Research Paper: Theoretical Foundations of Nursing

Pages: 10 (4161 words)  ·  Bibliography Sources: 30  ·  Level: Master's  ·  Topic: Health - Nursing  ·  Buy This Paper

SAMPLE EXCERPT:

[. . .] 32). The evaluation will help in developing a complete scientific rationale for nursing intervention to enhance quality of care.

Ethical Dilemma:

Ethical issues and dilemmas have become common in the nursing profession because of global developments and changes in the modern health care system. These issues and dilemmas require guidance in making ethical decisions in nurses' daily experiences and practice. Since the development of this field necessitates practice to be based on theory, nursing theory is usually used to enable nurses in ethical decision-making (Noureddine, 2001, p.2).

An example of an ethical dilemma recently faced in nursing practice involves a patient who asked for some paracetamol tablets because of pain in his legs. However, the patient does not have any pain but is attempting to collect enough tablets to commit suicide. The patient had received more tablets from another health practitioner and from the market. After unsuccessfully trying to commit suicide by swallowing the tablets, the patient accuses the nurse for being incompetent while concealing his attempt to commit suicide.

Ethical decision-making process in this scenario should be based on four major obligations i.e. protecting privacy and confidentiality, honest communication, carrying out an ethically informed-consent procedure, and promoting the patient's best interests (Lachman, 2008, p.44). The most suitable nursing theory that could be used to resolve the issue is Kristen Swanson's middle-range theory of caring. The theory encompasses five inter-related procedures i.e. maintaining belief, knowing, being with, doing for, and enabling. While the theory does not contain a specific ethical framework, the client's well-being is usually emphasized. Some of the major ethical concepts included in the theory include self-determination, beneficence, autonomy, justice, and nonmaleficence.

Through this theory, the most appropriate course of action would be to seek help from an experienced health practitioner to not only support the patient but also work towards clearing her name. In this case, the nurse will demonstrate nonmaleficence by attempts not to harm the patient and beneficence by seeking to keep her job and continue helping the community. As previously mentioned, Swanson's theory of caring emphasizes on patient's rights, provides clear directions for ethical decision-making, and focuses on ethical codes for practice. Moreover, the theory incorporates every aspect of four component model for ethical practitioner i.e. ethical sensitivity, ethical judgment, ethical motivation, and ethical action (Robichaux, 2012, p.66).

Global Perspective:

Mishel's theory of uncertainty in illness is a nursing theory that is relevant today because uncertainty remains a shared aspect of the modern illness experience. The uncertainty of the illness experience is attributed to the disruption illness cause to stability in life and its unprecedented outcomes. Through her theory, Mishel states that adaptation is the eventual goal and that nurses play a crucial role in influencing the adaptation process. During the process of promoting achievement, nurses not only serve as credible authorities but they also provide social support for patients as they cope with changes originating from illness (Mishel, 1998, p.227).

A clear example of the use of Mishel's theory of uncertainty in illness is its use in meningioma diagnosis. The ability of nurses to provide necessary support to patients for informed decision making regarding treatment options and interventions is dependent on understanding patients' response to uncertainty surrounding meningioma diagnosis (Guadalupe, 2010, p.77). The relevance of Mishel's theory in today's health care is evident in the factors that lead to uncertainty i.e. lack of information, doubt about the situation, complexity of care delivery, and unpredictability of disease prognosis and progression (Guadalupe, 2010, p.79). Generally, these are the most common challenges that healthcare workers experience in delivery of care to patients. The ability of these professionals to promote adaptability to illness-related conditions requires development of care plans that deal with these factors.

For Mishel's theory to better support the ethical and social issues that nurses face in healthcare, there is need to incorporate the most suitable approach nurses can use to have substantial impact on the illness experience. Mishel basically describes nurse as credible authorities and social support professionals but does not explain the approach nurse should take in dealing with patient's uncertainty in illness. The best possible approach I would include in the theory to better support ethical and social issues faced by nurses is a presence-centered approach to care in which nurses do their best to attune with patients (Klaver & Baart, 2011, p.687). This approach enables nurses to provide professional loving care through the use of professional knowledge and experience.

