NU 500 Unit 7 – Theory & Practice

Unit 7 – Theory & Practice

Which nursing theory do you feel will have the greatest impact on your practice and why.

The theory I found that applies most to my practice in the urology department is Dorothy Johnson’s behavioral system model. The theory is focused on reducing stress for patients, so they are able to more easily recover from their medical condition (Nursing theories, 2012). The focus on preventing stress is also focused in turn on promoting health and preventing illness. The theory also noted more emphasis on the person actually experiencing and going through a disease or illness rather than focusing on the disease (McEwen & Wills, 2019). This theory is more patient-centered. This theory applies to my nursing practice because as an RN, I see many post-operative bladder, prostate, and kidney cancer patients. In bladder cancer patients for example, once their tumor is removed there are a lot of next steps for these patients – they are almost immediately started on intravesical chemotherapy for 6 weeks. The treatments are very painful and have a lot of side effects. On top of that, their home life and bathroom habits must be changed drastically in order to have the most effectiveness of the treatments, and every few months they need to have another look into the bladder via cystoscopy, and possible multiple resections of the tumor. Kidney cancer patients usually are very sore, and have a high risk of metastasis, so many of our patients are referred to a bigger healthcare facility for their care. Our prostate cancer patients have an extremely long recovery period, and usually life-long personal deficits that affect their intimate relationships. Understandably enough, all of these situations cause a great amount of stress, and with the help of Johnson’s behavioral system model, we can better understand the stress these patients are under and work together to decrease their current stressors and help prevent any further stress for the patients and their families. Stress takes a huge toll on peoples’ lives, and it can intensify especially for cancer patients.

Is there an article that you particularly found most useful in utilizing theory in your area of practice?

I actually found two articles that I found the most useful in understanding and utilizing theory in Urology. The first article, “Patient Evaluation of a Discharge Program Following a Radical Prostatectomy,” goes through many methods of doing discharge teaching for a patient who recently had a prostatectomy for prostate cancer. It includes not only the moments when the patients leave the hospital, but discharge education days prior, and in follow-up care. With this article, I pertained Neuman’s system model to because it also focuses on decreasing stress for patients. The discharge process is very tedious, confusing, and no one remembers anything, so I think understanding how the entire discharge process works, from prior to leaving the hospital through days after follow-up is really important and can give someone a real picture of how it works. This article also allows us to view things from a patient’s perspective, and we are able to see really how difficult things are for patients following a major surgery for cancer.

The second article I found, “Treatment of Nocturia in the Elderly” examines the many different causes of nocturia in the elderly, how the elderly portrays symptoms, and different treatment options and preventions for these patients. In urology, much of the population of patients we see are elderly, and nocturia is a prevalent problem in this group. This article demonstrates much of Watson’s theory of caring as well as Orem’s theory of self-care. Watson’s caring theory promotes health and prevention of disease (Wayne, 2016), and Orem’s theory is based on providing nursing care for patients who cannot take care of themselves properly, and the care continues until the patient is able to resume self-care. This article talks about nocturia and urinary tract infections. Nocturia is a big symptom of a UTI in the elderly. With nursing care there to help the elderly with their hydration, adequate perineal cleanliness, and overall better health, the patient is less likely to develop nocturia as a UTI symptom, and hopefully prevent UTIs altogether. If a patient chronically has nocturia, the nurse can assist and provide care, making sure the patient stays dry and has timely bed changes when soiled. In urology, we see a lot of UTIs and many patients with nocturia, and it is important that nurses provide the right information to these patients, and the caregiving staff adhere to the medication regiment and overall care for the patient.

Which of the units’ discussion questions did you find most challenging; discuss why you chose that one?

I would say unit 1 seemed to be the most challenging for me. Besides the fact that it was our first unit, it was difficult for me to understand and wrap my head around nursing theory. I had never really dealt with it in my undergraduate program, or in my current practice, so it was hard to even really think about it or understand the relevance or why we even really needed to talk about it. It was one of those things where I never paid any attention to it, and therefore did not care about it. I thought I would really struggle with this class because it took me so long to understand theory and start applying it to personal experiences, finding articles about theories, or even understanding any one theory that I came across. I am glad now that I am able to interpret the theories and understand why they exist and be able to easily apply them to my personal and professional experiences.

Which discussion did you find more useful to understand nursing theory and its application in your area of practice?

Unit 4 was the most useful for me in understanding nursing theory and being able to apply what I learned to my area of practice. It was in unit 4 that I finally started understanding nursing theory on a deeper level and learning how to apply it to real-life experiences and instances in nursing. The article I found for unit 4 described interventions for a patient undergoing rehab due to a stroke. The article did a good job at describing basically everything that goes into care for a rehab patient and discussed the overall picture and management of these patients. As I was reading the article, I understood how nursing theory and management are related, and how it is applied in an actual situation of a stroke patient in rehab. While the article I found really did not relate to my area of practice, I can however apply the theory and management of nursing to a situation in urology. Patients recovering from a prostatectomy could use some sort of case management because of all of the factors and layers of care needed for the patients to fully recover. When a patient that has prostate cancer and goes through this surgery, they are basically unable to provide themselves care for quite some time. As said earlier these surgeries are major, and the recovery period is very long and strenuous. Stress is put on the patient and loved ones, so it would be beneficial for some management system to be included in the care of these patients. I think it is important for nursing theory and management to come together for patients with chronic conditions in order to give patients the best care and the best outcomes.

Resources

Davison, B. J., Moore, K. N., MacMillan, H., Bisaillon, A., & Weins, K. (2004). Patient evaluation of a discharge program following a radical prostatectomy. Urologic Nursing 24(6), 483-489.

Kallas, H. E., Chintanadilok, J., Maruenda, J., Donahue, J. L., & Lowenthal, D. T. (1999). Treatment of nocturia in the elderly. Drugs & Aging 15(6), 429-437.

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Nursing theories (2011, June 2). Johnson’s behavior system model. Retrieved from http://currentnursing.com/nursing_theory/behavioural_system_model.html

Nursing theories. (2012, February 4). Nursing theories: an overview. Retrieved from

http://currentnursing.com/nursing_theory/nursing_theories_overview.html

Wayne, G. (2016, January 5). Jean Watson’s theory of human caring. Retrieved from https://nurseslabs.com/jean-watsons-philosophy-theory-transpersonal-caring/