THEORITICAL FOUNDATION IN NURSING MIDTERM/POST TEST.

SIGNIFICANT EVENTS IN HISTORY OF NURSING THEORY.

HISTORY OF NURSING-The first known documents that mention nursing as a profession were written approximately
300 AD.

-The first Spanish hospital was built in the late 500s to early 600s in Merida, Spain, with the intent to care for any sick
individuals regardless of ethnic origin or religion.

SIGNIFICANT EVENTS

1.Florence Nightingale- Nightingale “Notes on Nursing” presents the first nursing theory that focus on the
manipulation of the environment for the benefit of the patient.

2.The Columbia-The 1950s- In the 1950s the need to prepare nurses at the graduate level for administrative and
faculty position was recognized.

3.The Yale School-The 1960s Focus on theoretical thinking in nursing move from problem/need and functional role
focus to the relationship between the nurse and the patient.

4.The 1970s- It was in this decade that many nursing theories were first presented. Most of these theories have been
revised since their original presentation.

5.The 1980s- Many nursing theories were revised based on the research findings that expanded them.

6.The 1990s- Research studies that tested and expanded nursing theory were numerous.

ERAS OF NURSING KNOWLEDGE

1.Curriculum Era( 1900-1940s)- This era emphasizes on courses included in nursing programs.

2.Research Era(1950s-1970s)- This era emphasizes role of nurses and what to research. The emerging goal is that
recognition that isolated studies do not yield unified knowledge.

3.Graduate Education Era(1950s-1970s)- Emphasis is caring out an advanced role and basis for nursing practice. The
emerging role is to focus graduate education on knowledge development.

4.Theory Era(1980-1990s)- The emphasis is that there are many ways to think about nursing.

5.Theory Utilization Era ( 21st century)- The emphasis is that nursing theory guides research ,practice, education and
administration.

HISTORICAL PERSPECTIVES

1.Nightingale (1860)- To facilitate “the body’s reparative processes” by manipulating client’s environment.

2. Peplau 1952- Nursing is; therapeutic interpersonal process.

3.Henderson 1955- The needs often called Henderson’s 14 basic needs.

4. 4.Abdellah 1960- The nursing theory developed by Faye Abdellah et al (1960) emphasizes delivering nursing care
for the whole person to meet the physical, emotional, intellectual, social, and spiritual needs of the client and family.

5.Orlando 1962- To Ida Orlando (1960), the client is an individual; with a need; that, when met, diminishes distress,
increases adequacy, or enhances well-being.

6.Johnson’s Theory 1968- Dorothy Johnson’s theory of nursing 1968 focuses on how the client adapts to illness and
how actual or potential stress can affect the ability to adapt. The goal of nursing to reduce stress so that; the client
can move more easily through recovery.

7. Rogers 1970- To maintain and promote health, prevent illness, and care for and rehabilitate ill and disabled client
through “humanistic science of nursing”
8.Orem1971- This is self-care deficit theory. Nursing care becomes necessary when client is unable to fulfill
biological, psychological, developmental, or social needs.

9. King 1971- To use communication to help client reestablish positive adaptation to environment.

10.Neuman 1972- Stress reduction is goal of system model of nursing practice.

11.Roy 1979- This adaptation model is based on the physiological, psychological, sociological and dependence-
independence adaptive.

12.Watson’s Theory 1979- Watson’s philosophy of caring 1979 attempts to define the outcome of nursing activity in
regard to the; humanistic aspects of life.

13.Benner and Wrubel-1989- Focus on patient’s need for caring as a means of coping with stressors of illness.

Discipline-is specific to academia and refers to a branch of education , a department of learning or a domain of
knowledge.

Profession-refers to a specialized field of practice founded on the theoretical structure of the science or knowledge
of the discipline and accompanying practice abilities.

CAREGIVER/ CARE PROVIDER- The traditional and most essential role functions as nurturer, comforter, provider
“mothering actions” of the nurse provides direct care and promotes comfort of client.

TEACHER- Provides information and helps the client to learn or acquire new knowledge and technical skills.

COUNSELOR- Helps client to recognize and cope with stressful psychological or social problems. Develop an improve
interpersonal relationships and to promote personal growth.

LEADER- As a nurse, he or she must be able to be an inch or a foot farther than other personnel.

CHANGE AGENT- Initiate changes or assist clients to make modifications in themselves or in the system of care.

CLIENT ADVOCATE- Involves concern for and actions in behalf of the client to bring about a change.

COMMUNICATOR- A nurse is actually an agent of communication. Communication is very important in the field of
nursing as this is the means of giving and receiving information.

MANAGER- Makes decisions, coordinates activities of others, allocate resource.

CASE MANAGER- Work with the multidisciplinary health care team to measure the effectiveness of the care
management plan and to monitor outcomes.

RESEARCHER- Participates in identifying significant researchable problems.

EXPANDED ROLE AS OF THE NURSE:

Clinical Specialists- is a nurse who has completed a master’s degree in specialty and has considerable clinical
expertise in that specialty.

Nurse Practitioner- is a nurse who has completed either as certificate program or a master’s degree in a specialty
and is also certified by the appropriate specialty organization.

Nurse-midwife- a nurse who has completed a program in midwifery; provides prenatal and postnatal care and
delivers babies to woman with uncomplicated pregnancies.

Nurse anesthetist: a nurse who completed the course of study in an anesthesia school and carries out pre-operative
status of clients.

Nurse Educator: A nurse usually with advanced degree, who beaches in clinical or educational settings, teaches
theoretical knowledge, clinical skills and conduct research.

