Key Words: Holism, nursing theory, pain
management, caring, relationship-centered
care, theory-practice gap, nursing practice,
holistic theory, client-centered care
Introduction
The use of theory to guide practice
has been advocated for decades, but the
translation of theory into practice has been
difficult for clinicians. Poor understanding
of theory and its purpose inhibits the nurse’s
ability to apply theoretical constructs in
practice, thus reducing practice to a task-
oriented enterprise rooted largely in habit.
Dossey’s (2008) theory of integral nursing
has recently emerged as a new holistic
theory that provides opportunities for
clinicians to invest in a worldview that
embraces the caring behaviors central to
the delivery of nursing care and encourages
nurses to design care that is relationship
centered and focused on healing. This
theory holds promise for application in
many care situations, though the client
experience of acute pain presents itself
as a uniquely universal opportunity to
demonstrate the prospective value of the
theory’s application.
It is widely known that pain is one of the
most common symptoms experienced by all
clients and that knowledge about effective
pain-relieving strategies is important
and essential in guiding practice. Despite
numerous advances in pain management,
pain continues to be insufficiently managed.
Inadequate understanding and use of theory
to guide pain management practice may
obscure nurses’ ability to rely on theoretical
knowledge as a basis for pain management
care. Insufficient knowledge about the
theory of integral nursing precludes
effective application of its theoretical
concepts in clinical practice, thereby
inhibiting nurses’ ability to improve pain
management practice while also inhibiting
clients’ ability to participate in the co-
creation of personalized interventions to
relieve pain. Failure of the nurse to engage
in holistic care, to capture the client’s
perspective in the design and delivery of
care, and to create a sacred space for
carrying out the holistic caring process
thwarts achievement of the mutually sought
after goal of healing. By embracing the
broader and deeper view of care offered by
the theory of integral nursing, the nurse and
client collaborate in the development of
trusting relationships as they intentionally
strive to improve client outcomes and
ultimately enhance client, nurse, and
provider satisfaction with care.
Background
Pain management has remained enigmatic
for clients and healthcare professionals for
decades. When caring for clients, pain is the
most common symptom for which nurses
need to intervene, yet it continues to be one
for which they may be least prepared to
successfully mediate (Lui, So, & Fong,
2008; Montes-Sandoval, 1999; Wilson,
2007). Pain is a multidimensional,
subjective phenomenon and experience.
As such, the meaning and impact of any
pain experience differs for ea ...
Theory of Integral Nursing to Clinical Practice Paper.docxwrite4
The document discusses applying the Theory of Integral Nursing to clinical practice, specifically pain management. It provides an overview of the theory, which focuses on healing through holism, caring relationships, and addressing people's mind, body and spirit. The theory emphasizes that people have an innate ability to heal and nurses facilitate this through trust-based relationships. It suggests the theory could help narrow the gap between nursing knowledge and practice by providing a framework to design comprehensive, client-centered interventions.
The nine Essentials addressed in this document delineate the knowl.docxarnoldmeredith47041
The nine Essentials addressed in this document delineate the knowledge and skills that all nurses prepared in master’s nursing programs acquire. These Essentials guide the preparation of graduates for diverse areas of practice in any healthcare setting.
• Essential I: Background for Practice from Sciences and Humanities o Recognizes that the master’s-prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.
• Essential II: Organizational and Systems Leadership o Recognizes that organizational and systems leadership are critical to the promotion of high quality and safe patient care. Leadership skills are needed that emphasize ethical and critical decision making, effective working relationships, and a systems-perspective.
• Essential III: Quality Improvement and Safety o Recognizes that a master’s-prepared nurse must be articulate in the methods, tools, performance measures, and standards related to quality, as well as prepared to apply quality principles within an organization.
• Essential IV: Translating and Integrating Scholarship into Practice o Recognizes that the master’s-prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.
• Essential V: Informatics and Healthcare Technologies. Recognizes that the master’s-prepared nurse uses patient-care technologies to deliver and enhance care and uses communication technologies to integrate and coordinate care.
• Essential VI: Health Policy and Advocacy o Recognizes that the master’s-prepared nurse is able to intervene at the system level through the policy development process and to employ advocacy strategies to influence health and health care.
• Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes o Recognizes that the master’s-prepared nurse, as a member and leader of interprofessional teams, communicates, collaborates, and consults with other health professionals to manage and coordinate care.
• Essential VIII: Clinical Prevention and Population Health for Improving Health o Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.
• Essential IX: Master’s-Level Nursing Practice o Recognizes that nursing practice, at the master’s level, is broadly defined as any form of nursing intervention that influences healthcare outcomes for individuals, populations, or systems. Master’s-level nursing graduates must have an advanced level of understanding of nursing and relevant sciences as well as the ability to inte.
Running head CONCEPT SYNTHESIS PAPER PERSONAL NURSING PHILOSOPHY.docxtodd271
Running head: CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 1
CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 10
Concept Synthesis Paper: Personal Nursing Philosophy
Yordanka Milanes
South University
Concept Synthesis Paper: Personal Nursing Philosophy
An understanding of nursing practice is made easier with a personal philosophy. Various theories have consequently been developed with the aim of defining practice concepts in this field. In specific, this paper focuses on Morse’s theory in nursing practice. The paper explores the author’s personal nursing autobiography in relation to Morse’s concepts of enduring and emotional suffering. In relation to Morse’s theory, the study discusses the four meta-paradigms namely person, health, nursing, and environment. Nurses who apply the identified concepts within the four meta-paradigms in personal philosophies attain positive outcomes.
Nursing Autobiography
My childhood desire was to serve and care for the needy people. Nursing was my target ambition, and now, I am in the profession. Throughout my role as a nurse practitioner, I have displayed acceptable standards of practices that achieve patient comfort and wellness. In reference to Morse’s concepts of enduring and emotional suffering, I serve with compassion and empathy with the aim of enhancing patient comfort and wellness. Having worked in the field of primary care, my zeal to exercise professionalism has consistently restored patient anguish and suffering. So as to achieve positive outcomes, I exhibit efficiency and effectiveness whenever dealing with patients. With frequent trainings that I undergo, I have developed a positive tendency of making influences on patients. More commonly, I try to advise them in line with Morse’s theory with the aim of facilitating their recovery and wellness.
