Abueg, Dorothy Rose S.


July 18, 2011 Elective Assignment

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Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and modifying environment Keep the body clean and well groomed and protect the integument Avoid dangers in the environment and avoid injuring others. Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to one’s faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

Individual • Have basic needs that are component of health. • Requiring assistance to achieve health and independence or a peaceful death. • Mind and body are inseparable and interrelated. • Considers the biological, psychological, sociological, and spiritual components. • The theory presents the patient as a sum of parts with biopsychosocial needs, and the patient is neither client nor consumer. Environment • Settings in which an individual learns unique pattern for living. • All external conditions and influences that affect life and development. • Individuals in relation to families • Minimally discusses the impact of the community on the individual and family. • Supports tasks of private and public agencies Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education. • Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided Health
• •

Definition based on individual’s ability to function independently as outlined in the 14 components. Nurses need to stress promotion of health and prevention and cure of disease.


and or provide an environment in which the individual can perform activity unaided • Henderson's classic definition of nursing "I say that the nurse does for others what they would do for themselves if they had the strength. BSNIV-B1 • July 18. Help build a common nursing terminology to use in communicating with other health professionals.” • And nurse has responsibility to assess the needs of the individual patient. will and knowledge to satisfy 1 or more of 14 basic needs. the will. physical. • But I go on to say that the nurse makes the patient independent of him or her as soon as possible. explain. • In the Nature of Nursing “ that the nurse is and should be legally. Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions. which are essential for effective decision making and implementation.” • In the Nature of Nursing Nurse role is. or making a prognosis. • Nurse serves to make patient “complete” “whole".Abueg. 2|Page . prescribing treatment for disease. for these are the physicians function. Serve to guide assessment. cleanliness and serving food." APPLICATION: • • • • • • • Assist nurses to describe. and emotional balance Is the individual’s ability to meet these needs independently? Nursing • Temporarily assisting an individual who lacks the necessary strength. and evaluation of nursing care. Affected by age. help individual meet their health need. or "independent. cultural background. and the knowledge. and intellectual capacities.” • “Nurse should have knowledge to practice individualized and human care and should be a scientific problem solver. Dorothy Rose S. • Use nursing research o Categorized Nursing : nursing care o Non nursing: ordering supplies. Provide a rationale for collecting reliable and valid data about the health status of clients. and predict everyday experiences. Help to describe criteria to measure the quality of nursing care. Ideas are developed and words are defined." • The nurse is expected to carry out physician’s therapeutic plan Individualized care is the result of the nurse’s creativity in planning for care.” to get inside the patient’s skin and supplement his strength will or knowledge according to his needs. • Assists and supports the individual in life activities and the attainment of independence. interventions. 2011 Elective Assignment Good health is a challenge. an independent practitioner and able to make independent judgments as long as s/he is not diagnosing.

2011 Elective Assignment FAYE GLENN ABDELLAH Three major categories • Physical.Abueg. cope with their health needs. and developmental needs RESTORATIVE CARE NEEDS • To accept the optimum possible goals in the light of limitations. emotional. rest and sleep • To promote safety through the prevention of accidents. and emotional needs of clients • Types of interpersonal relationships between the nurse and patient • Common elements of client care BASIC TO ALL PATIENTS • To maintain good hygiene and physical comfort • To promote optimal activity: exercise. physical and emotional • To use community resources as an aid in resolving problems arising from illness • To understand the role of social problems as influencing factors in the case of illness CONCEPT: Nursing • Nursing is a helping profession. 3|Page . Dorothy Rose S. or alleviating impairment. BSNIV-B1 “21 NURSING PROBLEMS” THEORY: July 18. • Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgment. sociological. increasing or restoring self-help ability. sick or well. • In Abdellah’s model. or other trauma and through the prevention of the spread of infection • To maintain good body mechanics and prevent and correct deformity SUSTENAL CARE NEEDS • To facilitate the maintenance of a supply of oxygen to all body cells • To facilitate the maintenance of nutrition of all body cells • To facilitate the maintenance of elimination • To facilitate the maintenance of fluid and electrolyte balance • To recognize the physiological responses of the body to disease conditions • To facilitate the maintenance of regulatory mechanisms and functions • To facilitate the maintenance of sensory function. feelings. injury. REMEDIAL CARE NEEDS • To identify and accept positive and negative expressions. and reactions • To identify and accept the interrelatedness of emotions and organic illness • To facilitate the maintenance of effective verbal and non verbal communication • To promote the development of productive interpersonal relationships • To facilitate progress toward achievement of personal spiritual goals • To create and / or maintain a therapeutic environment • To facilitate awareness of self as an individual with varying physical . • She considers nursing to be comprehensive service that is based on art and science and aims to help people. nursing care is doing something to or for the person or providing information to the person with the goals of meeting needs.

