You have spent six weeks exploring theories of nursing. These represent the “how” of what we do as nurses. This week we enter a higher level of thought and explore the “why” of what we do. Present a personal nursing philosophy. Apply what you have read throughout the course and explore the literature on nursing philosophy. While Fawcett was not a nursing theorist, she is a nursing philosopher and her Metaparadigm of Nursing approaches philosophy over theory. Once you have discussed your philosophy, identify a theoretical framework (not the middle-range theories but the underlying assumptions in that framework) that fits your philosophy. Compare and contrast your philosophy and the chosen framework. Describe a possible situation in which the framework may conflict or not fit your philosophy. While it is an important skill to be able to match a theory with a situation, it is also critical to understand when a theory or framework does not fit a situation.
Expectations
Format: APA 7th edition
Length: 5 pages, excluding title and reference pages, References: 7-10
Utley et al., Page 370 and Ch 14
Abou Malham, S., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within primary health care innovations: The case of advanced access model. BMC Nursing, 19(1), 115.
https://doi.org/10.1186/s12912-020-00504-z
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709259/
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Solution
Personal Theoretical Framework for Advanced Practice Nursing
Theoretical models and personal nursing philosophy significantly impact advanced practice nursing. Nurses are guided by various concepts outlined in theoretical frameworks in their clinical practices, thus providing quality and safe patient care to satisfy patients’ needs. This paper presents a personal nursing philosophy and underlying assumptions in Dorothea Orem’s Self-Care theory that fits the author’s philosophy. The paper will also compare the author’s nursing philosophy with Dorothea Orem’s Self-Care theory, indicating situations in which the Framework may conflict with the philosophy.
Personal Nursing Philosophy
My nursing philosophy is based on my role as an advanced nurse practitioner that involves providing holistic and patient-centered care to improve all my client’s physical, mental, and psychological well-being. Since when I enrolled for my nursing degree, I have perceived nursing as a helping profession in which practitioners should selflessly prioritize other people’s needs. For this reason, I always strive to help my clients to meet their health care needs, thus improving their quality of life and well-being. My primary goal is to assist people who cannot help themselves to prevent physical infirmity resulting in temporary or long-term impairment. Humans strive to meet their needs in 5 categories as prioritized by Abraham Maslow. People first focus on addressing their physiologic needs, including food, shelter, clothing, and oxygen since they are vital for survival. Secondly, individuals are interested in meeting their security, such as being free from any form of harm. The next category consists of belongingness and love, in which individuals strive to meet their need for affection. Meeting this need gives one fulfillment in belongingness. Individuals then strive to meet their esteem needs, including self-worth, respect, and accomplishment. A person acquires respect and reputation for their accomplishments in life. The last category involves self-actualization, which is at the pinnacle of Maslow’s hierarchy of needs triangle. Individuals in this category have achieved all their goals in life and have reached their full potential. People in this category can help or guide others to realize their potentials.
During my first clinical experience, I was assigned pediatrics. I was supposed to take care of the babies, including feeding them, changing their diapers, keeping them, and cuddling them. I ensured that all their physiologic needs were met at the right time to facilitate proper growth and development. Although a nurse practitioner should work alongside a pediatrician while diagnosing and treating children, nurses must meet babies’ physiologic needs. According to Ștefan et al. (2020), healthcare providers must meet the increasing patients’ needs and expectations to acquire a competitive advantage in the healthcare sector. Additionally, the significance of nursing theories during the delivery of health care was emphasized during my studies. Theories were considered the basis of providing quality, safe and efficient nursing care, thus restoring individuals’ health and well-being. However, most nurse practitioners failed to incorporate theories into their clinical practices. Instead, practitioners consider nursing as a profession dependent on doctors meaning nurses should practice “behind” physicians and not alongside the doctors. This incident results from the unwritten hierarchy, which exists in the medical industry. Additionally, inappropriate nurse-to-patient ratios hinder nurses from providing quality health care, leading to negative health outcomes. According to Griffiths et al. (2018), adverse clinical outcomes in a healthcare organization, particularly death is associated with low nurse staffing levels. Furthermore, nurses are usually underpaid; hence they provide health care services proportional to their compensation.
Nonetheless, I opposed the idea that nurses can only practice “behind” doctors and focus on my nursing philosophy, which involves assisting the patient in meeting their basic physiologic needs when functional abilities are impaired by their illnesses. This move will facilitate faster recovery, thus improving individuals’ quality of life and well-being. I believe that patients’ self-care deficits can be addressed by providing them with individualized nursing care, which will restore their health and functionality. I address the patient’s self-care deficits with compassion, respect, and empathy. Additionally, I will consider an individual’s beliefs, values, interests, and traditions to provide holistic care to my best level. This philosophy has been my guide throughout my nursing practice, and it will continue driving me once I become an advanced nurse practitioner. Upon being granted “Full Practice Authority,” I will rely on my philosophy during the diagnosis and treatment of all my patients without the supervision of a physician. As a nurse, I will always appreciate Maslow’s hierarchy of needs since health determines’ individual’s capacity to meet his or her needs. According to (their16), disorders impair individuals’ capacity to meet their needs, including the most basic ones.
