THEORETICAL FOUNDATION

OF NURSING
Lydia Hall
 Introduced the model on Nursing:
What is It?,
Click to edit the outline


 Consiststeoxfttfhorreme attenets

 The first is Sthecaot

nurOsinugtlifnuencLteiovenls
differently inthTehtirhdreOe
uintltienrelocking circles that
conLsetviteul te aspects of the
patient 1 Fourth Outline

The 3 circles are: Level
Fifth Outline



CARE - The patients b o d y 2
L e v e l

CURE -The diseaseafSfeixcttihng the
 body3
Outline

CORE -The person of the patient
Le v e l
which is being affected b y e ach
of the 
Seventh
Types of theories

 Grand theories

These theories that have a very broad scope

Each of the grand theories shares the common
ground offering a structure that enables
description and explanation of essential
conceptualization of nursing

Examples

Leninger

Newman

Parse
Middle Range Theories

As those “that lie between the minor but necessary working
hypotheses that evolve in abundance during day to day
research and all – inclusive systematic efforts to develop
unified theory

Principle ideas of middle range theories are relatively simple

Means rudimentary straight forward ideas that sum from the
factors of discipline

Thus, middle range theories is basic, usable structure of ideas, less
abstract than grand theories and more abstract than emperical
generalizations or micro-range theories

Examples: Orlando, Peplau,Watson, Modelling and Mercer’s
Micro – Range Theory

Situation specific

Focus on specific nursing phenomenon that reflect
clinical practice and that are limited to specific
populations or to particular field of practice

These theories offer a blue print that is more readily
operational and or less has more accessible utilization
clinical situation

Example: Korean immigrant women learned to adopt to
chronic illness.
NURSING PARADIGM


Nursing has a model or paradigm that explains the
linkages of science, philosophy, and theory that is
accepted and applied by the discipline.

The elements of Nursing paradigm direct the activity of
the nursing profession, including knowledge
development, philosophy, theory, educational experience,
research, practice and literature identified with the
profession

Nursing identified its domain in a paradigm that
includes four linkages: the person, health, environment/
situation, and nursing
 NURSING

PERSON HEALTH ENVIRONMENT

Four Major Concepts of Nursing Theories

1. PERSON – Refers to all human beings1

2. ENVIRONMENT – Include factors that affect
individuals internally and externally2
3. HEALTH – Addresses the person’s state of well – being
4. NURSING – is central to all nursing theories.
Definitions of nursing describe what nursing is, what
nurses do, and how nurses interact with clients. It is the
“diagnosis and treatment of human responses to actual
or potential health problems” (ANA, 1995).3
Florence Nightingale

Developed
aCnldickdteoscerdibitetdhetoheutlifinrest
Nursing Theoterxyt
format
udtislienaeseLe

Nightingale
wveals
belieSveecdontdhaOt
a reparative pro
cTeshsirdanOduttlhinaet the
manipulation of Levethl e
patient’s
surroundings-
ventilatio n , w a rm t
F o urth O u tli n
h ,
e
 light, diet, cleanliness, and noise
 Leve
She focused on changing and manipulating the
l environment
in order to put the patient in the best
possibleFicfothndOituiotlninse
for nature to act. Level

She provided the nursing profession the
“legacSyixotfhcaring”

Florence Nightingale = Outline
Environment Level

Seventh
13 Canons
 She identified the following aspects as major areas of the physical, social, and
psychological environment that the nurse could control:

 Health of houses

 Ventilation and warming

 Light

 Noise

 Variety

 Bed and bedding

 Cleanliness or rooms and walls

 Personal Cleanliness

 Nutrition and taking food

 Chattering hopes and advices

 Observation of the sick

CONCEPTS

 ENVIRONMENT: can be defined as anything that can

be manipulated to place a patient in the best possible
condition for nature to act
 This theory has both physical and psychological components

 The physical components of the environment refer to

ventilation, warmth, light, nutrition, medicine, stimulation,
room temperature and activity

 PERSON: the one who is receiving care; a dynamic

and complex being
 Nightingale envisioned the person as comprising
physical, intellectual, emotional, social and spiritual
components
 HEALTH: Nightingale wrote, “healthy is not only to be well,
but to be able to use well every power we have.”