It is paramount that I have advanced in my nursing philosophy. When handling patients, I specifically try to understand their needs, be it psychological, emotional, or even physical. In particular, this approach enables me to make personal contacts with affected patients in a bid to counter any associated enduring or emotional suffering. It is critical that my focus is based on paying special attention to suffering patients. It is essential that I employ nursing experience to address extreme cases. Against changing techniques in the healthcare setting, I have a philosophy of endeavoring to incorporate new ideas to enhance healing and comfort strategies. My aptitude to embrace diversity makes it easier for me to interact with all manner of patients irrespective of their backgrounds. In as much as I am proactively involved in nursing, I will always seek to equip myself with new knowledge to develop strategies for attaining emotional peace. My eagerness to integrate both preventive and curative measures is seen as fundamental in yielding positive patient outcomes.
Nursing Meta-paradigms in Morse’s Theory o.
Change Model Essay Assignment Discussion Paper.docx4934bk
This document discusses implementing a change initiative to improve pain management for surgery patients. It identifies theatre nurses' role in assessing and managing patient pain as problematic due to dependencies on doctors and constraints. Non-pharmaceutical pain management strategies are proposed to address this. Stakeholders like nurses and facility management would be impacted. Transformational leadership and the John Hopkins Nursing Model would guide the change process. Nursing personnel would serve as change agents. Barriers like resistance from medical personnel and funding would need addressing, and evaluation would compare pre-and post-change pain management outcomes. Formalizing successful changes into protocols would anchor the new approach.
Running Head PERSONAL PHILOSOPHY OF NURSINGPERSONAL PHILOSOPHY .docxgemaherd
Running Head: PERSONAL PHILOSOPHY OF NURSING
PERSONAL PHILOSOPHY OF NURSING
Personal Philosophy of Nursing
Personal Philosophy of Nursing
Keeping in mind the end goal to compose a philosophy of nursing, I trust that initial one must choose what philosophy intends to nurse practitioners. I think Meehan, (2012) expressed it best when she stated that philosophy is an approach toward life and realism that advances from every nurse practitioner convictions. This explanation gives me the opportunity to apply my own convictions. I don't need to acknowledge what another person has chosen. Scientists have been debating for quite a long time whether nursing is an art or a science. For what reason would it be able to not be both? I trust that to be a successful nurse practitioner someone must have the capacity to give the "art" of caring, and have the ambition to proceed to achieve and use the knowledge of "science" all through nursing profession. According to Jasmine (2009), nursing can be recognized as both science and art, in which caring formulates the nursing’s theoretical framework. Nursing and caring are based on a relational unity, understanding, and association between the patient and professional nursing. This idea is also echoed by Rose and Whitman (2003) in their article Using Art to Express a Personal Philosophy of Nursing. Whitman and Rose (2003) argue that one approach of isolating the influential and sensitive parts of nursing is to manage caring as the art of nursing. Without caring, the nurses and nurse practitioners can't unite with the patient. On the off chance that the practitioner can't unite, confidence won't develop. Without this faith in connection, helpful nursing won't occur. In this manner caring is at the focal point of all-effective nursing experiences. This isn't to make light of the worth of science. A proficient medical practitioner must have the capacity to utilize technical means accessible. The nursing practitioner ought to know about the life structures and physiology of the human body, pathology and recent rules for pharmacological treatment. This is a consistently changing body on learning. Science likewise incorporates the ability required to perform specialized undertakings. Nurse Educator model clarifies the science behind proficiency achievement. As medical practitioners we are all on a field to accomplish "expertise" in to each of the seven domains of skills.
As a nurse, I should first consider the idea of individuals. A man is substantially more than a person made through genomic technology and environmental impacts. They are considerably more prominent than the whole of his or her parts. They are a portion of the family, philosophy and society. I trust that adopting a patient focused strategy enables all people to be tended to, regarded and urged to achieve their maximum capacity. It is fundamental that the nurse practitioner perceive culture assorted range and racial variations, endeavoring to tre ...
Hildegard Peplau's theory of interpersonal relations focuses on the therapeutic relationship between nurse and patient and describes it as occurring in four phases: orientation, identification, exploitation, and resolution. The phases provide a simple framework for understanding the natural progression of the relationship. Peplau's theory emphasizes understanding the patient's perspective and helping them through communication and goal-setting. It can be applied to the nursing process to structure care and the relationship.
Running head PROFESSIONAL NURSING PHILOSOPHY1PROFESSIONAL N.docxtoltonkendal
Running head: PROFESSIONAL NURSING PHILOSOPHY 1
PROFESSIONAL NURSING PHILOSOPHY 7
Personal Philosophy of Advanced Nurse Practice Comment by Laura Wood: Follow this template outline This template title page can be applied to all future assignments
Cathy Wagner
MN502-1(October A)
Professor L. Alexander
November 5, 2017
Personal Philosophy of Advanced Nurse Practice Comment by Laura Wood: Title goes hereNo heading. Remember, the title of the paper is not a heading.
Human beings are viewed as unique life experiences. My personal philosophy of the advanced practice nurse is one who is compassionate, empathetic, well-rounded both in education and life experience. Communication, in abstract patterns, are just one of the aspects of an individually high level of complexity, as well as diversity, which sum up to further advance the knowledge of self and environment (Metaparadigm Concepts, 2014). It is important, not just for advanced practice nurses, but all nurses, to understand the value of every human being and to respect their decisions regarding their own health as well as providing appropriate guidance and coaching to live a healthy and full life.
Valued Personal Concepts Comment by Laura Wood: Level 1 Heading Here
Included in the metaparadigm concepts, involvement are the areas of nursing, person, health, and the environment, thus they further comprise the advanced-practice nurse (APN) and the concepts are as follows:
Nursing: when speaking in terms of nursing we look at what we do as nurses which includes our actions as well as interventions. This involves applying our professional knowledge already gained as well as direct and indirect patient contact (Thompson, 2017).
Person: involving family and close friends, including other caretakers for a patient, and that a nurse is engaged in the care of the patient across the lifespan (Thompson, 2017).
Health: this can be a relative term to each person as an individual and it is based on the patient’s perspective and understanding that each person has a different perspective, or idea, of healthy versus not healthy (Thompson, 2017).
Environment: can be any number of things which can include internal and external factors which can have an impact on a person’s health and this could include, but not limited to things such as genetics, culture, relationships, geographical location, etc., (Thompson, 2017).
Nursing Metaparadigm
Critical thinking skills, current research which translate into knowledge and skills into the nursing profession and thus must be goal-oriented, deliberate and systematic. Understanding that each person is an individual, we need to treat them as such and take into consideration the environment from which they come from as well as their understanding of their own health and what is healthy and what they perceive as being healthy versus unhealthy. Including family members as well as close friends in the care of our patients can truly benefit the patient if they h ...
