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Nursing is a profession associated with health care sector to maintain the quality of life. The nursing practice describes the expectation of people from nursing. It helps to meet the care needs of a patient, create a healthy environment, leads to fast recovery and improves the quality of care. The nurses need to understand and support patient future care. This practice includes two nursing theories-espoused theories and theories-in-use. The espoused theory explains to adopt and believes in own values and behavior. The theories-in-use means the actual theories based on research studies. The nursing theories provide structure for nursing intervention and estimate outcomes (Masters, 2015).
Nursing is a theoretical approach which guides direct, explains, and predicts nursing practice. This theory is of two types one is an own personal theory of nursing and second is based on nursing, health and environment. Nursing practice describes what everyone expects from the nursing staff for the patient. It is the therapeutic communication between the patient and nurse based on understanding, trust, effective communication and kindness. It involves treating all patients equally without discrimination, advocacy for the rights of the patient and maintains the high standard of quality in health services. This paper helps to understand the importance and applicability of both the theory for the patient safety needs and care. It also critically evaluates the gap between espoused theories and theories-in-use and discusses the important implications for the quality of nursing practice. As a nursing practitioner, I will apply these theories in my practice, which can be important to gain knowledge of theoretical work of nursing profession (Education, 2014).
Nursing is the well-organized profession. It has an enormous demand in the medical fraternity. I found that the appropriate nursing performs various duties like a diagnosis of the problem, ensures safety and recovery and helps in circulating awareness about health situation (Holloway & Galvin, 2016). Nursing involves good communication skills, requires a high level of diligence, emotional stability, good knowledge and the problem-solving skills. There is a gap between espoused theories and the actual theories-in-use practices. The individual person performs different theories in their own practices (Savaya& Gardner, 2012).
Importance of nursing theories
The nursing theory used by the medical practitioner to improve their practice and helps to reduce the practice variation. It helps in improvement in the quality of health care and leads to define and predict criteria to measure the quality of nursing. I found that nursing theories assist to maximize the effect of clinical judgment, observation and analysis of available information. It avails to take benefit of latest technology for the health benefit of the patient. Nursing theory also helps patient, manager and professional to identify the special contribution of nurses in healthcare service. It assists in the prevention of health disorder as the nursing expertise in theoretical knowledge as well. The nursing experience in work leads knowledge, as the person who has more year of experience has been expertise in practices(Alligood, 2014).
The one major theoretical perspective is self-care theory, which guides me to apply in my practice. It has a broad scope if clinical practice which can be based on deep understanding of problems and advanced practices. This theory was developed by Dorothea Orem between 1959 and 2001 and can be used in a rehabilitation center to encourage the patient to become independent. It is a collection of three inter-related theories i.e. a theory of self-care requisite, self-care deficit theory and theory of nursing system. The objective of this theory is to estimates the condition and recognizes the need of the patient. Nurses needs to express communication with the patient, select the theory for implementation and administer the theory to solve the identified problems to evaluate the area to be productive (Munhall, 2012).
The self-care theory can be performed by an individual is to keep their own health. It is performed to fulfill self-care essential requirements. Nursing is a form of action between two or more person. Self-care theory performs by the individual on his or her own behavior to maintain life healthy. Orem’s states that this theory exists only when the family members of a patient are able to provide care to the patient and his demand. If the person or family were not able to provide self-care then the nurse would be responsible for providing care. It also helps to provide principles to create further nursing knowledge.
I can choose this self-care theory because it helps to ensure patient and health care professionals to work together to contribute for care planning. Self-care theory support and manage people to access their needs, informed choices and develop the confidence to self-care. It supports and allows risk management to maximize independence and choices of the patient.
This theory guides impacts and me on my nursing practices, as it can be beneficial and applicable by beginning as well as advanced practitioners. It can be needed on nursing practices when the individual cannot able to maintain that amount of quality of care to recover from the disease or injuries and cope up with effects to encourage healthy and better life(Aneshensel, 2012).
A personal theory of nursing includes beliefs and values in relation to patient and I choose patient-centered approach in my practice. The patient-centered theory is the exercise of patient care in a meaningful and valuable way. I found that this approach focuses on the involvement of patient i.e. listening, informing and involving the patient in their care. It includes determining what matters to a patient, needs of the patient from the physician, proper communication regarding his problems and build a personal relationship. This approach involves the concept of health, environment, person and nursing like respect for patient values and preferences, physical comfort with patient; focus on effective communication and patient worries, emotional support, involvement of family and friends for improvement and informing patient regarding regular medication or care (Inzucchi, et al. 2012).
Person means the beneficiary of nursing care. A person is which interact flexibly in a physiological, developmental, psychological and socio-culture environment. The person can be under the care of nurse which satisfy health development needs and capable of self-care. It includes which internal and external factors influence the environment of nursing practice which involves the attention of nurse towards cleanliness to prevent infection, light, ventilation, warming, nutrition, noise and proper observation of the patient. The environment can be internal, external and created environment, which has to be supportive and focus on care of the patient for the healing process.
Health can be expressed regarding illness and wellness, which may occur in absence and presence of wound or injury. The nursing interventions involve the care of an entire patient. The actual treatment can be needed to avoid illness or wellness when situation occurring like immunization for vaccine-preventable disease and vaccination of tetanus. The nurse uses this for critically thinking skills, experience, and knowledge to decide which will help patient the most. There are three types of intervention. First is dependent, as it requires other health care provider for actions like a physician, secondly is independent, means the action can be commenced by the nurse independently, and third is interdependent, which means the participation of various members of health care team for intervention (Holloway& Galvin, 2016).