She believed in the prevention and health promotion in addition to
nursing patients from illness to health

 NURSING: Nightingale believed nursing to be a spiritual

calling. Nurses were to assist nature to repair the patient

She defioned different types of nursing as “ nursing prioper” (nursing
the sick), “general nursing” (health promotion), and “midwifery
nursing”

Nightingale viewed nursing the “Science of
environmental management”

Nurses were to use common sense, observation, and ingenuity to
allow nature to effectively repair the patient

Nightingale believed, “observation may always be improved with
training – seldom be present without training; for otherwise the nurse
does not know what to look for
 Application

Miss angel gonzaga is a 25 year old female who had been admitted to the
medical unit with the chief complaint of frequent, watery stool since last
night.This is accompanied by abdominal cramps, N&V. her VS are as
follows: T=38.6, P=98, RR23, BP=100/70. she complains of weakness,
thirst, dryness of mouth. Her skin is warm, flushed, and dry. Her urine is
dark yellow in color

She claims, she had eaten oysters for dinner. She lives in a crowded
community close to landfill and shares toilet with 4 other families.Their
source of drinking is from pump well in the community. She does not
practice good handwashing after using the toilet. SE revealed
salmonellosis

She is tearful. She express great concern over her absence from her job in
a garment factory and over her health and expense for hospitalization
A. Nursing the Sick
A. Assessment

1. Fluid and electrolyte losses related to frequent, watery

stools, nausea and vomiting as manifested by changes
in the VS; weakness; dryness of mouth; warmth,
flushed, dry skin; dark-colored urine.
2. Pain related to abdominal cramps
3. Inadequate food intake related to nausea and vomiting
4. Fever (T=38.6’C) related to infection
(salmonellosis) and dehydration
 B. Plan
1. Fluid and electrolyte losses

Provide fluid and electrolyte replacement

Administer medications to relieve frequent , watery stools and nausea and
vomiting as prescribed

Provide good oral care for dryness of mouth

Promote rest to relieve weakness

Monitor intake and output.To assess fluid balance status

Provide good perianal care

1. Pain related to abdominal cramps


Provide low fiber diet ® to reduce peristalsis

Promote rest ® to reduce peristalsis and to promote comfort

Avoid gas forming foods ® flatulence worseness abdominal pain
3. Inadequate food intake

Provide small frequent feeding.This better tolerated by patients with nausea

Provide ice chips to relieve nauses

Administer antiemitic as prescribed ® relieve nausea and vomiting

3. Fever related to infection and dehydration


Provide adequate room ventilation

Keep the room airy and free of odor.

Increase fluid intake

Administer antibiotic and antipyretic as prescribed

Render TSB

Keep skin clean and dry

Change gowns and bedding
B. Physical Environment
A. Home, Community/ Neighborhood and
Workplace Assessment

1. Pure water. Assess for adequate working water system

and storage that is free from contamination
2. Cleanliness.

Assess for sanitation conditions of food sources and
preparation and hygienic practices

Assess for the means to maintain sanitation conditions of
toilets.To keep food and water supply free from
contamination
Home, Community/Neighborhood and Workplace
Plan

1. Water

Have water checked for contamination in coordination with
local Department of Health personnel

Educate the client on water purification and storage methods

Keep garbage and other refuse away from water supply or
any parts of the water system

1. Cleanliness

Educate the client on proper food handling; the importance of
handwashing especially when preparing foods and before
and after using the toilet; proper waste disposal and personal
3. Home and workplace Assessment

Light. Assess for adequate windows and working light sources

Pure air. Assess for ventilation, offensive odors, eg. Odors of
the garbage and landfill

Water. Assess for working system that is free from contamination

Drainage. Assess the home and workplace for means to keep the
areas clean, and freedom from excessive dust, mold, mildew, pet
droppings (from cats and dogs), offensive odors, “dust catcher”
things (files of papers, unused jars, plastic container, unused old
clothes, etc)

Bed and bedding. Assess the bed for space and comfort.
Assess the bedding for cleanliness and availability of areas for
laundry and drying of bedding (for home environment only).

