...INTRODUCTION * Theorist : Dorothea Orem (1914-2007) * Born 1914 in Baltimore, US * Earned her diploma at Providence Hospital – Washington, DC * 1939 – BSN Ed., Catholic University of America * 1945 – MSN Ed., Catholic University of America * She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant. * Received honorary Doctor of Science degree in 1976. * Theory was first published in Nursing: Concepts of Practice in 1971, second in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS * People should be self-reliant and responsible for their own care and others in their family needing care * People are distinct individuals * Nursing is a form of action – interaction between two or more persons * Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health * A person’s knowledge of potential health problems is necessary for promoting self-care behaviors * Self care and dependent care are behaviors learned within a socio-cultural contextDEFINITIONS OF DOMAIN CONCEPTSNursing – is art, a helping service, and a technology * Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments * Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective * Goal of nursing – to render the patient...
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...Jean Watson’s Theory of Human Caring Caring Moment - “The moment (focal point in space and time) when the nurse and another person come together in such a way that an occasion for human caring is created” In Jean Watson's theory of caring she has tried to make “explicit nursing's values, knowledge, and practices of human caring that are geared toward subjective inner healing processes and the life world of the experiencing person, requiring unique caring-healing arts and a framework called "carative factors," which complemented conventional medicine, but stood in stark contrast to "curative factors." At the same time, this emerging philosophy and theory of human caring sought to balance the cure orientation of medicine, giving nursing its unique disciplinary, scientific, and professional standing with itself and its public.” (Watson, 1999) Concepts: • Carative factors (evolving toward "Clinical Caritas Processes") • Transpersonal Caring Relationship • Caring Moment/Caring Occasion Jean Watson’s 10 carative factors that can be used as a guideline to help nursing interventions. These carative factors provide a framework that aids the nurse to pay attention to the caring processes. 1. Embrace altruistic values and practice loving kindness with self and others. 2. Instill faith and hope and honor others. 3. Be sensitive to self and others by nurturing individual beliefs and practices. 4. Develop helping – trusting- caring relationships. 5. Promote and accept...
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...Proponents of mandatory, inpatient nurse-to-patient staffing ratios have lobbied state legislatures and the United States Congress to enact laws to improve overall working conditions in hospitals. Proposed minimum, nurse-to-patient staffing ratios, such as those enacted by California, are intended to address a growing concern that patients are being harmed by inadequate staffing related to increasing severity of illness and complexity of care. However, mandatory ratios, if imposed nationally, may result in increased overall costs of care with no guarantees for improvement in quality or positive outcomes of hospitalization. The costs associated with the additional registered nurses that will be needed for the higher, mandated ratios will not be offset by additional payments to hospitals, resulting in mandates that will be unfunded. An alternative approach would be to provide a market-based incentive to hospitals to optimize nurse staffing levels by unbundling nursing care from current room and board charges, billing for nursing care time (intensity) for individual patients, and adjusting hospital payments for optimum nursing care. The revenue code data, used to charge for inpatient nursing care, could be used to benchmark and evaluate inpatient nursing care performance by case mix across hospitals. A nursing intensity adjustment to hospital payment, such as that described above, has already been endorsed by national nursing organizations. Efforts to implement this model nationwide...
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...Introduction The quality of care delivered by the nurse remains with the patient long after discharge. Unfortunately, said care has become increasingly compromised due to nurse burnout. Higher turnover rates result in an increase of staff unfamiliar with their new environment. This knowledge deficiency can lead to delay of care as well as a decreased quality of care. It is important that the factors leading to, and, ultimately, resulting in, nurse burnout and turnover rates are understood so nurses are able to provide the best quality of care possible and create a long lasting positive impression on their patients. Background of Study The shortage of nursing has long had a negative impact on the workplace and its employees. Over the years, said shortage has become an increasing problem for post-industrialized countries. Researchers have developed many approaches to examine and determine contributing factors to this shortage. One approach, that of which is illustrated in this paper, focuses on the retention of nurses, and which factors promote a commitment to the workplace. Leiter & Maslach (2009) found that “dissatisfaction is predictive of both turnover intentions, which indicate that one is disengaging from the job and seriously considering other options, and actual turnover behavior which is the ultimate withdrawal from a job” (pg. 331). Gaining insight into what variables affect higher turnover and burnout rates allows for the implementations of appropriate...
