Meta Paradigm Of Nursing

Published Date: 02 Nov 2017

Tanya Sims

Centre for International and Professional Education

School of Nursing and Midwifery

Curtin University

GPO Box U1987

Perth, Western Australia 6845

Phone: +61 8 9266 2086

Fax: +61 8 9266 2959

Email: [email protected].

PART A – to be completed by student (please print)

PART B: Office Use only

Name: Fan Xueting

Address: Block 525, Bukit Batok Street 52, #01-727 Singapore (650525)

Received by :

School of Nursing

Returned to Student:

Unit: Foundations of Health Care 112 Singapore Student No: 16602382

Index No : NA Date Submitted: 21st April 2012

Assignment No : 1 Tutor’s Name: Sarah Jones

Assignment Title: Nursing Theories, Virginia Henderson

Table of Content

Assignment Attachment Form 1

Introduction

In health care today, there are many challenges to providing quality of care. In order to provide quality of care, nurses must practise based on theory. Bosher and Pharris (2009) explained that nursing theory is the body of knowledge that is adopted to guide nursing practice. Development of theory-guided practice is an essential hallmark of any professional discipline to guide and improve practices.

One of the importance of coming up with a concept of nursing would be to explain and standardise the profession. Many theorists have come up with conceptual models to define and explain phenomena. One of these theorists is Virginia Henderson.

Virginia Henderson’s Theory

This model is being used widely by nurses because of its practicality and realistic application into their daily encounters with patients. The inimitable function of the nurse is to assist the individual, sick or well, in the performance of those activities that contribute to health recovery, or peaceful death that the individual would perform unaided if he or she had the necessary strength, will, or knowledge. The process of nursing strives to do this as rapidly as possible, and the goal is independence as stated by (Henderson, 1966).

In Henderson’s theory, the nurse’s role can be substitutive, supplementary and complementary, with the goal of helping the person become as independent as possible as stated by (Kim & Kollak, 2006). Her theory is organised into fourteen basic human needs such as breathing normally, eating and drinking adequately, eliminating body waste, moving and maintaining desirable postures, sleeping and resting, selecting suitable clothing, maintaining body temperature, keeping body clean and well groomed, avoiding danger and injuring others, communicating with others, worshiping according to one’s faith, working with accomplishment, engaging in recreation and learning that leads to normal development (Henderson, 1966 in Leuven and Willkinson, 2007). The fourteen components are general and rational to serve as a guide for the individual patient and nurse in accomplishing the chosen goal. The degree of performance, patient’s participation and the level of the nurse activity will be dependent on the specific role the nurse will be playing.

Meta-Paradigm of Nursing

theoretical work in nursing focused on articulating relationshipsamong four major concepts: person, environment, health, and nursing. Because these four concepts can be superimposed on almost any work in nursing, theoretical work in nursing focused on articulating relationshipsamong four major concepts: person, environment, health, and nursing. Because these four concepts can be superimposed on almost any work in nursing,Theoretical work in nursing focuses on articulating relationships among four major concepts: person, environment, health and nursing. These four concepts can be applied in almost any aspect in nursing.theoretical work in nursing focused on articulating relationshipsamong four major concepts: person, environment, health, and nursing. Because these four concepts can be superimposed on almost any work in nursing,

Person

Henderson (1966) mentioned that humans as having basic needs that are component to health. She also mentioned that each individual requires biological, psychological, sociological, and spiritual needs to be met in order to achieve health and independence and that mind is inseparable (Aggletion & Chalmers, 2000, p.31). For instance, a patient who just had a ultra-low anterior resection of the colon with defunctioning ileostomy in a colorectal surgery setting, post-operatively may experience inadequate oxygenation, post operation pain which restricts the body movement, concern in maintaining normal range of body temperature due to post operation wound site and may require assistance in clearing eliminations from stoma bag to keep the body clean and well groomed. In this aspect, the nurse’s role is deemed as a substitute role (doing for the person). In another instance, the nurse could take on the role of complementary (working with the person) for a patient with stoma to educate and impart knowledge to enhance self- efficacy.

