Theory Guided Practice – Assignment 2 Solution

This article covers assignment solution about Theory Guided Practice.

Instruction

Use the six criteria from this week\’s readings from Fundamentals of Nursing Models, Theories, and Practice (Chapters 5 and 7) as a guide for this assignment. You can access these readings directly by using the Theory-Guided Practice Readings Link directly below this assignment entry.

Select a practice/clinical setting.

Use the following six criteria to select a theory appropriate for the setting you chose:

·         Clinical setting

·         Origin of the theory

·         Paradigms as a basis for choice

·         Simplicity

·         Patient\’s needs

·         Understandability

Explain what practice or clinical setting you chose, how the six criteria helped you choose, and why the selected theory is well suited to it.

Cite a minimum of three in-text sources, and include a page or slide with APA-formatted references.

Solution

Theory Guided Practice

Theory plays a critical role in clinical nursing practice. Nursing scholars acknowledge the nursing profession’s three pillars: practice, research, and theory, which constitute and define care delivery. Saleh (2018) avers that clinical practice generates questions for research and knowledge for theory. Research then guides nursing practice and knowledge through theory development, where theory ultimately guides research and improves practice.

With the nursing practice of the 21st century demanding evidence-based, patient-focused care, the effective practitioner must apply knowledge skills and caring that integrate research (a process of inquiry) and theory (product of knowledge). Consequently, this essay aims at exploring theory-guided practice in nursing in modern times. To achieve the goal, the author examines Jean Watson’s Theory of caring within the context of the clinical setting, theory origin, paradigms, simplicity, patient’s needs, and understanding.

Selected Clinical Setting

In the nursing theory selection process for the healthcare organization, one needs to be guided by the six criteria mentioned earlier in the introductory section, namely clinical setting, the origin of the theory, paradigms used, simplicity, and the patient’s needs understanding. In Modern Nursing Care Hospital (MNCH), the facility offers a long term geriatric mental health facility and applies Watson’s Caring Theory (WCT) to support its mission and objectives. At MNCH, the mission is to admit to patients that other facilities are not ready to accept a significant number of those who come from several hundreds of miles away.

Clinical Setting

First, a healthcare provider should align the nursing theory to the clinical setting. In MNCH, the clinical setting constitutes a long term mental health facility for geriatrics. The facility’s mission statement endeavors to offer compassionate care for the clients by cultivating an environment where individuals are committed to bringing out the patient’s happiness and well-being (Nielsen, 2015).

Daily activities in the facility seek to engage and inspire the patients to feel at home. The majority of the patients at MNCH have a chronic mental issue and therefore destined to remain in the facility permanently. My selection of the facility rests on the premise that I am familiar with a psychiatric hospital’s operations and the standards that the psychiatric nurse is expected to uphold.

Most importantly, the guiding principle of psychiatric nursing is to assist the individual who needs mental health help to live their life as it is. The client’s dignity through the recovery of their autonomy is realized by setting the patient’s dignity and protecting their rights as individuals. The provider must apply this and other fundamental principles using the taught and acquired professional expertise and skills.

Origin of the Theory

           After a clinical setting, the second criterion that informed WTC’s selection as the nursing theory to guide practice at MNCH involved reviewing its origins. Jean Watson’s caring theory was the only theory that included a spiritual dimension in nursing in its formative stages. Savieto & Leao (2016) opines that Margaret Jean Watson developed the theory of social care by exploring effective care through a transpersonal relationship that surpasses time, space, and matter of the patient and the provider.

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The patient-provider relationship constitutes one component of harmony besides the timely moment of integration in ways that promotes healing. In this manner, WTC is identifiable by preserving humanity’s wholeness and treating patients, particularly those with mental disorders, as people not like objects. WTC rests are tenets on Nightgale’s healing environment concept. Therefore, the MNCH foundation and mission statement are in the response of the growing elderly population in need of long term psychiatric care within Texas State and the wider context of the USA as a nation.

            Suffice it to say that due to the heavy science-oriented curricula that nursing students of the 2020s and beyond have to encounter, the learners have to acquire a firm grasp of the spiritual and humanities-focused background needed to demystify human caring. Essentially, WTC is premised on transpersonal psychology, which offers both nurses and educators the foundation upon which one can base their understanding of the human caring regardless of what disease the patient may be suffering from.

Postmodern discourse in the contemporary world constantly emphasizes that where a profession does not have a language of its own, it might as well be deemed not to exist. Hence, the psychiatric nurse has to name, claim, articulate and execute activities upon the phenomena of nursing and caring through the subjective real-life experiences of self and others by simultaneously focusing on nursing and caring science.

