Dear Asperion

8/9/2019 Dear Asperion

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(Dear Asperion: I've placed here a detailed outline of the Nursing Theorists that we will be discussing for

your TFN finals. Some things to remember, my dear students: THIS IS JUST AN OUTLINE AND THIS IS

ONLY A GUIDE FOR YOU TO FOLLOW. I expect you guys to read your books, attend my classes, complete

my requirements and pass the final exam. We only have a month left. Good luck and Godspeed. xoxo)

FLORENCE NIGHTINGALE: Environmental Theory

Born: May 12, 1820 in Florence, Italy

Got the name Lady of the Lamp during the Crimean War

Concentrated on army sanitation reforms, army hospitals, and sanitation in India and poorer classes in

England

Died: August 13, 1910 in London, England

Nursing Paradigms:

Person

Person = Patient

being acted upon by the nurse or affected by the environment (Major Assumption)

passive and does not influence the nurse or the environment (Major Assumption)

Health

As being well and using to the fullest extent every power available (Major Assumption)

Health Nursing - as being maintained through the prevention of disease via environmental health factors

(Major Assumption)

Disease - a reparative process that nature instituted because of some want of attention (Major

Assumption)

Environment

Capable of preventing, suppressing, or contributing to disease, accidents, or death, is all external

conditions affecting the life and development of an organism

One of the chief sources of infection (Major Assumption)

Main factor in producing an illness state and regarded disease as the reaction of kindly nature

against the conditions in which we have placed ourselves.


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External elements which affect the health and include everything from the patients food and

flowers to the nurses verbal and nonverbal interactions with the patient (Fitzpatrick and Whall).

(Major Assumption)

Healthy surroundings are necessary for proper nursing care

Five essential points in a healthy house:

Pure air

Pure water

Efficient drainage

Cleanliness

Light

Components of A Therapeutic Environment:

Ventilation

most vital

nurse should keep the air his patient breathe clean as the wind but without chilling the patient

a steady supply of fresh air - most important principle of nursing

pure air was the very first canon of nursing, the first and last thing upon which a nurses attention must

be fixed, the first essential to a patient, without which all the rest you can do for him is nothing

Light

direct sunlight - second need next to fresh air

A nurse might have to carry the patient about after the sun, according to the aspects of the room.

Warmth

Nurses should constantly monitor their patients body temperatures by palpating the extremities toprevent the effects of vital heat loss

The safest atmosphere of all for a patient is a good fire and open window, excepting in extreme

environment.


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Diet

A nurse should not only assess the dietary intake, but also assess the timeliness of the food and its effect

on the patient

Cleanliness

Clean environment compose of the patient, the nurse and the environment

Dirty carpets and walls contained large quantities of organic matter and provided a ready source of

infection

Unwashed skin interfered with healing and washing removes noxious matter from the system quickly

Nurses should wash their hands frequently and keep their patients very clean

Noise

Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient Any

sacrifice to secure silence is worthwhile, because no air, however good, no attendance however

careful, will do anything without quiet.

Noise could impede the patients recovery, even if there were fresh air and good attendance by nurses.

Nursing

A religious calling to be answered only by women (Major Assumption)

Every woman, at one time or another, would be a nurse in the sense that nursing was to have the

responsibility for someones health (Major Assumption)

Nurses are manipulator of the environment and actor on the patient.


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VIRGINIA HENDERSON: 14 Fundamental Needs

Born: November 30, 1897, Kansas City, Missouri

Died: March 19, 1996, Branford, Connecticut

"first lady of nursing"

"First truly international nurse."

An early advocate for the inclusion of psychiatric nursing in the curriculum and served on a committee

to develop such a course at Eastern State Hospital in Williamsburg, Virginia in 1929.

Nursing Paradigms:

Person

An individual who requires assistance to achieve health and independence or peaceful death

The mind and body are inseparable.

The patient and his family are viewed as a unit

The 14 Fundamental Needs:

Physiological

- 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 the

environment.

- Keep the body clean and well groomed and protect the integument.- Avoid dangers in the environment and avoid injuring others.

Spiritual

- Worship according to ones faith.Sociological

- Work in such a way that there is a sense of accomplishment.- Play or participate in various forms of recreation.


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Psychological

- Communicate with others in expressing emotions, needs, fears, or opinions.- Learn, discover, or satisfy the curiosity that leads to normal development and health and use the

available health facilities.

