Week 3: Steps of Concept Analysis
At the end of Week 4 your concept analysis is due. This discussion provides an opportunity to start this assignment.
Select a nursing concept, supported by a nursing theory, and address the following components included in a concept analysis:
• Definition of concept
• Identification of three attributes of the concept
• Description of one antecedent and one consequence of the concept
• Identification of at least one empirical referent
• Brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory?)
This information does not have to be comprehensive but provides a foundation to the upcoming
assignment. Be sure to include scholarly references.
NR 501 Week 3: Steps of Concept Analysis
NR 501 Week 3: Development of Nursing Theory and Concept Analysis
Week 3: Steps of Concept Analysis
At the end of Week 4 your concept analysis is due. This discussion provides an opportunity to start this assignment.
Select a nursing concept, supported by a nursing theory, and address the following components included in a concept analysis:
• Definition of concept
• Identification of three attributes of the concept
• Description of one antecedent and one consequence of the concept
• Identification of at least one empirical referent
• Brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory?)
This information does not have to be comprehensive but provides a foundation to the upcoming
assignment. Be sure to include scholarly references.
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Collapse SubdiscussionAdelaida Larduet Mayeta-Peart
Adelaida Larduet Mayeta-Peart
Jan 14, 2018Jan 14 at 11:25am
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Hi Professor Talley and colleagues,
Definition of concept: The concept this author has selected for analysis is caring. The caring concept is found in the nursing Theory of Human Caring, this Nursing Theory was developed by Jean Watson. According to Chamberlain College of Nursing (CCN) concept and theory analysis are dominant instruments that benefit and bring light to the nursing practice. There are eight steps to carry out when developing a concept analysis. These steps will be discussed by the writer during this discussion question.
The concept of interest for this discussion question is Caring. Caring and nursing are two terminologies that are impossible to be separated. According to Lindberg, Fagerstrȍm, Sivberg, & William (2014) caring is the basis of nursing and is firmly connected to ethos, whereas nursing primarily relates to actual work done by the nurses.
Caring is the core of nursing
and is closely connected to ethos, whereas nursing mainly
relates to the actual work done by the nurses
According to Lindberg, Fagerstrȍm, Sivberg, & William (2014) caring quality encompass respect for patient self-determination, practice aspect of nursing, caring relationships that nurses and patients establish and the health and wellness attitude. In other words, it is crucial in caring to have an understanding of the culture, attitude, variability, relationship, action and acceptance.
To provide a description of one antecedent and one consequence of the concept we could start by stating that nursing education is of paramount importance for the profession. The achievement of nursing accomplishments is a key antecedent for nursing. In order for a nursing student to become an RN the candidate ought to complete and be successful in completing nursing school as well as achieving passing scores on the board exam. The student nurse must fulfill a set of clinical practice hours in the clinical settings in which the student will achieve the necessary clinical skills where they will apply the theoretical content learnt in the classroom setting. Once the nursing student accomplishes the degree and becomes a professional registered nurse, and get a job, there is a necessary training period to confirm that this newly graduated nurse is self-sufficient, confident and has adequate skills that is safe to care for patients.
Identification of at least one empirical referent is how the concept of caring may be measured or assessed (CCN, 2017). Caring may be challenging to define and measure, since judgement and perception depends on both, the person providing and receiving the care. At the institution I currently work patient satisfaction is measured by a survey. This survey is mailed to patients at their home or by a telephone call survey after care is provided. This is a convenient tool that is able to set and maintain good quality standards within an institution.
There are many variations and perceptions of caring that may cause difficulties to explain in the sense of nursing, and can be perceived differently across cultures (Lindberg, Fagerström, Sivberg & Willman, 2014). This writer selected the concept of caring, focusing specifically on the care nurses provide to patients utilizing Jean Watson’s Theory of Human Caring.
References
Chamberlain College of Nursing. (2017). NR-501 Week 3 Development of Nursing Theory and Concept Analysis [Online lesson]. Talley, IL: DeVry Education Group
Lindberg, C., Fagerstrȍm, C., Sivberg, B., & William, A. (2014). Concept analysis: patient autonomy in a caring context, Journal of Advanced Nursing 70(10), 2208-2221. http://onlinelibrary.wiley.com.chamberlainuniversity.idm.oclc.org/doi/10.1111/jan.12412/epdf (Links to an external site.)
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 16, 2018Jan 16 at 4:25pm
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Adelaida, caring is certainly an important concept and is central to the experience of nursing! Watson’s theory of human caring will support your exploration of caring very well.
Possibly the most difficult aspect of a concept analysis is that of choosing an empirical referent.
In research, there are many surveys, tools, and “instruments” that are used to capture the presence of a concept. Sometimes quality measures can also capture the presence of a concept. However, while there may be an implication that a concept such as caring is involved, it may not specifically or precisely measure that concept in particular. Surveys such as the Patients’ Perspectives of Care Survey (HCAHPS) measures many aspects of the hospital experiences but not “caring” as we usually define it conceptually. It does measure the quality of interactions in terms of communication, attentiveness to needs (especially to pain management) and discharge education. while this may occur, perhaps more easily supported in a caring environment and in caring interactions, the survey does not actually measure caring as it is often defined in theory.
One of the major activities in research is to test the validity of a research “tool”…with the question being….does it measure what it is supposed to measure?
Fortunately, WE don’t have to do that. For example, Watson and associated developed a research tool which empirically measures caring as is defined in the theory of human caring (DiNapoli, Turkel, Nelson, & Watson, 2010).
How fortunate for us!
Reference
DiNapoli, P. P., Turkel, M., Nelson, J., & Watson, J. (2010). Measuring the Caritas Processes: Caring Factor Survey. International Journal for Human Caring 14(3), 15-20.
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Collapse SubdiscussionAdelaida Larduet Mayeta-Peart
Adelaida Larduet Mayeta-Peart
Jan 16, 2018Jan 16 at 9:46pm
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Hi Professor Talley,
Thank you for your additions and insights made to my response on this week discussion questions, I appreciate your observations and recommendations.
According to Ozan, Okumus, & Lash (2015) even though caring might represent an empirical and challenging form of a concept analysis; as a nurse I strongly believe that caring and its monitoring is of crucial importance. Indeed, the theory of Watson’s Human Caring focuses on human and nursing paradigm, which affirms that a human being is unable to be cured as an object. It disputes on the contrary that a human being, whether male or female, is an element of his or her environment, essence, and the macro world. Environment is described in this theory as appropriate, pleasant, appealing, and peaceful and that caring is the moral optimal that encompasses mind-body-soul commitment with one another. Nursing, classified as a humanitarian science, also described as a career that carries out personal, scientific, ethical, and aesthetical practice. Watson’s caring theory focus on assuring equity and cooperation between health and disorder that a person experience.
Measuring and evaluating care, is of extreme importance and is needed for the improvement of care and satisfaction of patient needs, however it is an abstract action, since it is based on perceptions. According to Ozan, Okumus, & Lash (2015) the theory of Human Caring is people-oriented that acquires the distinct character of human virtue without compromising its mind-body spirit. The theory postulates that the highest and most powerful curative source in nursing care is love. Watson’s caring theory describes nursing as the process of human-to-human caring that encompasses four elementary ideas: healing processes, interpersonal maintenance of relationship, the caring moment, and awareness of healing. Caring involves being present, a detailed observant, conscious, and intentional.
Reference
Ozan, Y. D., Okumus, H., & Lash, A, A. (2015). Implementation of Watson’s Theory of Human Caring: A Case Study. International Journal of Caring Sciences, 8(1), 25-35. Retrieved from http://www.internationaljournalofcaringsciences.org/docs/4-Lash%20-%20Original.pdf (Links to an external site.)
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 17, 2018Jan 17 at 5:14pm
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Class, should we make a distinction between “care” and “caring”?
Why or why not?
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Amanda Howell
Amanda Howell
Jan 18, 2018Jan 18 at 5:07pm
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I believe a distinction should be made between “care” and “caring.” The two words have differing meanings contextually, and to subsume one under the other would weaken the individual concepts. To “care” for somebody, in the verb tense of the word, constitutes simple tasks with the point being to make the person’s environment better. For nurses, such tasks include washing, feeding, medication administration or checking vital signs. “Caring” is an adjective describing a nurse’s attitude toward care. A “caring” nurse will develop a compassionate relationship with the patient, with a character of dignity, respect, and empathy (Coe & Fulton, 2016). A nurse can provide care for a patient without being caring. For example, I recently had a wound that needed to be attended to. The nurse practitioner I saw was able to care for the wound; she cleaned it, packed it, and prescribed medications and directions for care. However, she did not do so in a caring manner. She did not show empathy when I expressed pain from the procedure, and she did not respect me enough to explain what she was going to do before she did it.
References
Coe, D., & Fulton, J. (2016). Social arenas of caring practice. Journal of Ethnographic & Qualitative Research, 11(1), 32-54.
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Clarissa Smith
Clarissa Smith
Jan 18, 2018Jan 18 at 7:52pm
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Professor Talley and Class,
I believe that there should be a distinction between care and caring. A person may render care to someone and not be caring. On the other hand, a person can be caring without giving the proper care to patients. Although care and caring are supposed to be intertwined, in some instances they are not. While some nurses care for patients, others may simply be providing care because it is their job; not that they are caring. Care and caring have been inherently difficult concepts to define, but many believe that care is the central and unifying core of nursing itself. It is vital that nurses understand what care is and patients’ perception of what care means to them.
There is a difference between care and caring—good quality care is always important, but caring for patients is what they will really remember. Taking care of patients and caring for patients are not the same. Taking care of patients emphasizes objective professional care, such as the medical or psychological aspects of nursing. Caring for patients, on the other hand, is a humanistic way of interacting with patients that displays sincere care and concern for patients simply because they are human beings. Focus on patient-centered care necessitates adaptation to patient perceptions (Sossong & Poirier, 2013). It is during those caring moments that the transpersonal relationship between patient and nurse becomes clear.
Watson’s theory of human caring emphasizes the transpersonal relationships between patients and nurses (Watson, 2002). Patients are in various stages of illness and their perception of care and caring will be different versus what the nurse thinks or believes is care or caring. This is due to the needs of patients are different and is dependent upon what is occurring with the patient at that time. So, it is implicated that nurses across all medical disciplines must identify which aspects of caring are most important to patients at any given point in their disease process. According to Barnsteiner (2012), “Patient-centered care ensures the patient is at the center of the decision-making process and understands the plan of care that prevents errors from occurring”. Thus, it is essential to develop innovative strategies that can address the existing incongruence between patients’ and nurses’ perceptions of caring (Sossong & Poirier, 2013). Nurses must connect with patients on purpose to promote healing holistically. Then, nurses can develop interventions based on caring behaviors that are important to the patient.
References
Sossong, A., & Poirier, P. (2013). Patient and Nurse Perceptions of Caring in Rural United States. International Journal for Human Caring, 17(1), 79-85.
Watson, J. (2002). Assessing and measuring caring in nursing and health science. New York, NY: Springer
Barnsteiner, J. (2012). Quality and safety in nursing: A competency approach to improving outcomes. In G. &. Sherwood, Safety (pp. 149-169). Hoboken, NJ: Wiley-Blackwell.
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Collapse SubdiscussionMedinat Balogun
Medinat Balogun
Jan 19, 2018Jan 19 at 12:57pm
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Hello Dr. Talley and class,
Yes and no we can make a distinction between “Care” and “Caring”. Yes, we can make a distinction in the sense that I personally see caring as feeling and exhibiting concern /empathy for others. Caring is a feeling that requires for the participants to act on it. The best critical thinking nurse that provides the best care for their patients might not necessarily be caring, such nurse might lack the compassion/ empathy to providing care and that does not mean the patient will not receive a quality care. However, not showing empathy or compassion while providing care may demean the value of care provided. Caring has remained the art and science of nursing’s essence through time and into today’s practice. Understanding the concept of “care” helps to explain and assist in understanding how nursing is a caring job, and in providing care (Adams, 2016). I will also say No we cannot make a distinction because, providing care and caring go together and used in our daily practice. While most nurses by default provide care, it comes naturally because their line of responsibility dictates that they provide care to their patients, family and friends meeting all their basic needs, ranging from activities of daily living, to treating physical, safety and physiological needs. Providing care becomes part of a daily routine, and all these, they could easily achieve without being Caring I.e., without showing a caring attitude, emotion, feelings or empathy. Their uncaring attitude is masked by the excellent care they provide. For instance, in my unit, I work with quite a few seasoned nurses that are good in providing care but do not show any compassion/ caring towards the laboring patients. However, their level of commitment to providing care may make them come across as caring.
Reference
Adams, L. Y. (2016). The conundrum of caring in nursing. International Journal of Caring
Sciences, 9(1), 1-8
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Brenda Talley
Brenda Talley
Jan 21, 2018Jan 21 at 1:55pm
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Most excellent distinction between the concepts Medinat! Evidence of scholarly thinking!
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Collapse SubdiscussionShareese Johnson
Shareese Johnson
Jan 19, 2018Jan 19 at 11:53pm
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Hi Dr. Talley and Class,
Yes, I believe we should make a distinction between “care and “caring.” A substantial extent of our time in clinical practice is consumed with analyzing test results, collaborating with the interdisciplinary team and modifying patient orders. In addition to the previously mentioned tasks, we have to contend with executing the rising responsibility of electronic health records (EHR) and insurance demands. Recent studies indicated for every hour consumed on direct patient care, two added hours are consumed on EHR tasks. This sequence forms a considerable void between time dedicated to patients’ care versus the actual face-to-face time spent bonding with patients. The imposing dichotomy is although we have access to a spectrum of advanced electronic systems providing ways to care for patients, patients feel the most caring from the small things such as our presence, listening, or a kind word said. With this knowledge, it is evident there is a significant distinction between providing medical care and being more attentive to patients which are perceived as caring (Drutchas, 2017).
Reference
Drutchas, A. (2017). Eyelash: caring between the lines. Family Medicine, 49(8), 646. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=125049015&site=eds-live&scope=site (Links to an external site.)
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Brenda Talley
Brenda Talley
Jan 21, 2018Jan 21 at 1:56pm
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Someone once said (it could have been me…) that care is what we do and caring is who we are.
Well said Shareese!
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Nuha Bakkal
Nuha Bakkal
Jan 20, 2018Jan 20 at 3:31pm
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Dr. Talley:
On the subject of caring, I do believe that there should be a distinction between care and caring. In an interesting article about in vitro fertilization (IVF), a study was conducted by adapting to Jean Watson’s caring theory into the nursing methods used by nurses who care for the women attempting to get pregnant. Studies show that women who undergo the IVF process and is not successful, will attempt the second time with high levels of stress and anxiety, putting them at risk for depression (Ozan & Okumus, 2017). The study was aiming to differentiate if it would made a difference whether the type of care provided by nurses would change the results of distress and anxiety. The results showed that, compared to the standard nursing care, women who received special nursing care based on Watson’s theory of caring (pre and post treatment assessments and procedural follow-ups), significantly reduced their anxiety and stress during the whole process. Furthermore, application of Watson’s theory of caring was the intervention used versus just regular “care” given by a nurse was the key. It is always pleasing to know that “difference in the anxiety level is not medicine-focused but is based on the human, improvement and love” (Ozan & Okumus, 2017, p.105).
References
Ozan, Y. D., & Okumus, H. (2017). Effects of nursing care based on Watson’s theory of human caring on anxiety, distress, and coping, when infertility treatment fails: A randomized controlled trial. Research & Development in Medical Education, 6(2), 95-109. doi:10.15171/jcs.2017.010
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Collapse SubdiscussionYoko Khan
Yoko Khan
Jan 20, 2018Jan 20 at 5:58pm
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Dr. Talley and class,
A distinction between care and caring, I think there is a difference. When I use a word “caring,” I feel like it is ongoing, sympathy, human-like, caring for someone, compassion, more like doing favors than doing business. On the other hand, “care” sounds like a job. For example, “Patient Care Assistant,” (so-called a certified nursing assistant) is a job that takes care of a patient with feeding, changing, and assisting. It is more like voluntary (caring) vs. forcibly (care). “Patient care is important. Patient caring is memorable.” I cannot find the citation of those sentences, but I just remember someone said that.
