Feb 23, 2024 NR 510 Week 2: Theory and APN Role Discussion Part Two Discussion
NR 510 Week 2: Theory and APN Role Discussion Part Two Discussion
NR 510 Week 2: Theory and APN Role Discussion Part Two Discussion
According to Karnick (2014), nursing theory provides the ethics and beliefs that guide practice and help generate nursing knowledge. When nurses purposefully form their care around a particular theory, clinical practice takes place (Karnick, 2014). Karen should learn nursing theories because she will need the information to guide her care of the patient. Nursing theory is very important to APN practice because it provides nurses with the foundation and principles of the profession. The four main paradigms— person, health, environment, and nursing—that drive nursing theory aim to promote patient wellness. Also, learning nursing theory encourages critical thinking and suggests ways to relate the fundamentals of nursing to the actual practice of nursing (Karnick, 2014). Nursing theory is useful in many areas of nursing to include clinical, community health, legislative, administrative, educational, legal, etc. These theories provide invaluable knowledge that Karen can use to construct new knowledge. Nursing theory will teach Karen about the importance of evidence-based practice and how it relates to the decision-making process for patient care and patient values.
Karen’s concerns about the nursing theory being too broad should be addressed. While she is right, let’s put the reason why into context. As a new graduate nursing student, Karen will learn the theories are broad because there is more than one way to explain how to administer patient care or how to communicate with colleagues. There are multiple ways to display leadership and to educate oneself about new health processes, diseases, patient concerns, and all things dealing with nursing. Nursing theory is confusing at times because there are so many theories to learn. However, this should be viewed as a positive because it inspires a sharing of ideas and nursing practices. There is no singular way to provide the best patient care, and Karen can use many of the theories to enhance her clinical expertise. She can also compare nursing theories with current external clinical evidence and research to extract the most useful information to provide better patient care. The lack of agreement in the professional literature on nursing theory does not diminish the value of the theories nor does it make the theories irrelevant to practice. What the lack of agreement does is create dialogue and promote more evidence-based research. Karnick (2014) states eliminating nursing theory in the classroom will “degrade nursing as a viable profession.” The discipline of nursing needs these theories to guide effective patient care, or nursing will be just another set of actions or tasks that is not valued or needed by patients and their families (Karnick, 2014).
Reference:
Karnick, P. M. (2014). A case for nursing theory in practice. Nursing Science Quarterly, 27(2), 117. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/0894318414522711
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The Theory of Modeling and Role-Modeling states nurses should care for each patient with an understanding and respect for the patient’s uniqueness (Currentnursing.com, 2018). This is the basis of Erickson’s theory, which focuses on the patient’s needs and what should be the core of clinical practice. To apply this theory to family practice, the role of the FNP is to facilitate care, nurture the wellness of the client, and to accept the patient’s need for autonomy. The five goals of the theory apply to the practice of nursing, as well as leading nursing organizations’ missions and purposes. One of the first theories that nurses learn is the Code of Ethics. When put into practice, the code is the ethical obligations and duties of every nurse (Judge-Ellis & Wilson, 2017). Erickson’s theory and the Code of Ethics align with each other because both state that nursing goals and interventions should be to build trust between the patient and the nurse, to promote the patient’s autonomy and privacy, and to set health goals that promote the client’s strengths and respects cultural practices. As FNPs engage in family practice, they must apply these values to provide the best care to families.
References:
Currentnursing.com. (2018). Modeling and role modeling theory. Retrieved from http://currentnursing.com/theory/modeling_and_role-modeling_theory.html
Judge-Ellis, T., & Wilson, T. R. (2017). Time and NP Practice: Naming, claiming, and explaining the role of nurse practitioners. The Journal for Nurse Practitioners, 13(9), 583-589. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2017.06.024
NR 510 Week 2: Theory and APN Role Discussion Part Two Discussion
NR 510 Week 2: Theory and APN Role Discussion Part Two Discussion
Karen is still not convinced that Theory has any place in APN practice. Provide a specific example of how theory is relevant to APN practice in one of the four specialties (CNM, CNP, CRNA or CNS). Provide evidence to support your arguments.