This document presents a middle range theory for managing acute postoperative pain called "a balance between analgesia and side effects". The theory proposes using multimodal therapy, attentive nursing care, and patient participation to provide pain relief while minimizing side effects from opioid analgesics. It is intended for adult patients experiencing moderate to severe acute pain in inpatient hospital settings. The theory and its application to managing postoperative pain in abdominal surgery patients is analyzed using Fawcett's criteria for evaluating theories.
Theory of Integral Nursing to Clinical Practice Paper.docxwrite4
The document discusses applying the Theory of Integral Nursing to clinical practice, specifically pain management. It provides an overview of the theory, which focuses on healing through holism, caring relationships, and addressing people's mind, body and spirit. The theory emphasizes that people have an innate ability to heal and nurses facilitate this through trust-based relationships. It suggests the theory could help narrow the gap between nursing knowledge and practice by providing a framework to design comprehensive, client-centered interventions.
The nine Essentials addressed in this document delineate the knowl.docxarnoldmeredith47041
The nine Essentials addressed in this document delineate the knowledge and skills that all nurses prepared in master’s nursing programs acquire. These Essentials guide the preparation of graduates for diverse areas of practice in any healthcare setting.
• Essential I: Background for Practice from Sciences and Humanities o Recognizes that the master’s-prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.
• Essential II: Organizational and Systems Leadership o Recognizes that organizational and systems leadership are critical to the promotion of high quality and safe patient care. Leadership skills are needed that emphasize ethical and critical decision making, effective working relationships, and a systems-perspective.
• Essential III: Quality Improvement and Safety o Recognizes that a master’s-prepared nurse must be articulate in the methods, tools, performance measures, and standards related to quality, as well as prepared to apply quality principles within an organization.
• Essential IV: Translating and Integrating Scholarship into Practice o Recognizes that the master’s-prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.
• Essential V: Informatics and Healthcare Technologies. Recognizes that the master’s-prepared nurse uses patient-care technologies to deliver and enhance care and uses communication technologies to integrate and coordinate care.
• Essential VI: Health Policy and Advocacy o Recognizes that the master’s-prepared nurse is able to intervene at the system level through the policy development process and to employ advocacy strategies to influence health and health care.
• Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes o Recognizes that the master’s-prepared nurse, as a member and leader of interprofessional teams, communicates, collaborates, and consults with other health professionals to manage and coordinate care.
• Essential VIII: Clinical Prevention and Population Health for Improving Health o Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.
• Essential IX: Master’s-Level Nursing Practice o Recognizes that nursing practice, at the master’s level, is broadly defined as any form of nursing intervention that influences healthcare outcomes for individuals, populations, or systems. Master’s-level nursing graduates must have an advanced level of understanding of nursing and relevant sciences as well as the ability to inte.
Running head CONCEPT SYNTHESIS PAPER PERSONAL NURSING PHILOSOPHY.docxtodd271
Running head: CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 1
CONCEPT SYNTHESIS PAPER: PERSONAL NURSING PHILOSOPHY 10
Concept Synthesis Paper: Personal Nursing Philosophy
Yordanka Milanes
South University
Concept Synthesis Paper: Personal Nursing Philosophy
An understanding of nursing practice is made easier with a personal philosophy. Various theories have consequently been developed with the aim of defining practice concepts in this field. In specific, this paper focuses on Morse’s theory in nursing practice. The paper explores the author’s personal nursing autobiography in relation to Morse’s concepts of enduring and emotional suffering. In relation to Morse’s theory, the study discusses the four meta-paradigms namely person, health, nursing, and environment. Nurses who apply the identified concepts within the four meta-paradigms in personal philosophies attain positive outcomes.
Nursing Autobiography
My childhood desire was to serve and care for the needy people. Nursing was my target ambition, and now, I am in the profession. Throughout my role as a nurse practitioner, I have displayed acceptable standards of practices that achieve patient comfort and wellness. In reference to Morse’s concepts of enduring and emotional suffering, I serve with compassion and empathy with the aim of enhancing patient comfort and wellness. Having worked in the field of primary care, my zeal to exercise professionalism has consistently restored patient anguish and suffering. So as to achieve positive outcomes, I exhibit efficiency and effectiveness whenever dealing with patients. With frequent trainings that I undergo, I have developed a positive tendency of making influences on patients. More commonly, I try to advise them in line with Morse’s theory with the aim of facilitating their recovery and wellness.
It is paramount that I have advanced in my nursing philosophy. When handling patients, I specifically try to understand their needs, be it psychological, emotional, or even physical. In particular, this approach enables me to make personal contacts with affected patients in a bid to counter any associated enduring or emotional suffering. It is critical that my focus is based on paying special attention to suffering patients. It is essential that I employ nursing experience to address extreme cases. Against changing techniques in the healthcare setting, I have a philosophy of endeavoring to incorporate new ideas to enhance healing and comfort strategies. My aptitude to embrace diversity makes it easier for me to interact with all manner of patients irrespective of their backgrounds. In as much as I am proactively involved in nursing, I will always seek to equip myself with new knowledge to develop strategies for attaining emotional peace. My eagerness to integrate both preventive and curative measures is seen as fundamental in yielding positive patient outcomes.
Nursing Meta-paradigms in Morse’s Theory o.
Change Model Essay Assignment Discussion Paper.docx4934bk
This document discusses implementing a change initiative to improve pain management for surgery patients. It identifies theatre nurses' role in assessing and managing patient pain as problematic due to dependencies on doctors and constraints. Non-pharmaceutical pain management strategies are proposed to address this. Stakeholders like nurses and facility management would be impacted. Transformational leadership and the John Hopkins Nursing Model would guide the change process. Nursing personnel would serve as change agents. Barriers like resistance from medical personnel and funding would need addressing, and evaluation would compare pre-and post-change pain management outcomes. Formalizing successful changes into protocols would anchor the new approach.