Health

Individuals ability to function independently as outlined in the 14 components.

The quality of health rather than life itself, that margin of mental/physical vigor that allows a

person to work most effectively ant to reach his highest potential level of satisfaction in life.

Nurses need to stress promotion of health and prevention and cure of disease.

Good health is a challenge.

Affected by age, cultural background, physical, and intellectual capacities, and emotional

balance

Environment

The aggregate of all the external conditions and influences affecting the life and development

of an organism.

Society expects nurses to act for individuals who are unable to function independently

Basic nursing care involves providing conditions under which the patient can perform the 14

activities unaided

Nursing

Defined nursing in functional term

The unique function of the nurse is to assist the individual sick or well to perform his/her

activities contributing to health, its recovery, or to a peaceful death, the client would perform, if he had

the necessary strength, will and knowledge. And to do this in such a way as to help him gain

independence as rapidly as possible.

"I say that the nurse does for others what they would do for themselves if they had the strength,

the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or

her as soon as possible."

Nurse serves to make patient "complete", "whole", or "independent."

Individualized care


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BETTY NEUMAN: Systems Model

1924: Born near Lowell, Ohio.

1957: Attended University of California at Los Angeles (UCLA) with double major in psychology and

public health.

1966: Received Masters Degree in Mental Health, Public Health Consultation from UCLA.

Recognized as pioneer in the field of nursing involvement in community mental health.

Began developing her model while lecturing in community mental health at UCLA.

1972: Her model was first published as a 'Model for teaching total person approach to patient problems'

in Nursing Research.

Nursing Paradigms:

Person

The client system refers to more than one person, such as family or community

"an open system seeking balance and harmony; a composite of physiological, psychological, socio-

cultural and developmental variables viewed as a whole"

The client system can influence his/her environment.

The client as an open system that seeks balance and harmony through a central core of energyresources (physiologic, psychologic, sociocultural, developmental, & spiritual) surrounded by lines of

resistance that defends client against stressors

Health

Occurring on a continuum; at opposite poles are wellness and illness.

The client's health is not static and is a reflection of the ongoing interactions between the client and

his/her environment

"the best possible wellness state at any given time"

The usual state of wellness is coined "the normal line of defense"

Movement away from wellness is a result of stressors overwhelming the normal line of defense


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Environment

Viewed as all factors, both inside and outside the client or client system, which influence the person

Influences the client

Created environment - which serves to protect the person from reality when the person is ill-prepared

to handle the truth.

Nursing

The goal for nursing is a stable client system

Nursing is a unique profession in that it is concerned with all the variables affecting an individuals

response to stresses which are intra (within), inter (between one or more people) and extra-personal

(outside the individual) in nature.

The concern of nursing is to prevent stress invasion, to protect the clients basic structure and obtain ormaintain maximum level of wellness.

The nurse helps the client, through primary, secondary, and tertiary prevention modes, to adjust to

environmental stressors and maintain client system stability.

System Models:

Primary Prevention

- Appropriate before symptoms occur.- The focus is to build up the flexible line of defense which serves as a buffer around a person's

normal line of defense, or usual method of coping

Secondary Prevention

- Occurs when symptoms are evident.- The goal is to build up the internal lines of resistance which come into play once the normal

lines of defense have been penetrated by a stressor. These lines of resistance attempt to

maintain balance by drawing on additional resources that are not usually required

Tertiary Prevention

- Focuses on the return of system client balance, or client wellness.- This is achieved by building on the client's strengths.- Tertiary prevention leads to primary prevention


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IMOGENE KING: Goal Attainment Theory

Born: Jan. 30, 1923, in West Point, Iowa.

1961: received a Doctorate in Education from Teachers College, Columbia University, where she studied

under Mildred Montag.