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Brenda Talley
Brenda Talley
Jan 21, 2018Jan 21 at 1:58pm
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Yoko, excellent ideas. This little dialogue we have going truly shows the need for precision in how we define and understand concepts.
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Jacqueline Kenton-Jones
Jacqueline Kenton-Jones
Jan 21, 2018Jan 21 at 9:31pm
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There is a definite distinction between care and caring. I think that care can be taught but not the aspect of caring. The caring starts with the decision to be a nurse. Too many nurses have entered the field of nursing for the wrong reasons, like job opportunities and financial gain. The nurse that is caring, builds nurse patient relationships. Provides care with empathy, kindness and patience. A caring nurse knows the importance of creating a healing environment that has a positive effect on the patient experience and outcome.A nurse can provide competent care and make appropriate clinical decisions to provide adequate care but, never show care or concern. Many of the environments that we work in, demand time constraints and time sensitive assignments. Nurses sometimes fail to prioritize the patient instead of the documentation or the care. Nurse-patient connection and communication is so important to how the care is received. The compassion, trust and individual care is essential to the healing process. A caring nurse supports the patient through challenging circumstances and guides supportive care. The nurse has the most direct contact with the patient and has the most impact during the healing process. The emphasis of knowing the patient, identifies their needs and guides us to providing the best level of care.
McClendon,P. (2017). Authentic caring:Rediscover the essence of nursing. Nursing management 48(10),36-41
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Collapse SubdiscussionHailey Whisenant
Hailey Whisenant
Jan 15, 2018Jan 15 at 3:14am
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The nursing theory I chose for this discussion post is Kolcaba’s theory of comfort. Within this theory, I chose comfort as the nursing concept since it is so broad and important.
Comfort is a term that is always going to associate with nursing. It can be used as a verb or a noun and signifies both the physical and mental comfort of a person. There are four main meanings when it comes to comfort.
o A relief from discomfort and/or the state of comfort (Wensley et al., 2017).
o The state of peaceful contentment (Wensley et al., 2017).
o Relief from discomfort (Wensley et al., 2017).
o Whatever makes life or situations easy or pleasurable (Wensley et al., 2017).
Three attributes of the concept of comfort include a state sense of comfort, such as cessation of stressful activities, absence of severe discomfort, or an environmental influence employing comfort. The second attribute includes a relief sense, which includes an impulse of relief, no active requirement, and can be either a whole or a partial relief. The third attribute is a renewal sense, this includes an enduring condition, positive motivation, and a readiness to perform (Smith et al., 2015).
An antecedent about comfort includes the fact that comfort started back with the time of Florence Nightingale and even to this day is a desirable outcome of nursing care. This concept has also been utilized by other theorists such as Roy, Orlando, Watson, and Peterson. A consequence of this concept is that comfort is not permanent. It may be a brief or partial relief, but comfort is never permanent (Smith et al., 2015).
An empirical referent that makes this concept measurable is the overall outcome and wellbeing of the patient. Achieving desirable outcomes for our patients and selecting goals and interventions that apply to our patient’s diagnosis is an empirical referent of comfort. Comfort itself is tailored to the specific patient type (Smith et al., 2015).
We know that comfort is informally integrated into the entire nursing profession. Comfort should improve the nursing profession and is relevant to Kolcaba’s Theory of Comfort because Kolcaba describes comfort as a relief, an ease, and a transcending form in the nursing practice. Kolcaba goes in depth about how to address comfort in our field just as the concept of comfort addresses as well.
References:
Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice (4th ed.). Philadelphia, PA: F.A. Davis Company.
Wensley, C., Botti, M., Mckillop, A., & Merry, A. F. (2017). A framework of comfort for practice: An integrative review identifying the multiple influences on patients’ experience of comfort in healthcare settings. International Journal for Quality in Health Care. doi:10.1093/intqhc/mzw158
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 16, 2018Jan 16 at 4:40pm
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Hailey, great beginning!
Comfort is indeed a very broad concept. You did exceptionally well in determining attributes, especially!
Do you think that an antecedent of comfort would be discomfort?
Class, could you help us? Must a person actually experience discomfort before receiving comfort, does one need comfort in order to receive it?
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Collapse SubdiscussionNikki Ballinger
Nikki Ballinger
Jan 18, 2018Jan 18 at 8:36am
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Dr. T.,
I do believe that an antecedent of comfort can be discomfort, but does not have to be. An antecedent is occurring before something, with that being said, before someone has comfort they may be experiencing discomfort. Most studies on nursing comfort relate to the physical aspect of comfort. Comfort is a state resulting from satisfaction of the need for relief, ease, and transcendence in physical, spiritual, social, and environment contexts (Pinto, Caldeira, Martins, & Rodgers, 2017). Since Nightingale, the concept of caring has become more relevant in nursing theoretical development (Pinto, Caldeira, Martins, & Rodgers, 2017). Comfort is seen in nursing as a holistic experience, a state of satisfying human needs for ease, relief, and transcendence in many different contexts (Pinto, Caldeira, Martins, & Rodgers, 2017). These definitions proposed are restrictive in defining comfort because they only relate to the physical aspect of comfort, showing that the antecedent would be discomfort.
Kolcaba’s Comfort Theory is useful in understanding the concepts of comfort. According to Kolcaba’s theory, comfort is also related to satisfaction of needs, which relates to quality of life, happiness, and suffering (Pinto, Caldeira, Martins, & Rodgers, 2017). These concepts show the satisfaction with meeting personal needs and expectations towards life leading to a form of comfort.
The concept of comport is complex and dynamic in the nursing world. It is a concept that is holistic, subjective, and based on individuals needs (Pinto, Caldeira, Martins, & Rodgers, 2017). While discomfort can be an antecedent of comfort, there are also other dimensions of comfort that are not related to discomfort first. These include achieving comfort through spiritual, psychological, social, and environmental magnitudes (Pinto, Caldeira, Martins, & Rodgers, 2017). Aspects of the individual’s personality, age, culture, and beliefs influence the perception of comfort and how a person perceives it (Pinto, Caldeira, Martins, & Rodgers, 2017). Comfort is not a straightforward concept and can change over time due to a person’s perspective. A person can achieve comfort in one dimension such as physical, but not another such as spiritual leading to antecedents other than discomfort.
Nikki Ballinger
Pinto, S., Caldeira, S., Martins, J.C., & Rodgers, B. (2017). Evolutionary analysis of the concept of comfort. Holistic Nursing Practice, 31(4), 243-252. DOI: 10.1097/HNP.0000000000000217
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Brenda Talley
Brenda Talley
Jan 18, 2018Jan 18 at 7:37pm
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So the experience of comfort would differ in terms of the need or desire for comfort?
This will be apparent as you define the concept and provide context.
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Collapse SubdiscussionHailey Whisenant
Hailey Whisenant
Jan 18, 2018Jan 18 at 3:21pm
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Professor Talley,
I absolutely would say discomfort is an antecedent of comfort. I think distress and suffering are antecedents as well (Tsai, 2012). This may be a silly analogy, but this is what I think of right now when I think of comfort and discomfort:
I am currently 9-months pregnant. In fact, I am due January 29th. I am beyond uncomfortable! I cannot put on my shoes, reach something off the floor, etc. In order for me to realize I am experiencing discomfort, I must first know what makes me comfortable. Which right now includes laying down with my feet up, taking a long bath, or even finding measures that help me sleep. My discomfort comes from being pregnant and will be relieved (hopefully) when I am no longer pregnant! (Week and a half! Yay!)
With my first hand experience of discomfort, I crave comfort. I crave to have my body back and be able to perform my daily activities that I was able to do before. With this being said, I think that in order to know what makes you comfortable you must know what makes you uncomfortable first.
Some characteristics of comfort include:
1) An ability to maintain functionality (with a big baby in your belly you cannot do this easily!)
2) Physical symptom relief (that joyous feeling of relief after working all day and I can come home and put my feet up)
3) A sense of safety and security (Tsai, 2012).
4) A pleasant experience (Tsai, 2012).
5) Reduced suffering (Tsai, 2012).
6) An absence of discomfort (Tsai, 2012).
Reference:
Tsai, J. L., Lee, Y. L., & Hu, W. Y. (2012, February). Comfort: a concept analysis. Retrieved January 18, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/22314653
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Brenda Talley
Brenda Talley
Jan 18, 2018Jan 18 at 7:40pm
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Congratulations of the impending arriving of a sweet blessing….!
This reference sounds like a good source of material.
The key may be in understanding how comfort is perceived/experienced/implemented in nursing care. If it was the guy selling pillows in MN, we might attach a different meaning to the concept!
Excellent points Hailey!
put your feet up
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Nikki Ballinger
Nikki Ballinger
Jan 19, 2018Jan 19 at 7:06am
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Hailey,
First and foremost, congratulations in advance on your new little one. As an LDRP nurse I see what your describing every day at work with my patients and my pregnant co-workers. I think everyone starts a countdown towards the end! Your little one will be here before you know it.
I liked your characteristics of comfort as they clearly are relatable and made sense towards what comfort feels like. This seems like the perfect concept for you as you truly are experiencing discomfort at this time. One characteristic you mentioned was ” A pleasant experience”. I really enjoyed that because it is so true. Even if a person is not uncomfortable, a pleasant experience can bring comfort to them which helped answer the question that Dr. T. was asking. While I completely agree that discomfort is an antecedent of comfort, it doesn’t have to be. There are other antecedents such as a memory or spiritual belief that give comfort to someone even if they were not having discomfort. Another example you mentioned is “A sense of safety and security”. This can relate to your newborn. Babies crave the sense of safety and security. As a mother, there is no better person to comfort their newborn and bring them that sense of security.
Comfort is such an important topic to nursing and life in general. We as humans need comfort, we want it, and we miss it (especially in your case)! I hope you have a great labor experience and find comfort in the fact that you will have a blessing coming your way here soon. Hang in there!
Nikki
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Jamie Taylor
Jamie Taylor
Jan 20, 2018Jan 20 at 1:38pm
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Professor Talley,
I don’t believe that a person must feel discomfort before they feel comfort. If you think in terms of a pre-operative patient, it is clearer to see. There can be anticipation that a person is going to feel physical discomfort that may lead to comforting. When a patient arrives for surgery there is an expectation that there will be physical discomfort post-operatively. The nurse begins caring for the patient in a manner that is purposely meant to decrease anxiety related to anticipation and thus increase comfort in the absence of any real physical discomfort. The nurses do this through education and meeting physical needs such as warm blankets and emotional support through therapeutic communication. Although Anticipation is not a physical discomfort the expectation of pain can be worse than the pain itself (Story, 2014). For patients sitting in a pre-op holding area the wait and anticipation is not causing physical discomfort, but emotional discomfort related to anxiety.
Story, G. (2014, March). Anticipating Pain is Worse Than Feeling It. Retrieved from hbr.org: https://hbr.org/2014/03/anticipating-pain-is-worse-than-feeling-it
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Collapse SubdiscussionMegan Edwards
Megan Edwards
Jan 20, 2018Jan 20 at 8:54pm
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Dr. T,
That sounds a bit like the age old question of what came first, the chicken or the egg? I do not think that one has to experience discomfort before receiving comfort. When we are born, we are comforted by our parents. Parents react to the cries of the child as discomfort and respond by comforting them with food, a clean diaper, holding them, singing to them, rocking them etc. These are all comfort measures. It is a human response to comfort someone who is in a state of discomfort. However, on the other hand, we can be comforted without being in direct discomfort. I am comforted by a bowl of tomatoe soup and grilled cheese on a cold day. I am comforted by snuggling with my dog or listening to music. Just because I am not in any direct distress does not mean that those things do not comfort me. The same can be applied to nursing. I comfort my patients by introducing myself and communicating the plan of care clearly. Even if they are not in any immediate distress this comforts them to know that I am keeping them involved in their care.
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Brenda Talley
Brenda Talley
Jan 21, 2018Jan 21 at 2:03pm
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Megan, you are making me hungry…of to the kitchen…..
This brings it home that how we describe and experience a concept depends upon the meaning we attach to it. We do have sort of “generic” meanings and connotations to words that can be very powerful. For a scientific/theoretical base, out ability to effectively study the concept depends on the precision and accuracy of our definition.
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Allyson Tommasini
Allyson Tommasini
Jan 21, 2018Jan 21 at 6:50am
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Yes I do believe that on can experience discomfort before receiving comfort. From our first days of being born we are constantly learning new things that make us uncomfortable. Whether it is physical, emotional, or spiritual. Being uncomfortable brings on many emotions especially if we don’t know how to handle what we are experiencing. As a baby it’s the basic needs such as food. As babies grow they begin to realize more things that make them uncomfortable and cry out for those needs. Since they can’t speak we must try to understand what it is they are in need of. As we grow older we gain the ability to try and describe or mention what make us uncomfortable in order to make us comfortable.
In my current nursing job I work in an ICU and many of my patients are intubated in life support. They are often very uncomfortable whether it is the breathing tube, their positioning, they used the bathroom, they’re scared, they’re thirsty, etc. The list can go on and on. As their nurse it is my job to try and find out what it is they need. All to often they try to talk with the breathing tube in and I can’t tell what they are saying. I try to just go through a list of common things I can do for the patient and sometimes I never find out what they need. It’s difficult to overcome as a Nurse when I really want to do all that I can to make sure they’re in as little to no pain as possible and to make sure they’re needs are all taken care of. Especially, their basic comfort needs.
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Catherine Resendez
Catherine Resendez
Jan 21, 2018Jan 21 at 11:42pm
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Hi Professor and Hailey,
I think that discomfort can be an antecedent discomfort depending on the patient and what the perceives comfort to be. Being comfortable for each patient may be different. For some it could just be the comfort of lying in bed or being in clean clothes or showered. I don’t think patients need to necessarily be in discomfort to receive comfort. As stated by Irene Oliveira (2013), comfort measures change over time based on ongoing assessments on the effects of comfort measures. As time passes and development is made on patient quality of care patient’s needs change as well as comfort measures. Oliveira (2013) gives the example of a mother giving birth and how she chooses what comfort measures are more important to her. These could include pain relief, relaxation, safety, mental control to name a few. We may be talking care of a patient’s comfort before the patient experiences any discomfort. Comfort can be looked in many different way depending on the care the nurse is giving and the individual patient.
Oliveira, I. (2013). Comfort measures: a concept analysis. Research And Theory For Nursing Practice, 27(2), 95-114.
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Adelaida Larduet Mayeta-Peart
Adelaida Larduet Mayeta-Peart
Jan 17, 2018Jan 17 at 1:31pm
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Hi Hailey, professor and colleagues,
Thank you for your discussion, I agree with you that comfort is a broad, and yet important concept. However, the statements you made on your discussion are easy to understand by the reader. According to Hinkle & Cheever (2014) comfort is an impression of mental, physical, or social well-being. Nurses play an important role in the provision of comfort measures to those patients in need of and accepting care, also the appraisal of those measures for efficiency.
Also, according to Pinto, Caldeira, Martins & Rodgers (2017) who outlines that comfort is currently understood as a holistic practice, a state of satisfying human requirements for relaxation, relief, and wholeness in physical, psychological, social, and spiritual contexts. The concept of comfort has assumed much more significance since Nightingale when the topic of theoretical development is approached.
According to Pinto, Caldeira, Martins & Rodgers (2017) comfort theory is appropriate, it includes comfort for all involved parties’ patients, families, health care personnel including management and administrators. The comfort theory which was developed through Kolcaba’s concept analysis of comfort as an anticipated wanted result of nursing care as determined by the client.
We can also describe comfort as a complicated and subjective concept, according to Pinto, Caldeira, Martins & Rodgers (2017) comfort is described as a desired state of fulfillment and pleasure, a holistic experience closely correlated with the person’s insights and satisfaction of desires, to accomplish release, ease, and transcendence in all human life magnitudes.
Providing comfort while performing nursing interventions is an important aspect in nursing care, it complements the treatment and assist the patient in recovering and maintain a proper and stable status involving the mental, physical, or social well-being of the affected patient.
Reference
Hinkle J.L., & Cheever K. (2014). The 13th edition of Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. Lippincott, Williams & Wilkins, Philadelphia, Pa.