Running Head PERSONAL PHILOSOPHY OF NURSINGPERSONAL PHILOSOPHY .docxgemaherd
Running Head: PERSONAL PHILOSOPHY OF NURSING
PERSONAL PHILOSOPHY OF NURSING
Personal Philosophy of Nursing
Personal Philosophy of Nursing
Keeping in mind the end goal to compose a philosophy of nursing, I trust that initial one must choose what philosophy intends to nurse practitioners. I think Meehan, (2012) expressed it best when she stated that philosophy is an approach toward life and realism that advances from every nurse practitioner convictions. This explanation gives me the opportunity to apply my own convictions. I don't need to acknowledge what another person has chosen. Scientists have been debating for quite a long time whether nursing is an art or a science. For what reason would it be able to not be both? I trust that to be a successful nurse practitioner someone must have the capacity to give the "art" of caring, and have the ambition to proceed to achieve and use the knowledge of "science" all through nursing profession. According to Jasmine (2009), nursing can be recognized as both science and art, in which caring formulates the nursing’s theoretical framework. Nursing and caring are based on a relational unity, understanding, and association between the patient and professional nursing. This idea is also echoed by Rose and Whitman (2003) in their article Using Art to Express a Personal Philosophy of Nursing. Whitman and Rose (2003) argue that one approach of isolating the influential and sensitive parts of nursing is to manage caring as the art of nursing. Without caring, the nurses and nurse practitioners can't unite with the patient. On the off chance that the practitioner can't unite, confidence won't develop. Without this faith in connection, helpful nursing won't occur. In this manner caring is at the focal point of all-effective nursing experiences. This isn't to make light of the worth of science. A proficient medical practitioner must have the capacity to utilize technical means accessible. The nursing practitioner ought to know about the life structures and physiology of the human body, pathology and recent rules for pharmacological treatment. This is a consistently changing body on learning. Science likewise incorporates the ability required to perform specialized undertakings. Nurse Educator model clarifies the science behind proficiency achievement. As medical practitioners we are all on a field to accomplish "expertise" in to each of the seven domains of skills.
As a nurse, I should first consider the idea of individuals. A man is substantially more than a person made through genomic technology and environmental impacts. They are considerably more prominent than the whole of his or her parts. They are a portion of the family, philosophy and society. I trust that adopting a patient focused strategy enables all people to be tended to, regarded and urged to achieve their maximum capacity. It is fundamental that the nurse practitioner perceive culture assorted range and racial variations, endeavoring to tre ...
Hildegard Peplau's theory of interpersonal relations focuses on the therapeutic relationship between nurse and patient and describes it as occurring in four phases: orientation, identification, exploitation, and resolution. The phases provide a simple framework for understanding the natural progression of the relationship. Peplau's theory emphasizes understanding the patient's perspective and helping them through communication and goal-setting. It can be applied to the nursing process to structure care and the relationship.
Running head PROFESSIONAL NURSING PHILOSOPHY1PROFESSIONAL N.docxtoltonkendal
Running head: PROFESSIONAL NURSING PHILOSOPHY 1
PROFESSIONAL NURSING PHILOSOPHY 7
Personal Philosophy of Advanced Nurse Practice Comment by Laura Wood: Follow this template outline This template title page can be applied to all future assignments
Cathy Wagner
MN502-1(October A)
Professor L. Alexander
November 5, 2017
Personal Philosophy of Advanced Nurse Practice Comment by Laura Wood: Title goes hereNo heading. Remember, the title of the paper is not a heading.
Human beings are viewed as unique life experiences. My personal philosophy of the advanced practice nurse is one who is compassionate, empathetic, well-rounded both in education and life experience. Communication, in abstract patterns, are just one of the aspects of an individually high level of complexity, as well as diversity, which sum up to further advance the knowledge of self and environment (Metaparadigm Concepts, 2014). It is important, not just for advanced practice nurses, but all nurses, to understand the value of every human being and to respect their decisions regarding their own health as well as providing appropriate guidance and coaching to live a healthy and full life.
Valued Personal Concepts Comment by Laura Wood: Level 1 Heading Here
Included in the metaparadigm concepts, involvement are the areas of nursing, person, health, and the environment, thus they further comprise the advanced-practice nurse (APN) and the concepts are as follows:
Nursing: when speaking in terms of nursing we look at what we do as nurses which includes our actions as well as interventions. This involves applying our professional knowledge already gained as well as direct and indirect patient contact (Thompson, 2017).
Person: involving family and close friends, including other caretakers for a patient, and that a nurse is engaged in the care of the patient across the lifespan (Thompson, 2017).
Health: this can be a relative term to each person as an individual and it is based on the patient’s perspective and understanding that each person has a different perspective, or idea, of healthy versus not healthy (Thompson, 2017).
Environment: can be any number of things which can include internal and external factors which can have an impact on a person’s health and this could include, but not limited to things such as genetics, culture, relationships, geographical location, etc., (Thompson, 2017).
Nursing Metaparadigm
Critical thinking skills, current research which translate into knowledge and skills into the nursing profession and thus must be goal-oriented, deliberate and systematic. Understanding that each person is an individual, we need to treat them as such and take into consideration the environment from which they come from as well as their understanding of their own health and what is healthy and what they perceive as being healthy versus unhealthy. Including family members as well as close friends in the care of our patients can truly benefit the patient if they h ...
This document presents a middle range theory for managing acute postoperative pain called "a balance between analgesia and side effects". The theory proposes using multimodal therapy, attentive nursing care, and patient participation to provide pain relief while minimizing side effects from opioid analgesics. It is intended for adult patients experiencing moderate to severe acute pain in inpatient hospital settings. The theory and its application to managing postoperative pain in abdominal surgery patients is analyzed using Fawcett's criteria for evaluating theories.
The document discusses nursing metaparadigms and Betty Neuman's Systems Model. It describes Neuman's concepts of the person, environment, health, and nursing. It explains how Neuman sees the client as an open system that interacts with inputs, processes, outputs, and feedback. The document also provides an example of how Neuman's model can be applied to care for a newborn with a congenital heart defect through various levels of prevention.
Concept & Philosophy For APN Highest level-Quality Clinical Ca.docxdonnajames55
The document discusses a nursing concept focused on providing the highest quality clinical care. It outlines the Nurse Practitioner Care Model and Nightingale's Environmental Theory that inform this concept. The NP Care Model aims to facilitate high quality care through role clarification and a supportive delivery system. Nightingale's Theory argues that environmental quality is crucial for healing. The document also presents the author's nursing philosophy that quality care requires an idealist-realist view and commitment to improving life quality.
This presentation aims to explore the concept of shared governance in nursing and discuss the principles and models underpinning practice. It also aims to present the obstacles to effective implementation.