1945-51: worked as a clinical instructor in medical-surgical nursing at St. Johns Hospital School of

Nursing

Nursing Paradigms:

Person

a dynamic human being whose perceptions of objects, persons, and events influence his behavior, social

interaction, and health

three interacting system: individuals (personal systems), groups (interpersonal systems), and society

(social system); the persona; system is a unified, complex, whole self who perceives, thinks, desires,

images, decides, identifies goals and selects means to achieve goals

The Three Interacting System:

Personal Systems - focuses on the individual

Perception - a process in which data obtained through the senses and from memory are organized,

interpreted, and transformed

Self - made up of thoughts and feelings related to ones awareness of being a person separate from

others and influencing ones view of who and what he or she is

Growth & development - processes in peoples lives through which the move from a potential for

achievement to actualization of self

Body Image - includes both the way one perceives ones body and others reactions to ones appearance

Space - physical area known as territory and by the behaviors of those who occupy it

Time - an interval between the two events that is experienced differently by each person

Interpersonal systems - formed by human beings interacting

Interactions - observable behaviors of two or more persons in mutual presence

Communication - verbal and non verbal situational, perceptual, transactional, irreversible, or moving

fwd in time, personal, and dynamic


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Transactions - a series of exchanges between human beings and the environment that include

observable behaviors that seek to reach goals of worth to the participants

Role - characteristic of role include reciprocity in that a person may be a giver at one time and a taker at

another time, with a relationship b/t two or more individuals who are functioning in two or more roles

that are learned, social, complex, and situational

Stress - an ever changing condition in which an individual, through environmental interaction, seeks to

keep equilibrium to support growth and development and activity

Social Systems - is a structured larger group in a system that includes the roles behaviors, and practices

defined by the system for the purposes of sustaining desirable attributes and for creating methods to

maintained the practices and rules of the system

Organization - made up of individuals who have prescribed roles and positions and who make use of

resources to meet goals-both personal and organizationalAuthority - active, reciprocal process of

transaction in which the actors experience, understanding, and values influence the meaning,legitimacy and acceptance of those in organizational positions associated with authority

Status - the relationship of ones place in a group to others in the group or of a group to other groups

Decision Making - changing and orderly process through which choices related to goals are made among

identified possible activities and individual or group actions are taken to move toward the goal

Health

a dynamic state in the life cycle

illness is an interference in the life cycle

implies a continuous adaptation to stress

Environment

Adjustment to life and health are influenced by an individuals interactions with environment

Constantly changing

Nursing

A helping profession that assists individuals and groups in society to attain and maintain and restore

health. If this is not possible, nurses help individuals to die with dignity.

Nursing is a process that involves caring for human beings with health being the ultimate goal


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DOROTHEA OREM: Self-Care Model

Born: 1914, Baltimore, Maryland.

Providence Hospital School of Nursing, Washington, DC; BSN Ed. (1939)

MSN Ed. (1945) from the Catholic University of America, Washington, DC.

Doctor of Science from Georgetown University (1976)

Nursing Paradigms:

Person

Can take responsibility for their health and the health of others.

Have the capacity to care for themselves or their dependents.

Health

A state that is characterized by soundness or wholeness of developed human structures and of bodily

and mental functioning.

Includes physical, psychological, interpersonal, and social aspect.

Well-being individuals perceived condition of existence; also a state characterized by experiences of

contentment, pleasure, and certain kind of happiness; by spiritual experiences; by movement toward

fulfillment of ones self-ideal; and by continuing personalization

Well-being is associated with health, with success in personal endeavors, and with sufficiency of

resources

Environment

Linked to the individual, forming an integrated and interactive system

Nursing

Emphasizes the clients self-care needs, nursing care becomes necessary when client is unable to fulfill

biological, psychological, developmental or social needs.

Self-care - activities an individual performs independently to promote and maintain personal well-being.

Self-care deficit describes and explains why people can be helped through nursing


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Nursing systems nursing is human action and are action system formed by nurses through the exercise

of their nursing agency for persons with health derived or health-associated limitations in self and

dependent care

Wholly compensatory systems are required for individuals who are unable to control and monitor their

environment and process information.

Partly compensatory systems are designed for individuals who are unable to perform some, but not all,

self-care activities

Supportive-educative (developmental) systems are designed for persons who need to learn to perform

self-care measures and need assistance to do so.

Self-care requisites (self-care needs) actions or measures taken to provide care. There are three

categories:

Universal requisites:

- Intake of air, water and food- Care associated with elimination of excrements- balancing activity and rest- balancing solitude and social interaction- preventing hazards to life and well-being- promoting normal human functioning

Developmental requisites results from maturation or are associated with conditions and events.

Health deviation requisites result from illness, injury or disease or its treatment. (ex. Seeking health

care assistance, carrying out prescribed therapies, and learning to live with the effects of illness or

treatment)

Therapeutic self-care demand all self-care activities required to meet existing self-care requisites.