Paradigms as a Basis for Choice

The third criterion constitutes the nursing paradigm, which informed the nurse’s selection of the theory in context. By definition, a nursing paradigm refers to the patterns of beliefs and practices through which its identification explicates a scholar’s philosophical assumptions on their research topic. The main paradigms recognized in the nursing profession are empiricism, interpretive, and critical paradigm. In the empirical paradigm, the individual holds that there is one reality that is verifiable through senses. Under the empirical paradigm, one establishes knowledge by controlling specific variables’ circumstances to establish their relationship.

On the other hand, interpretive paradigm studies phenomena through the eyes of the individuals who experience it. Therefore, the nurse who adopts an interpretive paradigm holds that an event’s understanding and experience play a crucial role beyond what the external observer might see. In a critical paradigm, one focusses on the social challenges, denomination, and institutions with the overriding purpose of nurturing an egalitarian society.

However, within this paper’s context, the author embraces the definition of a nursing paradigm that refers to how individuals interact with the environment they live in, implying that the nursing paradigm that the nurse embraces has to be developed over some time. Subsequently, each nursing theory can develop one or more paradigms like developmental, behavioral, systems, or interactional.

According to Mckenna et al. (2014), WTC falls under the interactional paradigm. One has to understand the ethical, ontological basis of the unity of the mind, body, and spirit, which adequately clarifies what constitutes a relation within the caring paradigm.

Simplicity of WTC

In the process of picking a nursing theory to utilize in a given clinical setting, the provider should also select a theory that is easy to understand, easy to implement, and one whose defining hallmark is simplicity. In my considered opinion, WTC fits the bill considering that the theory itself caries the core nursing principle in its name.

Delving further into the principle leads one to the ten Caritas that are candidly explained for the readers. Similarly, incorporating WTC into nursing practice is simple since establishing a caring relationship with the patients. All that the nurse is required is to treat the patients as holistic beings, which manifests itself as unconditional acceptance.

The psychiatric nurse should treat the geriatric mentally ill patients positively and promote their mental health through knowledge and appropriate interventions. Once again, factoring in the other criteria and excluding the element of simplicity would significantly hamper the successful utilization of selected nursing theory in a given clinical setting, which in this context happens to a psychiatric facility for geriatrics.

Patient’s Needs

Like in order healthcare disciplines, nursing places the needs of a patient at the forefront. The nurse has got to be aware of the patients’ needs and act on them. At MNCH, the patients’ needs oscillate between medical and psychiatric needs. The introduction of patient-nurse relationships within the facility is crucial since it would open customized patient care within the shortest time possible. Pakar(2015) remarks that old age is a global phenomenon accompanied by several health problems, including mental disorders.

Of note is a gradual breakdown of the traditional joint family structure in some communities. The result is that aging is now a social problem that significantly contributes to mental health issues. One solution to these social problems is the emergence of institution care like MNCH, where the geriatric mental care needs are adequately addressed.

Understandability

The sixth and last of the six criteria to consider when selecting a nursing theory to guide practice in a healthcare organization is understandability, which is the fabric that interweaves all the other five right from the clinical setting, the theory’s origin, paradigms, simplicity, and patient needs. The significance of the provider understanding the chosen theory cannot be under\estimated.

Some nursing theorists choose to use complex language, which eventually obscures the intended concept to the average nurse. Be that as it may, I selected WTC because I believe that its meaning would remain intact as I continue practicing it. Therefore, I would urge fellow nurses to practice WTC during the caring for patients, in multidisciplinary care teams, amongst nursing assistants, and across all healthcare teams, not just in the confines of psychiatry setting.

Conclusion

In conclusion, this essay has established that an inappropriate theory can have adverse consequences on the patients and nursing staff. The chosen theory misinterpretation could also harm the healthcare facility. If MNCH adheres to WTC’s principles, the geriatric patients will find the organization as their home, considering that most would be unwelcome in other facilities.

The author also acknowledges that theory-guided practice holds the future of the nursing practice. As healthcare progresses into the third decade of the 21st century, all stakeholders who include nurse scholars, practitioners, scientists, and researchers, must place theory-guided practice at the top of the nursing profession.

References

McKenna, H., Pajnkihar, M., Murphy, F. (2014). Fundamentals of nursing models, theories, and practice. Malden, MA: John Wiley & Sons Ltd.

Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53.

Parkar, S. R. (2015). Elderly mental health: needs. Mens Sana Monographs, 13(1), 91.

Saleh, U. S. (2018). Theory guided practice in nursing—Journal of Nursing Research and Practice, 2(1), 18.

Savieto, R. M., & Leão, E. R. (2016). Nursing assistance and Jean Watson: a reflection on empathy. Escola Anna Nery, 20(1), 198-202.

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