The Hindenburg disaster took place on Thursday, May 6, 1937, as the German passenger airship LZ 129 Hindenburg caught fire and was destroyed during its attempt to dock with its mooring mast at the Lakehurst Naval Air Station,
Faye Glenn Abdellah was one of the most influential nursing theorist and public health scientists . It is extremely rare to find someone who has dedicated all her life to the advancement of the nursing profession and accomplish this feat with so much distinction and merit.
Faye Glenn Abdellah was born on March 13, 1919, in New York City.EDUCATIONAL ACHIEVEMENTSIn 1942, Abdellah earned a nursing diploma from Fitkin Memorial Hospitals School of Nursing New Jersey (now Ann May School of Nursing). She received her Bachelor of Science Degree in 1945, a Master of Arts degree in 1947 and Doctor of Education in Teacher’s College, Columbia University. In 1947 she also took Master of Arts Degree in Physiology.
Abdellah went on to become a nursing instructor and researcher and helped transform the focus of the profession from disease centered to patient centered. She expanded the role of nurses to include care of families and the elderly.She worked in many settings. She had been a staff nurse, a head nurse, a faculty member at Yale University and at Columbia University, a public health nurse, a researcher and an author of more than 147 articles and books.She was selected as Deputy Surgeon General in 1982. She retired in 1989.
1937 – She wanted to be a nurse on the day she saw Hindenburg explode.1949 – She spent 40 years in Public Health Service where she first became involved in research, being assigned to perform studies to improve nursing practices.1960 – She was influenced by the desire to promote client- centered comprehensive nursing care.
BASIC TO ALL PATIENTS1. To maintain good hygiene and physical comfort –After colonoscopy, patients are usually soiled from theprocedure. It is therefore important to clean themproperly. Physical comfort through proper positioningin bed.2. To promote optimal activity: exercise, rest, andsleep – Patients who were sedated during theprocedure stay in the unit until the effect of thesedation has decreased to a safe level. As anurse, make sure the patients are able to rest andsleep well by providing a conducive environment forrest, such as decreasing environmental noise anddimming the light if necessary.
3. To promote safety through prevention ofaccident, injury, or other trauma and through theprevention of the spread of infection – Making surethe side rails are always up when leaving the patient .one way we prevent the spread of infection is throughproper disinfection of the equipments .4. To maintain good body mechanics and prevent andcorrect deformity – Positioning the patientproperly, allowing for the normal anatomical positionof body parts.
5. facilitate the maintenance of a supply of oxygen to all body cells –when patients manifest breathing problems, oxygen is attached tothem, usually via nasal cannula. Sedated patients are attached tocardiac monitor and pulse oxi meter while having the oxygendelivered. When the oxygen saturation falls below the normallevels, the rate of oxygen is increased accordingly, as per physiciansorder.6. To facilitate the maintenance of nutrition of all body cells –patients undergoing endoscopic procedures are on NPO. For thisreason it is important to monitor the blood glucose level. When thepatients blood glucose falls from the normal value, we inject D50Wto the patient or we change the patients IVF to a dextrose containingfluid.
7. To facilitate the maintenance of elimination – Providingbedpans or urinals to patients and at times, insertion of Foleycatheter when the patient is not able to void.8. To facilitate the maintenance of fluid and electrolytebalance – Proper regulation of the intravenous solutions as wellas proper incorporations it may have. An example is whenpatients have low serum potassium; KCl is incorporated in thesolution.
9. To recognize the physiological responses of the body todisease conditions—pathological, physiological, andcompensatory – it is important to check the patients for signs ofinternal gastrointestinal bleeding by monitoring the bloodpressure and cardiac rate.10.To facilitate the maintenance of regulatory mechanisms andfunctions – When a patient has a difficulty in breathing and isshowing an increase respiratory rate, elevating the head part ofthe bed is done to facilitate the respiratory function.