Noise. Assess the area for loud, offensive and unnecessary noise
C. Psychological Environment
Assessment and Plan


Miss Angel Gonzaga has psychological concerns. She
is worried over her absence from her job, her health,
and expenses for hospitalization
1. Anxiety. Assess the client’s activities before illness. Attempt
to stimulate variety in the room and with the client during her
hospital stay – with cards, flowers, magazines, books, music.
Encourage visits of relatives and friends

2. Chattering hopes and advices. Refrain from giving the

patient your opinion. Provide factual information about
health. Allow her to verbalize her fears, feelings and
concerns
 Critical Thinking
 Miss Sarah Alonzo, a 22 year old female had consulted the health
center because of fever since three days ago.This accompanied by loss
of appetite to eat, body malaise, headache, abdominal pains, dizziness.
Her VS sre as follows T=38.7, PR=86, RR=21, BP=90/60. Miss
alonzo claims that she had lost weight because of her fever and loss of
appetite to eat. She lives in a crowded community which is constantly
submerged in water due to floods.This causes severe problems in
sanitation and source of water supply. Laboratory test and physical
examination revealed DHF

 Miss alonzo is extremely worried because she had a neighbor who

died because of DHF few months ago. In addition, she is concerned
over financial expenses for her illness and her absence from her job as
a crew in a fastfood center. She also verbalizes difficulty of sleeping in
unfamiliar environment like the hospital
1. Nursing the Sick

Assessment

Plan

1. Physical environment

Home, community/neighborhood and workplace assessment

Home, community/neighborhood and workplace plan

1. Psychological environment

Assessment and plan

1. Nutrition
 Virginia
Henderson 
Introduced the Nature of Nursing
Model Click to edit the outline
text format

She identified the 14 basic needs
Second Outline Level

She
postulated tha t th e u n iq u
T ir d O u tl in e
e function of the n u r s e is to
L e vel
assist the client sick or well in the
performance of
thoFsoeuratchtivOL itueievtsline
contributing to he a l thelor its
recovery, that FwifothuldOpue
client s

tlrinfoerm
unaided if they had
thLeenvelcessary strength, will
 or knowSliexdtghe*
Outline

Virginia Henderson =L1e4veBl asic
Needs 
Seventh
 14 Basic needs
 Breath Normally

 Eat and drink adequately

 Eliminate Body Waste

 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 the environment

 Keep body clean and well groomed and protect the integument

 Avoid dangers in the environment and avoid injuring others

 Communication with others in expressing emotions, needs, fears, or opinions

 Worship according one’s faith

 Work in such a way that there is a sense of accomplishment

 Play or participate in various forms of recreation

Faye Glenn Abdellah


ICntlricokdutoceeddiptat
thieenot-utline
cteenxttefroerdmAapt
proaches to
Nur s in g M o de l
S e c on d O u
tline Level

She id
eTnhtiifireddO2u1tlninu
ersing problemLesvel

She
definedFonuurrtshinOg
austliane service to
 Linedveivliduals and
families; thereFfoifrthe
tOoutthliene
society* Level

Sixth

Faye Glenn Ab d e ll a h =
O u t l in e
21
Level

Seventh
 21 Nursing Problems
 To maintain good hygiene and physical comfort
 To promote optimal activity; exercise; rest and sleep
 To promote safety through prevention of accident, injury, or
other trauma and through the prevention of the spread of
infection
 To maintain good hygiene and physical comfort
 To promote optimal activity: exercise, rest and sleep
 To promote safety through the prevention of accidents, injury,
or other trauma and through the prevention of the spread of
infection
 To maintain good body mechanics and prevent and correct
deformity

To identify and accept positive and negative
expressions, feelings, 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 , emotional, and developmental 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.

