NU500-7A Midterm exam Theoretical Foundation for Nursing

Midterm exam NU500-7A Theoretical Foundation for Nursing

1. From the Chinn and Kramer reading, define emancipatory knowing, emancipatory knowledge and praxis. How does each of these elements relate to and build upon the other? Provide an example of praxis in the patient care environment.

According to Chinn and Kramer, emancipatory knowledge is- “what they designate as the “praxis of nursing.” In their view, emancipatory knowing refers to human’s ability to critically examine the current status quo and to determine why it currently exists. This, in turn, supports identification of inequities in social and political institutions and clarification of cultural values and beliefs to improve conditions for all”. Caring is the foundation that provides a framework for nursing praxis. When I think of praxis of nursing I think of the care I provide to my liver patient when they come into the hospital. I work on a Hepatology PCU floor and my liver patients that come in are very sickly. They are fatigued, confusion can set in, they have no appetite, they are jaundiced, some are very itchy, edematous, and in pain. My heart hurts for these patient, so I try my best to comfort, I listen, I administer their medication, I provide as must information and teaching that is needed to easy the mind.

2. McEwen and Wills discuss the difference between science and philosophy. Identify three characteristics of science, and three characteristics of philosophy. How do science and philosophy complement each other in nursing theory?

The three characteristics in science that has been discussed by McEwen and Wills is  observation, verifiability, and experience. And the three characteristics of philosophy is human life, the nature of being, and reality. And although there has been plenty of discussion about the two topics at the end of the day science and philosophy together has one common goal, and that is for the receiver to increasing there knowledge base.

3. Match the following terms to the correct definitions: construct, concept, ontology, taxonomy

The most complex type of concept. Comprised of more than one concept and built to fit a purpose

Elements or components of a phenomenon necessary to understand the phenomenon. They are abstract and derived from impression the human mind receives from sensing the environment.

A classification scheme for defining or gathering various phenomena. Range in complexity from simple dichotomies to complicated hierarchical structures

The study of existence and the nature of reality

4. Based on McEwen and Wills, what are the four requirements for a metaparadigm.

The four Metaparadigms in nursing as defined by Patricia Benner are:

Nursing- which in according to Patricia Benner is described as an enabling condition of connection and concern which display a high level of emotional involvement in the nurse –client relationship.

Person – where as a person does not come into the world predefined but is defined as they go through the course of their life.

Health- Patricia Benner focused on the lived experience of being healthy and ill

Environment- instead of using the term environment, Benner used the term “situation” because it suggests a social environment with social definition and meaning.

5. As discussed during the module 3 lecture, according to Peplau there are 3 phases to the nurse patient relationship:

Peplau stated relationships are characterized by “personalities, moods, concerns, needs, personal values and views which a person brings into each interpersonal encounter” (1994). Understanding these elements and addressing them in the nursing process will ensure a greater likelihood of therapeutic interaction. Select one of the phases of Peplau’s theory. Explain how this phase can be supported by evidence based practice. Provide an example of how this element of theory has been researched and applied by nurses, and how you can apply it in your own practice environment.

Peplau’s theory- final phase is the resolution phase. It is the termination of the professional relationship, “since the patient’s needs have been met through the collaboration of patient and nurse. They must sever their relationship and dissolve any ties between them. This can be difficult for both if psychological dependence still exists. The patient drifts away from the nurse and breaks the bond between them. A healthier emotional balance is achieved and both become mature individuals. This is the evaluation of the nursing process. The nurse and patient evaluate the situation based on the goals set and whether or not they were met.

The goal of psychodynamic nursing is to help understand one’s own behavior, help others identify felt difficulties, and apply principles of human relations to the problems that come up at all experience levels. Peplau explains that nursing is therapeutic because it is a healing art, assisting a patient who is sick or in need of health care. It is also an interpersonal process because of the interaction between two or more individuals who have a common goal. The nurse and patient work together so both become mature and knowledgeable in the care process” .

Discharge Planning is a major theory that is practiced world wide. High-performing hospitals tended to start discharge planning immediately after the patient was admitted to the hospital. Low-performing hospitals tended to conduct discharge planning at the end of the patient’s stay, focusing on complying with guidelines rather than individual patient needs. High-performing hospitals also had strong, multidisciplinary case management services. At these sites, patients were not discharged until a plan was in place. In addition, there was a strong shared responsibility to educate and follow up with patients about their medications and post-hospital care. Education focused on both the patient and their families. Finally, in high-performing hospitals, primary care physicians were contacted within 1 to 2 days after discharge. At lower performing hospitals, the burden of passing discharge information along to the primary care physician was placed on the patient. 

As a stranger, “the nurse receives the patient in the same way the patient meets a stranger in other life situations. The nurse should create an environment that builds trust. As a teacher, the nurse imparts knowledge in reference to the needs or interests of the patient. In this way, the nurse is also a resource person, providing specific information needed by the patient that helps the patient understand a problem or situation. The nurse’s role as a counselor helps the patient understand and integrate the meaning of current life situations, as well as provide guidance and encouragement in order to make changes. As a surrogate, the nurse helps the patient clarify the domains of dependence, interdependence, and independence, and acts as an advocate for the patient. As a leader, the nurse helps the patient take on maximum responsibility for meeting his or her treatment goals. Additional roles of a nurse include technical expert, consultant, tutor, socializing and safety agent, environment manager, mediator, administrator, record observer, and researcher”.