Delivering compassionate care to older adults across the care spectrumanne spencer
This document discusses how complementary therapies can restore compassion in nursing care for older adults. It describes the background of the complementary therapy service in Claremont, which provides therapies like massage, aromatherapy and reflexology. These therapies can help reduce medications and enhance quality of life by addressing physical, emotional and spiritual needs. The role of the Clinical Nurse Specialist is to integrate these therapies into care, evaluate clients, and collaborate with staff to provide compassionate, holistic care for older adults. Complementary therapies are seen as a compassionate way to relieve suffering through touch and communication, especially for those with dementia.
Introduction to professional nursing concepts and practicesRushilaLaishram
Nursing theory and models provide a framework for nursing practice and the development of specialized nursing knowledge. Theories are conceptual frameworks that describe, explain, and predict phenomena related to nursing. They consist of concepts, definitions, relationships, and assumptions. Models demonstrate how theories can be applied in practice. The nursing metaparadigm defines the major concepts of nursing as the person, environment, health, and nursing. Nursing theories are important as they guide practice, provide a basis for research, and enhance communication within the profession.
Introduction to professional nursing concepts and practicesRushilaLaishram
Nursing theory and models provide a framework for nursing practice and the development of specialized nursing knowledge. Theories are conceptual frameworks that describe, explain, and predict phenomena related to nursing. They consist of concepts, definitions, relationships, and assumptions. Models are representations of theories that demonstrate how concepts interact. Theories and models help nurses assess patients, plan care, and ensure uniformity in care delivery. Developing nursing theory establishes nursing as a unique profession and guides research, education, and the advancement of the nursing knowledge base.
This document provides a concept analysis of holistic nursing using Rodgers' evolutionary concept analysis method. It defines holistic nursing as nursing that aims to heal the whole person. Related concepts like complementary/alternative care, integrative health, are encompassed under holistic nursing. Through analyzing literature, the document identifies antecedents and consequences of holistic nursing. It also provides a case study example and discusses tools to measure holistic nursing, identifying the Holistic Caring Inventory as a relevant tool but noting it could be improved to capture more recent aspects of holistic nursing.
Hildegard Peplau developed the Theory of Interpersonal Relations, which views nursing as a therapeutic interpersonal process between nurse and patient. The theory outlines four phases of the nurse-patient relationship (orientation, identification, exploitation, resolution) and defines key nursing roles. Peplau's theory influenced the development of the nursing process and remains influential in psychiatric nursing. Virginia Henderson defined nursing as assisting individuals with 14 components of basic human needs in order to gain independence. Her work emphasizes health promotion and influenced how nursing is practiced worldwide. Both theorists viewed nursing holistically and focused on the nurse-patient relationship to achieve health-related goals.
Chapter 22 Theories Focused on CaringJoanne R. DuffyINTRODUCTEstelaJeffery653
Chapter 22: Theories Focused on Caring
Joanne R. Duffy
INTRODUCTION
Caring is an evolving human science (Watson, 2012), a relational process (Duffy, 2013), a “nurturing way to relate to a valued other” (Swanson, 2016), and a way of being human (Roach, 1987) that enhances personhood (Boykin & Schoenhofer, 2001a). According to Duffy (2009, 2013), when practiced authentically, caring relationships lead to feeling “cared for,” an antecedent to optimal patient, nurse, and system outcomes. It has been the subject of much focus in nursing for the last 30 years, having formerly been described as the “moral ideal of nursing” (Watson, 1985, p. 29) and used by many to guide research, design measurement tools, lead, educate, and practice professional nursing. Some have contended that caring is the essence of nursing (Leininger, 1984; Watson, 1979, 1985), while others have asserted that caring is not solely the purview of nursing (Boykin & Schoenhofer, 2015). Within the disciplinary interpretation of nursing, however, caring has been a central tenet not only for theorists, but also for students and nursing educators, and is deeply reflected in the American Nurses Association’s Code for Nurses With Interpretive Statements (Boykin & Schoenhofer, 2015). Duffy (2013) contends that in the larger context of healthcare systems, when relationships among patients, families, nurses, and the entire healthcare team are of a caring nature, intermediate consequences occur, enabling forward progress or advancement.
Caring is a universal phenomenon that occurs in all societies and cultures (Leininger, 1978, 1991). In fact, Watson (2012) views human caring as a process that is “connected to universal human struggles and human tasks” (p. x). It is manifested most noticeably in many families. For example, in the parent–child relationship, parents can be observed delivering physical, emotional, and educative actions that enhance safety, promote physical growth, and encourage emotional and cognitive development in their children. According to Mayerhoff (1970), caring is essential for the attainment of such human goals. Thus, caring relationships are transforming in that they facilitate human change, growth, and forward movement, adding significantly to the evolution of human life. In the parent–child relationship, parental caring actions are founded on a loving bond or connection between parent and child that assumes expanded potentials and future advancement in the children. In the patient–nurse relationship, caring actions are founded on disciplinary values and the use of relational strategies that provide the context for specific nursing interventions that ultimately engender advancement (in terms of improving health outcomes) in recipients.
In the context of health care, the vulnerability of persons of all ages and backgrounds creates an unusual dependency on healthcare providers (in this case, professional nurses) for behaviors, skills, and attitudes that help protect pa ...
Running head STRENGTH BASED NURSING1STRENGTH BASED NURSING.docxtodd521
Running head: STRENGTH BASED NURSING 1
STRENGTH BASED NURSING 5
Strength Based Nursing
Strength-based nursing refers an approach to health care which promotes empowerment, hope, and self-efficacy. This approach acts as a guideline to health delivery for people and families and is at the front position of international reforms in health care and developments in nursing. This approach aims to optimize the well being of human beings, health and make better conditions for healing in the human lifespan. The approach works with persons and family strengths and resources together with the individual family and healthcare group (Melnyk, 2015). The approach is based on five main principles which include Person/family-centered care is a principle which is based on mutually cooperative partnerships among families, patients, and healthcare providers according to (Coyne, et al 2018). The principle redefines relationships in health care through emphasizing on collaborating with people of all levels and ages in all the healthcare settings. This principle aims to support the health and individuals well being as well as their families and uphold their control. The core concepts of this principle are participation, collaboration, sharing of information, dignity, and respect. Empowerment is also a strength-based nursing principle. This principle underpins the strengths model outlook of people as an energetic contributor in the delivery of service instead of diagnostic categories, passive consumers, and objects to be managed (Noble et al., 2000, p. 144). Health promotion and healing, the third principle aims at ensuring that better care is provided to the patients. The general emphasis of this principle is to ensure that the general outcome in health care is positive. The principle of Collaborative partnership aims at building a strong relationship between the patient, family, community and the professionals. All the parties involved in the partnership share a common goal which is better health care. Innate capacities for health and healing which the last principle of strength based nursing views people as inherently whole. Therefore mental health can be controlled by individuals and that can influence other factors of life such as the behaviour of an individual. While caring for families and the caregivers should also focus on the inner strengths (Castro et al 2016)
Strength-based Nursing is Built on Eight Core Values which Include: Health and healing: According to SBN, health and healing are the core goals of nursing. Health helps people to be flexible to challenges in life. Healing brings back wholeness and leads to the rediscovery of equilibrium. Uniqueness recognizes the fact that no one is like another person. All people are genetically dissimilar and have specific dissemination. Holism and embodiment is a value that recognizes how different parts of the human body are interconnected since they affect each other and the performan.