Underlying Assumptions in Dorothea Orem’s Self-Care Theory that Fits Author’s Philosophy
Dorothea Orem’s Self-Care theory fits my nursing philosophy. This nursing theory focuses on helping individuals provide and manage self-care either to retain or improve human functioning effectively while at home. Orem’s theory emphasizes an individual’s capacity to take care of oneself (Abyu, 2020). Therefore, this theory concentrates on the practices and activities that a person can initiate and perform on their own to maintain health, quality of life, and well-being. Orem’s theory consists of three interrelated theories: the theory of self-care, the theory of nursing systems, and the theory of self-care deficit (Abyu, 2020). The theory of self-care focuses on how and why human beings take care of themselves. The theory of nursing systems or nursing systems focuses on relationships between nurses and their patients and the impact of this relationship on the quality of nursing care. Lastly, the theory of self-care deficit focuses on how nursing practice helps human beings.
Orem proposed three significant assumptions concerning requirements of self-care (Younas, 2017). The first assumption states that human beings have common needs; hence require the same materials to sustain life. This concept was described as the universal self-care requisite. The second assumption states that human beings require multiple actions to enhance their growth and development in various stages of life. This concept was described as a developmental self-care requisite. The third assumption states that individuals’ tendency to deviate from the normal functional and structural well-being needs actions to lower the occurrences of and regulate the effect of any deprivation. This assumption was termed as health deviation self-care requisite. Inadequacy of requisite skills and knowledge to self-manage leads to self-care deficits. Therefore, people with limited self-care knowledge and skills need nursing care to restore their health and quality of life (Gomez et al., 2017). These assumptions fit the author’s philosophy, which involves providing holistic and patient-centered care to improve all clients’ physical, mental, and psychological well-being, including those who cannot perform self-care due to inadequacy of requisite skills and knowledge.
Comparison between Author’s Nursing Philosophy with Dorothea Orem’s Self-Care theory and Situations in which the Framework may Conflict with the Philosophy
Similarities between Orem’s Theory and Author’s Philosophy
Self-care entails various actions and measures taken to meet the requirement of patients with inadequate self-care requisite skills and knowledge. These patient groups include infants, geriatrics, hospitalized individuals, and older people aged 75 years and above. Therefore, these groups are provided with nursing care to help them to meet their physiological needs. This concept of Orem’s theory matches my nursing philosophy, which involves providing holistic and patient-centered care to improve all clients’ physical, mental, and psychological well-being. I have realized that some patient populations, particularly infant, geriatrics, hospitalized individuals, and older adults aged 75 years and above, require nursing care due to the inability to perform self-care. According to (Abou Malham et al. (2020), transforming nursing practice is an important strategy for boosting the quality, safety, and efficiency of patient care in primary care settings to meet various categories’ healthcare needs, including individuals, families groups, and communities. Therefore, I will strive to benefit these individuals during my clinical practice by providing them with individualized patient care.
Orem also discusses two deliberate actions. The first one is deliberate action and nursing. Nursing practice is considered an action performed deliberately by a social group member to benefit other community members (Younas, 2017). In other words, nursing actions are focused on addressing self-care deficits in some groups of people. This concept of Orem’s theory matches with my nursing philosophy, which involves providing holistic and patient-centered care to improve the physical, mental, and psychological well-being of all my clients since I will provide nursing care, aiming at benefiting some community members, such as infants, geriatrics, and pediatrics.
Differences between Orem’s Theory and Author’s Philosophy
Orem also discussed deliberate action and patients, which requires them to be aware of their conditions and challenges. Thus, patients should strive to address these challenges in the best possible manner. This concept contradicts my nursing philosophy, which involves providing holistic and patient-centered care to improve all my client’s physical, mental, and psychological well-being, including those unable to address issues associated with their health conditions, such as critically-ill patients and the geriatrics.
Conclusion
Nurses’ clinical practices are guided by various concepts outlined in theoretical frameworks. Additionally, the provision of patient care is impacted by one’s nursing philosophy. One of the most influential nursing theories is Dorothea Orem’s Self-Care theory, which consists of three interrelated theories, including the theory of self-care, nursing systems, and self-care deficit theory. Orem’s theory emphasizes an individual’s capacity to take care of oneself. Therefore, this theory concentrates on the practices and activities that a person can initiate and perform on their own to maintain health, quality of life, and well-being. Orem’s theory matches and contradicts the author’s nursing philosophy, which involves providing holistic and patient-centered care to improve all clients’ physical, mental, and psychological well-being.
References
Abou Malham, S., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within primary health care innovations: the case of advanced access model. BMC nursing, 19(1), 1-17.
Abyu, G, Y. (2020). Orem’s Self-Care Deficit Theory of Nursing. Research Gate https://www.researchgate.net/publication/339432461_Orem’s_self_care_deficit_theory_of_nursing
Gomez, N. J., Castner, D., & Hain, D. (2017). Nephrology nursing scope and standards of practice: Integration into clinical practice. Nephrology Nursing Journal, 44(1), 19-27.
Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Mariotti, A., Meredith, P., … & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of advanced nursing, 74(7), 1474-1487.
Linton, A. D. (2016). Psychological response to illness. An Introduction to Medical-Surgical Nursing (6th ed., p. 1273). Philadelphia, PA: Saunders.
Ștefan, S. C., Popa, Ș. C., & Albu, C. F. (2020). Implications of Maslow’s hierarchy of needs theory on healthcare employees’ performance. Transylvanian Review of Administrative Sciences, 16(59), 124-143.
Younas, A. (2017). A foundational analysis of Dorothea Orem’s self-care theory and evaluation of its significance for nursing practice and research. Creative Nursing, 23(1), 13-23. doi:10.1891/1078-4535.23.1.13