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...Nurse Manager Philosophy October 11, 2013 Nurse Manager Philosophy Being a nurse manager is a hard job that requires a dedicated individual. I have been a RN for three years, which I have been employed on the same unit for that time. During the past three years I have grown as a nurse. I have taken more responsibility and learned a lot about nursing and patient care. Also, I have been trained as relief charge, which is a good opportunity for me to grow and gain more experience. Because I have become relief charge my co-workers are more open to ask me questions and they trust me more as well. Being charge nurse allows me to work more with the nurse manager and learn how to deal with issues that occur on a daily basis. This is just a taste of what the manger has to do. * Personal Attributes I am a caring and compassionate, and the most important thing to me is proving excellent patient care. Patients and families are the reason that nurses have jobs and they are the reason why I can go home a feel accomplished with what I have done. * Leader and Manager Traits I believe that communication is key to being a good manger and leader. I feel like I am able to communicate with my coworker and listen, which would help me if I ever wanted to be a leader on the unit. * Leadership Style I believe shared leadership would best describe how I would lead a nursing unit (Sullivan, 2009). I feel like employees are best to respond to change when they have an...
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...I interviewed Emily, a nurse I have worked with on L&D for many years. She also has a Certificate in Holistic Nursing. She has been interested in holistic care since before nursing school. During her senior practicum for her BSN, she made a proposal to our director for a Healing Arts/Aromatherapy trial for our patients. In addition to our ‘normal’ labor patients, we have a high-risk unit where many patients stay for extended periods of time, sometimes 3 or more months. The trial patients really enjoyed the services. Our director liked the patient response so much, she worked hard to develop an Integrative Services program, which Emily oversees. A policy was developed, as well as order sets. Trained nurses provide aromatherapy, essential oils, guided imagery, and meditation as well as music therapy, art therapy and an entire healing arts program. Somehow word spread around the hospital, and Emily has since taken this program to the oncology department. She will also be training the entire nursing staff at another metro area hospital (another nurse from oncology is responsible for training too.) Emily said that the rewards are immediate, from a labor patient becoming more relaxed and confident in her abilities, to a high-risk patient combating boredom and becoming more optimistic regarding her pregnancy. The providers in L&D are very receptive to the program, and we have quite a few nurses trained in this area. She said going to the oncology department was quite different...
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...of “The American Nurse” In the documentary of “The American Nurse” it showed different nurses in the field and what a day in the nurses lives would look like. Viewers were able to see a labor and delivery nurse, a director of nursing for a nursing home, a home care nurse, a prison nurse and an Army nurse. In this paper I am going to discuss the roles and actions of the home care nurse and the prison nurse. Both the home care nurse and the prison nurse had a heart for what they were doing. Both gave their all and didn’t judge their patients. Both set outside factors to the side and looked at their patients as individuals and not as a criminal or a hopeless individual. The home care nurse went to an extreme to help his clients. He drove his vehicle through seasonal highways and on roads that were not kept up by the town. He went to the farthest efforts to be there and give his help and skills to his patient. The patient was not in the best living situation, the house was a mess, crammed and family members were seen smoking and not encouraging an atmosphere where healing could easily occur. The nurse was sensitive to this situation and did not stress the patient out anymore when he saw that there was a negative change in his health, instead the nurse approached the family member and addressed the change in the clients health so the family would be aware of it. The nurse stayed sensitive to the client and put the client first in the situation. The prison nurse acted in a similar...