(Actions to maintain health and well-being Self-care deficit results when self-care agency is not

adequate to meet the known self-care demand.)

5 Methods in Helping:

- Acting or doing for- Guiding- Teaching- Supporting- Providing an environment that promotes abilities to meet current demands


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Self-care agency individuals ability to perform self-care activities.

A self care agent an individual who performs self-care independently

A dependent care agent a person other than the individual who provides the care

Basic Conditioning Factors for Self-care Agency and Therapeutic Self Care Demand:

Age

Gender

Developmental state

Socio-cultural orientation

Health State

Family system factors

Health care system factors

Patterns of living

Environmental factors

Resource availability and adequacy

Basic Conditioning Factors for Nursing Agency

Age

Gender, race

Physical and constitutional characteristics

Health state

Family/Community roles

Nursing educational preparation

Nursing experience

Maturity/Status as a person


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FAYE GLENN ABDELLAH: 21 Nursing Problems

Born: March 13, 1919, New York City.

Earn three degrees from Columbia University: a Bachelor of Science degree in nursing in 1945, a Master

of Arts degree in physiology in 1947 and a doctor of education degree in 1955.

As a practicing nurse, Abdellah managed a primary care clinic at the Child Education Foundation in New

York

Managed the obstetrics gynecology floor at Columbia University's Presbyterian Medical Center

She researched nursing practices and taught research methods and theory at several universities,

including schools in Washington, Colorado, Minnesota, and South Carolina.

1970s: was responsible for establishing nursing-home standards in the United States.

Nursing Paradigms:

Person:

The recipient of nursing care having physical, emotional, and sociologic needs that may be overt or

covert.

Health:

Implicitly defined as a state when the individual has no unmet needs and no anticipated or actual

impairments.

Environment:

Client interacts with their environment, of which the nurse is a part.

Nursing:

A service to people, families and society.

Patient-Centered Approaches to Nursings purpose is to deliver nursing care for the whole individual.

The nurse helps people, sick or well, to cope with their health needs.

Nursing care means providing information to the client or doing something to the client with the goal of

meeting needs or alleviating impairment.


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21 Nursing Problems:

- To maintain good hygiene.- To promote optimal activity: exercise, rest, and sleep.- To promote safety.- To maintain good body mechanics.- To facilitate the maintenance of supply of oxygen.- To facilitate maintenance of nutrition.- To facilitate maintenance of elimination.- To facilitate the maintenance of fluid and electrolytes balance.- To recognize the physiologic response of the body to disease conditions.- To facilitate the maintenance of regulatory mechanisms and functions.- To facilitate the maintenance of sensory function.- To identify and accept positive and negative expressions, feelings and reactions.- To identify and accept the interrelatedness of emotions and illness.-

To facilitate the maintenance of effective verbal and non-verbal communication.

- To promote the development of productive interpersonal relationship.- To facilitate progress toward achievement of personal spiritual goals.- To create and maintain a therapeutic environment.- To facilitate awareness of self as an individual with varying needs.- To accept the optimum possible goals.- To use community resources as an aid in resolving problems arising from illness.- To understand the role of social problems as influencing factors.


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MADELEINE LEININGER: Transcultural Nursing

Born: 13 July 1925 in Sutton, U.S.

Founder of transcultural nursing in the mid-1950s.

She brought nursing and anthropology together and coined the term transcultural nursing as an

essential formal area of study and practice.

Her Culture Care Diversity & Universality theory was one of the earliest nursing theories and it remains

the only theory focused specifically on transcultural nursing with a culture care focus. Her theory is used

worldwide.

Developed the concept of transcultural nursing, bringing the role of cultural factors in nursing practice

into the discussion of how to best attend to those in need of nursing care.

Established the first Caring Research Conference in 1978. She developed the theory of Culture Care with

the ethno-nursing method.

Nursing Paradigms:

Person

should refer to families, groups, and communities

Health

A state of well being that is culturally defined, valued and practiced and reflects the ability of individuals

(or groups) to perform their daily role activities in culturally expressed, beneficial, and patterned

lifeways.

Environment

Included events with meanings and interpretations given to them in particular physical, ecological,

sociopolitical or cultural setting.

Environmental context refers to the totality of an event, situation or particular experience that gives

meaning to human expressions, interpretations, and social interactions, particularly physical, ecological,

sociopolitical, and/or cultural setting.