Nursing Theory. (2016). Hildegard Peplau Theory. Retrieved from:

http://www.nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php

*Essay needs to be 500-750 words and include referenced support.

6. Nursing managers are often faced with the challenge of motivating their staff. Consider the following example:

John is a nurse who has been working on your department for nine months. He is currently half way through a mandatory six month night rotation. Last week you overheard him complaining in the hallway that he was unhappy with night shift, found it boring and had a hard time staying awake. He made one medication error a week ago which he immediately brought to the nursing supervisor’s attention and the patient was not harmed. You are concerned that his attitude made bring down the morale of other staff members and possibly affect his ability to provide patient care.

Select one of the following motivational theories. Explain the theoretical background of the theory and how it relates to nursing management. Explain how you would apply the theory to John.

Achievement-motivation theory

Expectancy Theory

Equity Theory

Expectancy Theory according to research is, “the mental processes involved in making choices. In organizational behavior, expectancy theory embraces Victor Vroom’s definition of motivation. Vroom proposed that a person decides to behave in a certain way, selecting one behavior over other behaviors, based on the expected result of the selected behavior. For example, people will be willing to work harder if they think the extra effort will be rewarded.

In essence, the motivation behind chosen behavior is determined by the desirability of the expected outcome. At the theory’s core is the cognitive process of how an individual processes the different motivational elements. Processing is done before an individual makes the final choice. The expected result, therefore, is not the sole determining factor in the decision of how to behave because the person has to predict whether or not the expectation will be fulfilled.

Expectancy theory can help managers understand how individuals are motivated to choose among various behavioral alternatives. To enhance the connection between performance and outcomes, managers should use systems that tie rewards very closely to performance. Managers also need to ensure that the rewards provided are deserved and wanted by the recipients. To improve the connection between effort and performance, managers should use training to improve employee capabilities and help employees believe that added effort will in fact lead to better performance” (Boundless, 2016).

Expectancy theory is a great example in which authentic leadership comes into place. With great leadership, John’s entire attitude could make a three sixty turn for the best. If there’s a manager notified of John’s negative behavior and attitude he could be reprimanded and disciplined accordingly if he isn’t careful of how or who he speaks with about his feelings toward nightshift and all other concerns he’s unhappy with. When management has incentives in place that motivate their staff to do all that he or she can for his or her patients, the work environment is always at an exciting, high energy level which in turn creates a pleasant work place for everyone. When there’s a reward, attitudes and the way things are projected begins to change because of their expectation of whatever reward is set in place.

Boundless. “Expectancy Theory.” Boundless Management. Boundless, 26 May. 2016. Retrieved 02 Oct. 2016 from https://www.boundless.com/management/textbooks/boundless-management-textbook/organizational-behavior-5/process-and-motivation-47/expectancy-theory-242-3951/

*Essay needs to be 500-750 words and include referenced support

7. Describe 2 strategies for becoming a transformational leader.

According to Burns (1978), transformational leaders- “include strong commitment to the profession and to the organization, the ability to help their followers look at old problems in new ways, as well as the ability to excite and motivate followers to produce extra effort to achieve group goals. The hallmark of the transformational leader is vision and the ability to communicate that vision to others so that it becomes a shared vision”. To become a transformational leaders that person must inspire great loyalty and trust in their followers.

8. How do you envision conceptual knowledge, theory and the practical elements of nursing care interfacing in your practice? List at list at least one theory or theorist that you feel best embodies effective application of theory in practice.

Watson’s theory of Human Caring is an theory that is effective in practice. Watson believes that “authentic human-to-human caring is core to professional theory-guided, evidenced-based practices, and caring-healing relationships affecting patient/system outcomes.

Care is crucial for human development, and is first and foremost aimed at physical needs. Caring is necessary on the biological level for infants to survive, but also for the patient who is dependent at end of life. Care ethics stem from the idea that care is basic to human existence. Caring weaves people into a network of relationships

Lachman, D. (2000). Applying the ethic of care to Your Nurisng Practice. Retrieved from:

http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Applying-the-Ethics-of-Care-to-Your-Nursing-Practice.pdf

9. Based on week 3’s supplemental activity link, what are some core components of ANCC’s magnet status program for nursing.

The ANCC magnet status program for nursing isn’t a prize or an award but instead It’s a performance-driven recognition credential. Magnet hospitals provide high-quality care, a safer environment, and better patient outcomes. Studies show Magnet hospitals have higher percentages of satisfied registered nurses (RNs), lower RN turnover and vacancy, improved clinical outcomes, greater nurse autonomy, and improved patient satisfaction.

https://www.americannursetoday.com/going-for-the-gold-the-value-of-attaining-magnet-recognition/

10. Provide an in-depth explanation the nursing theory you like best. Why is it your favorite?

Dr. Patricia Benner has been my favorite nurse theorist for many years now because of her simple theory approach that has turned out to be very true over the years since her doctorate in 1982. The foundation of her theory is relevant to the old cliché,”practice makes perfect.” Of course it is a must to have the proper educational background but its even more important to have a multitude of hands on experiences. Those experiences are very vital to the growth in knowledge. The more you practice the more skilled you will become over time making you an expert in the field.