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...recommendations to increase care in the community, making home the centre of care aiming to reduce the strain on limited resources and give value for money. Within the community care district nurses are vital, there role is autonomous, unique and varied. Furthermore there expert theory, skills, and knowledge of self and practice adds to their advanced interpersonal communication skills to assess clients with increasing complex needs (Blazor et al 2008). Communication is the cornerstone of the nurse patient therapeutic relationship and is the essence of good care (Stein-Parbury, 2009). Within the community care setting, therapeutic relationships are a high priority of the health service to enhance the well-being of the growing ageing population and patients with complex palliative care needs (Bain and Baguley 2012). The Department of Health (2006) acknowledges that communication is paramount for human interaction, otherwise people cannot relate to others effectively, make their needs known and identify what is happening to them. A fundamental aspect for district nursing staff is to ensure the whole family unit is included in the communication process which is an essential part of the therapeutic relationship. The therapeutic relationship is grounded in an interpersonal process that occurs between the nurse and the client. It is a purpose, goal directed relationship that is directed at advancing the best interest and outcome of the...
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...engaged in on daily basis. They may also be stressed by the kind of leadership that is in their work place. The other possibility of cause of stress is the emotional cost as well as the professional conflict that is mainly brought by either not knowing how to carry out a certain operation or incompetence in certain field of operation (Cox, 1978). This requires them to be well supported mentally and physically as the work they does is very sensitive and fragile. Each person has to evaluate him/herself to come up with an issue that stress oneself more to ensure that affirmative action is taken against such issue preventing becoming a nuisance in the work place. For my case here, I will discuss death of patient as the main cause of stress as a nurse. In each and everything that one does has the desire to make it work. Otherwise, if one thing goes contrary to once will, one feels demoralized and thus stress. According to Cipriani, et al, 2000, in a situation where everyone is looking up to you to bring back to life a person in the verge of dying create a lot of pressure to oneself. It creates a mix reaction that one cannot explain. It requires a lot of emotional restrain to ensure that the emotion created is not transferred to the vulnerable people. Caring of the dying people is distressful and emotionally...
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...RETENTION RESEARCH PAPER Nurse Retention 07/28/08 Contents Introduction Literature review Plan of action Discussion Conclusion Introduction The priority goal of every hospital leadership team is to develop and retain a stable workforce that provides high quality patient care (Missouri Hospital Association [MHA], 2005). Nurse retention and recruitment are the top issues that all health organizations are facing in nowadays. They most effectively develop strategies not only to recruit nurses, but to retain experienced and knowledgeable bedside nurses who will deliver an excellent care. Practical retention plans and strategies are crucial to the financial and quality outcomes of an organization (Golden, 2008) Factors that are contributing and affecting nurse retention and consequently causing workforce disruption are related to high turnover, aging workforce, and job dissatisfaction. Literature Review Turnover is costly to an organization, creating significant financial burdens and affecting morale and clinical quality (Golden, 2008). Although the full impact of staff nurse turnover on hospital costs has not been assessed, costs associated with recruitment and hiring, personnel processing and training of new nurses are known to significantly increase as result of high turnover (Weisman, Alexander&Chase, 1981). There are several factors that contribute to hospitals currently high turnover...
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...Danielle Rudolph Position Paper #1 A nurse is someone who has the knowledge and capability to take care of those in need. Nurses manage, maintain, or recover health and quality of life. This means providing care in not only a vital/physical manner, but in ways such as comfort, confidentiality, teaching, and advocacy. Nurses strive to achieve the best quality of life for their patients regardless of their ailments, culture, religion, ethnicity, age and so on. Nurses are capable of assessing, planning, implementing, and evaluating care. Being a nurse requires someone who is able to care for others with a pure heart, rather than focusing on meeting merely the requirements. Nursing is a profession focused on the holistic care of individuals, families, and communities. Nursing not only focuses on what the health care team is concerned about but the patient’s outlook as well. It is an art combined with applied science to help people in their most vulnerable times, doing the things they cannot do for themselves. Nursing also plays an important role in balancing illness, health maintenance, and health education. It will always be the present and future of our economy. I want to be a nurse because I have a great desire to help people and care for them in times of need. I have been lucky enough to meet and work alongside some nurses who have inspired me, and I hope one day to equal their skill, attentiveness, and passion. I also think it would be very fulfilling that my input no matter...