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Nursing

Learned humanistic and scientific profession and discipline that is focuses on human care phenomena

and activities to assist, support, facilitate, or enable individuals or groups to maintain or regain their

well-being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or

death.

- Care has the greatest meaning which explains nursing- Care always occurs in a cultural context- Culture is viewed as framework people use to solve human problems- Culture is the lifeways of an individual or a group with reference to values, beliefs, norms,

patterns, and practices

- Information on culture is essential for holistic assessment of an individual, family, or community- The assessment process must be comprehensive, accurate, and systemic- Individuals, family, or communitys perspective of their culture is needed for an accurate

assessment.

Nurses should:

Approaches an individual, family, or community with the intent to gain understanding of the

expressions, patterns of health, and care

Obtains knowledge about the dynamic cultural and social structural dimensions influencing health.

Invites an individual, family, or community to describe their own experience about health and caring

Documents the description of an individuals, familys, or communitys cultural and social structure that

influence health patterns and concern

Should value diversity for they have the capacity to perform a cultural self-assessment.

Should be conscious of the dynamics inherent when cultures interact and we should exercise cultural

awareness. Being culturally competent is essential to being an efficient nurse.


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PATRICIA BENNER: Novice to Expert Theory

Professor of the Department of Physiological Nursing in the School of Nursing at the University of

California, San Francisco

Author of nine books including From Novice to Expert

An internationally noted researcher and lecturer on health, stress and coping, skill acquisition and

ethics.

Have been a staff nurse in the areas of medical-surgical, emergency room, coronary care, intensive care

units and home care

Nursing Paradigms:

Person

A self-interpretating being, that is, the person does not come into the world predefined but gets defined

in the course of living a life

Has an effortless and nonreflective understanding of the self in the world

A participant in common meanings

Health

What can be assessed, whereas well-being is the human experience of health or wholeness

Described as not just the absence of disease and illness

A person may have a disease and not experience illness because illness is the human experience of loss

or dysfunction, whereas disease is what can be assessed at the physical level

Environment

Used situation rather than environment because situation conveys a social environment with social

definition and meaningfulness

To be situated implies that one has a past, present and future and all of these aspects influence the

current situation


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Nursing

Caring relationship, an establishing condition of connection and concern

A caring practice whose science is guided by the moral art and ethics of care and responsibility

The care and study of the lived experience of health, illness and disease and relationships among these

three elements

Novice to Expert

Benner's Stages of Clinical Competence

Application to Nursing of the Dreyfus Model of Skill Acquisition

Five Levels of Proficiency:

Novice

Beginners have no experience of the situations in which they are expected to perform.

Novices are taught rules, (context-free and independent of specific cases; hence they are applied

universally) .

The rule-governed behavior is extremely limited and inflexible.

Novices have no "life experience" in the application of rules.

"Just tell me what I need to do and I'll do it."

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.


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Competent

Competence, is achieved when a nurse experience a same or similar situations two or three years ago

It develops when the nurse see his actions in long-range goals which he is aware.

A competent nurses plan gives perspective, and is based on conscious, abstract, analytic contemplation

of the problem. The conscious, deliberate planning in this skill level provides efficiency and organization.

The competent nurse lacks the speed and flexibility of the proficient nurse but does have mastery and

ability to cope with and manage the many clinical nursing problems.

The competent nurse does not yet have enough experience to recognize a situation in terms of an

overall picture or in terms of which aspects are most important.

Proficient

The proficient nurse perceives situations as whole rather than in parts, and performance is guided bymaxims (certain guiding principles of law and jurisprudence).

Understands a situation as a whole because they perceive its meaning in terms of long-term goals.

Learns from experience what typical events to expect in a given situation and how plans need to be

modified in response to these events.

Recognize when the expected outcomes do not materialize, and provides alternative solutions.

Uses maxims as guides which, for a competent or novice nurse, appear as unintelligible variation of the

situation.

Expert

The expert nurse no longer relies on an analytic principle (rule, guideline, maxim) to understand the

situation and its appropriate action.

The expert nurse, with a numerous experience, now has an intuitive grasp of each situation and

accurately provides solutions.

Operates from a deep understanding of the total situation.

His/her performance becomes fluid and flexible and highly proficient.

Highly skilled analytic ability is needed for situations in which the nurse has had no previous experience.

Analytic tools are also necessary for those times when the expert nurse gets a wrong grasp of the

situation and then finds that events and behaviors are not occurring as expected.