These needs may overt. Health • • In Patient–Centered Approaches to Nursing. • The environment is the home or community from which patient comes. 2011 Elective Assignment Abdellah describes people as having physical. Society and Environment • Society is included in “planning for optimum health on local. Although Abdellah does not give a definition of health.Abueg. and sociological needs. is the purpose of nursing services. APPLICATION: • • Nurses can give better patient care through the organization of hospital facilities. services and staff around the changing medical and nursing needs of the patient Nurses can now care for the right patient in the right bed with the right services at the right time 4|Page . consisting of largely physical needs. or achieving of it. the focus of nursing service is clearly the individual. However. she speaks to “total health needs” and “a healthy state of mind and body” in her description of nursing as a comprehensive service. Patient is described as the only justification for the existence of nursing. national. Individuals (and families) are the recipients of nursing Health. such as emotional and social needs. Abdellah describes health as a state mutually exclusive of illness. or covert. as she further delineated her ideas. Dorothy Rose S. state. emotional. and international levels”. BSNIV-B1 Person • • • • July 18.

BSNIV-B1 July 18. o The inaugural meeting or original encounter o Visibility of personal identities/ emerging identities. Nurse's job is to help the patient to maintain hope and avoid hopelessness. This relationship can only be established by an interaction process. o Empathy o Sympathy o Establishing mutual understanding and contact/ rapport Travelbee's ideas have greatly influenced the hospice movement in the west. Dorothy Rose S. It has five phases. developing feelings of empathy. CONCEPT: Person • • Person is defined as a human being. • Objective health is an absence of discernible disease. 2011 Elective Assignment JOYCE TRAVELBEE “HUMAN TO HUMAN RELATIONSHIP MODEL” THEORY: • • • • • Travelbee believed nursing is accomplished through human-to-human relationships that begin with the original encounter and then progress through stages of emerging identities. Health • Health is subjective and objective. Environment • Environment is not clearly defined. family or community to prevent or cope with experience or illness and suffering. and if necessary to find meaning in these experiences. For meeting the goals of nursing it is a prerequisite to achieving a genuine human-to-human relationship.Abueg. The nurse and patient attain a rapport in the final stage. Nurse must have a systematic intellectual approach to the patient's situation.” APPLICATION: • • • • Nurses are responsible for helping the patient avoid and alleviate the distress of unmet needs. Both the nurse and the patient are human beings. 5|Page . • Subjective health is an individually defined state of well being in accord with self-appraisal of physical-emotional-spiritual status. and later feelings of sympathy. Nurse has a responsibility to help individuals and their families to find meaning. Nursing • "an interpersonal process whereby the professional nurse practitioner assists an individual. disability of defect as measured by physical examination. laboratory tests and assessment by spiritual director or psychological counselor.

