The purpose of this paper is to review the theory of self-regulation and how it can be applied to practice in health care settings to improve patient outcomes. According to Johnson (1997), more than 25 years of research has influenced the development of the self-regulation theory, which is about coping with healthcare experiences. Health problems have shifted from acute to chronic where it has been identified that personal behaviors are linked to over half of societies chronic health problems (Ryan & Sawin, 2009). As the modern nurse strives to provide specialized care and improve patient outcomes, the utilization of nursing theory continues to gain importance. This theory explains how patients use specific types of information to cope with health care events thus providing a rational for selecting information that can be expected to benefit patients. The concept of self-regulation has been a part of nursing practice in a circumlocutory fashion for years. It has been most commonly referred to as self-management creating considerable ambiguity and overlapping of definitions for that term and self-regulation (SR). For the purpose of this paper these terms will imply that people follow self-set goals introduced by their health care provider.
Jean E. Johnson (1997), a registered nurse and graduate professor at the University of Rochester School of Nursing, is considered responsible for developing the Self-Regulation Theory (SRT) in the late nineteen nineties. It was through years of contributions and interactions with her professional colleagues, students, and attendees of her “Stress and Coping” group that contributed to the development of this theory. It was identified, and holds true today, that patients are expected to play an ...
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..., activation and use of goals, discrepancy detection and implementation, self-evaluation, and that self monitoring is fundamental to self-regulation. The largest group of health care providers comprise of nurses. Implementing this theory into the practice of todays nurse is not an unrealistic task as it has been taking place one one level or another for many years. Because modern nurses are faced with providing care to individuals, families, groups and communities of people, educating and expecting them to use SRT will provide better patient outcomes overall. Perhaps the practice of wanting the very best for patients is actually an inherent quality of nurses. Baumeister, Vohs, and Tice (2007) support and argue that self-regulation is a homeostatic process such as maintaining a constant body temperature and that with the proper gauges/resources this can be obtained.
Still, the previous advantages discussed should influence the nurse to improve in identifying patient vulnerability. This is evident by this patient where I utilized my interpersonal skills to communicate to this patient so that he/she is aware that he/she is not alone in this journey. Nurses need to utilize models and theories to guide nursing practice. For instance, McCormack’s framework focuses on patient-centered care which influences nurses to understand the patient as a whole and their values (Abley, 2012, p. 42). Being able to identify values will give nurses and myself a better comprehension about the patients resulting in worthiness and belonging expressed. As a result, informing nurses about patient’s subjective vulnerability because a trust and understanding relationship is established. This is supported in a clinical experience where a patient “felt understood and opened up for further interactions based on trust” through an honest, supportive relationship with a nurse (Gjengedal, 2013, p. 134). Nurses should provide patient-focused provision of service, and assist this patient in overcoming his/her obstacle as a way of encouragement. Furthermore, Sellman (2005) explains how encouragement may compromise human flourish (p. 7), it is dependent on the situation and it cannot be assumed all encouragement will lead to harm. This informs nurses to be aware of the consequences that prevent the
This entails that the professional nurse provide not only ordinary but extraordinary care and support to make it possible for these individuals to achieve their requirements for self-care. Furthermore, the professional nurse judiciously and collaboratively partakes in the individual’s health care provided by the medical doctor. Dorthea Orem understood that individuals possess the natural capability of self-care, and nurses have a duty to place emphasis on enhancing that capability. Nurses who deliver direct care can support these capabilities by offering learning opportunities and teaching methods that enhance self-care activities, therefore contributing a positive and encouraging influence on the individuals and caregivers quality of
Johnson’s Behavioral System Model is a model of nursing care that supports the development of efficient and effective behavioral functioning in the patient to prevent illness. The patient is recognized as a behavioral system composed of seven behavioral subsystems including affiliative, dependency, ingestive, eliminative, sexual, aggressive, and achievement. The purposeful requirements for these subsystems include protection from noxious influences, provision for a nurturing environment, and stimulation for growth. When any subsystem is imbalanced, it is the nurse’s role to help the patient return to a state of equilibrium.
I never stops to educate myself. I consider myself as a life-long learner. The profession of nursing offers an opportunity for me to learn daily because I always learn something every day. Once I learn something new, I like to apply it to my practice. Duffy’s quality of caring guides me to practice. I just had a 64-year-old patient who is going to have dialysis the first time. Understanding the anxiety that she had was more important than educating the process of dialysis. The patient stated that she wanted to live longer and finally decided to have the dialysis, but she was nervous about this. A care plan relate to coping mechanism was developed because showing a sense of sympathy and caring could help her to relieve the anxiety. When caring is evident, patients enhance self-esteem, quality of life, knowledge and coping mechanisms, as well as decreased lengths of stay and healthcare costs (Desmond, et al., 2014). On the other hand, in an uncaring situation, a patient feels humiliated, vulnerable, and
A nurse is able to achieve this great balance, with the patient and self, by being conscious of the environment that surrounds them and through self awareness. For example, in the scene of an emergency, first and foremost, a nurse must check the environment before started emergent care. Both the patient and nurse must be safe for treatment to be effective. The environment is what surrounds us; our workplace, home, communities, issues we think about, the people we interact with, and the emotions associated with these interactions. The nurse knows that all of these components play an integral role in maintaining stability in a person’s life and health. The nurse assumes care of not just a disease process but of a human being as a whole; a family, a livelihood, a spirit, a person. A nurse knows that in order for holistic care to be effective, the care taker themselves should be at a point of stability as well. A true nurse knows that in order to excel you must know your limits and understand that while your main goal is to help the patient regain their strength, identity, and independence, that goal does not have to be achieved by compromising your own self, identity, and
The development of nursing theories has provided a perspective in which one can define the purpose of nursing, when nursing is required, and establish the parameters and goals of therapeutic nursing activities (Ahmed,2001). A nursing theory is defined "as concepts, definitions, relationships, and assumptions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining and predicting the phenomena of nursing” (Boxer & Jones, 2010). In addition, nursing theories provide frameworks through which nurses can examine various situations. As nurses encounter new situations, these frameworks provide a structure for organization, analysis, decision making and communication (Ahmed, 2001). The following paper will discuss the middle range nursing theory of Family Stress and Adaptation by Geri LoBiondo-Wood, and how it relates to patient care and guides nursing practice.