Pinto, S., Caldeira, S., Martins, J. C. & Rodgers, B. (2017). Evolutionary Analysis of the Concept of Comfort. Holistic Nursing Practice 31(4), 243–252. DOI: 10.1097/HNP.0000000000000217
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Yoko Khan
Yoko Khan
Jan 20, 2018Jan 20 at 6:22pm
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Hailey,
Great posting, you considered well to come up with three attributes of state, relief, and renewal. I was interested in your posting because my nursing concept would be “Quality of Care,” and your concept of “comfort” could have a similarity of the measurable empirical referent to mine. Speaking of the empirical referent, I believe that comfort level would be related to their quality of life. Therefore, measurable tools for that concept would be verbalizing comfort level, surveys of lifestyle changed, adequate pain control, medication compliance, and maintaining their optimal well-being. As you mentioned, comfort is not permanent, nor the quality of life (Smith et al., 2015). Level of comfort and quality of life would fluctuate and sometimes depend on patients’ financial, mental, physical, social, environment, relationship, and health. I agreed with Kolcaba’s theory would go with your nursing concept. I hope we will write a good paper about this Concept Analysis. Good luck to us!
Reference
Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice (4th ed.). Philadelphia, PA: F.A. Davis Company.
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Collapse SubdiscussionAllyson Tommasini
Allyson Tommasini
Jan 15, 2018Jan 15 at 9:15am
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Our book defines concept as the “phenomena that occur in nature of thought” (McEwen & Wills, 2014). The concept I have chosen to focus on is compassion fatigue. Often as caregivers we spend a lot of time offering our emotional support to our patients in need. By doing so we can sometimes forget that we need to remember to care for our own emotional health and release of stress. The American Institute of Stress defines compassion fatigue as “the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events (2017).
Three attributes that relate to the concept of compassion fatigue are emotional intensity increase (Sorenson, Bolick, Wright, & Hamilton, 2017), abrupt onset (Sorenson, Bolick, Wright, & Hamilton, 2017), loss of job satisfaction (Sheppard, 2016). Among these there are many more attributes that identify how compassion fatigue is seen.
An antecedent is something that has to occur before an event. In this case an example of an antecedent could be the desire to absorb or alleviate an individual suffering by connecting with a patient on an emotional and compassionate level (Sorenson, Bolick, Wright, & Hamilton, 2017).
A consequence is something that is the result of something that has occurred. An example of a consequence when related to compassion fatigue could be the feeling of dreading work.
An empirical referent that could be asked to determine if compassion fatigue in present in an individual is the question of “Do you suddenly feel more angry, sad, empty or seem to be crying more frequently”? This helps to identify if the attributes that were mentioned are being exhibited in this individual.
Watson’s theory of human care is all about the relationship a nurse has with a patient. The core concept of this relationship-based nursing relationship is empathy and communication empathy (Lombardo & Eyre, 2011). Compassion fatigue is experienced by nurses who help with life changing problems. When one cannot cope or properly manage these stressors they develop compassion fatigue. Inadequate self-care behaviors or an increase in self-sacrifice is often seen in those who suffer from compassion fatigue.
While we all joined nursing to care for others and be their emotional support during their time a need we should keep in mind ways in which we can relieve the emotional stress and baggage we try to care for others. By relaxing and reflecting we can help to eliminate these in the moments they occur, but one can also think about working out as a great way to reduce stress.
References
American Institute of Stress. “Compassion Fatigue.” The American Institute of Stress, 2017, www.stress.org/military/for-practitionersleaders/compassion-fatigue/
Lombardo, B., & Eyre, C. (2011). Compassion fatigue: a nurse’s primer. Online Journal of Issues in Nursing, 16(1), 3. doi:10.3912/OJIN.Vol16No01Man03
McEwen, M., & Wills, E. (2014). Theoretical basis for nursing (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins
Sorenson, C., Bolick, B., Wright, K., & Hamilton, R. (2017). An Evolutionary Concept Analysis of Compassion Fatigue. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing, 49(5), 557-563. doi:10.1111/jnu.12312
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Brenda Talley
Brenda Talley
Jan 16, 2018Jan 16 at 6:39pm
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Wow Allyson, great beginning!
The concept compassion fatigue was introduced in order to explain the phenomenon as it is differentiated from nurse burnout. Melvin extended this differentiation to include secondary traumatic stress disorder (2015). The subtle differences/distinctions are important and they are experienced differently and strategies for returning well-being differ.
A qualitative approach is a good strategy for “measurement” of an abstract experiential phenomenon. Conducting a concept analysis would assist in creating an interview guide to capture the experiences of participants.
Reference
Melvin, S. (2015). Historical review in understanding burnout, professional compassion fatigue, and secondary traumatic stress disorder from a hospice and palliative nursing perspective. Journal of Hospice and Palliative Nursing, 17(1):66-72.
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Collapse SubdiscussionNikki Ballinger
Nikki Ballinger
Jan 15, 2018Jan 15 at 11:26am
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Nursing is a dynamic and perplexing profession requiring engaging and inspiring leadership and role models (Scully, 2015). The concept of leadership is complex and multidimensional but stays true to the fact that leadership is a goal to motivate a group of people to act towards achieving a common objective (Scully, 2015). Nurse leaders are essential to the profession for maintenance, establishing direction, aligning people, motivating, and inspiring colleagues towards a mutual target in the healthcare setting (Scully, 2015).
Attributes of leadership in nursing include supporting clinical colleagues, inspiring followers to transform themselves and their situations, and acting as a role model to those who look up to the leaders. Leaders and the way leadership is performed have an important role in nursing. Leaders in nursing make decisions that affect nursing quality, patient satisfaction, finances, and ethical and professional dignity (Zydziunaite & Suominen, 2014). An antecedent of leadership is the leader’s self-awareness. A self-aware leader may be more conscious of how others perceive them, resulting in a more accurate self-assessment of themselves. A consequence of leadership is due to the environment nurses are in. The health care world is constantly changing. Leadership skills require the nurse to face unprecedented challenges daily (Zydziunaite & Suominen, 2014). To confront these demands nurse leaders must have the ability to make decisions that will not always make everyone happy. Most often, nurse leaders must make decisions that go against their own personal values, as well as others. This is a consequence of leadership, not being able to please everyone involved in the decision-making process while going against personal beliefs and values.
While there are many empirical referents to the concept of leadership in nursing, Shelly A. Fischer (2016) wrote an analysis on transformational leadership in nursing. The background of her analysis was based on improving patient outcomes while decreasing the cost of care provision through leadership. Per Fischer (2016), healthcare reform is dependent of leaders with innovative thinking and skills to implement rapid change. Leadership in nursing is essential for preparing current and future nurse leaders to improve the health care system. From her analysis, she concluded that leadership in nursing has been associated with high performing teams and improved patient care (Fischer, 2016). This helps to create a foundation for teaching leadership and aims to enhance the understanding of leadership in nursing.
The Neuman Systems Model (NSM) offers nurse leaders a dynamic and comprehensive tool to enhance their leadership skills. The NSM facilitates critical thinking about the healthcare environment, assesses strengths and weakness, and identifies stressors in the health care setting (Neuman,1997). This theory identifies the concept of leadership in nursing and accommodates the ever-changing health care setting in the nursing field (Neuman,1997).
Fischer, S.A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing.72 (11). 2644-2653.
Neuman, B. (1997). The neuman system model: Reflections and projections. Nursing Science Quarterly, 10(1), 18. doi: 10. 1177/089431849701000108
Scully, N.B. (2015). Leadership in nursing: The importance of recognizing inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444. doi: 10.1016/j.colegn.2014.09.004
Zydziunaite, V., & Suominen, T. (2014). Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences. Contemporary Nurse: A Journal for the Australian Nursing Profession. 48(2), 150-167.
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Clarissa Smith
Clarissa Smith
Jan 17, 2018Jan 17 at 8:34am
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Nikki,
Awesome display of Betty Neuman’s systems model and the role of leadership. This brought more insight into my world of nursing theorists. In addition to your response, I found it interesting that Neuman believed that nursing is concerned with the whole person and that nursing as a unique profession it consists of all the variables affecting an individual’s response to stress. As nurses, the primary goal is the stability of the patient system and improve the patient’s health and quality of life. An effective way to promote nursing care is by applying nursing theories. Thus, this care and improved health is achieved via nursing intervention to reduce the stressors. Neuman’s process contained three basic parts: nursing diagnosis, nursing goals and nursing outcomes (Ahmadi & Sadeghi, 2017). Each of these processes play an intricate part in caring for patients. Ms. Betty Neuman stressed the importance of identifying the patient’s as well as the caregiver’s perceptions and collaboration with the nurse-patient relationship.
In nursing, possessing various qualities have significance. One of those qualities is leadership. Leadership is important to professional nursing in that a good leader can guide their team members in the right direction which leaves them feeling empowered, as you stated, Nikki. Unlike management, leadership cannot be taught but is can be strengthened via mentoring and coaching. Successful leaders inspire others to do and be their best. To be beneficial in this role, nurses must possess self-awareness and social awareness skills that involves relationship management. You mentioned this in your discussion. The benefits of self-awareness direct the nurses’ knowledge of their strengths and weaknesses (Shapira-Lishchinsky, 2014). This in turn causes the nurse to develop stronger active and critical thinking skills when an issue arises. Leadership habits of the nurse determines the nurse’s effectiveness in practice (Hood, 2014). Being effective in leadership; however, requires continuous learning, listening and giving and receiving feedback.
Social awareness skills also play a role in leadership which includes communication and social skills as well as understanding the needs of others. Being able to know and understand others can tap into their needs. Also, a nurse must respect the decisions that patients may make being they are from a different background or ethnic group. Skills such as recognizing emotions, active listening and being able to identify what’s behind a person’s words can affect the relationship a leader has with his/her colleagues and other healthcare professionals; this includes their patients. By utilizing Neuman’s systems model, a nurse can elevate and strengthen leadership skills.
Thanks, Nikki!
References
Ahmadi, Z., & Sadeghi, T. (2017). Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis. Multiple Sclerosis Journal—Experimental, Translational and Clinical, 3(3), 1-8. http://doi.org/10.1177/2055217317726798 (Links to an external site.)
Shapira-Lishchinsky, O. (2014). Simulations in nursing practice: toward authentic leadership. Journal of Nursing Management, 22, 60-69. doi: 10.1111/j.1365-2834.2012.01426.x
Hood, L. (2014). Leddy’s and Pepper’s conceptual baes of professional nursing (8th ed.). Philadelphia, Pennsylvania: Wolters Kluwer Health & Lippincott, Williams & Wilkins.
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Megan Edwards
Megan Edwards
Jan 17, 2018Jan 17 at 11:58am
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Nikki,
I enjoyed reading your post about the concept of leadership and agree that leadership is an important part of the nursing profession. Of all of the issues in nursing, good leadership seems to be involved with most solutions. Any concept or issue that I have researched thus far has strong leadership as one of the solutions to improving the status quo. I feel that the state of leadership in a particular setting can make or break a work environment. I have worked in jobs were the leadership was oppressive and lacked involvement. They only time you were asked to go to the bosses office was when you were in trouble. There was no support or positive reinforcement from the leadership role. As a result morale was low and turn over was high. I have also worked in places were the leadership was receptive and supportive. It made all of the difference in the world. Staff seemed to get along much better and the turn over rate was much lower.
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Brenda Talley
Brenda Talley
Jan 17, 2018Jan 17 at 5:30pm
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Nikki, you’ve a good match with Neuman’s systems model and leadership.
Nursing draws heavily on “borrowed” theories for nursing leadership, such as transformational leadership that arose from the business/administration professions and psychology, namely Burns (1978) and Bass (1985, Bass & Riggio, 2006). It should be noted that there is NOT a nursing theory of transformational leadership. However, as Nikki as presented, there are nursing theories that ARE compatible with transformational leadership. We will talk about BORROWED theories later in the semesters, but they won’t be used in the paper assignments.
Burns wrote about Franklin D. Roosevelt, and in analyzing FDR’s leadership style, began his explanation of transformational leadership. Just a bit of interest here!
Class, given that we don’t have a nursing theory of transformtional leadership, what nursing theories do we have that might be supportive of our understanding of this concept (other than Neuman’s as Nikki has provided already)? What principles of the theory would be most supportive?
References
Bass, B.M. (1985). Leadership and performance beyond expectations. NY: Free Press.
Bass, B.M. & Riggio, R.E. (2006) Transformational leadership. Mahwah, NJ: Erlbaum.
Burns, J.M. (1978). Leadership. NY: Harper & Row.
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Collapse SubdiscussionMegan Edwards
Megan Edwards
Jan 15, 2018Jan 15 at 1:34pm
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Steps of Concept Analysis
The concept of nurses’ grief is important to the profession of nursing because it can affect patient care and the overall health and well being of the nurse (Wisekal, 2015). The relationships that nurses develop with their patients and families makes them susceptible to grief when dealing with the loss of a patient or even the experience of a bad outcome for the patient (Wisekal, 2015). Wisekal (2015) believes that nurses do not always adequately process their grief because of the expectations to maintain a professional environment and their responsibilities to other patients. Some of the attributes of nurses’ grief include finding meaning or sense from loss, managing grief’s affects, and redefining relationships (Wisekal, 2015). One antecedent of nurses’ grief could be defined as a “licensed registered or practical nurse, as well as the primary nurse for a patient; experiencing a loss or a perceived loss of a patient; and having developed a relationship with a patient and his or her family before the patient’s death” (Wisekal, 2015, p. 104). A consequence of nurses’ grief would be that it could go unresolved and has been linked to nurse burn out, increased staff turnover, work related stress, and decreased job satisfaction (Wisekal, 2015). Empirical referents for nurses’ grief are made through observing an individual’s coping mechanisms, which are unique to the individual (Wisekal, 2015). Coping mechanisms “may include fatigue, burnout, anxiety, emotional disassociation, helplessness, loss of job productivity, and decreased concentration” (Wisekal, 2015, p. 106). The end goal of the grieving process would be resolution and the ability of the individual to adapt to loss (Wisekal, 2015). I feel that Conti-O’Hare’s theory of the Nurse as Wounded Healer can be applied to the concept of nurses’ grief. O’hare’s theory suggests that if nurses have adequate coping mechanisms for the experienced trauma in their workplace, they can resolve that experience and use it to improve their future practice (Christie & Jones, 2014). The theory discusses the term ‘walking wounded,’ which refers to the nurse who’s coping is unresolved and experiences negative impacts in their workplace, intimate, and social relationships (Christie & Jones, 2014). This is relevant to the concept of nurses’ grief because it suggests that nurses have the ability to supersede their own suffering in order to build more therapeutic relationships with their patients and family members (Christie & Jones, 2014).
References
Christie, W., & Jones, S. (2014). Lateral violence in nursing and the theory of the nurse as wounded healer. Online Journal of Issues in Nursing, 19(1). http://dx.doi.org/10.3912/OJIN.Vol19No01PPT01
Wisekal, A. E. (2015). A concept analysis of nurses’ grief. Clinical Journal of Oncology Nursing, 19(5), 103-107. http://dx.doi.org/10.1188/15.CJON.E103-E107
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Collapse SubdiscussionAllyson Tommasini
Allyson Tommasini
Jan 16, 2018Jan 16 at 10:42am
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Megan your concept of nurses’ grief is very well written and understood. The grief that we fee can be very troublesome if we don’t manage it well. Any sort of emotional trauma can be detrimental to nurses as a whole. We are the caring forces of healthcare. We care everyday for our patients, their families, our coworkers, friends and families of our own. When we experience loss and don’t have time to cope with it or adjust before experiencing it again it can build up on ones self. I can relate very much to the term of walking wounded because I felt that way when I returned from the military and could not cope with my life and transition back to civilian life as well as shortly after the death of my brother. It took a few years, but I feel like I’ve developed a new stronger me. As a nurse I tend to find myself trying to help those who are grieving or unable to cope with the news they have received. My topic I chose is compassion fatigue. I feel like your topic and mine have many similarities. I do like to help people cope and grieve about the new diagnosis, loss of a family member, or any other traumatic event. My topic research often suggests to develop a decompression room of nice warm relaxing colors and sounds with silence to help one reflect and cope with the emotional stress of the job. I for one would love to see this in multiple areas of my hospital, especially our unit. I feel like we could all benefit from it being that we are a high acuity ICU and frequently deal with patient tragedies. We have often been stuck with emotions regarding the quality of life our patients have when family members continue to want us to provide full aggressive treatment on someone who is not doing very well with a low chance of getting better. One thing I have had to learn to cope with is death. At times I get very teary eyed, but I try to tell myself that this is their time to grieve and mine can come later. It doesn’t get easier, but it gets more manageable. Meaning I feel like I am better able to deal with the stress of grief to the point of being able to help those in need.
