IMPORTANCE OF NURSING THEORY: 1. Aim to describe, predict and explain the phenomenon of nursing Chinn and Jacob, 1978 2. PROVIDE THE FOUNDATIONS OF NURSING PRACTICE, HELP TO GENERATE FURTHER KNOWLEDGE AND INDICATE IN WHICH DIRECTION NURSING SHOULD DEVELOP IN THE FUTURE Brown,1994 3. HELP TO DISTINGUISH WHAT SHOULD FORM THE BASIS OF PRACTICE BY EXPLICITLY DESCRIBING NURSING 4. HELP PROVIDE BETTER PATIENT CARE, ENHANCED PROFESSIONAL STATUS FOR NURSES, IMPROVED COMMUNICATION BETWEEN NURSES, AND GUIDANCE FOR RESEARCH AND EDUCATION Nolan,1996 5. THE MAIN EXPONENT OF NURSING- CARINGCANNOT BE MEASURED, IT IS VITAL TO HAVE THE THEORY TO ANALYZE AND EXPLAIN WHAT NURSES DO 6. ESTABLISH A UNIQUE BODY OF KNOWLEDGE KNOWLEDGE PERCEPTION COMMUNICATION ASSOCIATION LEARNING REASONING THE DEVELOPMENT OF NURSING THEORIES ⦿1. General Systems Theory ⦿2. Change Theory ⦿3. Development Theory ⦿4. Adaptation Theory THE DEVELOPMENT OF NURSING THEORIES ⦿ GENERAL SYSTEMS THEORY ◼describes how to break whole things into parts & then to learn how the parts work together in “systems”. ◼These concepts may be applied to different kinds of systems, e.g. Molecules in chemistry, cultures in sociology, and organs in Anatomy & Health in Nursing. ⦿ ADAPTATION THEORY ◼defines adaptation as the adjustment of living matter to other living things & to environmental conditions. ◼Adaptation is a continuously occurring process that affects change & involves interaction & response. ○ Human adaptation occurs on three levels : 1. The internal (self) 2. The social (others) & 3. the physical (biochemical reactions) ⦿ Self adaptation ⦿ Different time zone ⦿ Jet lag ⦿ Eventually adapt social adaptation adjustment and adaptation of humans to other individuals and community groups working together for a common purpose ⦿ DEVELOPMENTAL THEORY ⦿ It outlines the process of growth & development of humans as orderly & predictable, beginning with conception & ending with death. ⦿ The progress & behaviors of an individual within each stage are unique. ⦿ The growth & development of an individual are influenced by heredity, temperament, emotional, & physical environment, life experiences & health status. NURSING THEORISTS AND THEIR WORKS FLORENCE NIGHTINGALE MODERN NURSING and ENVIRONMENTAL THEORY Nursing “is an act of utilizing the environment of the patient to assist him in his recovery.” BIOGRAPHY ⦿ First Nursing Theorists and the Mother of Modern Nursing. ⦿ Born in May 12, 1820 in Italy to a wealthy British family. ⦿ In 1853, she accepted the position of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London. • She tended to wounded soldiers during the Crimean War. She became known as the "Lady with the Lamp" because of her night rounds. Immortalized in the poem “Santa Filomena” by Henry Wadsworth Longfellow • After the Crimean War, she established a nursing school at St. Thomas' Hospital and King’s College in London in 1860. ⦿ FLORENCE NIGHTINGALE ⦿ Nightingale wrote Notes on Nursing (1859), which was the foundation of the curriculum for her nursing school and other nursing schools. ⦿ Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army Notes on Hospitals Report on Measures Adopted for Sanitary Improvements in India from June 1869 to June 1870 ⦿ “She helped to pioneer the revolutionary notion that social phenomena could be objectively measured and subjected to mathematical analysis.” (Cohen) ⦿ Nightingale’s research skills: Recording, Communicating, ordering, coding, conceptualizing, inferring, analyzing and synthesizing (Palmer) ⦿ Nightingale emphasized the concurrent use of observation and the performance of tasks in the education of nurses. ⦿In 1883 - Royal Red Cross by Queen Victoria. In 1907 - the Order of Merit. In 1908 - Honorary Freedom of the City of London. ⦿She was able to work into her eighties and died in her sleep on August 13, 1910 at age 90 ⦿International Nurses Day is celebrated on her birthday. INFLUENCES ⦿ Education ⦿ Family’s aristocratic social status. ⦿ Exposure England ⦿ The provided by her Father to political process of the Victorian Industrial Age ⦿ Charles Dickens’ social commentaries and novels ⦿ Dialogues with many political leaders ⦿ Unitarian religious affiliation. ENVIRONMENTAL THEORY NIGHTINGALE’S MAJOR CONCEPTS 1. Person ⦿ Patient who is acted on by nurse ⦿ Emphasized that the Nurse has in control of the patient’s environment. ⦿ Affected ⦿ Passive powers by environment yet has reparative 2. Environment ⦿ Foundation of theory. ⦿ Included everything, physical, psychological, and social ⦿ Nurses are instruments to change the social status of the poor by improving their living conditions 3. Health ⦿“We know nothing of health, the positive of which pathology is the negative, except from the observation and experience.” ⦿Given her definition that of the art of nursing is to “unmake what God had made disease,” then the goal of all nursing activities should be client health. ⦿ Nursing should provide care to the healthy as well as the ill and discussed health promotion as an activity in which nurses should engage. ⦿ Envisioned maintenance of health through prevention of disease via environmental control. 4. Nursing ⦿ ⦿ “What nursing has to do… is to put the patient in the best condition for nature to act upon him” (Nightingale, 1859/1992) nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet – all at the least expense of vital power to the patient.” ⦿ Nursing is having the responsibility for someone else’s health. ⦿ She wrote her Notes on Nursing to provide women how to “Think like a Nurse.” ⦿Ventilation and warming ⦿Light and noise ⦿Health of houses ⦿Bed and bedding ⦿Personal cleanliness ⦿Variety ⦿Chattering hope and advices ⦿Food VENTILATION AND WARMING “ Keep the air he breathes as pure as the external air, without chilling him.” • • Recognized this environmental component as a source of disease and recovery. • Provided description for measuring the patient’s body temperature through palpation of extremities. • Nurses were instructed to manipulate the environment to maintain both ventilation and patient warm by good fire, opening windows and properly positioning the patient in the room. LIGHT ⦿ Light has quite as real and tangible effects upon the human body…who has not observed the purifying effect of light, and especially of direct sunlight, upon the air of the room NOISE ⦿ Noises created by physical activities in the environment (room) was to be avoided by the nurse CLEANLINESS • Bathing of patients on a frequent, even daily, basis. • Nurses should wash their hands regularly. BED AND BEDDINGS • Noted that a dirty environment (floors, carpets, walls and bed linens) was a source of infection through the organic matter it contained. • The appropriate handling and disposal of bodily excretions and sewage was required to prevent contamination of the environment. HEALTH OF HOUSES • What badly constructed houses do for the healthy • what badly constructed hospitals do for the sick.” VARIETY ⦿ To an old nurse, or an old patient, the degree would be quite inconceivable to which the nerves of the sick suffer from seeing the same walls, the same ceiling, the same surroundings during a long confinement to one or two rooms” FOOD • Instructed nurses to assess dietary intake , meal schedules and its effect on the patient. CHATTERING OF HOPE AND ADVICES • Protects patient from receiving upsetting news, seeing visitors who can affect the patient’s recovery negatively and from suddenly receiving disruptions from sleep.