To accept the optimum possible goals in the light of
limitations, 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
 Dorothy Johnson

Concep
tuCalliiczkedtotheedBitethhaevi
oourtalline System
Mtoedxtelformat

Subsytem Second Outline Level
s
Third Outline



Ingestive Level

Eliminativ Fourth Outline
e Level

Affiliative

Dependence Achievement

Fifth Outline Level 
Sixth

Sexual and role identityObuethlianveior
Level

Seventh

In addition she viewed that each person strives to achieve
balance and stability both internally and externally and to
function effectively by adjusting and adapting to
environmental forces through learned patterns of
response

Furthermore, she believed that the patient strives to
become a person whose behavior is commensurate with
social demands; who is able to modify his behavior in ways
that support biologic imperatives; who is able to benefit to
the fullest extent during illness from the health care
professional’s knowledge and skills; and whose behavior
does not give evidence of unecessary trauma as a
consequence of illness

Dorothy Johnson – Behavioral Systems model
Dorothea Orem  Developed the self-care and self-
care deficit Theory

Click to edit the outline

She defintedxtdfeofirnmeadt self care
as the
“practice of activities that individuals
initiate and
pSecrfoonrdmOountltihneirLeovwenl
behalf in main taTinhiinrgd
lOifeu,thlienaelth and
well being.” Level

She
conceptualizesFtohurretehNOuurtsliin
ge
systems as f
evel 
Fifth Outline

Wholly compensatory
Level

Partially compensatorySixth

Supportive Outline
educative Level

Dorothea Orem – SeSlfeCveanreth
Madeline Linenger  Developed Transcultural
Nursing Model

Click to edit the outline

Shteexatdvfoorcmataetd that
Nursing
is a humanistic and scientific
modeSeocf ohnedlpOingutalinc
elieLnetvel
through TspheircdifiOc
cuutllitnueral
caring prLoecveesls* to
improve or maintain
h ea l t h c on d i t io
Fo u r t h O u tl i n e
n

Advocated tLheavtecl aring
is universal and vaFrifitehs
Outline transculturally.
LMeavjeolr concepts inclu
dSeixctahre, caring,
cultural Oanudtlcinueltu
values ral
variations Level

Furthermore, Leininger believed that caring serves to
ameliorate or improve human conditions and life base.
And that care is the essence and the dominant, distinctive
and unifying feature of nursing

Madeleine Leininger - Transcultural
Imogene King  Postulated the Goal attainment
Theory
She d escCrliibcekdtonuerdsint



gthaes oa uhtelilnpeing
professiotenxthfaotrmasastists
individuals and groups
SinecsooncdieOtyuttolinaettLaie
nv,el maintain, and restore
health*

Third Outline

In addition, kinLgevvielwed
nursing as an interaction
procFeosusrtbhetOwuetelnine
client and nurse wLheevreelby
during
perceiving, setting goaFlisft,
 hanOd uatclitnineg
on transactions goals are
occurLeavnedl
achieved

Sixth

Imogene King =
GoalOAuttlaininement
Theory Leve
l
Myra Levin  She advocated that nursing is a
human interaction and
propCosliecdk ftouer nthserovuatiloin
dciot ne
princtiepxletsfoorfmnautrsing
which are
concern e d w it h un i t y
a n d S eintegrity
co n dofOthe u t l in
e L evel
individual.

Third Outline

Described tLheeveFlour
Conservation
P r in c i p le s
F o u r t h O utline

ConservationLoefvEenlergy


Fifth
Conservation of Structural
Outline
 Integrity Level

Sixth

Conservation of POerustolinnael
Integrity
Level

Conservation of
SSoecviaelnitnhtegrity
 
Conservation of energy – the human body functions by utilizing
energy.The human needs energy producing input (food, oxygen, fluids)
to allow energy utilization as output

Conservation of structural integrity – the human body has a physical
boundaries (skin and mucous membrane) that must be maintained to
facilitate health and prevent harmful agents from entering the body

Censervation of personal integrity – the nursing interventions are
based on the conservation of the individual client’s personality. Every
individual has a sense of identity, self worth and self esteem, which must
be preserved and enhanced by nurses