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MARTHA ROGERS: Science of Unitary Human Beings

Born: on May 12, 1914

University of Tennessee in Knoxville in 1931 N

Nursing school at Knoxville General Hospital in September 1933

received her nursing diploma in 1936

Bachelor of Science degree in Public Health Nursing form the George Peabody College in Nashville in

1937

Became a public health nurse in rural Michigan

Nursing Paradigms:

Person

Views person as an irreducible whole, the whole being greater than the sum of its parts. Whole is

differentiated from holistic.

There is more to a person than his/her physical entity.

If one aspect is not in harmony the person as a whole is not in harmony. The disharmony may cause

disease.

States that the humans are dynamic energy fields in continuous exchange with environmental fields,both of which are infinite.

Considers man as a unitary human being co-existing within the universe, views nursing primarily as a

science and is committed to nursing research.

Unitary man:

Is an irreducible, four-dimensional energy field identified by pattern

Manifests characteristics different from the sum of parts

Interacts continuously and creatively with the environment

Behaves as a totality

As a sentient being, participates creatively in change.


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5 Basic Assumptions

Wholeness: a human being is a unified whole which is greater than the sum of the parts

Openness: the individual & environment are continuously exchanging matter and energy with each

other

Unidirectionality: life process exists along an irreversible space time continuum

Pattern & Organization: the individuals wholeness

Sentience & Thought: the human being is only capable of abstract thinking, imagery, language,

sensation, and emotion

4 Critical Elements

Energy Fields: fundamental unit of living & non living. The human field is irreducible, indivisible,

pandimensional energy field identified by pattern.

Open systems: 'openness" continuous interaction of energy between fields

Pattern: the characteristics of the energy field (identity) that are specific to the whole and cannot be

predicted from the parts

Pandimensionality: nonlinear domain (perceive more than what is seen)

3 Principles of Homeodynamics

Integrality: continuous interaction of human field & environment

Helicy: variety of the human & environment field patterns

Resonancy: continuous change

Health

should not be limited to the physical but include mind, spirit with consideration of the person's

surroundings


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Environment

Both human and environmental fields are characterized by pattern, a universe of open systems, and

four dimensionality

health should not be limited to the physical but include mind, spirit with consideration of the person's

surroundings

Nursing

"humanistic science dedicated to compassionate concern for maintaining and promoting health,

preventing illness, and caring for and rehabilitating the sick and disabled

promote human/environment field patterning and the nursing process

nurses should take into consideration all the aspects of the person as a whole

goal of nursing is to promote human/environment field patterning and the nursing process

nurses must take into consideration all the aspects of the person as a whole


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LYDIA HALL: Core, Care, and Cure Theory

Graduate of York Hospital School of Nursing, in York, Pennsylvania

BS and MA in Teachers College, Columbia University, New York

Fields involved were public health nursing, cardiovascular nursing, pediatric cardiology, and nursing of

long-term illnesses.

1967: received the Award for Distinguished Achievement in Nursing Practice from Columbia University

Greatest achievement in nursing was her design and development of the Loeb Center at Montefiore

Hospital in New York City

Nursing Paradigms:

Person

individuals could be conceptualized in three separate domains: the body (care), the illness, (cure), and

the person (core)

patients achieve their maximal potential through a learning process; therefore the chief therapy they

need is teaching

people strive to meet their own goals and not the goals set by others for them

three aspects of a patient: Body, Pathology, Person

people behave on the basis of their feelings, not on the basis of their knowledge

Health

being ill is a behavior

illness is directed by feelings-out-of-awareness, which is the root of adjustment difficulties

healing may be hastened by helping people move in the direction of self-awareness

once people are brought to terms with their true feelings and motivations, they become free to release

their own powers of healing


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Environment

Hospital nursing services are organized to accomplish tasks efficiently

Hospital nursings goal was to help physicians and administrators to get their work done.

Team nursing- "any career that is defined around the work that has to be done, and how it is divided to

get it done, is a "trade" (rather than a profession).

Nursing

Nursing can and should be professional and that patients should receive care only from professional

registered nurses who can take total responsibility for the care and teaching of their patients

Stages of Illness:

First Stage:

Time of biological crisis

Nurses are ancillary to medicine

Second Stage:

the professional nurse functions most therapeutically

recuperating, or non-acute, phase of illness

- Nursing involves interacting with a patient in a complex process of teaching and learning.- Nursing is complex. The patient is complex. Not only that the patient is a human being, brining

the influences of his or her culture and environment, but the patient may be suffering form an

illness that medicine is still struggling to understand and treat.