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Nuha Bakkal
Nuha Bakkal
Jan 21, 2018Jan 21 at 11:09pm
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Megan:
The loss of a loved one is very distressing to the family of the deceased, but most people don’t think about the fact that it is distressing to the nurses that cared for them as well. Intensive care unit (ICU) nurses spend the most time with their patients and their families due to nurse-patient ratio assignments. As a result, they are the ones who will most likely need to be educated on bereavement when it comes to dealing with end-of-life cases. As a matter of fact, many ICU nurses report feeling underprepared to give the families the appropriate support when needed, especially during the event of sudden death of a patient (Shariff, Olson, Santos Salas, & Cranley, 2017). According to Shariff et al., nurses who frequently deal with death and dying face psychological, emotional, and physical consequences as a result (2017). A similar experience occurred for me not too long ago, I lost my grandfather while he was in the ICU and the nurse caring for him was not very good at comforting my family and I. This was not a big issue for me being in the field and knowing how busy it can be to be there for us the entire time. However, a physician assistant that was present at the time of my grandfather’s death made a difference. He was very emotionally supportive and that made a big impact on the whole experience. As a nurse, I was in the shoes of those families who experienced the death of a close relative, and it made me realize how important it is for us to seek education about dealing with grief, both for our own sake, and the patient families’ sake.
References
Shariff, A., Olson, J., Santos Salas, A., & Cranley, L. (2017). Nurses’ experiences of providing care to bereaved families who experience unexpected death in intensive care units: A narrative overview. Canadian Journal of Critical Care Nursing, 28(1), 21-29. Retrieved from http://eds.a.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=4&sid=5bf75750-99d0-45f2-9fc9-86160e09dd3f%40sessionmgr4009
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 17, 2018Jan 17 at 5:49pm
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Megan, you have an excellent beginning for your paper. Your choice of Nurse as a Wounded Healer is a great fit for the concept of grief as experienced by the nurse.
There are quite a number of scales, inventories and various research tool designed to measure grief in its many different aspects. The key is finding one that closely matches the qualities of grief experienced by nurses.
Houck (2014). identifies characteristics of what is termed cumulative grief and compassion fatigue. Clear ties to these distinct but closely related experiences are important to understand.
Class, why might it be important to make clear distinctions between and among related concepts? Could this impact the means of empirical assessment?
Reference
Houck, D. (2014). Helping nurses cope with grief and compassion fatigue: An educational intervention. Clinical Journal of Oncology Nursing, 18(4), 454-458. Retrieved from: https://cjon.ons.org/file/22486/download
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Janice Bethards
Janice Bethards
Jan 19, 2018Jan 19 at 3:16am
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Dr. T., Megan & Allyson,
Thank you for your insightful commentary about grief and compassion fatigue. Both concepts could lead to decreased job satisfaction and increased staff turnover if they are allowed to go unchecked in the workplace.
Nursing competency develops with experience. Nurses need time to develop their skills, and they need to feel supported by their administrative staff during this period of development (Flinkman, et al, (2016). When personnel or patient care issues cause prolonged emotional distress for the nursing staff, it erodes their competency growth process.
Nurses and ancillary staff need to develop the ability to nurture themselves in order to provide optimal care for their patients. The experienced staff members have an important effect on the morale of a unit, and their patients can sense the emotional tone between the nurses. The patients’ perceptions affect their ability to heal, as well as their reported patient satisfaction scores after discharge.
In order for the managerial staff to support the nurses, they must adequately assess the factors that are causing the emotional distress. Various sources of stress may be alleviated by different strategies.
If the same nurse has been assigned to a difficult patient for consecutive shifts, they may begin to feel overwhelmed by that patient’s needs. Measurable signs of compassion fatigue may be a delay in answering call lights, for example. The nurse may also page the physicians more often once they get tired of attempting to intervene in situations by themselves.
On the other hand, staffing shortages may be causing general burnout on the unit. If the nurses are expected to take on heavy patient loads to cover for these shortages, it may manifest in chronic subpar care. This situation could result in negative patient satisfaction ratings, which can often increase staff burnout in the end.
Staffing shortages may also cause problems with granting schedule requests for individual days off or vacation time. In this case, the staff burnout may manifest itself with increased callouts and tardiness, which becomes a vicious cycle for the whole unit.
Reference
Flinkman, M., Leino-Kilpi, H., Numminen, O., Jeon, Y., Kuokkanen, L. & Meretoja, R. (2016). Nurse competence scale: A systematic and psychometric review. Journal of Advanced Nursing, 73(5), 1035-1050. doi: 10.1111/jan.13183
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Neppsi Pauline Parker
Neppsi Pauline Parker
Jan 21, 2018Jan 21 at 12:30pm
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Dr. Talley,
I think that it is important to make clear distinctions between and among related concepts so that we clearly understand the defining attributes and how they are similar but, different as well. For example, I have always interchangeably used holistic care and patient-centered care. Until this class and this week’s discussion, I was not aware that there was a distinction between the two. Upon my initial review of the literature, it was noted that researchers often equate the two concepts (Jasemi, Valizadeh, Zamanzadeh, & Keogh, 2017). However, when I was trying to decipher between the two, I found that the concept of holistic care is an attribute of patient-centered care. Holistic care focuses on healing the whole patient while patient-centered care focuses on the individualistic needs/values of the patient and guides decisions (Klebanoff & Hess, 2013; Morgan & Yonder, 2012). Nurses must holistically assess the patient to provide patient-guided, individualized care.
Not clearly understanding the difference in the concepts can impact the empirical assessments because the data is largely subjective. For example, one concept analysis of patient-centered care identified its attributes as patient autonomy, caring, and individualizing nursing care (Lusk & Fater, 2013). However, another concept analysis of patient-centered care identified its attributes as holistic, individualized, respectful, and empowering (Morgan & Yonder, 2012). These are two concept analyses but, with different attributes discovered. And, since attributes help define the concept, the impact of the empirical assessment is important to consider as it can re-define the concept; thus, paving the way for new concepts and theories to develop.
Thank you,
Pauline
References
Jasemi, M., Valizadeh, L., Zamanzadeh, V., & Keogh, B. (2017). A concept analysis of holistic care by hybrid model. Indian Journal of Palliative Care, 23(1), 71-80. doi:10.4103/0973-1075.197960
Klebanoff, N.A., & Hess, D. (2013). Holistic nursing: Focusing on the whole person. American Nurse Today, 8(10), 9.
Lusk, J., & Fater, K. (2013). A concept analysis of patient-centered care. Nursing Forum, 48(2), 89-98. doi:10.1111/nuf.12019
Morgan, S., & Yoder, L.H. (2012). A concept analysis of person-centered care. Journal of Holistic Nursing, 30(1), 6-15. doi:10.1177/0898010111412189
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Mary Pollard
Mary Pollard
Jan 20, 2018Jan 20 at 3:16pm
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Megan,
The concept you’ve chosen of nurse’s grief is an interesting one. I know for myself, I can definitely say I that usually only think about my patients while I’m working, it doesn’t usually occur to me to see how my coworkers are. And, I have also felt what you’ve described, burnout and work-related stress. It is difficult, or in some cases impossible, to offer caring to another when the caregiver is consumed with sadness, anger, or other negative emotions.
You mentioned the different coping mechanisms individuals may have. It opened my eyes to think that what I may sometimes think of as “not coping” may actually be the only way the individual knows how to deal with a situation. Perhaps somebody shutting down is copying.
I do wonder now what a possible solution is to better helping nurses work with or through grief? Your post has definitely given me a different perspective. Thank you for broadening my view!
-Mary Claire
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Shareese Johnson
Shareese Johnson
Jan 21, 2018Jan 21 at 1:31am
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Hi Megan,
Most nurses grieve when patients die, but this grief often goes unacknowledged. Not a lot of consideration in nursing school or orientation to healthcare organization is given to preparing nurses for this experience. Nurses who grieve require acknowledgment, support, and education. Supporting staff through their grief may ultimately have a positive influence on the quality of work life, home life and quality of care for bereaved families (Jonas-Simpson, Beryl-Pilkington, MacDonald & McMahon, 2013).
Nursing students have expressed feelings of turmoil when caring for dying patients. Students have also shown a need for further education and preparation when caring for this population. Few nursing curriculums include courses on death, dying and the human experience of grieving a loss. Education along with support is beneficial in aiding staff in developing coping skills and managing their reactions to death(Jonas-Simpson, Beryl-Pilkington, MacDonald & McMahon, 2013).
Grief is not readily spoken about, but it is a significant experience that nurses encounter when providing care to families whose lose a loved one. When nurses’ grieving is acknowledged, they feel better supported, which could lead to enhanced nursing practice, quality of care, home life and work life (Jonas-Simpson, Beryl-Pilkington, MacDonald & McMahon, 2013).
Reference
Jonas-Simpson, C., Beryl-Pilkington, F., MacDonald, C. & McMahon, E. (2013). Nurses’ experiences of grieving when there is a perinatal death. SAGE Open, Vol 3, Iss 2 (2013), (2), doi:10.1177/2158244013486116. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.714909f1f91b49198b02508ef01d59ac&site=eds-live&scope=site (Links to an external site.)
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Collapse SubdiscussionClarissa Smith
Clarissa Smith
Jan 15, 2018Jan 15 at 6:15pm
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Professor and Class,
Concept analysis is the first step in creating and developing a theory in a systematic way in relation to the concept. It is defined by its attributes and characteristics in relation to application to nursing practice. The perception of what the concept is conveying can be an intricate part to implement or consider in the delivery of care to patients. A concept is an idea that is abstract in nature or a general notion or intention. Concepts are the foundation of thoughts and beliefs that play an important role in all aspects of cognition. Concept analysis assists in understanding the basis of the concept presented and its theoretical and practical implications for nursing more broadly.
The concept of humanistic nursing has come to symbolize the concept of caring for patients and serve as a model of inspiration to others. This concept has been used across health disciplines to define one’s ability to work through or understand an issue, problem, obstacle or situation. Humanistic nursing is termed to denote ways to surpass resistance and maximize nurses’ effects on tending to patients’ call for help. Attributes to Paterson and Zderad’s Humanistic Nursing Theory (1988) consist of Humanism, Existentialism and Nursing Dialogue, which are the bases of nursing. Each of these contribute to nursing practice in that this theory provides a basic philosophical and structural framework for the therapeutic nurse-patient relationship. Its influences on caring theory development and relational encounters builds on the standards of nursing as a profession. First, Humanism is the effort or venture to take a broader look of the patient’s potential and then attempting to understand each person for the context of their own personal experiences. Now, Existentialism is related to the understanding of life itself. Its concept is that thinking begins with the human which is the feeling, acting, living person; someone that exists. This attribute enhances the patient’s right to choose and their self-determination and responsibility to themselves. Paterson and Zderad (2013) consider the phenomenon of nursing as “the thing itself’: nursing occurs every day in the world as lived experience. According to this theory, nursing is a complex phenomenon that is encountered by each nurse and creates a nurse’s foundation of how they treat and care for patients throughout their nursing experience. So, Nursing Dialogue occurs as the nurse communicates with the patient and they come together; the nurse assists the patient and is open to grasp how the patient feels, as the intention of improvement occurs. Openness is pivotal to the humanistic nursing theory as well.
Nursing is person-focused, and experiences are shared between the nurse and patient. Humanistic nursing refers to the nurses’ response to humanism, existentialism and nursing dialogue and is consistent with caring theories proposed by nurses because of their correspondence with patient-centered perspective (Silva, 2013). Concentration on and analysis of human experience and relationships are significant in the nursing profession. Paterson and Zderad’s original intent was to distinguish humanistic nursing from other disciplines. Logic dictates that emphasis be placed on caring that transcends the profession of nursing can be applied on a grander scale to help other professions. Because of this selected nursing concept of human, this theory has influenced many other theories, i.e., the Theory of Nursing as Caring of Boykin & Schoenhofer (2001). This theory brings out that as the nurse learns that caring is living in the context of relational responsibilities. Because of actual experience, person-hood is enhanced and the nurse gains knowledge from the experience itself. In the process of humanistic nursing, an antecedent that must arise is that a nurse must first identify the existence of and need to respond to a patient’s call for assistance, their current condition, behavior, situation or problem. Thus, outcome and efficacy expectations include beliefs about whether the desire outcome will happen and the patients’ perceived capacity to perform relevant tasks toward that goal. So, a consequence would be a positive experience for both nurse and patient not to mention a growing nursing profession as nurses deliver quality care.
Empirical referents are measurable ways to demonstrate the occurrence of the concept. The defining attributes of the patient outcomes concept are abstract in nature; therefore, empirical referents are necessary to make the concept measurable. In other words, these are the categories that demonstrate the concept itself. Patient outcomes are pivotal measures utilized in learning about the effectiveness of cost-sensitive, quality health care. One such empirical referent is that of incorporating assessment and being caring toward patient, displaying behavior in some way and not being observed engaged in unhealthy behaviors, i.e., smoking, etc. This can measure the outcome of the patient as to what they are seeing is how they should act or behave. Also, another empirical referent worth mentioning is transferring knowledge of human behaviors to self, for one’s own well-being. An example of this would be taking the time to get to know each patient as individuals. Humanistic nursing theory has been used and applied to practice by nurses to position their studies. How patients respond to what is happening to them as well as what treatment is best. According to Paterson and Zderad (2013), nurses must recognize patients’ realities. For example, a patient that needs someone that when there is no one points to Paterson and Zderad’s belief in the importance of nurses being there or present and being open to this shared experience. As nurses, they fill many roles such as an advocate and supporting patients and their families. Thus, this nursing theory is very relevant to nursing theory as it displays the core concepts and that nurses must learn from their judgments and create actions based on a caring, critically conscious intent no matter what specialty has been chosen. Nursing is based on caring for patients and being human and accepting others as themselves display this attribute. This nursing theory and its core conceptions reinforce the importance and nurses’ contribution to nurse-patient relationship to patients’ and nurses’ lives.
References
Paterson, J. G., & Zderad, L. T. (1988). Humanistic Nursing. New York, NY: National League for Nursing.
Wolf, Z. R., & Bailey, D. N. (2013). Paterson and Zderad’s Humanistic Nursing Theory: Concepts and Applications. International Journal for Human Caring, 17(4), 60-69.
Silva, T. N. (2012). Paterson and Zderad’s humanistic theory: Entering the between through being when called upon. Nursing Science Quarterly, 26, 132-135. doi:10.1177/0894318413477209
Boykin, A., & Schoenhofer, S. O. (2001). Nursing as caring: A model for transforming practice.Sudbury, MA: Jones & Bartlett.
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 18, 2018Jan 18 at 8:01pm
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Clarissa, exploring humanistic nursing as a concept will be exciting! On an “abstract scale” of 1 – 10, with 10 being the most abstract, this is about a 25!!
I am reminded of Nightingale’s work, Notes on nursing: What it is and what it is not(1974/1859). Humanistic nursing may best be understood by what it is and what it is not. This is an analysis that will depend heavily on attributes, antecedents and consequences. Cases will help illuminate that which it is and that which it is not. Less likely will be the strength of empirical referents. It may be possible to gauge the presence of humanistic nursing (or the absence) by a survey or questionnaire, but I would think it not likely…would question the validity if if we did!. Still, it is critically important to nursing to know when it is present (being experienced) and when it is absent.
Sometimes we can estimate the presence of a quality by a proxy measure. We can look to the attributes, for instance, to see if they are present. However, it must be remembered that the proxy measure is not the “thing itself”; the thing itself is a constellation and must be experienced directly, in full force.