Nursing is both an art and a science. The science of nursing examines the relationship among person, health and environment. The art of nursing is embedded in caring relationship between nurse and client.
As an increasingly emerging profession, nursing is now deeply involved in identifying its own unique body of knowledge that is essential to nursing practice. The development of a body of knowledge is basic to any professional discipline, which can be applied to its practice. Such knowledge often expressed in terms of concepts and theories in the area of the behavioral or social sciences.
Individual factors like experience, knowledge, creative thinking and self-concept influence clinical reasoning and decision-making in nursing. Effective communication, appropriate staffing levels and skills mix, ongoing education and training, and adequate resources also impact clinical decision-making and patient outcomes. Intuition plays a role in expert nurses' clinical reasoning, though reliance on intuition alone is not sufficient and must be supported by rational analysis and evidence-based practice. Developing strong clinical reasoning skills is important for nurses to explain treatment choices and provide high-quality, safe patient care.
The document discusses alternative methods of pain treatment being investigated, such as using cannabis as an alternative to opioids for chronic pain management. It notes that while medical marijuana laws have passed in some states and cities, opioids currently remain the standard treatment approved in New York where the author is training to be a nurse. The author believes they may need to educate themselves on cannabis as a possible future treatment option for patients, depending on changes to state legislation.
My task is only to give a positive opinion of.docxstirlingvwriters
1. The document discusses two discussions about Peplau's nursing theory and the surrogate nurse role.
2. Peplau's theory outlines four phases of the patient-nurse relationship and defines the surrogate role as substituting for a significant person in the patient's life.
3. While the surrogate role is less emphasized today, both discussions argue it remains relevant and important for developing patient independence, interdependence, and dependence.
The document discusses the Parse Theory of human becoming and its application in a case study involving a nurse caring for a patient named Ben and his wife Ann. It provides an overview of the Parse Theory, which focuses on understanding the human as a unified whole through physiological, sociological, biological and spiritual aspects. It also examines characteristics of the theory like meaning, rhythmicity and transcendence. The document then discusses how the nurse can apply the Parse Theory and Peplau's Theory to develop a care plan for Ben and Ann based on understanding their experiences from their perspectives.
1. Hildegard Peplau was an influential American nursing theorist known for developing the theory of interpersonal relations. 2. Her theory emphasized the nurse-client relationship and established phases to guide the progression of this relationship from stranger to resolution. 3. Peplau was influenced by her experiences as a psychiatric nurse and believed the interpersonal process between nurse and client was therapeutic and essential to treatment.
1. Discuss the organization and the family role in every one of the.docxcroysierkathey
1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.
2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.
References must be no older than 5 years. A minimum of 700 words is required.
.
1. Compare and contrast DEmilios Capitalism and Gay Identity .docxcroysierkathey
1. Compare and contrast D'Emilio's
Capitalism and Gay Identity
with the
From Mary to Modern Woman
reading. What patterns do you see that are similar to the modern American society? What can be said about global notions of gender in the modern age? Feel free to invoke Foucault.
2. How is the writer's experience important in the story being told in
Middlesex
? Describe your reaction to the reading and invoke some of the concepts discussed in the
Queer Theory
reading to try to make sense of sexuality when it does not match your own conventions. Compare both readings, but go deeper to explore your own stereotypes and socialization.
**PLEASE READ THE READINGS IN ODER TO DO THIS ASSIGNMENT.
.
1.Purpose the purpose of this essay is to spread awareness .docxcroysierkathey
1.
Purpose: the purpose of this essay is to spread awareness around stereotyping and how it can be very hurtful to some people.
2.
Audience: Anyone that uses stereotypical jokes or saying around people that are different than them even without realizing that they are making a stereotypical joke or statement.
3.
Genre: the genre that I will be trying to reach out to in this essay will be informational, reason being is that I mainly look at informational online documentaries and stories.
4.
Stance and tone: I’m just a young man who grew up around a lot of people from different places and have different cultures and never paid attention in my younger years to what was happening from stereotyping others that they are different till recently.
5.
Graphic design
: My essay will be a strict academic essay
.
1. Tell us why it is your favorite film.2. Talk about the .docxcroysierkathey
1. Tell us why it is your favorite film.
2. Talk about the interconnection between the aesthetic and the technical aspects of the film. This should include at least seven of the following: Editing, Film Structure, Cinematography, Lighting, Colors, Screenwriting, Special effects, Sound and Music.
3. After this course, will you see you favorite film in a different light? Why or why not?
.
1.What are the main issues facing Fargo and Town Manager Susan.docxcroysierkathey
1.What are the main issues facing Fargo and Town Manager Susan Harlow?
Fargo and Town Manager Harlow are on a slippery slope to corruption. I think that Harlow is handling her position the correct way by trying to remain neutral and sticking to a code of ethics so the problem really comes down to the political actors in the town. It is good that Harlow declined the invite to the dinner party, and cracked down on employees playing politics at work, that is a step in the right direction to removing the possibility of political corruption.
2.What is the basis for your answer to question #1?
At the end of the article Harlow remembers another city manager saying “you never have more authority than the day you walk into your office” What I get from that, and what I think Harlow got from that is that when you come into a position as a public manager everyone is going to want something from you. Political actors are going to want political favors, quid pro quos, you have something that everyone else wants and they are going to try and get that from you.
3.What are your recommended solutions to the problems you identified?
I think the best thing to do would be to continue to try to remain neutral. It will always be impossible to please absolutely everybody so the best thing to do is try to avoid doing everything everyone asks and stick to some sort of code of ethics.