According to the Healthy People Database, in 2010 the aging population was estimated at 40 million, this number is expected rise to nearly 70 million by the year 2030 (National Center for Health Statistics, 2000). At the forefront of health concerns for this aging population will be the intervention, management and treatment of chronic diseases. This increase in both this specific population as well as the required medical care will place a significant amount of stress on an already distressed healthcare system, which in turn will affect the availability of recourses and costs. Including patients in their self care with strategic health promotion such as encouragement and education geared towards specific socioeconomic groups will be more cost effective and beneficial in the management of chronic disease. Studies indicate that patients involved in self management of disease processes often have better patient outcomes.
It takes a while to get to know yourself before you are able to care for another person. Studying oneself is challenging because it allows reflection of one’s inner self, exposing your strengths, weaknesses, vulnerabilities, interests, habits, defenses, and values. On the same note, it allows a person to be more familiar with the challenges he or she faces, how they might respond to certain situations, and offers an opportunity for learning and growth. Throughout this paper, I will discuss the various pieces of myself. I will consider my personal and professional life as a nurse, what I might employ as my mental model, which may limit my frame of thinking, how it has shaped me so far in my education, and how I relate to others.
In March, my PSYC class was presented with a challenge - to identify a personal improvement goal and to address this issue using an Immunity to Change map. My lengthy list of personal struggles was quickly narrowed down to one item with focused reflection. My improvement goal was to engage in productive thoughts and behaviors that would provide better time management practices. I was initially looking to improve my behaviors at home so that it would translate into success in all areas of my life including my career. With thoughtful observation and consideration, the Immunity to Change (ITC) map provided a developmentally raw process that continues to help me focus on my improvement goal today. Although I am still working on this goal, this process created more opportunities to make significant development changes above and beyond my initial intentions.
The career of a registered nurse is one of the most interesting professions in the medical field, because not only do they help to improve the health of their patients, they also help their patients to maintain a healthy lifestyle. Registered nurses work to promote health, prevent disease, and help patients cope with illness. Their job is to help patients get their health back on track, and prevent increased visits to the physician. When providing care directly to the patient, they observe, assess, and record symptoms, reactions, and progress. They do this to see where the patient’s health stands and prevent further illness or health problems if such occurs. Registered Nurses help to develop and manage nursing plans, and instruct the patient and their
Everybody makes mistakes, but it is always good to learn from them. In professions like nursing which combines pressure and tight schedules, it is important for nurses to stay sharp at all times. However, focus is easy to maintain if we adopt a problem-solving mentality and a positive attitude (Tucker, 2000). Only then can we go far.
My philosophy of nursing is based on Erickson’s Theory of Modeling and Role-Modeling, which allows me to incorporate the patients’ needs into my plan of care. In order to have an effective and thorough plan of care, I must take the time to get to know the patient. Once I have built a rapport and trusting relationship, I can help meet the patients’ needs by implementing a plan of care with reachable goals. These reachable goals will be set and agreed upon by the nurse and patient. Not only is it important for the nurse and patient to establish individualized reachable goals, but it is important for the nurse to also have goals. The nurse may have personal and professional goals. My goals are to continually find, propose, and implement ways to make the
Every action that a nurse will make will be for the overall wellness of the patient, based directly on the type of care that the patient desires. One nursing journal that reflects on the concepts of the nursing metaparadigm defined the person as “a framework for organizing data about the individual person as the basic focus of the nursing’s attention” (Thorne et al, 1998). The person is the center of nursing care, and the care that the patient will receive is directly based on the information that they inform to the nurse. But the person also refers to the family and the loved ones of the patient. The family is the patient’s support system but they are also the ones that will advocate for the patient and put their own sense on the care that they believe their love one deserves or needs. The patient and the patient’s family will interact with the nurse directly to ensure that the patient receives the best care
The nurses do this by following their scope of practice, this involves being with the patient every step of the way and ensuring they are in proper care. While doing such, the nurses consider their own mental state in order to give that proper care. This example meets the standard of professional responsibility and accountability indicator 6(CRNBC,2013) as the nurses were aware of how to maintain fitness to practice by recognizing how to set boundaries and safeguard their emotional
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).