Reference
Nightingale, F. (1974) [First published 1859]. Notes on nursing: What it is and what it is not. Glasgow & London: Blackie & Son Ltd. ISBN (Links to an external site.) 0-216-89974-5 (Links to an external site.).
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Clarissa Smith
Clarissa Smith
Jan 20, 2018Jan 20 at 7:26pm
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Dr. Talley,
Thanks so much for the response and input. I did not realize that humanistic nursing would be abstract as it is until after I began researching it. This subject interested me being that we treat people everyday and some we see for only a few times and they are back to good health. Getting into the “meat” of what we do and how we do what we do in relation to theories that came before us is what intrigued me to this topic. Thanks again.
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Collapse SubdiscussionFride Edith Wandji
Fride Edith Wandji
Jan 15, 2018Jan 15 at 11:02pm
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Professor and class,
Concept analysis is a part of theory development and nursing science discipline. It is the activity whereby concepts, concept characteristics, as well as the relation of the concept to other nursing concepts are clarified. The nursing concept selected is person-centered care from Faye G. Abdellah’s person-centered care theory. Person-centered care is recognized as one component or critical element required to redesign the healthcare system. Person-Centered care is an important part of quality healthcare delivery. The person-centered care is being incorporated and advocated increasingly into healthcare providers training. The practice of person-centered care is dependent on the health care setting. This influences theory development, creates confusion, as well as affects implementation of person-centered care practices (Morgan and Yoder, 2012). This discussion provides steps included in person-centered care concept analysis. The steps include determining the defining attributes, identifying a model case, identifying alternative cases, identifying antecedents and consequences, and defining empirical referents.
Concept attributes are the heart of concept analysis. The aim is to identify attributes associated with the concept most frequently. Identification of concept attributes helps in phenomenon clarification as well as differentiation of the concept from other related or similar concepts. Some attributes of person-centered care include holistic, empowering, respectful, and individualized. Holistic care is the behavior that values and recognizes whole persons and the interdependence of the person’s parts. The whole person/individual is described as the spiritual, psychological, social, and biological aspects of the person. By providing holistic care, nurses are allowed to understand the manner in which the illness affects the whole person better as well as how they should respond to the individual’s true needs. Care must focus on the four aspects so as to avoid hampering healing as well as contribute to quality healthcare outcomes. In person-centered care, nurses consider each person’s unique needs as well as the specific health concerns. The nurses cannot achieve individualization without understanding the life situation of the patient/person in addition to the person’s desire or ability to make decisions as well as take control of her or his life. Individualized care is a demonstration of appreciation of the patient’s unique personality and history of the person while recognizing the person’s perspective. Patients have the right to be treated with respect. Empowerment encourages self-confidence and autonomy.
Antecedents are events that occur before the concept. Without them, nurses cannot have the ability to provide person-centered care effectively. Antecedents that create person-centered care climate within healthcare include shared governance, organizational behaviors and attitudes, and vision and commitment. Within the health facilities, the culture and climate created by the leaders support a devoted vision of person-centered care. The attitudes and behavior of organizational leaders set the cultural environment tone. If organizational leaders do not support creation of person-centered care couture, this prevents the nurses from incorporate it into their everyday practice. Shared governance empowers nurses to become a part of PCC making process. Consequences are events that take place due to the concept. The three person-centered care primary consequences are improved health outcomes, increased satisfaction with the healthcare, and improved healthcare quality.
Empirical referents are actual phenomena groups demonstrating the concept occurrence. They are the means by which one measures or recognizes the defining attributes. Person-centered care is normally measured from the point of view of the patient receiving care. The four instruments that are used to measure person-centered care are person-centered climate questionnaire, individualized care scale, patient-centered impatient scale, and patient satisfaction with the quality of care questionnaire. Person-centered climate questionnaire and patient satisfaction with the quality of care questionnaire focus on consequences and antecedents of person-centered care.
Model cases are concept examples exhibiting all defining qualities an attributes. Alternative cases lack all the defining attributes or has some of the defining attributes. The alternative cases mostly used are borderline and contrary cased. Borderline case has similar attributes or elements as the model case but one or more attributes differs in a way. A contrary case is an example of what the analyzed concept is not.
References
Morgan, S. and Yoder, L. (2012) A concept analysis of person-centred care. Journal of Holistic Nursing. Vol. 30. No. 1. pp 6-15. doi 10.1177/0898010111McCormack, B., Borg, M.,
Reed, J. (2014). eHealth: A concept analysis from a nursing perspective. Canadian Journal ofNursing Informatics.
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Hailey Whisenant
Hailey Whisenant
Jan 16, 2018Jan 16 at 2:24pm
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Fride,
You did a great job with your concept analysis in this post as well as defining attributes to this concept. When I think of person centered care I think of one person’s point of view, and as you’ve mentioned, individualized care pertaining their health status and condition.
On top of your post, I found an article regarding person-centered care I wanted to share with you and the class. Person-centered care is, in fact, individualized but it is also global. It’s global because it is a global priority in healthcare. Person-centered care correlates with another concept: person-hood. We must consider this concept in context of both relationships and our interactions with the patient. Both patient-centered care and person-hood should assess the needs and desires of patients and include recognition, respect, and trust (Fick, 2015).
It also is focused highly in the elderly population, which I found interesting. In the elderly population, patient-centered care brings attention to the need to both assess and plan the care around individuals preferences, values, concerns, and wishes regarding their care. Geriatric care brings value to the field of patient-centered care due to the history and research completed during that patient’s time frame (Fick, 2015).
Reference:
Fick, D. M. (2015). What is Old is New Again: Introducing a New Section on Person-Centered Care. Journal of Gerontological Nursing, 41(8), 3-4. doi:10.3928/00989134-20150722-01
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Medinat Balogun
Medinat Balogun
Jan 20, 2018Jan 20 at 8:58am
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Hello Fride and Class,
Person centered- care is broad and could be specific in the field of nursing. This concept might not necessarily work in all settings. As a home health nurse, it is important to incorporate this approach into practice as it may reflect on the nurse, the nursing agency and the way we are viewed. This concept is goal focused and person directed for the individual that is seeking support. Attributes include mutual respect which means that the nurse respects the person’s needs, preference and values as it relates to their history and present condition without being bias or judgmental. This will create a trusting caregiving relationship that emphasizes freedom of choice. This may also reflect how receptive patients will be towards care and the nursing agency they have chosen to provide care. When patients view themselves as equal partners that have a stake in how they will be treated, this helps them to know their view is welcome and their contribution will be considered in creating the plan of care, and ultimately, the way they will be helped. This also goes a long way to creating a therapeutic environment with an appropriate holistic approach to care. It is important that each care plan problems are individualized to reflect on the patient’s history and also meet the specifics of the patient’s needs as this gives patients the confidence to freely share information that is pertinent and would enable the nurse to have better care outcome.
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Brenda Talley
Brenda Talley
Jan 17, 2018Jan 17 at 5:55pm
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Week 3 Mid-week Post
This week so far!
Greetings Class:
Each of you made much progress in developing a concept for analysis. Great work!
You have selected a concept that is important to your practice of nursing. As we continue to explore, we can find depth and meaning within that context of practice, but also identify with the larger expression of the concept and how it might apply universally in the nursing profession.
Selecting the concept for analysis may SEEM easy, but, as we have discussed, often we find that a concept may not convey exactly what we want it too. Perhaps there is another word closely affiliated that has a meaning closer to our needs. For example, caring and empathy. Motivation and inspiration. Thoughtfulness and reflection. Obligation and commitment.
Students at times, find model cases difficult. Many times model cases can be found in the literature. Other times, it takes immersion into the clinical practice or the population of interest. And CREATIVITY. Taking the attributes and placing them into meaning.
Determining empirical referents, or measurement of the concept can also be a challenge. If the concept is concrete, it may be weighted, counted, etc. It may be placed on a scale or objectively rated. However “measuring” becomes more complex with the more abstract concepts. For one thing, the measurement approach must be consistent with philosophical base of the theory. Often, a research tool/instrument is developed by the theorist or those deeply engaged with the theory. For this course, we won’t get too deeply involved with HOW these measurement devices are developed, but let’s look at examples.
One with which I am familiar is Elizabeth Ann Manhart Barrett’s (2010) Power as Knowing Participation in Change theory and the measurement tool she and others developed based on the theory. The measurement, the Power as Knowing Participation in Change tool (PKPCT) is conceptually consistent with the theory. So it is measuring the concept as it is defined in the theory.
Caring is certainly an abstract concept! Yet scales, questionnaires and surveys have been developed for just such a measure.
For example, Sossong and Poirier (2013), used Wolf’s Caring Behaviors Inventory (CBI-E) to determine the congruence between the perceptions of caring in nurses and in patients.
I look forward to our continued dialogue!
Dr. T.
References
Barrett E. A. (2010). Power as knowing participation in change: What’s new and what’s next. Nursing Science Quarterly 23(1), 47-54. doi: 10.1177/0894318409353797
Sossong, A., & Poirier, P. (2013). Patient and nurse perceptions of caring in rural United States. International Journal for Human Caring, 17(1), 79-85.
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Collapse SubdiscussionMary Pollard
Mary Pollard
Jan 17, 2018Jan 17 at 6:14pm
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For this week’s topic I will discuss the concept of caring and how it is supported by the Nursing as Caring theory. Additionally, I will begin to develop a concept analysis of caring.
Caring is defined by the Oxford Dictionary (n.d.) as “The work or practice of looking after those unable to care for themselves” (para. 1).
Three attributes that serve as descriptors for the concept of caring include having concern for another, listening, and altruism. For these attributes to be realized, the individual offering care must be in a moment where they are able to focus their attentiveness on another. An antecedent to the concept of caring is emotional stability. A person in crisis is not able to offer caring to another. When caring is given to another, especially as a component of one’s job function, there is a consequence for the caregiver in the form of moral distress or compassion fatigue.
The presence of caring can be measured by the response of the recipient (spoken, actions, or changes in demeanor). Lenette and Sherman (2014) found that as a result of implementing caring into the day-to-day interactions between nurse managers and nurses, that collaboration increased between mangers and nurses as well as nurses and patients. They found that nurses showed more courage in taking on tasks, and that they were able to better recognize caring in others while also becoming more caring with their patients at the bedside as a result of their nurse leaders fostering a caring environment (Lenette & Sherman, 2014). These outcomes could be measured with surveys or questionnaires to evaluate a recipient’s perception of the care they received.
Linette and Sherman (2014) applied caring utilizing Boykin and Schoenhofer’s theory of Nursing as Caring. The Nursing as Caring theory outlines that one should live caring in their practice. The authors summarized that the theory’s basic assumptions include every person being innately caring, and that living is grounded in caring. Caring is central to the theory and could be summarized as live caring through your practice (2014).
The concept of caring is at the core of the nursing profession, and spans mosts nursing theories. This discussion has summarized the beginning of a concept analysis of caring, and description of how the concept of caring is central to the theory of Nursing as Caring.
References
caring. (n.d.) In The Oxford Dictionary. Retrieved from https://en.oxforddictionaries.com/definition/caring
Linette, D., & Sherman, R. O. (2014). Transforming a practice environment through caring-based nursing leadership. Nurse Leader, 1235-38. doi:10.1016/j.mnl.2013.09.014. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1541461213002693&site=eds-live&scope=site
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Fride Edith Wandji
Fride Edith Wandji
Jan 18, 2018Jan 18 at 3:08am
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Great post Mary,
I like how your concept choice is very clear and easy to follow. The caring theory is important to nursing because it helps our patients see that we care and nursing is not just a job. Compassion, empathy, and genuine heartfelt gestures are not something that can be taught. Nurses generally come by these caring concepts naturally. I believe that most nurses care a great deal about their patients. However, it is easy to become desensitized to situations. For example, nurses usually feel bad and do not want to give childhood immunizations to infants because they do not want to hurt them. I felt this way when I worked at flu clinics. I no longer feel bad about giving shots because I know that the little poke is vital for disease prevention and suffering. I would rather see a child cry for a few minutes then see them suffer with pain and illness.
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Amanda Howell
Amanda Howell
Jan 17, 2018Jan 17 at 6:42pm
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In her Theory of Goal Attainment, Imogen King identifies the concept of “transactions.” King defines transactions as “purposeful interactions where human beings communicate with their environment to achieve goals that are valued (de Leon-Demare, MacDonald, Gregory, Katz, & Halas, 2015).” Three attributes of transactions include active participation, goal orientation, and an exchange of ideas. To be considered a transaction, both the nurse and the patient must be active participants in the process (Primo & Brandão, 2017). There must be a desired end-point, or goal, that is the primary purpose of the interaction between the nurse and patient. Finally, there must be an exchange of ideas that results from the identified mutual goal, that focus on achieving that goal. One antecedent of a transaction is a disturbance, defined as an incongruence in the perception of a topic between the nurse and the patient, usually related to the patient’s health. One consequence of a transaction, if the transaction is successful, is the attainment of goals (de Leon-Demare, MacDonald, Gregory, Katz, & Halas, 2015). One empirical referent of transactions is the exchange of ideas between a nurse and patient that is intended to identify and achieve common goals. Transactions are an integral part of Goal Attainment Theory, as they describe how the nurse and patient work together to achieve common goals related to the patient’s health. Transactions are a necessary part of the nurse-patient relationship because they are how healthcare goals are identified and interventions are established. For example, the patient has just been given a diagnosis of prediabetes and does not understand what this is and how it relates to his health (the disturbance). The nurse shares information about prediabetes with the patient, and what tests were performed to diagnose the condition. The patient asks questions about the disease and the nurse answers. This constitutes a transaction. The patient and nurse are both active participants in an exchange of ideas about prediabetes with the mutual goal of having the patient understand prediabetes and how it relates to his health.
References
de Leon-Demare, K., MacDonald, J., Gregory, D. M., Katz, A., & Halas, G. (2015). Articulating nurse practitioner practice using King’s theory of goal attainment. Journal of The American Association of Nurse Practitioners, 27(11), 631-636. doi:10.1002/2327-6924.12218
Primo, C. C., & Brandão, M.A.G. (2017). Interactive theory of breastfeeding: Creation and application of a middle-range theory. Revista Brasileira de Enfermagem, 70(6), 1191-1198. doi:10.1590/0034-7167-2016-0523
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Collapse SubdiscussionMedinat Balogun
Medinat Balogun
Jan 17, 2018Jan 17 at 7:19pm
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Concept within nursing is an accepted mechanism that define and operationalize the system to generate knowledge, new ideas in order to gain a broader view and get clarity (Parker & Smith, 2010). The nursing concept I would like to discuss is one of Parse’s. Parse’s view of nursing is based on humanism as opposed to positivism. She suggests man chooses options and is responsible for the choices. She came up with the principle of Man- living-Health with interrelated concepts. One of her concepts is Rhythmicity which is the rhythmic pattern of living with 3 concepts of revealing-concealing, enabling-limiting and connecting-separating. For instance, the purpose of the enabling-limiting analysis is aimed at determining the care outcome based on enabling a patient versus limiting them in decision making process. Merriam-Webster Online defines “Enabling” as to give strength, or ability to: provide with means or opportunity. While it defines “Limiting “as restrictive, placing limitation on what is possible or allowed. 3 attributes of limiting could be restricting, preventing and confines. Also, 3 attributes of Enabling could be Allow, Permit and Empower. To put this concept into practice, we could examine a case of a single mum with a very sick child that needs constant hospitalization, and this poses a health hazard to her immune system. It was decided she gets 24hr home nurse service. By all means the mother wanted to be involved with her child’s care. The health care team will “Enable” and “Empower” her to make informed decision in case the nurse was not around, and an emergency arises. They will equip her with the proper resources and education to succeed with care in their absence. They will empower her with the ability to care for her child without feeling helpless, in so doing, she feels a sense of control, determination and autonomy over her child’s health and care. Enabling the mom to be actively involved in meeting and identifying the needs of her child’s health improves family function (Dunst, 1988). However, contrary would be the case if she wants to be self limiting, had a nonchalant attitude and does not want to be involved or she was given the opportunity and she limited herself by not paying attention to the education or resources provided to her. Ultimately the antecedent is that each individual, patient, family or community must be a willing partner/ participant and able to learn about their health, willing to ask questions and be involved with the care process. A positive “Consequence” will occur after education and training, there would be better control of infection and less hospitalization/ re-hospitalization for the child (Wilson, 2016). Her symptoms will be better managed and will be in good hands at all time, be it with the health care team or her mum. The empirical referent of empowerment can be measured by asking questions of the mom. “if the education provided gives her the autonomy needed to self-manage her child in the healthcare team’s absence. A simple yes is a measurable, able the decreased number of re-hospitalization in emergent could depict the success of the empowerment. The concept is relevant to nursing theory, as we feel empowered if we have information, support and access to resources and opportunities to learn and grow.