refers to mental processes and emotions. functioning of body systems homeostatically. cognitive ability.refers to the influence of spiritual beliefs. • The normal line of defense can change over time in response to coping or responding to the environment. the resulting energy loss can result in death. 2011 Elective Assignment BETTY NEUMAN “SYSTEM MODEL IN NURSING PRACTICE” THEORY: PERSON VARIABLES Each layer. Reconstitution begins at any point following initiation of treatment for invasion of 6|Page . or homeostasis. physical strength. body temperature regulation ability. Dorothy Rose S. each of the person variables should be considered simultaneously and comprehensively. Example: activation of the immune response after invasion of microorganisms. 3.refers to those processes related to development over the life span. Ideally. 1995. and the core structure. 2. or concentric circle. CENTRAL CORE • The basic structure. • The flexible line of defense is dynamic and can be changed/altered in a relatively short period of time. 5. genetic features. An example is skin. RECONSTITUTION • Reconstitution is the increase in energy that occurs in relation to the degree of reaction to the stressor. • The person's system is an open system and therefore is dynamic and constantly changing and evolving. • The flexible line of defense acts as a cushion and is described as accordion-like as it expands away from or contracts closer to the normal line of defense. NORMAL LINE OF DEFENSE • The normal line of defense represents system stability over time. • If the flexible line of defense fails to provide adequate protection to the normal line of defense. Sociocultural . the line of resistance. the system can reconstitute and if the lines of resistance are not effective. Psychological . 1996). • Stability. which is stable and fairly constant. or central core. and compensation. Spiritual . the lines of resistance become activated. FLEXIBLE LINES OF DEFENSE• The flexible line of defense is the outer barrier or cushion to the normal line of defense. output. • It is considered to be the usual level of stability in the system. in George. feedback. If the lines of resistance are effective. occurs when the amount of energy that is available exceeds that being used by the system. 1. and the strengths and weaknesses of the system parts. of the Neuman model is made up of the five person variables. • A homeostatic body system is constantly in a dynamic process of input.Abueg. but can thicken into a callus over time.refers to relationships. which leads to a state of balance. BSNIV-B1 July 18. Physiological . 4. and social/cultural expectations and activities. Examples of these may include: hair color. Developmental . and value systems. LINES OF RESISTANCE • The lines of resistance protect the basic structure and become activated when environmental stressors invade the normal line of defense.refers of the physicochemical structure and function of the body. is made up of the basic survival factors that are common to the species (Neuman. • These factors include: system variables.

genetic structure. Prevention focuses on keeping stressors and the stress response from having a detrimental effect on the body. Dorothy Rose S. the person (or the nurse) attempts to restore or maintain the stability of the system. dynamic interaction with the environment. The nature of the reaction depends in part on the strength of the lines of resistance and defense.e. STRESSORS • The Neuman Systems Model looks at the impact of stressors on health and addresses stress and the reduction of stress (in the form of stressors). emotions and feelings o Interpersonal . e. 7|Page . is seen as being in constant. The person may in fact be an individual. • Secondary-Secondary prevention occurs after the system reacts to a stressor and is provided in terms of existing systems. • The person. • Lines of resistance and two lines of defense protect this core.occur between individuals. it strengthens the person (primarily the flexible line of defense) to enable him to better deal with stressors. Primary prevention includes health promotion and maintenance of wellness. e. a group. A stressor is any environmental force which can potentially affect the stability of the system: they may be: o Intrapersonal . consist of the central core. job or finance pressures • The person has a certain degree of reaction to any given stressor at any given time.g. lines of resistance. On the one hand. 2011 Elective Assignment stressors. • The basic core structure is comprised of survival mechanisms including: organ function. and being affected by it). affecting. BSNIV-B1 July 18. ego. stabilize the system at a lower level. with the lines of resistance nearer to the core. secondary and tertiary interventions. PREVENTION • As defined by Neuman's model. response patterns. lines of normal defense.occur within person. and lines of flexible defense. prevention is the primary nursing intervention.Abueg. Each layer consists of five person variables or subsystems: o Physical/Physiological o Psychological o Socio-cultural o Developmental o Spiritual • The layers.g. usually represented by concentric circle. role expectations o Extra personal . e.g. Secondary prevention focuses on preventing damage to the central core by strengthening the internal lines of resistance and/or removing the stressor. • The person is seen as being in a state of constant change and-as an open system-in reciprocal interaction with the environment (i. By means of primary. temperature control. or return it to the level that existed before the illness. Reconstitution may expand the normal line of defense beyond its previous level. CONCEPTS: PERSON • The person is a layered multidimensional being. with a core of basic structures. • Primary -Primary prevention occurs before the system reacts to a stressor. • Around the basic core structures are lines of defense and resistance (shown diagrammatically as concentric circles. • Tertiary -Tertiary prevention occurs after the system has been treated through secondary prevention strategies. and what Neuman terms 'knowns and commonalities'. Stressors are capable of having either a positive or negative effect on the client system. and on the other hand manipulates the environment to reduce or weaken stressors. Tertiary prevention offers support to the client and attempts to add energy to the system or reduce energy needed in order to facilitate reconstitution. a family.occur outside the individual. or a community in Neuman's model.