Health

According to Henderson’s theory, the interpretation of health is based on one’s capability in achieving the fourteen basic human needs independently (Henderson, 1966 in Alligood and Tomey, 1988). This means that health is equivalent to independence therefore promotion of health and patient’s independence is crucial for patient to attain the path of recovery. Nurses play a huge role in disease prevention and health promotion as they take up the role of ambassadors of wellness. For instance, in this day of worldwide staffing shortage and cost reduction, health promotion makes sense. If we can preserve wellness, we can reduce the number of times a person needs to enter the health-care system, thus reducing costs. To facilitate that process, we must provide people with appropriate and sufficient information. For example, while changing the dressing of a diabetic foot ulcer, there is the opportunity to discuss blood glucose monitoring, compliance to medication regime, diet control, appropriate foot wear and assess patient’s knowledge on his/her condition. Thus, a nurse can close the gaps.

Environment

The environment is where human exists with an interactive system (Ramont & Niedringhaus, 2004). Henderson considered environment to be comprised of biological, physical and behavioural components (Butt & Rich, 2011, p. 394). According to Henderson, basic nursing care also involves providing a safe setting for patient to perform fourteen activities independently. Nurses are in a unique position to improve patient safety because of their close proximity to patients. In the healthcare setting, numerous materials are used daily producing a large number of waste disposals that may affect the health of our environment. There are approaches in which nurses can work to prevent environmentally hazardous, and identify environmental problems related to soiled products, bio hazardous and hazardous chemical wastes. By having the knowledge of proper disposing of waste products, the spread of infections is minimized and this reduces the risk of accidental injury to staffs, patients, and the community. Improper medical waste disposal is one of the greatest threats in a healthcare setting. By means of educating staff about the dangers of contaminated medical waste posing threats to healthcare workers and community, the risks associated with waste disposal can be minimized.

Nursing

The nursing role emphasized by Virginia Henderson is assisting individuals who lack necessary strength, will and knowledge to satisfy one or more of fourteen basic needs. The ultimate goal is to support an individual in life activities and the accomplishment of independence. A nurse is expected to carry out a physician’s therapeutic plan but the nurse can enhance and individualize the care for patients to meet different needs. For instance, patients who have undergone a major surgery will not only require analgesia and antibiotics as a basic need to be attained. Psychological and emotional support is also somewhat indispensable especially after a major operation. To some patients, the surgery could be deemed as a traumatic event. Often, these supports come from the nursing personnel and not from the medical team as nurses has more contact time with patient. The emotional impact of a traumatic event can be profound as different individuals will response differently. However, patients will recover when their life returns to normal, with the support of their family or religious groups and community.

Limitations of Virginia Henderson’s Theory

In Henderson’s fourteen basic needs, all aspects of the needs of a person were related to physiological, sociological, and spiritual aspects. The only point that was overlooked perhaps was the love and belonging aspect of human needs.

If the assumption is made that the 14 components are prioritised, the relationship among the components are not well defined. Apart from that, the theory lacks the interrelationship of factors and the impact on nursing care. Henderson mentioned dying process in her definition of nursing but it is not well explained as to what the role of the nurse is. Peaceful death is a probing question and substantial in nursing role.

Conclusions

Henderson provides the idea of what she believes is a definition of nursing. Her emphasis on basic human needs as the vital emphasis of nursing practices has led to more theory development concerning the needs of the person and how nursing can help in meeting those needs. The ultimate goal is to promote independence as much as possible towards patients, not forgetting that caring for patients is a vital component. Caring would include a genuine interaction with the patients, being a source of comfort, strength and empower them to take care of themselves by providing appropriate resources. Virginia Henderson theory’s is broad in scope and abstract in her description and these theories are termed as grand theory. However, the statement of peaceful death was not clearly exemplified in her theory. There is little explanation as to what a nurse can do to obtain peaceful death for the patient. Nevertheless, her ground-breaking theory has led to a huge leap in nursing practices. In this day, her theory is still current and being cited in literatures and publications worldwide. Thus, she deserves much credit as a pioneer.

Nursing theory is imperative because it helps us to adopt what we know and what we need to know. It provides the fundamentals of nursing practices, produces more knowledge and points the direction nursing should develop into in the future. The benefits of having a well-defined body of theory in nursing include better patient care, heightened professional prestige for nurses, improved communication among nurses and other health care workers, and guidance for research and education.