- The nurse giving the care is also a unique human being, interacting with the patient in a complexprocess of teaching and learning

- Nursing functions in all three of the circles (core, care, and cure) but shares them to differentdegrees with other disciplines.

- Nursing expertise centers around the body and viewed the patient as composed of Body,Pathology and Personality

- The uniqueness of nursing lies not only by knowing bodily care, but also in knowing how tomodify theses processes in line with the pathological process and treatment and amend them in

line with the personality of the patient


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MYRA ESTRIN LEVINE: Conservation Model

1944: diploma at Cook County School of Nursing

1949: SB, University of Chicago

1962: MSN, Wayne State University

1944: private duty nurse

1945: civilian nurse, US Army

1947-1987: academe in Cook County School of Nursing, Drexel Home in Chicago, University of Chicago

Clinics, Henry Ford Hospital in Detroit, Bryan Memorial Hospital, Lincoln, Nebraska, Loyola University,

Rush University and University of Illinois

Nursing Paradigms:

Person

Holistic being; wholeness is integrity the person has freedom of choice and movement

Has a sense of identity ad self-worth

A system of systems, and in its wholeness expresses the organization of all the contributing parts

Person experience life as change through adaptation with the goal of conservation

Health

Socially determined by the ability to function in reasonably normal manner

Predetermined by social groups and it is not just an absence of pathological conditions

Return to self; individuals are free and able to pursue their own interests within the context of their own

resources

Also culturally determined it is nor an entity on its own, but rather a definition which individuals

belong


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Environment

Context in which we live our lives not a passive backdrop we are active participants in it.

- INTERNAL ENVIRONMENT is the integration of bodily functions that resembles a stabilized flow(homeorrhesis) rather than a static state (homeostasis) and is subject to challenges of the

external environment, which always are a form of energy.

- EXTERNAL ENVIRONMENTis divided into the perceptual, operational, and conceptualenvironments.

- PERCEPTUAL ENVIRONMENTis that portion of the external environment which individualsrespond to with their sense organs and includes light, sound, touch, temperature, chemical

change that is smelled or tasted, and position sense and balance.

- OPERATIONAL ENVIRONMENTis that portion of the external environment which interacts withliving tissue even though the individual does not possess sensory organs that can record the

presence of these factors and includes all forms of radiation, microorganisms, and pollutants.

- CONCEPTUAL ENVIRONMENTis that portion of the external environment that consists oflanguage, ideas, symbols, and concepts and inventions and encompasses the exchange of

language, the ability to think and experience emotion, value systems, religious beliefs, ethnic

and cultural traditions, and individual psychological patterns that come from life experiences.

Nursing

a human interaction and proposed four conservation principles of nursing which are concerned with the

unity and integrity of the individual

The nursing process of Levine's conceptual model is conservation, which is defined as "keeping

together" and emphasizes the wholeness and integrity of every individual

Professional nursing should be reserved for those few who can complete a graduate program as

demanding as that expected of professionals in any other discipline

The nurses task to bring a body of scientific principles, on which decisions depend, into the precise

situation which she shares with the patient


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The nurse participates actively in every patients environment and much of what she does supports his

adjustments as he struggles in the predicament of illness

When nursing intervention influences adaptation favorably, or toward renewed social well-being, then

the nurse is acting in a therapeutic sense; when the response is unfavorable, the nurse provides care.

Goal of nursing is to promote adaptation and maintain wholeness

Four Conservation Principles:

Conservation of Energy The human body functions by utilizing energy. The human body needs energy

producing input (food, oxygen, fluids) to allow energy utilization as output.

Conservation of Structural Integrity - the human body has physical boundaries (skin, and mucous

membranes) that must be maintained to facilitate health and prevent harmful agents from entering the

body.

Conservation of Personal Integrity - the nursing interventions are based on the conservation of the

individuals personality. Every individual has a sense of identity, self-worth and self-esteem, which must

be preserved and enhanced by the nurses.

Conservation of Social Integrity - the social integrity of the clients reflects the family and the community

in which the clients functions. Health care institutions may separate individuals form their family. It is

important for nurses to consider the individual in the context of a family.