The Theory of Modeling and Role-Modeling states nurses should care for each patient with an understanding and respect for the patient’s uniqueness (Currentnursing.com, 2018). This is the basis of Erickson’s theory, which focuses on the patient’s needs and what should be the core of clinical practice. To apply this theory to family practice, the role of the FNP is to facilitate care, nurture the wellness of the client, and to accept the patient’s need for autonomy. The five goals of the theory apply to the practice of nursing, as well as leading nursing organizations’ missions and purposes. One of the first theories that nurses learn is the Code of Ethics. When put into practice, the code is the ethical obligations and duties of every nurse (Judge-Ellis & Wilson, 2017). Erickson’s theory and the Code of Ethics align with each other because both state that nursing goals and interventions should be to build trust between the patient and the nurse, to promote the patient’s autonomy and privacy, and to set health goals that promote the client’s strengths and respects cultural practices. As FNPs engage in family practice, they must apply these values to provide the best care to families.
References:
Currentnursing.com. (2018). Modeling and role modeling theory. Retrieved from http://currentnursing.com/theory/modeling_and_role-modeling_theory.html
Judge-Ellis, T., & Wilson, T. R. (2017). Time and NP Practice: Naming, claiming, and explaining the role of nurse practitioners. The Journal for Nurse Practitioners, 13(9), 583-589. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2017.06.024
Great insight on the correlation of Erickson’s theory, the theory of Modeling and Role-Modeling and nursing practice as an FNP. Might I add, not only with Erickson’s theory, but with many, if not all theories, will provide a way for Karen to develop and apply new knowledge for caring for her patients an an APN FNP. Nursing theories will provide a way for Karen to understand the importance of evidence-based practice in the APN role and also the correlation it has critically for her decision making ability while caring for individuals as the primary care provider. Karen should also understand that nursing theories are also essential as they utilized to expand and explain clinical interventions and decisions. While nursing theories are broad and there are many to learn, they all have a common connection of being develop to optimize patient care and outcome. Because Karen is just starting her new journey as a MSN graduate level student it will take her time to develop an appreciation and through understanding as to how theory are seen, utilized, and valued in today’s practice amongst APN FNP and other APNs.
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As a future CNP, Karen will establish relationships with patients and colleagues. She is a primary care provider who will deal with patients of all ages. Karen will be trained to individually assess health problems and risk factors and to develop treatment plans. She may decide to collaborate with other health providers and colleagues to identify patients’ health problems and implement the appropriate interventions. Karen’s overall goal is to improve the health of the individual and family. To foster a strong relationship between herself, her patients, and other healthcare providers on her patients’ healthcare teams, Karen must master the art of interpersonal communication. This is the process that allows people to exchange information and feelings through verbal and non-verbal messages (Lee & Doran, 2017). Interpersonal communication is face-to-face communication that determines how well patients and CNPs understand each other and work together to reach health goals (Lee & Doran, 2017).
Psychiatric nursing pioneer, Hildegard Peplau’s Theory of Interpersonal Relations model points out four sequential phases, the primary areas of communication essential to the nurse/patient relationship: orientation, identification, exploitation, and resolution (Nursingtheory.org, 2016). These frameworks help nurses understand their behavior in relation to listening to patients describe their health problems and working with other health providers. Peplau describes nursing as a “therapeutic, healing art” that becomes an interpersonal process because of the interaction between the NP, patient, and other healthcare providers (Arora, 2015). Interpersonal communication guides the way NPs create treatment plans and set health goals for patients and their families. Positive, open, and respectful interpersonal communication help the nurse and patient work together to become mature, knowledgeable partners in the care process (Arora, 2015). In my experience, patients often feel nervous and anxious around medical personnel. Many patients become defensive, passive-aggressive, shy, or uncomfortable all because they do not want to be perceived as uneducated about their health or the diagnosis/treatment information being relayed. Patients feel nurses and doctors talk at them instead of with them. I have heard patients complain that nurses are rude just because the patient did not understand what the nurse said about a diagnosis or treatment. Karen can use Peplau’s theory to engage in better ways to communicate with patients and help them feel valued. Undergraduate nursing school taught me best practices in creating a solid patient-nurse relationship. In Peplau’s model, this begins with the orientation stage. First, I should introduce myself to the patient then state my credentials and the role I will play. I should ask the patient his or her preferred name. I want to relieve the patient’s anxiety, so I ask the patient if there are any recent health changes he or she would like to discuss with me. I want to normalize the situation, so I may even ask about family life, hobbies, talk about the news, etc. There are so many ways for me to help the patient feel comfortable talking to me. The point is to let the patient know through verbal and non-verbal communication that I am here to help.