Conservation of social integrity – the social integrity of the client
reflects the family and the community in which the client functions.
Healthcare institutions may separate individuals from their family. It is
important for the nurses to consider the individual in the context of the
family

 Myra LEVIN – Conservation

 “conserve the energy”
Hildegard Peplau

 In trCodlicukcetdo
tehdeitIntht
eropeurtslionneal Modteexl t
format
 She dSeeficnoendd
nOuurstilninge Laesvealn
interpersoTnhailrd
Opruotclienses
of
therapeutiLcevel interactions
between
in di v anid ua l wh o
Fo u r th O u t lin e
’s
sick or in n ee d of health
services andL v ael nurse
especially utlintoe

F if t h O
e du c a t e d
Le ve l
recognize and r e s p ond to
the need for he lpSixth


Outline
Level

Seventh

She identified the four phases of the nurse-client
relationship namely
 Orientation – the nurse and the client initially do not know
each other’s goal and testing the role each will assume1

 Identification – the client responds to the professionals or the

significant others who can meet the identified needs2

 Exploitation – the client utilizes all available resources to

move toward a goal of maximum health or functionality

 Resolution – Refers to the termination phase of the nurse –

client relationship3

Hildegard PepLau – Interpersonal Model
Martha Rogers  Conceptualized the Science of Unitary
Human Beings
 Energy Click to edit the outline

Fiel d text format

Human
Field* Second Outline Level

Environmental Field*

Third Outline
 Unitary Man is an field in constant
enLervgeyl
interaction with the
envFiroounrmtheOntutline
Level
 The unitary human being and the
environment are
integral a n dfththOeruetfloinre
F i

 viewed as a Level
whole*

Furthermore, she believed that human being is charSaicxttehrized
by
the
aOndcapacity
t h o for
u abstraction
ght, and imagery, language
u t li n e
sensation and emotion Level
 
Click to edit the outline
text format
Second Outline Level

Third Outline
Level
Fourth Outline
Level

Fifth
Outline
Level

Martha ROgers – UNItary maN 
Sixth
Outline
Level
Sister Callista Roy

Presented the adaptation model

She viewe d eCaclihckpetrosoendiats




tuhneifioedutline biopsychosotceiaxl
tsyfostremmaitn constant interaction
with a c h a n gin g
Sec on d O
e n v ir on m en t 1
u t l in e L ev e l

The system
consistsTohfirindpuOt,uctolinnter
ol process, output and fee d b
L ev e l
ack

In addition she advocateFdotuhratthalOl
puetolpinlee have certain needs
whicLhevtheely endeavor to meet in order
to maintain integrity2
 
Fifth Outline
 Accordingly she believed that adaptive human behaviorLeisvdeilrected
as an attempt to maintain homeostatis or integrity of the individual by
conserving energy and promoting the survival, growth,Sixt production and
mastery of human system hOutline
 RAM – Roy’s Adaptation Level
Model
 Nursing operates in all three circles, but it shares them
with other professions to different degrees

 Care – nurturance ntuhresinogu*

Canldicekxctluosiveedtiot tline
 Core – involves thetethxetrafpoerumticautse of self
and
emphasizes the use of r efl e c ti on *
S e c o n d Outline
Level
 Cure – Pathological conditions areOutline
Third focuses on
nursing related to the physician’s orders*
Level
 Second, relates to the core postu la t e o f he r
F ou r t h O
t he o ry
u tl in e
 As the patient needs less mLedeivcael lcare, he or
 she needs more professional Nursing care and
teaching

Third , wholly professional nursing care will hasten
recoLveervyel
 Describes the concept of team nursing, which give sSitxhteh
care of less complicated cases to caregivers with les s
training
O utline
Level

Lydia HALL – CaRE, CoRE,
CuRE
Ida Jean Orlando (Pellitier)

 Conce
ptCulaiclikzetdoTehdeitDthyen
aomuticline Nurse –
tePxatiefonrtmRaetlationship
Model
Second Outline Level
 She
believedthTaht irthdeOnurlsinee
helps patients meet
aLepveerlceived need
that
c anthe
n patients
o t m ee t f o r
F o u rt h O u li n e
themselves
Level
 She observed that
thFeifntuhrOseutline provides
direct assistLanevcel to meet an
immediate nSeiexdthfor help in
order to alleviate dOisutrtelinsse
or
helplessness* Level

