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discussion of the evolution of nursing theories
the importance of nursing theory today
Historical development of nursing theories
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During the 1970s, Sister Callista Roy was a young graduate student in the midst of developing a new theoretical framework for nursing practice. Her experiences and studies led her to form the Roy Adaptation Model (RAM). Roy’s model identifies people as adaptive systems in a holistic manner. The essential elements of her model include adaptation, the person, the environment, health, and the goal of nursing (Roy, 2009). Modes of adaptation are further broken down into physiological and psychological needs. Roy continues to publish works detailing modern applications of her model for nursing practice and education. This essay will offer insight on Callista Roy as a theorist and on the RAM.
Sister Callista Roy received her Bachelor of Arts degree
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Shifts in theory and focus related to patient care were dynamically changing. Theorists worked to define nursing in a distinct manner that separated the medical and nursing frameworks. This period presented new ideas, “this shift offered the potential to move nursing from a context-dependent reactive position to a context-interactive proactive stance” (Chinn & Kramer, 2011, p. 44-45). Roy’s Adaptation Model indicates that “nurses direct care at helping the client adapt” (Potter & Perry, 2009, p. 50). Furthermore, the nurse must interact with each patient to evaluate the patient’s own feelings regarding their current health status, environment, and goals in order to anticipate what interventions may be required to encourage adaptation.
Callista Roy has worked for over three decades to further detail her model. Through the years, modifications improved upon the initial model. Earlier versions of the RAM include three “…essential elements: the person, the goal, and nursing intervention” (Roy & Roberts, 1981, p. 42). However, a more recent publishing includes five concepts when defining the model: adaptation, the person, the environment, health, and goal of nursing (Roy, 2009). She also defines four adaptive modes that describe how a person reacts to stimulation from the environment (Roy,
Betty Neuman was inspired by many different theorists to develop a system's model in 1970 that serves as a teaching tool for graduate students. It is one of the most frequently used models for nursing research. This conceptual model focuses attention on the response of the client system to stressors in the environment. According to Butts & Rich ( 2012) as cited in Fawcett (2005), Neuman's Systems Model is pragmatic and can be used as guide for nursing education and practice, it can be translated to other cultures, and it has the potential to facilitate resolution of universal nursing concerns. Like other models of nursing, the major concepts are person, health, nursing and the environment but Neuman uses a systems approach to explain how these
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
Nursing theory can best be defined as a set of logically interrelated concepts, statements, propositions, and definitions, which have been derived from philosophical beliefs of scientific data and from which questions or hypotheses will be deduced, tested, and verified (McEwen & Wills, 2014, p. 26). A theory purports to account for or characterize some phenomenon (McEwen & Wills, 2014, p. 26). The Roy Adaptation Model (RAM) is a grand theory that promotes holistic patient care. Holistic patient care treats the patient as a whole. Sections prepared for this paper include important key concepts such as nursing theory, summary of the Roy Adaptation Model, views of the Roy Adaptation Model and conclusion.
The APRN listens and engages with the patient as care and compassion take place. As the nurse discerns what the patient’s needs are and considers obstacles to achieving optimal care the application of theory is necessary as the process is not always quantifiable. The APRN who does not learn nursing theory may focus primarily on EBP and miss this engagement opportunity with the patient. One may prescribe medication; however, if the patient does not take the medication, then the nurse assumes the patient is noncompliant. The application of Watson’s themes where appropriate helps the APRN discern how to help the patient become compliant. It is necessary to care for the patient outside of the idea of only providing care to understand the obstacle in that patients circumstances and reach improved patient outcomes to any disease
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
Watson, J. (1985). Nursing: Human Science and Human. Norwalk; CT: Appleton – Century – Crofts.
Fawcett, J. (2001). The nurse theorists: 21st-century updates - - Dorothea E. Orem. Journal of Nursing Science Quarterly, 14(1), 34-38. doi: 10.1177/08943180122108021.
The field of nursing provides one the opportunity to make a difference in the lives of others. Nurses interact directly with patients at times of hardship, vulnerability, and loss. The nursing profession has been around for decades. Due to the contribution from historical leaders in nursing, the nurse’s role has progressed over time. Although the roles of nurses have evolved throughout the years, one thing has remained the same: the purpose in giving the best patient care.