Nursing helps to change and manage the environment to implement the natural law of health. It assists the person status either sick or well, evaluate daily base performance and help to gain independence at the earliest. A caring relationship can be built to help the patient to recover soon. Nursing can help the patient to diagnose and treatment of illness, contribute to health and quality of life, promote adaptive abilities for individual and develop health and well-being.
In my practice, there has one patient who has been hospitalized and taken care of properly. I used the patient-centered approach for the treatment as it challenges belief and my practice. I found one article on pros and cons of the patient-centered medical home model ( one view, 2017). I apply this approach and found advantages and disadvantages of this approach.
It helps to indicate a strong patient own experience of health or illness, promote emotional comfort, emphasis on freedom of choice of patient, proper involvement and satisfaction of friends and family, encouraging trust and care giving relationship, providing meaningful care, leads better response and respect value, needs and preference of the patient.
It also indicates some disadvantages like it is a complicated process and over involvement of family and patient. This approach requires deep expectation, conviction and beliefs of the patient, which cannot be easy to provide for the treatment.
The self-assessment and reflection practice in nursing can be useful to provide professional nursing services. It helps to support nurse and focus on providing standard quality of services and to become reflective practitioner. It can be an assessment tool that improves abilities and skills of nursing and clinical practices. The nursing has to provide quality care in respect of the task without discrimination and within the self-guideline. The concept of nursing theories helps to determine practices, person, nursing, health and environment. It has to provide an overall practice of nursing which includes proper sleeping and resting, maintaining body temperature by adjusting clothes and convert environment, keep the body clean and learning health habits (Moon, 2013).
The relationship between the nurse and client can be established to make the patient feel more comfortable while questioning and disclosing personal information. The safe relationship built on morality and ethics which helps to establish trust and make the patient active i.e. in paying consultation charge of physician, to make the patient aware of moral implication of the work and helps to understand the background knowledge of the patient.
As a medical practitioner I prefer The Gibbs reflective model for my own personal theory and it impacts on actual nursing practices (Bulman & Schutz, 2013). It can be used by health practitioners for understanding medical practices with respect to values and behavior in the nursing practices. It helps medical practitioner in reflection and personal development, and ensures systematic learning and improving in their roles. With the help of this model all the aspect can be considered, evaluated by me for the patient and helps me to understand the actions at the similar situation for the next time. It also helps me to determine the best course of action for the patient. Critical reflection can be required to maintain good relationship with the patient.
It impacts on actual nursing practices like increase the ability to deal more effectively with the situation, dealing with the problems, provide the best care possible and improving knowledge and awareness of nursing professional (Macqueen& Bruce, 2012).
With reference to the current academic literature the nursing practice in general can be the theory-based learning. It is a theoretical based concept obtained from nursing model and assigns a systematic situation by designing inter-relationship. The objective of theory is to evaluate the patient condition by applying different methods of nursing theory. I have applied this theory and enclosed the patient perspective towards health condition. The goal of the theory is to maintain a state of health. It provides a way to analyze or explains the situation and stimulates better communication.
The advantage of theory-based nursing is to provide the perspective to view the patient situation systematically and have better control on the results of their care. It stabilizes and controls the effects of disability or poor health of the patient. This theory helps the nurse to focus on important information related to health or daily routine rather than unimportant data and what intervention can be needed for the patient. Theory based nursing could be useful in my nursing as it increases patient health, improve patient outcomes and job satisfaction, and provides consistent approach for health care. (Aneshensel, 2012)
The nursing practice in general for academic literature is evidence based practice, which means to use the best current evidence in making the decisions of patient health. There are various literatures, which describe the positive effects of evidence-based practices (Brown, 2013). The impact of this theory on my own practice leads to improving quality and healthcare transformation, promoting consistency of care, reducing practice variations, and assigning patient safety. It can be important for my nursing to meet changing energetic or positive market dynamics to improve patient care or results and cost-effectiveness. It helps me to increase knowledge of nursing practices and administration, provides clinical experience and closes the gap between experimental and scientific evidence (DiCenso, et al.2014).
These theories can be effectively used in my own practices and the importance and applicability of theory can be usefully guided in nursing practices. These theories can be important for me to incorporate innovations, improve healthcare operations, update knowledge and enhance development, to attend the conference or professional meets, and read journals and magazines to increase the nursing practice. This can be possible when this theories and practices can be applied on our own practices. The proper treatment can be possible when the proper training can be given to the practitioners or nurses to deal with all kinds of patient. The lack of training or guidance makes the patient conditions worst (Chinn& Kramer, 2013).
Nursing is a challenging role, which raises significant ethical issues. The goal of nursing is to help the individual to their highest possible level of care and improve the skills and ability of nurses. With the improved understanding of the need or competency of the patient, the nurses would be necessary to respond the challenges in the practices. There is a gap between espoused theories and theories-in-use practice which impacts on their own practices in which has been discussed in this essay. The major theory, which guides me in my practice, is self-care theory and evidence based practice as it helps me to make the patient independent and leads improvement (Townsend, 2014). I have applied the patient centered approach as the personal theory in my practice, which can be beneficial in my practice. The nurse-client relationship can be developed through theory-based practice, which is necessary for the improvement and enhancement. Theory based nursing helps to improve the quality of care and job satisfaction, which result in the retention of the nurses in the health care sector.
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