Interdependence
 Patient must have a meaningful system, not only with the nurse but with the people surrounding him as
well.
 They must feel loved, valued, and respected

14) Ldyia Hall – Care Core Cure

 She used her knowledge as a psychiatrist about 3 Cs.
 
Care  Cure
 Patient receiving care from the nurse.  Activities in relation to the doctor's order
 Everything that you do  Doesn't necessarily mean that it comes from
  the doctor alone; also in collaboration with
Core other HCWs
 Setting of the goals; yours as a nurse, and
theirs as a patient.

15) Jean Watson – Human Caring Model

 Nursing involves the application of art and human science through transpersonal transaction in order to
help the person achieve mind, body, and soul harmony.
 Embraces positive energy that flows in the mind, body, and spirit of the patient.
 Art – More on caring.
 Science – More on treatment.

16) Rosemarie Rizzo Parse – Theory of Human Becoming

 Emphasis is a Free Choice (with personal meaning)
 Actions of patients may either be:
 Revealing or Concealing
 Enabling or Limiting
 Therefore, there is a consequence.
 This pertains to behavior and action.
 It's a free choice of the patient if they will allow you to provide care or not.

17) Josephine Patterson and Loreta Zderad – Humanistic Nursing Practice Theory
 Defined Nursing as:
 Nursing is an Existential Experience between the nurse and the patient.
o Nagkataon-Nagkatagpo
 Nursing is a live dialogue between the patient who wants to be nursed and the nurse who has the skill
to nurse.

18) Tomlyn and Marry Ann Swain – Modeling and Remodeling Theory
 Focus is on the person.
 Emphasis on the unconditional acceptance of the patient.

19) Ann Boykin and Savina Schoenhofer – Grand Theory of Nursing as a Caring Theory
 Nursing is not based on a deficit but rather it is an egalitarian mode of helping.
 This theory is against the theory of Dorothea Orem.
 Nursing is an obligation towards humanity, whether there is a need or not.

20) Margaret Newman – Health as Expanding Consciousness

 Humans are Unitary Human Beings
 The nurse is not a goal-setter or an outcome predictor, rather, is a partner of the patient.

21) Joyce Travelbee – Interpersonal Process Theory

 Nurse needs to go beyond nursing roles to establish therapeutic relationship.
 Transpersonal Communication as the means to establish therapeutic relationship.
 This implies that the nurse should not be rigid in the nursing role.

22) Ida Jean Orlando – Dynamin Nurse-Patient Relationship Model

 There is movement; the relationship is not static.
 If the patient’s condition improved, then the intervention is effective and the patient moves on to new
problems.

23) Nola Pender – Health Promotion Model

 Motivation to participate in Health Care Activities influenced by Cognitive and Perceptual Factors.

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  Importance of Health to the Person  Perceived Health Status
 Perceived Control of Health  Definitions of Health
 Self-efficiency  Perceived Barriers to Action

24) Phil Barker and Poppy Buchanan-Barker – Tidal Model

 Helping patients recall their own personal stories of distress is the first step in helping them regain
control of their lives again.

25) Corbin and Strauss – Trajectory Model

 The patient moves in a Trajection of 8 Phases
 Nurse needs to follow the patient along the eight phases of trajection.

8 PHASES OF TRAJECTION BY CORBIN AND STRAUSS

1. Pre-Trajectory Phase
 Patient shows no signs and symptoms of illness.
 No sickness.

2. Trajectory Onset Phase

 Patient now has signs and symptoms of illness.

3. Crisis Phase
 Patient is unstable
 Patient is in a life-threatening situation
 Patient is critical

4. Acute Phase
 Patient is in a state of active illness

5. Stable Phase
 Patient’s illness is controlled.
 Patient may still be in the hospital.

6. Unstable Phase
 Patient is on a critical period.
 Signs and symptoms are present.
 Patient is not in the hospital.
 Patient is not under control.
 Patient is out of the hospital.

7. Downward Phase
 Patient is in a deteriorating phase.

8. Death

26) Bonnie Weaver Duldt Battey – Humanistic Nursing Communication Theory

 Emphasis is on the interpersonal relationship between the nurse, the patient, the peers, and
colleagues.

27) McGill – Model of Nursing

 Emphasis is to encourage and engage the patient and the family to actively participate in learning about
health.

28) Kathryn Barnard – Parent-Child Interaction Model

 In order to produce a healthy person, the baby’s need should be addressed at once.
 Application: Bonding

29) Alfred Adler – Theory of Personality

 The personality of an individual is affected by the Birth Order.

30) Gladys Husted and James Husted – Symphonological-Bioethical Theory

 Symphono means “Harmony” and “Agreement”
 Governed by ethical standards, which influence nursing actions.

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