References
Arora, S. (2015). Integration of nursing theories in practice. International Journal of Nursing Science Practice and Research, 1(1), 8-12. Retrieved from https://www.researchgate.net/publication/283319003_Integration_of_Nursing_Theories_in_Practice
Lee, C. T., & Doran, D. M. (2017). The role of interpersonal relations in healthcare team communication and patient safety: A proposed model of interpersonal process in teamwork. Canadian Journal of Nursing Research, 49(2), 75-93. Retrieved from https://doi.org/10.1177/0844562117699349
Nursingtheory.org. (2016). Hildegard Peplau Theory. Retrieved from http://www.nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php
Great choice of theory. In my experience as a nurse, effective communication is the most important thing to patient care and collaboration with all the staff involved in a patients care. A simple greet of the day and calling them by their last name in the first introduction usually establishes a rapport. After a rapport is established, we can begin to ask patients what they prefer to be called. I always take advantage of the first introduction to establish a rapport. If patients feel uncomfortable, asking them how they are feeling is a very simple way to give them the opportunity to open up to you. If they remain uncomfortable, I let them know to call me if there is anything they need. And when they call for something, I ensure I accomplish it. Doing this almost always reduces anxiety and creates a strong rapport between me and my patient and family members.
Theory in communications will help us improve holistic care. Far too often, I have patients coming into the hospital with inadequate information after leaving a doctor’s office, which boggles my mind. This is also common in the hospital setting, where doctors leave the patients room and they don’t have a clue what the doctor said to them in regards to medications and treatment plans. This just tells me that, holistic care is not being taught because acute care continues to dominate health care. I hope that one day, holistic care dominate health care and health care education.
I think work Erikson’s is very important, yet classical model to look at when discussing how it relates to family practice. A nurse practitioner that specializes in family nurse practitioner practice, will have education that goes across the board. During clinical, one will do pediatrics, women’s health, adult and geriatric health. It is important to understand the psychological needs and accomplishments of each age group. Healthcare tries to now look into a patient as a holistic person and not just a person with signs and symptoms and a illness or disease to treat. When caring for a patient, one has to look at the patient mentally, physically, emotionally and even sometimes spiritually. For example with 45 to 65, according to Erickson, they are experiencing generative vs stagnation. People experience a need to create or nurture things that will outlast them, often having mentees or creating positive changes that will benefit other people. Success will equal to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world. 65 and older will be experiencing ego integrity vs despair. This stage takes place after age 65 and involves reflecting on one’s life and either moving into feeling satisfied and happy with one’s life or feeling a deep sense of regret.Success at this stages leads to feelings of wisdom, while failure results in regret, bitterness, and despair. For a nurse or nurse practitioner will do a thorough assessment to examine all avenues of the patient. A patient who is 55 years old might be going thru depression because her only son is in jail and she might feel as though she failed her son. This might cause her to eat less, grow weaker and become non compliant with blood pressure medication. If the NP did not look into this, she would have missed this important factor and just aimlessly order different interventions without examining the psycho social aspect of it. One patient in a clinic who is 69 years old, is generally healthy for their age, happy, compliant with medications might have been satisfied with life, vs the 70 year old patient that did not work in a profession he/she wanted, divorced and has been lonely may be unhappy, unsatisfied and non compliant with medication. Often, nurses and nursing practice becomes busy with different task and interventions to do, however, it is still important to look at the patient holistically. (Dunkel & Harbke, 2017) Reference: Dunkel, C., & Harbke, C. (2017). A Review of Measures of Erikson’s Stages of Psychosocial Development: Evidence for a General Factor. Journal Of Adult Development, 24(1), 58-76. doi:10.1007/s10804-016-9247-4
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