References
Dunst, C., Trivette, C., Davis, M., & Cornwell, J (1988). Enabling and empowering families of
children with health impairments. Children’s Health Care, 17(2), 71-81.
Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice (3rd ed.). Philadelphia, PA: F. A. Davis Company.
Wilson, D. R. (2016). Parse’s Nursing Theory and its application to families experiencing empty
arms. International Journal of Childbirth Education, 31(2), 29-33.
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Medinat Balogun
Medinat Balogun
Jan 19, 2018Jan 19 at 3:38pm
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Concept within nursing is an accepted mechanism that define and operationalize the system to generate knowledge, new ideas in order to gain a broader view and get clarity (Parker & Smith, 2010). The nursing concept I would like to discuss is one of Parse’s. Parse’s view of nursing is based on humanism as opposed to positivism. She suggests man chooses options and is responsible for the choices. She came up with the principle of Man- living-Health with interrelated concepts. One of her concepts is Rhythmicity which is the rhythmic pattern of living with 3 concepts of revealing-concealing, enabling-limiting and connecting-separating. For instance, the purpose of the enabling-limiting analysis is aimed at determining the care outcome based on enabling a patient versus limiting them in decision making process. Merriam-Webster Online defines “Enabling” as to give strength, or ability to: provide with means or opportunity. While it defines “Limiting “as restrictive, placing limitation on what is possible or allowed. 3 attributes of limiting could be restricting, preventing and confines. Also, 3 attributes of Enabling could be Allow, Permit and Empower. To put this concept into practice, we could examine a case of a single mum with a very sick child that needs constant hospitalization, and this poses a health hazard to her immune system. It was decided she gets 24hr home nurse service. By all means the mother wanted to be involved with her child’s care. The health care team will “Enable” and “Empower” her to make informed decision in case the nurse was not around, and an emergency arises. They will equip her with the proper resources and education to succeed with care in their absence. They will empower her with the ability to care for her child without feeling helpless, in so doing, she feels a sense of control, determination and autonomy over her child’s health and care. Enabling the mom to be actively involved in meeting and identifying the needs of her child’s health improves family function (Dunst, 1988). However, contrary would be the case if she wants to be self limiting, had a nonchalant attitude and does not want to be involved or she was given the opportunity and she limited herself by not paying attention to the education or resources provided to her. Ultimately the antecedent is that each individual, patient, family or community must be a willing partner/ participant and able to learn about their health, willing to ask questions and be involved with the care process. A positive “Consequence” will occur after education and training, there would be better control of infection and less hospitalization/ rehospitalization for the child (Wilson, 2016). Her symptoms will be better managed and will be in good hands at all time, be it with the health care team or her mum. The empirical referent of empowerment can be measured by asking questions of the mom. “if the education provided gives her the autonomy needed to self-manage her child in the healthcare team’s absence. A simple yes/no is a measurable tool to show that she was empowered or not. Also, measurable is the decreased number of rehospitalization in emergent situation as this could depict the success of empowerment. The concept is relevant to nursing theory, as we feel empowered if we have information, support and access to resources and opportunities to learn and grow.
References
Dunst, C., Trivette, C., Davis, M., & Cornwell, J (1988). Enabling and empowering families of children with health impairments. Children’s Health Care, 17(2), 71-81.
Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice (3rd ed.). Philadelphia, PA: F. A. Davis Company.
Wilson, D. R. (2016). Parse’s Nursing Theory and its application to families experiencing empty arms. International Journal of Childbirth Education, 31(2), 29-33.
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Collapse SubdiscussionYoko Khan
Yoko Khan
Jan 17, 2018Jan 17 at 8:30pm
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Hello Dr. T and class,
For this week’ discussion, I have chosen “Quality of Life” as a nursing concept and for Concept Analysis assignment. “Quality of Life” concept would be closely relevant to my chosen nursing theory, “Self-Care Deficit Nursing Theory,” by Dorothea Orem.
o Definition of concept: According to Oxford English Dictionaries (2018), a concept meant plan, idea, invention, and direction.
o Three attributes of the concept of “Quality of Life” would be Age (generations), Diagnoses (medical condition), and Social background (social status).
o Description of one antecedent and one consequence of the concept: An elderly peritoneal dialysis patient who lived by himself (widow). He could be either medication compliance or non-compliance depending on his supporting deficit. The antecedent for this case was his QOL was not optimal due to non-compliance with medication, frequently suffering from peritonitis due to poor hand hygiene; his health declined.
o Identification of at least one empirical referent: An empirical referent for this concept would be measures of ability to utilize supports (homecare, daycare, outpatient service) to meet patient satisfaction, improve his QOL (Shultz, 2015).
o A brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory?): “Quality of Life” would be closely relevant to Dorothea Orem’s theory “Self-Care Deficit Nursing Theory”. Eliminating “deficit” from patients by supporting, educating, promoting, optimal health would be maintained and his QOL could be optimal.
References
Oxford English Dictionaries, 2018. Oxford University Press. Retrieved from https://en.oxforddictionaries.com/definition/concept (Links to an external site.)
Shultz, S., & Hand, M. W. (2015). Usability: A Concept Analysis. Journal Of Theory Construction & Testing, 19(2), 65-70.
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Amanda Howell
Amanda Howell
Jan 19, 2018Jan 19 at 7:44am
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Hi Yoko,
Quality of life is a great nursing concept to consider, I am glad to see somebody else is interested in such a concept. It is important because healthcare providers become caught in the race to improve a patient’s healthcare outcomes without considering the patient’s quality of life. It seems there is no definitive definition of “quality of life” that satisfies all the different uses of the word (Lavdaniti & Tsitsis, 2015). Age, diagnoses, and social background all contribute to the patient’s quality of life. The patient’s perception of their quality of life is also an important attribute of quality of life. One antecedent to quality of life, as I perceive it, may be the patient’s health status. Health status is all encompassing, including social and psychological health. Whatever their health status will lead to a specific quality of life. One consequence of “quality of life” is the patient’s mood; for example, a patient with poor quality of life may become depressed. I agree that quality of life can be measured by the patient’s ability to increase their quality of life. Quality of life can also be measured by just about any means of observing a patient’s life. Although I have not researched Orem’s specific theory, I imagine that self-care deficits negatively impact the patient’s quality of life.
Thanks for the post, I think quality of life will be an interesting topic for the concept analysis assignment.
References
Lavdaniti, M., & Tsitsis, N. (2015). Definitions and conceptual models of quality of life in cancer patients. Health Science Journal, 9(2), 1-5.
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Fride Edith Wandji
Fride Edith Wandji
Jan 20, 2018Jan 20 at 2:43am
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Great post Yoko,
I like the way that you define the theory of Orem on self-care.We all agree that concept and theory analysis are the means that we used to reveal to others the components of our profession. Self-care theory carries a particular way of viewing the reality of nursing treatments. Every individual adult has the capacity for self-care; however, when a health problem arises it is possible that this capability is insufficient to confront the situation, making it then necessary to receive help from other persons who compensate for this deficit. Orem’s theory of nursing is of extreme importance when caring for patients especially elderly since we know that their health is very fragile and declined rapidly. By embracing Orem Self-Care theory, this will help to guide and improve our practice.
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 20, 2018Jan 20 at 5:42pm
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Yoko, quality of life is an interesting concept! It is more difficult to define than one might think. The individual’s perceptions of their own litfe may be very different than that of the healthcare professional.
It is important to obtain a clear definition of the concept of quality of life.
I have known some people who would be determined as disabled…mobility issues, deafness, blindness…that should you ask them, would consider themselves to have a high quality of life. Just something to consider. Does the literature speak to that?
Class, in analyzing a concept, in what way and in what instances might the individual’s (patient”s) perspectives and experiences aid in understanding the concept?
Could certain conditions, such as age, length of or expected length of health issues, family support???? For example, Boggatz (2016) analysed quality of life as experienced in old age while Mandzuk and McMillian (2005) focused on the orthopedic patient.
Yoko, you have an excellent beginning for your paper.
Reference
Boggatz, T. (2016). Quality of life in old age – A concept analysis. International Journal of Older People Nursing, 11(1), 55-69. doi: https://doi.org/10.1111/opn.12089
Mandzuk, L. L. & McMillan, D. E. (2005). A concept analysis of quality of life. Journal of Orthopaedic Nursing, 9 (1), 12-18. Doe: http//doi. org/10.1016/j.joon.2004.11.001
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Lolita Jerrell
Lolita Jerrell
Jan 21, 2018Jan 21 at 1:26pm
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Professor Talley,
You present a very interesting question about how an individual’s or patient’s perspective and experiences aid in understanding the concept. While reading on the concept of health literacy and its antecedent health disparity I realized many of the differences between the two come from the individual’s perspective and experiences as it relates to the healthcare system. Health literacy is often influenced by the patient age, race, gender, economic status, level of education in which deficits on one or all areas can cause health disparities. When assessing a patient for their level of health literacy it is based on subjective, self-reported, patient perspective scales, which requires nurses to confront our own biases and experiences to better understand our patient’s point of view. In a study completed by van der Heide, Wang, Droomers, Spreevwenberg, Rademaker & Uiters (2013) the suggestion is made that in order to improve health literacy we must reduce disparities in health as well basic education as each of these factors play a major role in patient outcomes. One way to improve disparities in health literacy is to have the nursing profession provide a more standardized literacy assessment tools to establish patients true health deficits and not just health perception deficits.
Reference
van der Heide, I., Wang, J., Droomers, M., Spreeuwenberg, P., Rademakers, J., & Uiters, E. (2013). The relationship between health, education, and health literacy: results from the Dutch Adult Literacy and Life Skills Survey. Journal Of Health Communication, 18 Suppl 1172-184. doi:10.1080/10810730.2013.825668
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Mary Pollard
Mary Pollard
Jan 21, 2018Jan 21 at 5:12pm
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Dr. Talley,
In response to: Class, in analyzing a concept, in what way and in what instances might the individual’s (patient’s) perspectives and experiences aid in understanding the concept?
While brainstorming ideas on the concept of caring for my posting this week, and upcoming paper, I found that I had to think from the patient’s perspective to wrap my mind around what some of the attributes would be, as well as the antecedents and consequences. During concept analysis, especially for the concept of caring, the patient’s (and patient’s family) perspective is all that will be considered when attempting to measure caring. I can imagine, at the inception of survey creation, the authors of the survey would have to discuss the many different ways caring could be perceived by patients. And, possibly the higher hurdle, how to accurately measure each of these in just a few survey questions.
I can imagine some concepts that primarily impact the nurse, or nurse-to-nurse relationships, but even with this type of concept the patient’s perspective would need to be considered as a consequence. I believe nursing begins from the patient’s perspective. Almost all (if not all!) nursing concepts would point back to the patient either by contributing to the attributes, an antecedent or affecting the patient with a consequence of the concept. Even with the most nurse-focused concept, separating the nurse from the patient seems nearly impossible.
-Mary Claire
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Collapse SubdiscussionNeppsi Pauline Parker
Neppsi Pauline Parker
Jan 17, 2018Jan 17 at 9:13pm
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Dr. Talley and fellow students,
Understanding the methods of nursing theory development is an important aspect within advanced clinical nursing practice. Concepts within nursing are the basics from which nursing theories are formed. One concept that contributes to nursing theory and has great potential for improving the outcomes of patient care is the concept of holistic care.
Holistic care, however, is not easily defined due to its complexity and largely subjective qualities. Review of the literature does not reveal one definition. The definition that I found that is the most clearly recognizable and discerning is the definition provided by Jasemi, Valizadeh, Zamanzadeh, and Keogh (2017). They define holistic care “as behavior that recognizes a person as a whole and acknowledges the interdependence among their biological, social, psychological, and spiritual aspects” (Jasemi et al., 2017). Nurses deliver and provide holistic care by focusing on the whole person.
Jasemi et al. (2017) noted three characteristic domains of holistic care. These include spiritual, social, and clinical care (Jasemi et al., 2017). The following descriptions of these characteristics were noted by the work of Jasemei et al.: spiritual care is practiced by acknowledging and supporting belief practices such as praying; social care is practiced by understanding cultural practices and addressing social needs such as financial and social service needs; and clinical needs are practiced by prioritizing care to meet the needs of patients such as, pain control, positioning, and assistance with toileting. Each of these descriptions are samples of how nurses provide holistic care through addressing the spiritual, social, and clinical care needs of their patients.
One antecedent of the concept of holistic care is knowledge. Studies indicate that nurses do not fully understand the defining characteristics of the concept of holistic care (Jasemi et al., 2017). This is in part due to the ambiguity of what holistic care is and how to address the multitude of needs of the whole patient. Often, nurses interchange the concepts of holistic care and person-centered care (Jasemi et al, 2017). While these two concepts have similarities, holistic care is more complex and subjective.
A consequence of the concept of holistic care is negative interpretations (Jasemi et al., 2017). Critical attitudes suggest that holistic care is unspecialized, non-task oriented, and that it is a non-statistical model of caring (Jasemi et al., 2017). They also suggest that providing holistic care is a waste of time for nurse’s and leads to emotional exhaustion by focusing too much time on the psychological aspects of patient care (Jasemi et al., 2017). Nurses are strained with lean staffing models, long working hours, and issues of lateral violence and should not be expected to add additional work and time to their already hectic schedules.
One empirical referent used to analyze the holistic care concept is the Schwartz-Barcott and Kim hybrid model. This model is often used with creating, developing, and expanding comprehensive concepts (Jasemi et al., 2017). This model is comprised of three phases: theoretical phase; fieldwork phase; and the final analysis phase (Jasemi et al., 2017). The three phases include an extensive literature review, participant and environment selection, and analysis of the findings which identifies the attributes of the concept.
The concept of holistic care is relevant to Parse’s Human Becoming Theory. Parse’s Human Becoming Theory basically states that human beings are a combination of biological, sociological, psychological, and spiritual components and are in constant interaction with the world around them. Providing holistic care involves acknowledging, respecting, addressing, empathizing, and supporting patients’ needs. This also includes care of self for the nurses and how they develop a nurse-patient relationship; thereby, strengthening the interconnectedness between nursing care and patient outcomes.
Thank you,
Pauline
Reference
Jasemi, M., Valizadeh, L., Zamanzadeh, V., & Keogh, B. (2017). A concept analysis of holistic care by hybrid model. Indian Journal of Palliative Care, 23(1), 71-80. doi:10.4103/0973-1075.197960.
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Brenda Talley
Brenda Talley
Jan 20, 2018Jan 20 at 6pm
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Pauline, the concept of holism is an essential aspect of nursing. While we are aware of the aspects of of humans that we label as spiritual, emotional, physical, these aspects must be experienced in unitary knowing.
Martha Rogers, when asked by doctoral students to explain holism, said that we should think of cake. While it may be useful to know about eggs and flour and such, one could not understand cake by looking at an egg. The unitary appreciation gives cake.
Good beginning for your paper!
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Collapse SubdiscussionJacqueline Kenton-Jones
Jacqueline Kenton-Jones
Jan 17, 2018Jan 17 at 11:01pm
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Concept: An abstract idea, a general notion. An idea or invention to help sell or publicize a commodity.
The concept of choice is the model for stages of clinical competence based on the theory Novice to expert. Framework for assessing nurses needs at different stages of professional growth.Benner does a phenomenal job in capturing the development of nurses through the different levels of experience. She differentiates the stages of nursing and how we advance to providing an optimal level of care through education, experience and time.
Attributes of the concept refers to nurses directly and the impact of their development and patient care. Achiever/Achievement, then nurse achieves a level of experience that helps to identify needs and make better assessments to provide adequate care. Competence, the nurse acquires the skillful training and education to make appropriate decisions and plan for advanced care. Knowledge, obtained through communicative skills, time and insight that results in better patient outcomes.