Theory Integration:

Nursing is an educational practice that is guided by various principles including respect for the patient's lifestyle and autonomy. The delivery of improved patient care in this field requires competence, which is described as a combination of experience, professional attitudes, and knowledge (Paganini & Egry, 2011, p.578). I believe that nursing is a field that focuses on promoting patient's well being, health, and adaptation to illness-related changes. Nurses carry out their respective care duties in an environment that promotes and fosters a patient's well-being and health regardless of his/her condition. Patient care delivery is a process that is geared towards improving a patient's health condition through appropriate care plans, treatment options, and interventions. However, nurses usually experience changes in the health care environment that necessitates the development of culturally-relevant patient care to meet the diverse needs of individuals, families, and groups.

Leininger's Culture Care Theory described advanced practice nursing as a process that is based on educational preparation, primary care contextual practice, and outcome-centered research initiatives (McFarland & Eipperle, 2008, p.48). The theory ascertains that provision of culturally-relevant care to meet diverse healthcare needs is based on education, research, and practice. Therefore, nurses should competently and sensitively assimilate culture care into clinical techniques, relative schedules, and approaches. This theory is congruent with my personal values that the nursing process should be based on competence while nursing care and environment is characterized with different challenges that require culturally-relevant care. Actually, the nursing environment is faced with increased cultural diversity that requires delivery of culturally-relevant care to meet the populations' needs (Bernal, 1993, p.228).

Global View:

Modernism is a global view that identifies to my overall outlook of life and is considered as one model for research and practice. Unlike other global perspectives, this view promotes individual constructions or the notion of the self as a coherent agent. With regards to evidence-based practice, modernism is associated with truth, reason, and scientific improvements. Therefore, the best possible research is one that identifies the objective truth of occurrences in therapy, determination of informal relationships between techniques and outcomes, and removal of other casual relationships (Ramey & Grubb, 2009, p.76). One of the major arguments by modernist practitioners and researchers is that research processes and findings contribute to the improvement of evidence-based practice.

As the world continues to experience numerous changes across various settings and societies, there is need for ongoing research to improve delivery of care and evidence-based practice. This perspective resonates with my overall outlook in life because changes in the modern societies and settings require the development and use of new processes and measures to meet the needs of populations. Unlike post-modernism perspective, the modernism global view is dependent on rationalism and naturalism, which have proven to be beneficial for the nursing profession throughout its history (Salladay, 2000, p.42).

The improvement of the modern society is dependent on promoting the understanding and use of science though modernism (Esade & McKelvey, 2010, p.418). The modernist perspective has been the basis of the huge technological advancements and industrialization that have characterized today's society. These technological advancements have affected every facet of society including nursing, which implies that processes in this field require the use of a modernist perspective to improve outcomes. The modernist perspective provides objectivity in understanding and improving processes across various fields, especially the health care field because of the consideration of people as the basis of representation and interpretations.

Reflection:

This course has played a crucial role in my development as a nurse in an advanced role by promoting understanding of conceptual knowledge in advanced nurse roles, application of nursing theories and conceptual frameworks, and development of a professional nursing philosophy. In addition to this, the other learning outcome for the course was formulating a conceptual framework to direct advance nurse roles. The course has enabled to understand that nursing practice is based on conceptual knowledge and the significance of competence in patient care delivery. In advanced nursing roles, conceptual knowledge is not only important in guiding nursing practice but it also helps in governing research initiatives. The conceptual knowledge is presented in models, which represent abstract and complex conditions as a means of reflecting reality (Murphy, Williams & Pridmore, 2010).

Secondly, the course has demonstrated how nursing theories and concepts are the basis for developing nursing models, formulating a professional nursing philosophy, and creating a conceptual framework to guide advanced nurse roles. The… [END OF PREVIEW]

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