11. To facilitate the maintenance of sensory function –Sometimes there are semi-conscious patients, in these cases, itis still necessary to talk to them while performing nursinginterventions to maintain their auditory sense.
12. To identify and accept positive and negativeexpressions, feelings, and reactions – most patients feel anxiousbefore undergoing the procedures. It is necessary to listen to thepatients expressions and allow them to ask questions. To decreasetheir anxiety, proper instructions are given, what they are toexpect, how long the procedure will take, what they should doduring and after the procedure as well as other concerns.13. To identify and accept interrelatedness of emotions and organicillness – Encourage patients to verbalize their feelings and allowthem to cry when they have the need to do so will help thememotionally. Some patients are diagnosed with malignancy afterthe procedure and during this time the emotional needs of thepatient is a priority.
14. To facilitate the maintenance of effective verbal andnonverbal communication – when patients are not able toexpress themselves verbally, it is important to assess fornonverbal cues. For instance when patients are in pain, assessingfor facial grimacing.15. To promote the development of productive interpersonalrelationships – allow the patients significant others to stay withthe patient before and after the procedure. This allows forbonding and promotes interpersonal relationship.
16. To facilitate progress toward achievement of personalspiritual goals – nurse usually visits the patients in the unit.Patients may benefit from this, allowing them time to practicetheir faith.17. To create and/or maintain a therapeutic environment -providing proper lighting, proper room temperature, a quietenvironment are done to patients staying in the unit.
18. To facilitate awareness of self as an individual with varyingphysical, emotional, and developmental needs – care topatients vary according to their developmental needs. Allowingthe parents to stay during the procedure help the pediatricpatients in their emotional and developmental needs.
19. To accept the optimum possible goals in the light oflimitations, physical, and emotional – The goals for each patientvary depending on the capability of the patient. The nutritionalgoal for a patient with a PEG tube for instance will bedifferent, knowing that the patient has limited feeding options.20. To use community resources as an aid in resolving problemsarising from illness – Some patients live far from the city andthus referral to health centers is sometimes done.
21. To understand the role of social problems as influencingfactors in the cause of illness – Some patients who arediagnosed with amoebic colitis for instance are advised to avoidbuying street foods to which the preparation they are not sureof, and also avoid drinking water that are not safe.
Abdellah describes people as having physical, emotional, and sociological needs. These needs may overt, consisting of largely physical needs, or covert, such as emotional, sociological and interpersonal needs- which are often missed and perceived incorrectly The individuals (and families) are the recipients of nursing, and health, or achieving of it, is the purpose of nursing services.
Emphasis should be placed upon prevention and rehabilitation. Holistic approach must be taken by the nurse to help the client achieve state of health. However the nurse must accurately identify the lacks or deficits regarding health that the client is experiencing. These lacks or deficits are the client’s health needs.
The environment is implicitly defined by Abdellah as the home or community from which patient comes. Society is included in “planning for optimum health.” However, as Abdellah further delineated her ideas, the focus of nursing service is clearly the individual.
These would mean a comprehensive nursing service, this would include:1. Recognizing the nursing problems of thepatient.2. Deciding the appropriate actions to takein terms of relevant nursing principles.3. Providing continuous care of theindividual’s total health needs.4. Providing continuous care to relieve painand discomfort.5. Adjusting total nursing care plan to meetthe patient’s individual needs.
6. Helping the individual to become more self directing inattaining or maintaining a healthy state of mind and body.7. Instructing nursing personnel and family to help theindividual8. Helping the individual to adjust to his limitations andemotional problems.9. Working with allied health professional in planning foroptimum health10. Carrying out continuous evaluation and research to improvenursing techniques and to develop new techniques to meet allthe health needs of the people.