Viewing patient in a holistic manner. implementation and evaluation of the planned care for the patient. through nursing interventions to reduce stressors. o The internal environment exists within the client system. • Neuman also identified a created environment which is an environment that is created and developed unconsciously by the client and is symbolic of system wholeness. Nurses can now provide care in a comprehensive manner. 1995)". interpersonal and extra personal stressors which can affect the person's normal line of defense and so can affect the stability of the system. Dorothy Rose S. Nurses may use this theory for accurate assessment. • As the person is in a constant interaction with the environment. It can also be used in research to produce new nursing knowledge the\at I significant to the scope of nursing practice. • The client system moves toward illness and death when more energy is needed than is available. • Neuman defines nursing as actions which assist individuals. and the use of primary. the state of wellness (and by implication any other state) is in dynamic equilibrium. secondary and tertiary prevention interventions for solving the problems in the client. 2011 Elective Assignment ENVIRONMENT • The environment is seen to be the totality of the internal and external forces which surround a person and with which they interact at any given time. 8|Page . and the primary aim is stability of the patient/client system. o The external environment exists outside the client system. with the person's position on that continuum being influenced by their interaction with the variables and the stressors they encounter. but so must those of the caregiver (nurse). planning. • Neuman states that. HEALTH • Neuman sees health as being equated with wellness. because the nurse's perception will influence the care given. These forces include the intrapersonal. She defines health/wellness as "the condition in which all parts and subparts (variables) are in harmony with the whole of the client (Neuman. families and groups to maintain a maximum level of wellness. The client system moves toward wellness when more energy is available than is needed. secondary and tertiary interventions. NURSING • Neuman sees nursing as a unique profession that is concerned with all of the variables which influence the response a person might have to a stressor.Abueg. • The role of the nurse is seen in terms of degrees of reaction to stressors. BSNIV-B1 July 18. rather than in any kind of steady state. and it is the task of nursing to address the whole person. APPLICATION: • • • • Nurse may use the primary. then not only must the patient/client's perceptions be assessed. • Neuman proposes a wellness-illness continuum. • The person is seen as a whole.

subtle environment of energy and consciousness whereby wholeness. 3. esthetic and ethical human transactions”. an intimacy. beauty. 7. The nurse must know himself will be able to have a more accepting relationship with another person. 6. • It focuses on health promotion and treatment of disease. The systematic use of the scientific problem-solving method for decision making The promotion of interpersonal teaching-learning.Abueg. better care for the patient will be given. the sum of his or her parts”. Dorothy Rose S. physical. The development of a helping-trust relationship The promotion and acceptance of the expression of positive and negative feelings. socio-cultural and spiritual environment. 2. 8. preventing illness. a nurse can share something of himself to the patient can help establish a connection. In creating a healing environment at all levels. 4. respected. The formation of a humanistic. CONCEPT: Human • She adopts a view of the human being as: “…. 5. • • • APPLICATION: • • • • Through love and caring. mental and social functioning A general adaptive-maintenance level of daily functioning The absence of illness (or the presence of efforts that leads its absence) Environment/society • A caring attitude is not transmitted from generation to generation.altruistic system of values. in general a philosophical view of a person as a fully functional integrated self. 10. scientific. dignity and peace will be potentiated. understood and assisted.. 2011 Elective Assignment JEAN WATSON “PHILOSOPHY AND SCIENCE OF CARING” THEORY: 1. The cultivation of sensitivity to one’s self and to others. 9. personal. Nursing • “Nursing is concerned with promoting health. The installation of faith-hope. The provision for a supportive. protective and /or corrective mental. The allowance for existential-phenomenological forces. Health A high level of overall physical. which will allow patient to relate with the nurse. human is viewed as greater than and different from. • “a human science of persons and human health-illness experiences that are mediated by professional. It is transmitted by the culture of the profession as a unique way of coping with its environment. nurtured. a valued person in and of him or herself to be cared for. He. Besides from caring moment occasion. comfort. caring for the sick and restoring health”. physical as well as nonphysical. Assistance with the gratification of human needs. BSNIV-B1 July 18. 9|Page .