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...Nurse Preparedness: ADN vs BSN Grand Canyon University June 7, 2015 Nurse Preparedness: ADN vs BSN In the early 1980’s though 2000 a shortage within the nursing field came to peak within the healthcare industry. For over 50 years the associate’s degree had significantly addressed the needs of nurses and nursing staff. However, with the rapid technological advancement of medical diagnosis and treatment, the competencies between nurses with an associate’s degree and a baccalaureate degree became the focus of the healthcare industry. With a demand for higher educational hospitals, a link between patient care and the education levels of nursing staff; the question was, are the competency levels adequate for the nurse with an associate’s degree? Though in writings, there have been no real major differences that are noted between the cognitive abilities of nursing students within baccalaureate degree programs and associate degree programs. Baccalaureate nurses are generally perceived as being better prepared for a wide range of nursing competencies and are seen as performing in the professional role for which they have been prepared during their education. Associate degree nurses are seen as performing well in the technical role for which they have been prepared in their education. In general, nurses were seen as performing in the roles for which they had been educationally prepared (Davis-Martin, 1990). I read an article in the Journal of Advanced...
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...Instructor’s Foreword Movies tell us that in the wake of a murder, detectives would stretch what appear to be pipe cleaners, or a very taut yarn, through the bullet holes left in walls, in lamps, in the hollow doors of haunted rooms. The yarn was there to demonstrate the location of the shooter – or indeed, shooters – relative to the victim. But the fact is that other forces might have conspired in the murder. (Poison may have been used; bullets may have been fired only as an afterthought; perhaps they were fired by the victim himself, before he died . . .) Yarn can tell us the story only in certain circumstances. As a researcher and a writer, Matthew Gribble analyzes his crime scene with diligence and care. The crisis: The shortage of nurses in America. The question: How and why did this shortage become a persistent problem? Matthew affixes strings of yarn to a number of gunshots: the increasing average age of the workforce, long hours, work that is often menial or clerical, and finally, relatively low salaries. But these strands lead to new questions, wider causes which have nothing to do with social yarn. These new questions have to do with rhetoric and the enduring association of nursing with “women’s work” and “femininity.” Matthew has the audacity to ask how the rhetoric of femininity actually functions. How and why are we compelled to accept images and tropes as ‘normal’ or ‘natural’ when they are anything but normal and natural? Is it possible that the rhetoric of nursing...
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...talk to all these people and they’re like, isn’t there a nursing shortage? And I’m like actually it’s the complete opposite,” Ms. Smith said. As the Wall Street Journal reported, even the booming health-care sector isn’t a refuge from the slow job market. The story focused on jobs at the bottom of the nursing ladder, licensed practical nurses and registered nurses with associate’s degrees. But even highly qualified nurses — those with bachelor’s degrees — are finding it hard to catch a break. How hard? A survey of recent nursing grads by the National Student Nurses’ Association last September found that four months after graduation, more than a third had been unable to find work as registered nurses. The numbers look better for nurses with bachelor’s degrees (72% employment vs. 61% for those with associate’s degrees), but the numbers still suggest a much harder road than many graduates were expecting. More than three quarters of respondents said employers were filling jobs with experienced RNs, not new grads. It’s bad enough that the American Society of Registered Nurses has launched a “Save the Grads” program to help newly minted nurses find work. “We got hundreds of hundreds and hundreds of people contacting us saying we can’t find jobs, we’ve got tens and hundreds of thousands in student loans,” said Ronnie...
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...Studies of Staffing and Quality in Nursing homes,” the results of thereview are based to three major categories, Staffing measures, Quality measures, and RiskAdjustment or Control Measures. Staffing measures are different nurse staffing calculations usedin the literature and range from numbers of staff per resident to staff turnover rates. Qualitymeasures indicate a measurement for quality care and are classified as either resident outcomesor facility outcomes....
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