This interactive grand theory is grounded in humanist philosophy, which expresses the belief that humans are unitary beings and energy fields in constant interaction with the universal energy field. This model guides the nurse who is interested in “physiologic” and “psychological” adoptions (McEwen & Wills, 2014, p. 177). This model views the nurse as holistic adaptive system constantly interacting with different stimuli. And also explains how different sets of interrelated systems maintain a balance between various stimuli to promote individual and environmental transformation (Alkrisat & Dee, 2014). This model creates a framework to provide care for individuals in health and “in acute, chronic, or terminal illness” (Shah, Abdullah, & Khan, 2015, p. 1834). It focuses on improving basic life processes of individuals, families, groups of people; nurses see communities as holistic adaptive systems. It consists of three basic assumptions: philosophical, scientific, and cultural. And it also contains many defined concepts about the environment, health, person, goal of nursing, adaptation, focal, contextual, and residual stimuli, cognator and regulator subsystem, and stabilizer and innovator control processes (McEwen & Wills, 2014, p.
Around the 1960s, nursing educational leaders wanted to formulate a nursing theory that contained knowledge and basic principles to guide future nurses’ in their practice (Thorne, 2010, p.64). Thus, Jacqueline Fawcett introduced the metaparadigm of nursing. Metaparadigm “identifies the concepts central to the discipline without relating them to the assumptions of a particular world view” (MacIntyre & Mcdonald, 2014). Fawcett’s metaparadigm of nursing included concepts of person, environment, health, and nursing that were interrelated. The metaparadigm ultimately contributed to conceptual framework to guide nurses to perform critical thinking and the nursing process in everyday experiences in clinical settings.
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 ...
As an RN whose specialties have included Medical, Geriatric and Pediatrics, I am drawn to learn more about Katherine Kolcabas Theory of Comfort. It is also the theory from which my organization based its pain and comfort documentation requirements upon.
My journey to nursing began with my personal healthcare experience, and has continued to evolve since entering the nursing program at State University. My personal philosophy of nursing is related my life experience and my personal philosophy of life. Using reflection-on-action, I have begun to understand the influences that have lead me to nursing. I discovered client and family centered care to be an important quality when I look at the influential nurses in my life. To develop a positive therapeutic nurse-client relationship, nurses must integrate all 5 dimensions of the therapeutic nurse-client relationship into their practice (CNO, 2006). When it comes to providing client-centered care, the dimensions of trust, empathy and respect are particularly important (CNO, 2006). Illness can be a traumatic experience for patients and their families, and it is important to be empathetic to the patient’s needs, while still trusting the patient to be an expert in their illness and care.
Roy’s adaptation theory has had a significant impact on nursing and the way we view and approach patient care. It is a systemic approach to understanding and addressing the physiological, self-concept, role function and interdependence needs of a patient and helping them adapt to their environment. By addressing each of theses needs we are able to treat them as a whole. It can be compared to the web of causation in that just as there are many factors that influence disease, by understanding addressing each factor individually, nurses can better treat the disease as a whole. Nurses can benefit by utilizing Roy’s adaptation theory during the nursing process to assist them with conducting a more thorough assessment and developing a more effective care plan.
Sister Callista Roy developed the Roy Adaptation Model during her graduate studies at the University of California. The model was published in 1970 and is one of the most famous and useful conceptual frameworks in the nursing practice (Alligood & Tomey, 2010). In the model, adaptation is defined as the process and outcome resulted from interaction between each individual and their environment. Therefore adaptation is a life coping process, which includes innate and acquired coping mechanisms. Innate coping processes are genetically determined while acquired coping processes are developed by each individual (Alligood & Tomey, 2010). Specifically to nursing, four metaparadigm concepts are mentioned in the model. The first one is person, who is described as an adaptive system, the main focus and receiver of nursing care. Next is environment, which is all the surrounding aspect that influences the development and behavior of persons. The third one is health that reflects the state of being and process of adaptation. The last one is nursing,...