1. Observation of health status2. Skills of communication3. Application of knowledge4. Teaching of patients and families5. Planning and organization of work6. Use of resource materials7. Use of personnel resources8. Problem-solving9. Direction of work of others10. Therapeutic use of the self11. Nursing procedures
Physical, Sociological, emotional NeedsCommon Elements Of Patient Interpersonal Relationship Area
Nursing PracticeAbdeallah’s main goal is the improvement of the nursing education.The most important impact of Abdellah’s theory to the nursing practice is that it helped transform the focus of the profession from being “disease- centered” to “patient-centered.”The steps of the nursing process are assessment, diagnosis, planning, implem entation and evaluation
Professors and educators realized the importance of client centered care rather than focusing on medical interventions. Nursing education then slowly deviated its concentration from the complex, medical concepts, into exercising better attention to the client as the primary concern. It’s very strong nurse-centered orientation—is, on the other hand, it’s major contribution to nursing education.
Her theories continue to guide researchers to focus on the body of nursing knowledge itself, the identification of patient problems, the organization of nursing interventions, the improvement of nursing education, and the structure of the curriculum. The extensive research done regarding the patient’s needs and problems has served as a foundation for the development of what is now known as nursing diagnoses.
Nursing problems provide guidelines for the collection of data.A principle underlying the problem solving approach is that for each identified problem, pertinent data are collected.The overt or covert nature of the problems necessitates a direct or indirect approach, respectively.
NURSING DIAGNOSISThe results of data collection would determine the client’s specific overt or covert problems.These specific problems would be grouped under one or more of the broader nursing problems.This step is consistent with that involved in nursing diagnosis
PLANNING PHASEThe statements of nursing problems most closely resemble goal statements. Once the problem has been diagnosed, the nursing goals have been established.
IMPLEMENTATIONUsing the goals as the framework, a plan is developed and appropriate nursing interventions are determined.
EVALUATIONThe most appropriate evaluation would be the nurse progress or lack of progress toward the achievement of the stated goals..
The case of SimarHe experienced severe chest pain. In addition he experienced shortness of breadth, tachycardia and profuse diaphoresis.
Assessmentreveals: cardiac Past History : He damage had gone through similar episodes since past 2 years.
PAIN IMPAIRED CARDIAC FUNCTIONING` WORK RELATED STRESS FAILURE TO SEEK MEDICAL ATTENTION
STAGES OF Abdellah nsg Nsg intervensions NsgILLNESS problem intervensionsBasic to care 1. To maintain good 1. Administer oxygen Amount of pain hygiene and 2. Elevate headrest physical comfort 3. Reposition of client 4. Administer analgesics as advisedSusternal care 5 to facilitate the 1 promote rest Vital signs.needs maintenance of 2 Place in sitting supply of oxygen to position body cells 3 Promote deep breathing and coughing exercises 4 Implement exercises as toleratedRemedial care 13 To identify and 1 to find the nature of his knowledge ofneeds accept the job. relationship interrelatedness of 2 explore his work related between stress emotional and goal and his illness organic illness 3 stress associated with jobs.
Stages of illness Abdellah nsg Nsg intervensions Criterion measure problemsRestorative care 20 to use 1. Teach early Knowledge aboutneeds community signs and the use of resources as an symptoms of community aid in resolving cardiac resources. problems arising distress. from illness 2. Teach course of action .
Abdellah’s theory has interrelated the concepts of health, nursing problems and problem solving as she attempts to create a different way of viewing nursing phenomenon.
The major limitation of Abdellah theory and the twenty one nursing problems is their very strong nursing centered orientation. With the orientation appropriate use might be the organization of teaching content for nursing students, the evaluation of a students, performance in the clinical area or both. But in terms of client care there is little emphasis on what the client is to achieve.
Using Abdellah’s concepts of health, nursing problems, and problem solving, the theoretical statement of nursing that can be derived is the use of the problem solving approach with key nursing problems related to health needs of people. From this framework, 21 nursing problems were developed.Abdellah’s theory provides a basis for determining and organizing nursing care. The problems also provide a basis for organizing appropriate nursing strategies.