4.What points do you agree, disagree or want further discussion from your fellow classmates and why? (tell them not me)
I think the overarching theme of this article is that people are going to want things from the government. I agree with Harlow's steps to avoid political corruption in her administration by cracking down on political favors with the snow plows and referring to the ICMA code of ethics.
.
1.Writing Practice in Reading a PhotographAttached Files.docxcroysierkathey
This document provides instructions for analyzing a photograph by Jonathan Bachman titled "Bachman, Ieshia Evans, Baton Rouge (2016)". Students are asked to select three rhetorical elements from a provided list and write three paragraphs analyzing how each element contributes to the overall meaning or message of the photograph. Additional context is provided about when and where the photo was taken, and that it was a finalist for a Pulitzer Prize. Students are then given similar instructions to analyze a political advertisement, and to watch and take notes on the documentary film "Advertising and the End of the World" by Sut Jhally. A folder of additional images is also provided for future analysis.
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Nursing theory and models provide a framework for nursing practice and the development of specialized nursing knowledge. Theories are conceptual frameworks that describe, explain, and predict phenomena related to nursing. They consist of concepts, definitions, relationships, and assumptions. Models demonstrate how theories can be applied in practice. The nursing metaparadigm defines the major concepts of nursing as the person, environment, health, and nursing. Nursing theories are important as they guide practice, provide a basis for research, and enhance communication within the profession.
Introduction to professional nursing concepts and practicesRushilaLaishram
Nursing theory and models provide a framework for nursing practice and the development of specialized nursing knowledge. Theories are conceptual frameworks that describe, explain, and predict phenomena related to nursing. They consist of concepts, definitions, relationships, and assumptions. Models are representations of theories that demonstrate how concepts interact. Theories and models help nurses assess patients, plan care, and ensure uniformity in care delivery. Developing nursing theory establishes nursing as a unique profession and guides research, education, and the advancement of the nursing knowledge base.
This document provides a concept analysis of holistic nursing using Rodgers' evolutionary concept analysis method. It defines holistic nursing as nursing that aims to heal the whole person. Related concepts like complementary/alternative care, integrative health, are encompassed under holistic nursing. Through analyzing literature, the document identifies antecedents and consequences of holistic nursing. It also provides a case study example and discusses tools to measure holistic nursing, identifying the Holistic Caring Inventory as a relevant tool but noting it could be improved to capture more recent aspects of holistic nursing.
Hildegard Peplau developed the Theory of Interpersonal Relations, which views nursing as a therapeutic interpersonal process between nurse and patient. The theory outlines four phases of the nurse-patient relationship (orientation, identification, exploitation, resolution) and defines key nursing roles. Peplau's theory influenced the development of the nursing process and remains influential in psychiatric nursing. Virginia Henderson defined nursing as assisting individuals with 14 components of basic human needs in order to gain independence. Her work emphasizes health promotion and influenced how nursing is practiced worldwide. Both theorists viewed nursing holistically and focused on the nurse-patient relationship to achieve health-related goals.
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Chapter 22: Theories Focused on Caring
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INTRODUCTION
Caring is an evolving human science (Watson, 2012), a relational process (Duffy, 2013), a “nurturing way to relate to a valued other” (Swanson, 2016), and a way of being human (Roach, 1987) that enhances personhood (Boykin & Schoenhofer, 2001a). According to Duffy (2009, 2013), when practiced authentically, caring relationships lead to feeling “cared for,” an antecedent to optimal patient, nurse, and system outcomes. It has been the subject of much focus in nursing for the last 30 years, having formerly been described as the “moral ideal of nursing” (Watson, 1985, p. 29) and used by many to guide research, design measurement tools, lead, educate, and practice professional nursing. Some have contended that caring is the essence of nursing (Leininger, 1984; Watson, 1979, 1985), while others have asserted that caring is not solely the purview of nursing (Boykin & Schoenhofer, 2015). Within the disciplinary interpretation of nursing, however, caring has been a central tenet not only for theorists, but also for students and nursing educators, and is deeply reflected in the American Nurses Association’s Code for Nurses With Interpretive Statements (Boykin & Schoenhofer, 2015). Duffy (2013) contends that in the larger context of healthcare systems, when relationships among patients, families, nurses, and the entire healthcare team are of a caring nature, intermediate consequences occur, enabling forward progress or advancement.
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In the context of health care, the vulnerability of persons of all ages and backgrounds creates an unusual dependency on healthcare providers (in this case, professional nurses) for behaviors, skills, and attitudes that help protect pa ...
Running head STRENGTH BASED NURSING1STRENGTH BASED NURSING.docxtodd521
Running head: STRENGTH BASED NURSING 1
STRENGTH BASED NURSING 5
Strength Based Nursing
Strength-based nursing refers an approach to health care which promotes empowerment, hope, and self-efficacy. This approach acts as a guideline to health delivery for people and families and is at the front position of international reforms in health care and developments in nursing. This approach aims to optimize the well being of human beings, health and make better conditions for healing in the human lifespan. The approach works with persons and family strengths and resources together with the individual family and healthcare group (Melnyk, 2015). The approach is based on five main principles which include Person/family-centered care is a principle which is based on mutually cooperative partnerships among families, patients, and healthcare providers according to (Coyne, et al 2018). The principle redefines relationships in health care through emphasizing on collaborating with people of all levels and ages in all the healthcare settings. This principle aims to support the health and individuals well being as well as their families and uphold their control. The core concepts of this principle are participation, collaboration, sharing of information, dignity, and respect. Empowerment is also a strength-based nursing principle. This principle underpins the strengths model outlook of people as an energetic contributor in the delivery of service instead of diagnostic categories, passive consumers, and objects to be managed (Noble et al., 2000, p. 144). Health promotion and healing, the third principle aims at ensuring that better care is provided to the patients. The general emphasis of this principle is to ensure that the general outcome in health care is positive. The principle of Collaborative partnership aims at building a strong relationship between the patient, family, community and the professionals. All the parties involved in the partnership share a common goal which is better health care. Innate capacities for health and healing which the last principle of strength based nursing views people as inherently whole. Therefore mental health can be controlled by individuals and that can influence other factors of life such as the behaviour of an individual. While caring for families and the caregivers should also focus on the inner strengths (Castro et al 2016)
Strength-based Nursing is Built on Eight Core Values which Include: Health and healing: According to SBN, health and healing are the core goals of nursing. Health helps people to be flexible to challenges in life. Healing brings back wholeness and leads to the rediscovery of equilibrium. Uniqueness recognizes the fact that no one is like another person. All people are genetically dissimilar and have specific dissemination. Holism and embodiment is a value that recognizes how different parts of the human body are interconnected since they affect each other and the performan.