The antecedent of the concept is the lack of wisdom to knowledge, the novice stage of nursing, This stage lacks the experience and clinical competence, the inability to identify change in patient status or take specific steps toward advance planning. One consequence of the concept may be individual advancement and retention, An advanced nurse has the ability to apply knowledge and experience to an employment opportunity, rather than an advanced level of patient care.
An empirical referent of the concept can be measured by improved clinical judgments and improved clinical practices. Nursing expertise is fundamental to quality of care. Improved patient outcomes is indicative of best practices and application of competent care.
Mentored clinical learning situations in both classrooms and practice sites offer critical opportunities for nurses to apply and integrate theoretical knowledge with actual events ( Field 2004). Experienced nurses have the ability to empower novice nurses to utilize theory and principle to integrate care that impacts overall outcomes. The multi levels of nursing stages, advance nurses to identify patient needs and anticipate care.Nurses become proficient and proactive in the planning processs. The stages of clinical competence captures the clinical ladder that is obtained while gaining knowledge and skill.
Mennella,H.A. (2016).Benner’s Professional advancement model.CINAHL Nursing Guide
Jackson,S. Building bridges from theory to practice: Nursing theory for clinical Nurses.Med-Surg matters 26 (3), 1-15
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 20, 2018Jan 20 at 6:03pm
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Jacqueline, great beginning for your paper
Remember that the CINHAL nursing guides are a synthesis of information and an easy source of information, but they are not peer reviewed. Look at the sources THEY used for leads on journal articles.
Good work!
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Jacqueline Kenton-Jones
Jacqueline Kenton-Jones
Jan 20, 2018Jan 20 at 9:31pm
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Thanks Professor
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Collapse SubdiscussionJanice Bethards
Janice Bethards
Jan 17, 2018Jan 17 at 11:30pm
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Dr. T. & Classmates:
The nursing theory that I’ve chosen for our Concept Analysis paper is Patricia Benner’s Novice to Expert Model. The concept that I’ve chosen is competency.
Defining and Explaining Competence: Merriam-Webster (n.d.) describes competence as possessing the knowledge and skillset to adequately perform a task. Competent people can perform tasks in a sufficient manner.
Identification of Three Attributes of Competency:
o After nurses have been trained to perform certain clinical tasks on the floor, they should be able to competently perform these skills at the bedside.
o Professional competence involves the use of critical thinking skills, not just a rote memorization of steps when performing procedures on patients (Franklin, et al 2015).
o True competency develops as nurses incorporate an appreciation of individual patients into their skillsets.
Description of One Antecedent and One Consequence of the Concept:
o Antecedent- Graduate nurses are task- oriented and concrete thinkers when they first begin to practice at the bedside (Franklin, et al 2015).
o Consequence- Proficient nurses have developed more critical thinking skills and are able to appreciate the uniqueness in different patient encounters (Franklin, et al 2015).
Identification of at least One Empirical Referent:
Patients assess their nurses’ competency when they fill out their satisfaction surveys after discharge. Their answers are put into a formula that enables comparisons between different hospitals within the community (Franklin, et al 2015).
Brief Explanation of Theoretical Applications of the Concept:
Patricia Benner’s Novice to Expert Model is based on five levels of skill development that measure a nurse’s overall competency level. The stages are novice, advanced beginner, competent, proficient, and expert.
References
Franklin, N. & Melville, P. (2015). Competency assessment tools: An exploration of the pedagogical issues facing competency assessment for nurses in the clinical environment.Collegian, 22(1), 25-31.
doi: 10.1016/j.colegn.2013.10.005
Merriam-Webster (n.d.). Competence. Merriam-Webster Dictionary. Retrieved from: https://www.merriam-webster.com/dictionary/competence
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 20, 2018Jan 20 at 6:10pm
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Jan, interesting method of empirical referent for competency. This may be a case where the measurement would need to fit the definition selected for the concept.
Class, now WHY would I say THAT???
It can get freaky thinking about ALL of the aspects of nursing in which nurses must have competencies. Patient satisfaction surveys capture the impressions and perceptions of the patients (and probably family members) but would not be aware of each and every competency required of the nurse. So which ones might be, specifically, given the patient satisfaction survey components (for example, pain management, communication, teaching). Class what do you think?
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Catherine Resendez
Catherine Resendez
Jan 20, 2018Jan 20 at 11:49pm
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Hi Jan and Professor,
I enjoyed reading your post. The competencies included on my unit’s patient satisfaction surveys are, education given about medications given (specifically if side effects were educated on), was pain managed to their comfort, did they feel they were checked on enough to satisfy their needs, and was stuff explained in a way they understood. Our supervisors actually make rounds weekly to ask these questions personally. I like that they do it this way because the supervisors are able to get better answers and clarification on what the patients feel the nurse or nurses are or aren’t doing to satisfy their needs. Most of the time what the patients aren’t satisfied with has nothing to do with the nurse and when given these surveys they automatically are a reflection on the care given by the nurse. Our unit manager initiated this system to get one on one feedback on what can be done to improve patient care and I think it is very effective. I don’t feel like the care I am providing is being over looked or misjudged.
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Janice Bethards
Janice Bethards
Jan 21, 2018Jan 21 at 9:37pm
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Dr. T. and Catherine,
Thank you for your feedback on my post.
In a sense, patients (and family members) are more concerned with the nurses’ and physicians’ communication skills than they are with other aspects of their care (Al-Abri, et al 2013). They are more cognizant of the level of respect that they received while they were in the hospital than anything else. If the nurses listened to their concerns about their pain level, kept them informed about procedure scheduling and answered the call lights promptly, they are generally satisfied with their care.
On the other hand, nurses tend to place more emphasis on their competency in relation to specific mechanical skills. Those skill sets and the ability to recognize escalating crisis situations often take precedence over general communication considerations on busy medical floors. Patient surveys help the medical staff be more aware of their patients’ concerns in a general sense, however.
Reference
Al-Abri, R. & Al-Balushi, R. (2013). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal, 29(1), 3-7.
doi: 10.5001/omj.2014.02
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Collapse SubdiscussionNuha Bakkal
Nuha Bakkal
Jan 17, 2018Jan 17 at 11:55pm
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Dr. Talley and class:
Nursing concepts create the very foundation to all nursing theories (Parker & Smith, 2010). The selected nursing concept is caring by the famous theorist Jean Watson. Caring is considered the central theme and core of the four metaparadigms (Sitzman, 2017). The definition of caring is assisting with all needs of the patient, engaging by listening and interacting, as we as being present with the patient (Sitzman, 2017). Watson’s human caring theory was published in 1979 (Norman, Rossillo, & Skelton, 2016). His theory is composed of 10 Caritas Processes (Caritas means to cherish in Latin). Briefly, the Caritas Processes are as follows:
1. Practicing love and kindness.
2. Being genuinely present.
3. Cultivating one’s own spiritual practices and transpersonal self, going beyond ego self.
4. Developing and sustaining a helping-trusting, authentic caring relationship.
5. Being present to, and supportive of the expression of positive and negative feelings.
6. Creatively using self as part of the caring process.
7. Engaging in genuine teaching-learning experience
8. Creating a healing environment at all levels.
9. Assisting with all basic needs.
10. Opening and attending to one’s life-death; soul care for self and the one-being-cared-for.
(Norman, et al., 2016).
An antecedent is an event that must occur before occurrence of a concept (Robert, Tilley, & Petersen, 2014). In this case, the antecedent of the concept of caring is when the nurse creates a therapeutic relationship with the patient (Wolf, King, & France, 2015). A consequence is the influence of the actions, and in this case the consequence of the concept of caring is that the patient will create trust for the nurse throughout the interaction (Wolf et al., 2015). An empirical referent is defined as how something exists or measured (Robert et al., 2014). Usually, empirical referents are measured through their attributes (Parker & Smith, 2010). When a patient is well cared for, he/she will be in happier, more content and comfortable with the care given. The patient satisfaction level is one example of an empirical referent (Norman, et al., 2016). Another example is if the patients in a hospital have an extended stay, this could possibly mean that the patients are not well cared for, meaning they are not improving; caring methods can have a big impact if hospital-acquired complications occur.
The concept of caring is relevant to a nursing theory because it is the reason why nurses explain, diagnose, and prescribe their actions. The caring concept is the phenomena that gives nurses a purpose and justification to carry out their actions. Nursing theory is not reality, but the concept of caring is the actions that bring the nursing theories to life, by representing its healing characteristics to the patient, which ultimately, yields the goal of delivering healing to the patient (Brito et al., 2017).
References
Alves de Brito, L. S., Lopes de Sousa, N. D., Parente Garcia Alencar, A. M., de Cássia Félix Rebouças, V., Pessoa Pinheiro, P., & Gonçalves Júnior, J. (2017). Concepts, theoretical models and nursing theories: Integrative review. International Archives of Medicine (International Medical Society),10(166), 1-8. doi:10.3823/2436
Norman, V., Rossillo, K., & Skelton, K. (2016). Featured article: Creating healing environments through the theory of caring. AORN Journal, 104(Special focus issue: Conscious leadership), 401-409. doi:10.1016/j.aorn.2016.09.006
Robert, R. R., Tilley, D. S., & Petersen, S. (2014). A power in clinical nursing practice: Concept analysis on nursing intuition. MEDSURG Nursing, 23(5), 343-349. Retrieved from http://eds.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=2d7c4fb3-7b18-4ba0-a13e-12e957c7105a%40sessionmgr104
Sitzman, K. (2017). Evolution of Watson’s human caring science in the digital age. International Journal for Human Caring, 21(1), 46-52. Retrieved from http://eds.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=6&sid=0909aa4a-fc18-4ff7-919c-0704dfea7252%40pdc-v-sessmgr01
Wolf, Z. R., King, B. M., & France, N. M. (2015). Antecedent context and structure of communication during a caring moment: Scoping review and analysis. International Journal for Human Caring, 19(2), 7-21. Retrieved from http://eds.a.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=3&sid=49147842-7763-4585-bf2a-97fee122882f%40sessionmgr4006
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Laquanta Russell
Laquanta Russell
Jan 21, 2018Jan 21 at 11:13pm
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Hello Nuha,
I also selected caring as the concept analysis to explore. The act of caring consist of many factors that impact the nursing process. To care means to be an active listener, sensitive, honesty, competence, ability to express empathy, and to provide comfort. The nurse is to care for the patient while teaching them to care for themselves. Watson understood the care of the patient is to care for the physical and mental being as well as the nurse. Caring is to provide care for those who are unable to care for themselves as well as displaying kindness, compassion, and concern.
LaQuanta
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Catherine Resendez
Catherine Resendez
Jan 17, 2018Jan 17 at 11:56pm
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Hi Professor and Class,
To have a clear and further understanding of concepts Avant and Walker developed concept analysis. Nursing care is a concept that is still to this being explored. Nursing care provides concrete and abstract contributions to patient and organizational outcomes. In the article, The Value of Nursing Care: A concept Analysis, (Dick, Patrician, & Loan,2017), a concept analysis of nursing care is performed with the method of dimensional analysis. Dick, Patrician, and Loan (2017), state that the nursing care in the nursing profession reflects a slow but important transition from a role defined as task-oriented behaviors to today’s more autonomous nursing role which is, patient centered and involves critical thinking and patient advocacy. Three qualities of nursing care are caring, understanding, and the ability to provide care without judgements and emphasize with patient’s no matter the circumstances. Nursing acre is evolving to what it was decades or even five years ago. Some still believe that nursing care just involves performing task such as drawing blood, handing a medication, administering an injection but nursing care is more than just a task. When joining the profession, it is believed that nurses come into it with the intentions to have these connections with patients but patients need to have the understanding of what nurses are willing to provided. This is why research and the exposure of what nursing care consist of is of great importance. This way nurses have the ability to provide quality care and patient’s respect it to where it is received meaning there will be a good outcome. Nursing theory is needed for the value of nursing care to be exposed as asset to the nursing profession. As shared in the article, nursing education should have the ability to put a greater emphasis on the outcomes related to quality nursing care. This would better prepare nurses to have active role in value of nursing care.
References
Dick, T. K., Patrician, P. A., & Loan, L. A. (2017). The Value of Nursing Care: A Concept Analysis. Nursing Forum, 52(4), 357-365. doi:10.1111/nuf.12204
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Clara Northcutt
Clara Northcutt
Jan 17, 2018Jan 17 at 11:59pm
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Hello Professor and Classmates
I chose pain as my concept analysis
Definition of pain
Pain is defined in the OED as (a) the sensation which one feels when hurt (in body or mind); (b) suffering, distress, the opposite of pleasure; (c) in specifically physical and psychical senses: bodily suffering; mental suffering, trouble, grief, sorrow; (d) trouble as taken for the accomplishment of something difficult.
Defining attributes is to list the characteristics that are associated with a concept. Any concept analysis will consist of more than one defining attribute; however, one needs to determine which attributes are appropriate for the purpose of exploration of the concept (Walker & Avant, 1995).
Based on this principle, the critical attributes of the concept of pain include: (a) unpleasant and distressful experiences originating from physical sensation and having both positive and negative meanings for an individual; (b) an individual human experience; (c) a state of feeling in both sensation and emotion (verbal), and behavioral components;
Description of one antecedent and one consequence of the concept
Antecedents are the events or incidents that happen before the existing concept (Walker & Avant, 1995).
personal values act as antecedents related to the concept of pain. The personal issue includes the individual’s current-physical and emotional condition, personality, gender and socio-economic class. Consequences are the events or incidents that happen as results of the concept (Walker & Avant, 1995).
The consequences of pain are related to pain reaction and the individual’s own interpretation of the meaning of pain (Bueno-Gómez, 2017). Pain reaction has a more physical and biological focus; coping with pain.
Identification of one empirical referent
Empirical references present how the concept is to be measured or what the observation of a phenomenon should in reality be. It is the event that demonstrates the existence of the concept.
Measuring pain should include the location, intensity and quality of the pain. Behavioral cues are used to assess patients’ pain and include crying, restlessness or avoidance of movement, and alterations in muscle tone (Bueno-Gómez, 2017).
Brief explanation of theoretical applications of the concept (how is the concept relevant to a nursing theory.
As a nurse practitioner pain assessment will be used daily when assessing, treating, and checking outcomes of patient care. Pain is relevant to Jean Watson’s Caring theory. Pain is subjective so understanding how to measure pain and how to treat each patient will be a unique. Person, environment, health, and nursing will definitely affect how pain is perceived by the patient, treated, and resolved.
Walker, L. O., & Avant, K. C. (2010). Strategies for theory construction in nursing. Boston, MA: Pearson.
pain. (n.d.). Dictionary.com Unabridged. Retrieved January 18, 2018 from Dictionary.com website http://www.dictionary.com/browse/pain (Links to an external site.)
Bueno-Gómez, N. (2017). Conceptualizing suffering and pain. Philosophy, Ethics, And Humanities In Medicine: PEHM, 12(1), 7. doi:10.1186/s13010-017-0049-5
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Collapse SubdiscussionLolita Jerrell
Lolita Jerrell
Jan 18, 2018Jan 18 at 8:44am
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The nursing concept I selected is health literacy. Babnik, Kolnik, & Bratuz (2013) define health literacy as ones ability to understand, process and evaluate basic health-related information in order to make an informed decision about your health.
Several attributes of improved health literacy include the perception of better communication between patient and provider, improved patient health outcomes and better management of chronic diseases.
One antecedent of improving health literacy is the nurse is able to spend enough time to provide an extensive literacy assessment in order to recognize and provide a care plan for any literacy deficits. Additionally, the nurse must establish a trusting relationship with the patient in order to perform a meaningful assessment and have the patient positively receive their recommendations.
One consequence of health literacy is for the patient to have a better perception of their health and be engaged in improving and maintaining a healthy lifestyle because of increased health literacy.
An empirical referent of better health literacy is a patients perception of improved provider communication with will lead to improved patient outcomes because patients won’t feel like their healthcare provider is talking over their head but in terms, they can understand.