Nurse Entrepreneur: a nurse who has an advanced degree, and manages health-related business.
Nurse administrator- a nurse who functions at various levels of management in health settings; responsible for the
management and administration of resources and personnel involved in giving patient care.

FIELDS AND OPPORTUNITIES IN NURSING

Hospital/Institutional Nursing –a nurse working in an institution with patients

Example: rehabilitation, lying-in.

Public Health Nursing/Community Health Nursing- –usually deals with families and communities.

Eg. In the village/family/primary health center.

Private Duty/special Duty Nurse–privately hired

Industrial/Occupational Nursing –a nurse working infactories /companies.

Nursing Education –nurses works in school/college.

Military Nurse –nurses working in a military base/hospital.

Clinic Nurse –nurses working in a private and public clinic.

Independent Nursing Practice –private practice, BP monitoring, home service.

ICN: Infection Control Nurse is a specialized in infection control programme and works in hospital.

Nurse Researcher: Nurse who carryout/assist in research activities.

Nurse administrator: works in hospital as Director

HISTORICAL VIEWS OF THE NATURE OF SCIENCE

Science- is important because it is the method for describing , explaining, and predicting causes or outcomes of
interventions.

Two competing philosophical perspectives used in science are rationalism and empiricism:

RATIONALISM- A theory in which the criterion of the truth is not sensory but intellectual and deductive. use of
rational senses in ensuring the truthfulness of phenomenon.

EMPIRICISM- This approach called the inductive method ,is based on the idea that collection of facts precede
attempts to formulate generalizations.

ANALYSIS AND EVALUATION OF THEORETICAL KNOWLEDGE IN NURSING

Analysis of Theory- Analysis ,critique, and evaluation are methods used to study nursing theoretical works critically

-It is carried out to acquire knowledge of theoretical adequacy. It is an important process and the first step in
applying nursing theoretical works to education, research, administration or practice.

CRITERIA FOR EVALUATING THEORETICAL WORK

1.Clarity- “How clear is this theory?”-Words often have multiple meanings within and across disciplines; therefore
words should be defined carefully and specifically to the framework (philosophy, conceptual model, or theory) from
which it is derived. Diagrams and examples may facilitate clarity and should be consistent.

2. SIMPLICITY- How simple is the Theory? A theory should be sufficiently Comprehensive presented at a level of
abstraction to provide guidance and have as few concepts as possible with as simplistic relation as possible to aid
clarity.

3.Generality- “How general is this theory?”- To determine the generality of theory, the scope of concepts and goals
within the theory are examined.
4.EMPIRICAL PRECISION (ACCESSIBILITY) -”HOW ACCESSIBLE IS THIS THEORY” Addresses the extent to which empiric
indicators for the concepts can be identified and to what extent the purpose of the theory can be attained.

EMPIRICAL PRECISION (ACCESSIBILITY) ”HOW ACCESSIBLE IS THIS THEORY”

- Addresses the extent to which empiric indicators for the concepts can be identified and to what extent the
purpose of the theory can be attained.
- Closely related to the testability and the operational use of the theory.
- The theory showed be able to generate hypotheses upon which you can test.
- Addresses the extent to which empiric indicators for the concept can be identified

Critique: Neuman’s System Model

- The model has been tested and is used extensively to guide nursing research.

Critique: Johnson’s Behavioral System Model

- The clarity of the definitions of the subsystems add to theory’s empirical precision

DERIVABLE CONSEQUENCES- Propose that if research, theory, and practice are to be meaningfully related, then
nursing theory should lend itself to research testing and research testing should lead to knowledge that guides
practice. Indicates that to be considered useful, “it is essential for theory to develop and guide practice.

‘Notes in Nursing“ can have great significance for the world of nursing today.

Client centered theory- Focused on the needs and problems of clients which are met, resolved or alleviated by
nursing interventions. This category includes theories developed by the following Nightingale, Abdellah, Henderson,
Orem, Pender, Roy, Levine, Hall

Nurse – client dynamics- Focus on interaction between the nurse and client. This category includes theories
developed by the following: Peplau, Watson, King and Orlando.

Client Nurse Environment Dynamics- Focus on the interaction between nurse and client in an environment that
includes broader dimensions of time and space.

Florence Nightingale is known as the mother of Modern Nursing,the lady with the lamp. Nightingale is the daughter
of the wealthy landowner,WillamNightingale of Embly Park,Hamsphire.She was born in Florence,Italy on the 12th
day of May 1820.Her father was a respected Unitarian and a Whig who was actively involved in the anti slavery
movement. As a child, Florence was very close to her father who treated Florence as his friend and Companion.
William took responsibility for her education and taught her Greek,Latin,French,German,Italian,history,philosophy
and mathematics. By the age of seventeen,Florence believed to do some unnamed great cause.At the age of
25,Florence told her parents she wanted to become a nurse. Her parents were totally opposed to the idea of
Florence because they viewed nursing as associated with working class. In 1851 Florence’ father gave her permission
to train as a nurse.She was already 31 years old. Nightingale went to Kaiserwerth,Germany where she studied to
become a nurse at the Institute of Protestant Deaconesses.Two years later she was appointed resident lady
superintendent of a hospital for invalid women in Harley Street,London. During Crimean war, Florence Nightingale
tended to the wounded soldiers She became known as the “Lady With The Lamp”because of her night rounds. She
and a team of nurses improved the unsanitary conditions at a British base hospital, reducing the death count by two-
thirds. Nightingale wrote Notes on Nursing, which was the foundation of the curriculum for her nursing school and
other nursing school. Her writings sparked worldwide health care reform. In 1860 she established St. Thomas’
Hospital and the Nightingale Training School for Nurses. She died August 13, 1910, in London.