She also indicated that nursing actions can be automatic1
or deliberative2

She also advocated that the three elements composing
nursing situation are: client behavior, nurse reaction and
nurse action

Ida Jean Orlando – Nursing Process Theory
Jean Watson
 Conceptualized the Human Caring
Model
(NCurliscinkgt: oHuemdiatnthSeci


eonuctelinaned Human
Ctaerxet). format

 She emphasizSeedcothnadt
nOuurstilningethLeevel
application of
the
TharirtdanOduhtulimnean
Science through Ltreavneslpersonal
caring transactions to help person
achieve mind-body soul
F o u r th Outline
harm o n y *
Level
 She included health
 Leve
proFmifothtioOn uatnlidne
treatment of illness in nursing
 She believed that a person is valued being to be cared for,
respected, nurtured, understood and assisted; a fullySfiuxntchtional
integrated self Outline
 Jean Watson –Science and Philosophy of Level
Caring
 10 Carative Factors in Nursing

 Forming humanistic – altruistic value system

 Instilling faith- hope

 Cultivating sensitivity to self and others

 Developing helping – trust relationship

 Promoting expression of feelings

 Using problem – solving for decision making

 Promoting teaching - learning

 Promoting supportive environment

 Assisting with gratification of human needs

 Allowing for existential- phenomenological forces

Rosemarie Rizzo Parse

 IntroducedCtlihcek
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contrascending in many e l
 She believed that each 
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 while closing others Level
 
Sixth
Since each individual makes his or her own personal choices,
Outline
the role of the nurse is that of guide, not a decision maker
Level
 Rosemarie Riso Parse –Theory OF HUMAN BeCOminG
 Joyce Travelbee

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illness, regaining healt h , fi n d in g
F ooru mr t ah inO
meaning in illness,
utline L ev e l
taining maximal degree  of health
 She further viewed that interpersonal process
F i fth O u t lin e
i s a hu m a n –
 L e vel
to – human relationship formed during illness a n d
“experience of 
Sixth
suffering”* Outline

The H2H in nursing situations, is the means through which
the purpose of nursing is accomplished Level
 The H2H relationship is established when the nurse and
the recipient of her care attain a rapport after having
progressed through the stages of original encounter,
emerging identities, empathy and sympathy. (continuum
of suffering)
 Transitory feeling of displeasure

 Extreme anguish

 Malignant phase of despairful not caring

 Terminal Phase of apathetic indifference

 She believed that a person is a unique, irreplaceable

individual who is in a continuous process of
becoming,
Patricia Benner

 Dr
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 She further explains

through a as a mFuoltuirttuhdOe uotlfine
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 She proposed that onLeevceol uld
composed of the extension of practical knowledge
g a i n k n o w le d g e
(know how) through r e s ea r c h an d t h e
a n d s Sk ix il tlhs
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
Seventh
 Benner’s Stages of clinical competence

 Stage 1: Novice
 Beginners have had no experience of the situations in
which they are expected to perform. Novices are taught
rules to help them perform.
 The rules are context-free and independent of specific
cases; hence the rules tend to be applied universally.
 The rule-governed behavior typical of the novice is
extremely limited and inflexible.
 As such, novices have no "life experience" in the
application of rules."Just tell me what I need to do and
I'll do it."
 Stage 2: Advanced Beginner

Advanced beginners are those who can
demonstrate marginally acceptable performance,
those who have coped with enough real situations
to note, or to have pointed out to them by a
mentor, the recurring meaningful situational
components.

These components require prior experience in
actual situations for recognition.

Principles to guide actions begin to be formulated.

The principles are based on experience.
 Stage 3: Competent
 Competence, typified by the nurse who has been on the job in the
same or similar situations two or three years, develops when the
nurse begins to see his or her actions in terms of long-range
goals or plans of which he or she is consciously aware.