One nursing theory that uses the nursing concept of health literacy is Watson’s caring theory, in which one of the main goals of the theory is to improve health and wellbeing by human caring. Watson (2008) states in two of her core concepts that caring should be ” authentic presence enabling deep belief of other ( patient, colleague, family, etc) and the practice of loving-kindness and equanimity” for which the success of good health literacy depends on as a foundation.
References
Babnik, K., Kolnik, T.S., & Bratuz, A., (2013). Health literacy concept integration of definitions and the role of nursing in the further development of concepts. Obzomik Zdravstvene Nege. 47(1), 62-73. Cinahl complete
Watson, J.,(2008). Nursing: the philosophy and science of caring. Boulder, CO. University Press of Colorado.
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Collapse SubdiscussionNeppsi Pauline Parker
Neppsi Pauline Parker
Jan 19, 2018Jan 19 at 5:51pm
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Lolita,
Health literacy is a great concept to analyze. I appreciate the insight that you have brought to this concept through your discussion post. I am perusing the family nurse practitioner track and found this concept intriguing as it needs to be a focus with providing care to various populations within the community. Understanding that people perceive and receive education differently does make a difference in the compliance and outcomes of health improvement. As I was reading through the empirical referent section of your discussion, I wondered if there was a more quantitative way to measure health literacy. As I was researching this topic, I came across an article that you may want to review as part of your study. The article focuses on studies in the Netherlands. However, the Dutch authors utilize a survey tool for measuring health literacy that has been conducted in many countries. This tool is known as the Health Activities and Literacy Scale (HALS) and it objectively measures the performance of respondents on various graded tasks (van der Heide, Wang, Droomers, Spreeuwenberg, Rademakers, & Uiters, 2013). Apparently, this scale is a commonly used with measuring health literacy. I hope this helps you as well!
Thanks for your post,
Pauline
Reference
Van der Heide, I., Wang, J., Droomers, M., Spreeuwenberg, P., Rademakers, J., & Uiters, E. (2013). The relationship between health, education, and health literacy: Results from the Dutch adult literacy and life skills survey. Journal of Health Communication, 18(1), 172-184. doi:10.1080/10810730.2013.825668
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Lolita Jerrell
Lolita Jerrell
Jan 20, 2018Jan 20 at 1:28pm
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Pauline,
Thanks for your suggestion on objective tools to measure my empirical referent of health literacy, I think I was a little confused about the context in my post. I was able to review the article you suggested and I will be helpful in my analysis. Additionally, I found an article by Mantwill, Monestel, and Schutz (2015) that suggest that health disparity is the antecedent of health literacy for which very little research has been collected. The article explains that there are many factors that possibly contribute to health disparity such as race, gender, social, economic and environmental disadvantages and there is no clear picture of how it plays a direct role in a patients health literacy. The authors agree that health literacy is definitely affected by health disparities but to what degree, no one can be sure. Some tools they used in their study of health disparity and health literacy include REALM ( rapid estimate of adult literacy) and S-TOFHLA (short test of functional health literacy) to screen individuals reading ability.
As nurses, we understand that our patient’s ability to read and understand discharge instructions, medication instructions even procedure consent forms are paramount for effective patient education. In order for to properly care for her patient from initial contact until their discharge for her care, we must assess, evaluate and promote improved health literacy at whatever level the patient currently exists.
References
Mantwill, S., Monestel-Umana, S., & Schulz, P. J. (2015). The Relationship between Health Literacy and Health Disparities: A Systematic Review. Plos One, 10(12), e0145455. doi:10.1371/journal.pone.0145455
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Jacqueline Kenton-Jones
Jacqueline Kenton-Jones
Jan 20, 2018Jan 20 at 10:35pm
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Hi Lolita,
I really love the concept of health literacy. I think that it is an important topic when discussing care and the understanding of patient needs. Currently, I work in the South Bronx and find that there is a great need for understanding and interpretation of healthcare information. We have care plan meetings with patients and families that can sometimes be very frustrating. The social workers present documents for the patients to sign and they refuse. I have identified the need to present documents to patients in a private setting and offer assistance to completing the paperwork. As a healthcare provider,we cannot take for granted that the patient can read or understand the content of the instructions. Limited levels of education or understanding may be present.Healthcare information is pertinent to their care. Surgical follow up care, medication review, treatment instructions and discharge planning.I agree that the provider communication has a major impact on patient outcomes. Our communication and delivery method is key to the interpreting healthcare information. If traditional methods of communication are not successful, there are many ways to deliver effective healthcare information to patients/families. Technology has offered alternative methods of delivering healthcare information if a patient/family has difficulty in literacy. As a nurse and a patient advocate, I want to make certain that my patient can continue the plan of care for the best results/outcomes.
Logan,R.A.(2016).Robert A Logan- Seeking an expanded,multidimensional conceptual approach to health literacy and health disparities research.Information & use,36 (3/4),217-241
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Collapse SubdiscussionJamie Taylor
Jamie Taylor
Jan 19, 2018Jan 19 at 12:23am
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Professor and class,
Select a nursing concept, supported by a nursing theory, and address the following components included in a concept analysis:
• Definition of concept– Critical Thinking (n) : Ability to ask relevant questions, clearly define a problem, ability to arrive at a conclusion that reflects analysis of the problem (Schub & Heering, 2018).
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Identification of three attributes of the concept: Critical Thinking is disciplined thinking that is clear, rational, open-minded, and informed by evidence(Critical Thinking, n.d.).
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Description of one antecedent and one consequence of the concept: Antecedent: Prior to utilization of critical thinking as a concept in nursing, nursing is task oriented. Nurses ar e given orders and follow them without regard to outcome or consequence.
Consequence: However, since the introduction and movement toward evidence-based practice the use of critical thinking has allowed for the exploration of evidence and best practice. Nurses question orders that seem to differ from learned or previously experienced situations. They define problems by using rationales.
o Identification of at least one empirical referent: One empirical referent would be improved patient outcomes.
• Brief explanation of theoretical applications of the concept (How is the concept relevant to a nursing theory? ) according to the middle-range theory of critical thinking of nurses from Benner and Paul; nurses develop expertise through experience and acquisition knowledge(Martin, 2002). The ability to ask questions, define a problem, analyze the problem, and arrive at a conclusion greatly increases the level of clinical expertise.
Critical Thinking. (n.d.). Dictionary.com Unabridged. Retrieved January 19, 2018, from Dictionary.com: http://www.dictionary.com/browse/critical-thinking
Euzebia Pereira Santos, V., de Souza Rego Pinto Carvalho, D., Ferreira Junior, M., Peterson Cogo, A., & Vitor, A. (2017). Theory of communicative action: a basis for the development of critical thinking. 70, 1343-1346. doi:10.1590/0034-7167-2016-0383
Martin, C. (2002). THE THEORYOF Critical Thinking in Nursing. Nursing Education Perspctives, 23(5), 243-247. Retrieved from journals.lww.com: https://journals.lww.com/neponline/Abstract/2002/09000/THE_THEORY_OF_Critical_Thinking_of_Nursing.13.aspx
Schub, E., & Heering, H. (2018). Evidence-based care sheet: Critical Thinking an Overview. Retrieved from Chamberlain University: http://eds.a.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=b2a219f5-1d5a-4a59-9cce-8da6519c496b%40sessionmgr4009
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Collapse SubdiscussionYoko Khan
Yoko Khan
Jan 21, 2018Jan 21 at 8:45am
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Jamie,
Critical Thinking as your nursing concept is interesting and I enjoyed reading your posting. Critical Thinking could be applied to any environment and any circumstance. I agreed with the attributes of the concept you provided, clear, rational, and open-minded. Additionally, the antecedent and consequence of the concept you provided was also my concern in the real nursing practice setting. We, RNs, often follow the orders without regard to outcomes of consequence. For example, a hospital systematic technology like a charting system, an order from a provider goes to the pharmacy, then units receive medications from the pharmacy. RNs pick medications from patients’ drawers, scan them, administer the meds to patients. In a course of medication administration, where could we use “critical thinking”? Hospital informatic technologies these days tend to make care speedy and simple. “Critical thinking” skill could be taken away from nurses. Therefore, bedside RNs are the last line of defense and I agreed with “The ability to ask questions, define a problem, analyze the problem, and arrive at a conclusion greatly increases the level of clinical expertise.”
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Jamie Taylor
Jamie Taylor
Jan 21, 2018Jan 21 at 3:08pm
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Yoko,
I have to agree that nurses are being driven away from critical thinking as we automate everything from the simplest tasks to medication administration. I work in the critical care environment and from time to time a med-surg nurse will come to work in our unit. They take the over-flow patients that are not ICU and care as they would on the floor.From time to time, we recognize that not all nurses can be ICU nurses. By this I mean, they are task oriented and don’t use critical thinking skills as well as the ICU nurses who are trained to perform tasks and titrate drips to achieve outcomes quickly. I con not tell you how often we receive patients to the ICU who are deteriorating on the floor, and with proper intervention could have remained on the floor. If a patient has a low oxygen saturation, they will send them to the ICU without seeking the cause. Perhaps all that is necessary is a dose of lasix or titrating the oxygen. Without critical thinking, nurses are at a disadvantage as well as the patients.
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Clara Northcutt
Clara Northcutt
Jan 21, 2018Jan 21 at 10:56pm
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Jamie,
I agree that critical thinking is a great nursing concept to discuss. According to Dictionary.com, critical thinking can also be defined as the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion. This definition truly explains what nurses do daily as they manage the health of their patient. The consequence of questioning orders is definitely a consequence of critical thinking. Most nurses who apply critical thinking skills throughout the care of the patient will know when to question and why to question an order based on the overall health of the patient. Another consequence of critical thinking is to make a call to get an order for a patient based on assessment, interventions, and outcomes. I am not sure of how efficient the empirical referent would be, because I am not sure how to actually measure critical thinking skills. Scenario testing is a start but not sure how effective that would be in the real world atmosphere.
Reference
critical thinking. (n.d.). Dictionary.com Unabridged. Retrieved January 22, 2018 from Dictionary.com website http://www.dictionary.com/browse/critical-thinking (Links to an external site.)
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Shareese Johnson
Shareese Johnson
Jan 19, 2018Jan 19 at 1:43am
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Week 3: Steps of Concept Analysis Discussion Post
Definition of concept
The concept of acuity is appropriate for comprehending customized care needs for patients. In this aspect, acuity is characterized as the patient need for care.
Identification of three attributes of the concept
Calculating the variable acuity within and among patients can contribute to decision making for
1.level of care, 2. staffing, and 3. nurse-to-patient ratio providing an evidence-based practice for customized care within an acute care setting.
Description of one antecedent and one consequence of the concept
Practices currently in place for allocation of funds and staffing nursing units go off the assumption of constant patient needs, making it challenging to strategize and implement customized acuity modified care. Studies show the lack of customized care needs of patients, but inconsistencies remain regarding unbiased measures of acuity, variability, and the relationship of acuity to patient, nursing, and financial outcomes.
Identification of at least one empirical referent
Most present-day staffing procedures depend on assumptions about the regular care needs of patients. Current approaches to staffing nursing units assume uniform patient acuity, nursing skills, and resources, making it challenging to plan for and implement customized care. The failure to compute the individual need for care makes it problematic to calculate the expense of nursing care for individual patients. Clinical and Administrative leaders recognize need for variable acuity, but clinical allocation of funds remain based on assumptions of average acuity. Terminating these voids requires the documentation and study of variability within and among specific patient populations.
Brief explanation of the theoretical applications of the concept (how is the concept relevant to a nursing theory?)
In the past acuity was based on diagnosis, nursing judgment, lists of nursing interventions, and clinical indicators compiled by hand. This operation is inefficient, time-intensive, and subject to human error in acuity scores. Endeavors are in progress to pinpoint the advantages of using electronic health records (EHRs) to document patient care and calculate acuity. Within this model, nurses need the cognitive expertise to actuate if patients are progressing toward the desired goal and determine the nursing actions are necessary to move the patient to future goal well-being. The model emphasizes the importance of documenting the entire nursing process, including problem identification, diagnosis, planning, interventions, and evaluation.
Reference
Garcia, A. L. (2017). Variability in acuity in acute care. Journal Of Nursing Administration, 47(10), 476. doi:10.1097/NNA.0000000000000518. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=125553267&site=eds-live&scope=site (Links to an external site.)
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Brenda Talley
Brenda Talley
Jan 20, 2018Jan 20 at 5:17pm
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Week 3 Summary
Hello everyone
Progress this week! Outstanding work!
This has been a great week. In this discussion, we talked about the steps in concept analysis and each of you began collecting material for you concept paper. We are having interesting discussions on many theories.
We continued in our goal to meet course objectives ONE and FOUR:
0. Analyze theories from nursing and relevant fields with respect to their components, relationships among the components, logic of the propositions, comprehensiveness, and utility to advanced nursing. (PO #1)
1. Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO #4)
I think everyone is getting excited about your upcoming concept analysis paper! I have communicated with several of you about your choice in concepts. I know we are all reading about the specific concepts of interest in this discussion thread.
I’m glad that we are getting to know each other. One thing you should know about me, is that when I read the postings I tend to omit the quotations and reiteration of the material from the course materials and textbooks. I DO notice the ones that carry particular impact, so be judicious in your choices of quotations from the scholarly sources. I know that sometimes we need to include direct reference to the material, but I focus on what YOU have to say.
Just a reminder….you should NOT use the course textbooks (even older editions) as references for your papers. Also know that current nursing website is not considered a scholarly source.
Most of you have provided excellent, peer reviewed journal articles. This is wonderful! It takes considerable time and energy to search and find appropriate articles. However, these articles warrant more than a single (often vague or general!) sentence. You had a reason for selecting it. Something caught your attention, appealed to you. Please share a brief summary of the article and more fully describe how the article informs our learning objectives/discussions for the week. Make the connections–clearly!
I’m looking forward to continuing our discussions!
Regards, Dr. T.
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Collapse SubdiscussionLaquanta Russell
Laquanta Russell
Jan 20, 2018Jan 20 at 11:58pm
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Hello class,
There are many nursing concepts supported by nursing theory. The nursing concept I choose is caring. Caring is defined as “human behavior that includes cognitive, affective, psychomotor and administrative skills within which professional caring may be expressed (Wilkin, 2003).Caring is a necessary in the application of nursing care. According to the University of Saint Mary there are five attributes to caring in nursing. Three of the attributes are commitment, competence, and conscience. Commitment includes understanding that the care of patients are important and nurses must be dedicated to providing the best care possible. Competence is the ability to hold yourself to a high standard of excellence when fulfilling daily tasks, regardless of the behavior of others or the circumstances. Conscience involves moral responsibility. The nurse must be aware of personal and work-related stress that may affect the quality of care provided and try to remove that from their focus in order to concentrate on the patient. The ancedent of caring is the acknowledgement of the need to help others. Consequences of caring may be the negative impact of care on the nurse. Sometimes caring for critically ill patients can have a moral and emotional effect on the nurse. Caring is imperative to the theory of nursing. Jean Watson Theory of Human Caring/Caring Science defines how self – (Wilkin, 2003)care and care for other is important to optimal health.
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Laquanta Russell
Laquanta Russell
Jan 21, 2018Jan 21 at 12am
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The meaning of caring in the practice of intensive care nursing [Journal] / auth. Wilkin K // US National Library of Medicine National Institute of Health. – Nov 2003. – 20 : Vol. 12.
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Collapse SubdiscussionBrenda Talley
Brenda Talley
Jan 21, 2018Jan 21 at 2:06pm
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Laquanta, this will be an interesting concept to explore and Watson’s human caring will support the analysis. Good choice!
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Laquanta Russell
Laquanta Russell
Jan 21, 2018Jan 21 at 11:55pm
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Class, in analyzing a concept, in what way and in what instances might the individual’s (patient’s) perspectives and experiences aid in understanding the concept?
Patient outcomes measures the effectiveness of concept analysis. Caring consist of all aspects of nursing. Caring includes the clinical skills and knowledge necessary to increase the chances of a positive outcome. Gaining information and insight on patient expeiences and perpective pertaining to their care will allow for healthcare provides better understand different concepts. It will also show areas that may need improvement and areas that met or were above expectations. If the patient felt the nurse did not listen to their concerns regarding their treatment and care could result in losing them as a patient. Understanding where the standards have not been met could improve the quality of care and improve the understanding of each nursing concept.