• Man and environment cocreate ( imaging. Inseparable. complimentary to and evolving with Health: Open process of being and becoming. Dorothy Rose S. • Refers to reaching out and beyond the limits that a person sets • One constantly transforms CONCEPT: Person: Open being who is more than and different from the sum of the parts Environment: Everything in the person and his experiences. • Man’s reality is given meaning through lived experiences • Man and environment cocreate Rhythmicity • Human Becoming is cocreating rhythmical patterns of relating in mutual process with the universe. 2011 Elective Assignment ROSEMARIE RIZZO PARSE Meaning • Human Becoming is freely choosing personal meaning in situations in the intersubjective process of living value priorities. particularly in that it does not seek to “fix” problems Ability to see patients perspective allows nurse to “be with” patient and guide them toward desired health outcomes Nurse-person relationship co creates changing health patterns 10 | P a g e . valuing. Involves synthesis of values Nursing: A human science and art that uses an abstract body of knowledge to serve people APPLICATION: • • • • A transformative approach to all levels of nursing Differs from the traditional nursing process. BSNIV-B1 “HUMAN BECOMING THEORY” THEORY: July 18.Abueg. languaging) in rhythmical patterns Transcendence • Human Becoming is cotranscending multidimensionally with emerging possibles.

BSNIV-B1 “HUMANISTIC THEORY” THEORY: • • July 18. implications for the future.Abueg. Dorothy Rose S. o The central tripod of communing is trust. “confronting with caring. thinks. gives structure and system to one’s environment. know. not). feelings or beliefs. regarding “here and now” or existential events o Feedback is describing another’s behavior. Inventing: able to be aware of. ordering his environment. risking potential loss in attempting to achieve a goal. Ordering: able to develop categories and hierarchies according to some value or theme. when the outcome is uncertain. and do things beyond his or her relationship to the environment. the heart of humanistic communication. and consider one’s own non-existence. perceiving the negative.     11 | P a g e . Dreaming: able to dream of how things could be if all were perfect. 2011 Elective Assignment JOSEPHINE PATERSON AND LORETTA ZDERAD Humanizing communication involves an awareness of the unique characteristics of being human. Choosing: able to consider numerous alternatives. Dehumanizing communication ignores the unique characteristics of being human. hopes for the future. viable entity. make rules (laws regarding the “thou shalt not’s”). expectations. confident manner while being respectful of other’s thoughts. and perceived implications. self-disclosure. intimate communication between two or more people. thoughts. o Trust is one person relying on another. transcending his environment by his inventions. and feedback. and so on.” Confrontation: providing feedback about another plus requesting a change in his or her behavior.” CONCEPT: Human: Man is a living being capable of symbolizing. “asserting with authenticity. honest. and self-reflecting. Patterns of interactions or skills: Communing: Dialogical. beliefs. striving for perfection. and the potential for loss is greater than for gain if the trust is violated. feelings or beliefs in a direct. o Self-disclosure is risking rejection in telling how one feels. none. particularly to expressions of feelings. worry about what may not happen. meanings. and so on. no. o Characteristics of humans:    Living: able to function biologically and physiologically as an animalistic. plus giving one’s evaluation or feelings. o Listening: is the core of communing and involves making a conscious effort to attend to what another person is saying. Communicating: able to label things and to talk about them when they are not present. Negativing: able to talk about the symbolic negative (-1. making choices. Assertiveness: expressing one’s needs.

Environment: One’s time/space/environment context. Nursing: the art and science of positive. humanistic intervention in the changing health status of human beings interacting in the environment of critical life situations. Its elements are communicating. and coaching. of becoming: of self-awareness. The ability to be with and travel with the patient in the routine of living is often overlooked. respect the difference and accept responsibility for challenges of nursing 12 | P a g e . reflect on one’s own behavior and understand self. but is an essential part of the professional life of a nurse. reflection being a learned process that can help enhance the experience of the nurse and prepare them for similar situations in the clinical environment. 2011 Elective Assignment Self-reflecting: able to think about and talk about self. APPLICATION: • • • Encourages reflection. body. BSNIV-B1  July 18. It is indicative of one’s adaptation to the environment. caring. behaviors.Abueg. Health: one’s state of being. Dorothy Rose S. etc. Understanding the professional differences between other medical staff and allied health professionals.

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