 For the competent nurse, a plan establishes a perspective, and the

plan is based on considerable conscious, abstract, analytic
contemplation of the problem.

 The conscious, deliberate planning that is characteristic of this

skill level helps achieve efficiency and organization.

 The competent nurse lacks the speed and flexibility of the

proficient nurse but does have a feeling of mastery and the ability
to cope with and manage the many contingencies of clinical
nursing.
 The competent person does not yet have enough experience to
 Stage 4: Proficient
 The proficient performer perceives situations as wholes rather than
in terms of chopped up parts or aspects, and performance is guided
by maxims.

 Proficient nurses understand a situation as a whole because they

perceive its meaning in terms of long-term goals.

 The proficient nurse learns from experience what typical events to

expect in a given situation and how plans need to be modified in
response to these events.

 The proficient nurse can now recognize when the expected normal
picture does not materialize.
 This holistic understanding improves the proficient nurse's decision
making; it becomes less labored because the nurse now has a
perspective on which of the many existing attributes and aspects in
the present situation are the important ones.

Stage 5:The Expert

The expert performer no longer relies on an analytic principle
(rule, guideline, maxim) to connect her or his understanding of
the situation to an appropriate action.

The expert nurse, with an enormous background of experience,
now has an intuitive grasp of each situation and zeroes in on the
accurate region of the problem without wasteful consideration of
a large range of unfruitful, alternative diagnoses and solutions.

The expert operates from a deep understanding of the total
situation.The chess master, for instance, when asked why he or
she made a particularly masterful move, will just say: "Because
it felt right; it looked good."

The performer is no longer aware of features and rules;' his/her
performance becomes fluid and flexible and highly proficient.

This is not to say that the expert never uses analytic tools. Highly
Rozzano Locsin
 
Click to edit the outline

Credteextnfotrmiaat ls
Second Outline Level

PhD: nTh eOurtlisneit
U  iir y
vLeve
l
d

of the Fourth Outline

Level
PhilippineLevel
sFifth Outline

(1988) - MOutline
Saixtnh


ila,
PhilippinesSeventh

Level

Teaching

Philosophies of Science Grounding Nursing

Introduction to Nursing as Discipline and Profession

Nursing Research

Arts as Healing Modalities in Nursing

Philosophical & Theoretical Foundations of Advanced
Practice Nursing

Advancing Technology, Caring, and Nursing

Research interest

Experiences of Caring for/Being Cared for
 Awards

 Academic Excellence Award, Philippine American Society, 2010

 Balik Scientist (Returning Scientist) Program, Department of Science
& Technology, Philippines 2009

 University Research of the Year - Professor, Scholarly & Creative Works,

FAU 2006

 Outstanding Alumni Award – Lifetime Achievement in Nursing

Education St. Paul University of Dumaguete, Dumaguete City, Philippines
2004

 Fulbright Alumni Initiative Award Center for International Exchange

of Scholars,Washington, D.C. 2004-2006

 Edith Moore Copeland Award for Excellence in Creativity (Founders Award)

Sigma Theta Tau International Honor Society of Nursing - Indianapolis (37th
Biennial Convention – November 1-5) 2003

 Julita V. Sotejo Medallion of Honor: Lifetime Achievement Award University of

the Philippines, Nursing Alumni International Inc., Los Angeles, California
2003
 He describes nursing as caring through technological
competency
 In his chapter, Locsin described how technological
competency in nursing practice is an expression of caring.
 He outlined his theory in his book by stating “the practice
of the 21st century nursing is conducted in environment
that rely on complex biomedical machine technology,
practice environments that differ vastly from those of an
earlier era.
 The core of nursing, the basic service of nursing, however
has not changed.
 Caring continues to be the most essential and the most
direct expression of nursing service.
 Nurses now face the challenge of creating an environment
of personal care in the context of highly sophisticated,
although impersonal, health care technology
 He provided a description of nursing practice, and implied
the potential for objectification of clients due to
technological competency.
 Locsin explored the dichotomy between technology and
caring, and through references to current literature about
nursing as caring, he developed a harmonious merger of
this dichotomy