Nursing is both an art and a science. The science of nursing examines the relationship among person, health and environment. The art of nursing is embedded in caring relationship between nurse and client.
As an increasingly emerging profession, nursing is now deeply involved in identifying its own unique body of knowledge that is essential to nursing practice. The development of a body of knowledge is basic to any professional discipline, which can be applied to its practice. Such knowledge often expressed in terms of concepts and theories in the area of the behavioral or social sciences.
Individual factors like experience, knowledge, creative thinking and self-concept influence clinical reasoning and decision-making in nursing. Effective communication, appropriate staffing levels and skills mix, ongoing education and training, and adequate resources also impact clinical decision-making and patient outcomes. Intuition plays a role in expert nurses' clinical reasoning, though reliance on intuition alone is not sufficient and must be supported by rational analysis and evidence-based practice. Developing strong clinical reasoning skills is important for nurses to explain treatment choices and provide high-quality, safe patient care.
The document discusses alternative methods of pain treatment being investigated, such as using cannabis as an alternative to opioids for chronic pain management. It notes that while medical marijuana laws have passed in some states and cities, opioids currently remain the standard treatment approved in New York where the author is training to be a nurse. The author believes they may need to educate themselves on cannabis as a possible future treatment option for patients, depending on changes to state legislation.
My task is only to give a positive opinion of.docxstirlingvwriters
1. The document discusses two discussions about Peplau's nursing theory and the surrogate nurse role.
2. Peplau's theory outlines four phases of the patient-nurse relationship and defines the surrogate role as substituting for a significant person in the patient's life.
3. While the surrogate role is less emphasized today, both discussions argue it remains relevant and important for developing patient independence, interdependence, and dependence.
The document discusses the Parse Theory of human becoming and its application in a case study involving a nurse caring for a patient named Ben and his wife Ann. It provides an overview of the Parse Theory, which focuses on understanding the human as a unified whole through physiological, sociological, biological and spiritual aspects. It also examines characteristics of the theory like meaning, rhythmicity and transcendence. The document then discusses how the nurse can apply the Parse Theory and Peplau's Theory to develop a care plan for Ben and Ann based on understanding their experiences from their perspectives.
1. Hildegard Peplau was an influential American nursing theorist known for developing the theory of interpersonal relations. 2. Her theory emphasized the nurse-client relationship and established phases to guide the progression of this relationship from stranger to resolution. 3. Peplau was influenced by her experiences as a psychiatric nurse and believed the interpersonal process between nurse and client was therapeutic and essential to treatment.
Similar to Key Words Holism, nursing theory, painmanagement, caring,.docx (16)
1. Discuss the organization and the family role in every one of the.docxcroysierkathey
1. Discuss the organization and the family role in every one of the heritages mentioned about and how they affect (positively or negatively) the delivery of health care.
2. Identify sociocultural variables within the Irish, Italian and Puerto Rican heritage and mention some examples.
References must be no older than 5 years. A minimum of 700 words is required.
.
1. Compare and contrast DEmilios Capitalism and Gay Identity .docxcroysierkathey
1. Compare and contrast D'Emilio's
Capitalism and Gay Identity
with the
From Mary to Modern Woman
reading. What patterns do you see that are similar to the modern American society? What can be said about global notions of gender in the modern age? Feel free to invoke Foucault.
2. How is the writer's experience important in the story being told in
Middlesex
? Describe your reaction to the reading and invoke some of the concepts discussed in the
Queer Theory
reading to try to make sense of sexuality when it does not match your own conventions. Compare both readings, but go deeper to explore your own stereotypes and socialization.
**PLEASE READ THE READINGS IN ODER TO DO THIS ASSIGNMENT.
.
1.Purpose the purpose of this essay is to spread awareness .docxcroysierkathey
1.
Purpose: the purpose of this essay is to spread awareness around stereotyping and how it can be very hurtful to some people.
2.
Audience: Anyone that uses stereotypical jokes or saying around people that are different than them even without realizing that they are making a stereotypical joke or statement.
3.
Genre: the genre that I will be trying to reach out to in this essay will be informational, reason being is that I mainly look at informational online documentaries and stories.
4.
Stance and tone: I’m just a young man who grew up around a lot of people from different places and have different cultures and never paid attention in my younger years to what was happening from stereotyping others that they are different till recently.
5.
Graphic design
: My essay will be a strict academic essay
.
1. Tell us why it is your favorite film.2. Talk about the .docxcroysierkathey
1. Tell us why it is your favorite film.
2. Talk about the interconnection between the aesthetic and the technical aspects of the film. This should include at least seven of the following: Editing, Film Structure, Cinematography, Lighting, Colors, Screenwriting, Special effects, Sound and Music.
3. After this course, will you see you favorite film in a different light? Why or why not?
.
1.What are the main issues facing Fargo and Town Manager Susan.docxcroysierkathey
1.What are the main issues facing Fargo and Town Manager Susan Harlow?
Fargo and Town Manager Harlow are on a slippery slope to corruption. I think that Harlow is handling her position the correct way by trying to remain neutral and sticking to a code of ethics so the problem really comes down to the political actors in the town. It is good that Harlow declined the invite to the dinner party, and cracked down on employees playing politics at work, that is a step in the right direction to removing the possibility of political corruption.
2.What is the basis for your answer to question #1?
At the end of the article Harlow remembers another city manager saying “you never have more authority than the day you walk into your office” What I get from that, and what I think Harlow got from that is that when you come into a position as a public manager everyone is going to want something from you. Political actors are going to want political favors, quid pro quos, you have something that everyone else wants and they are going to try and get that from you.
3.What are your recommended solutions to the problems you identified?
I think the best thing to do would be to continue to try to remain neutral. It will always be impossible to please absolutely everybody so the best thing to do is try to avoid doing everything everyone asks and stick to some sort of code of ethics.
4.What points do you agree, disagree or want further discussion from your fellow classmates and why? (tell them not me)
I think the overarching theme of this article is that people are going to want things from the government. I agree with Harlow's steps to avoid political corruption in her administration by cracking down on political favors with the snow plows and referring to the ICMA code of ethics.
.
1.Writing Practice in Reading a PhotographAttached Files.docxcroysierkathey
This document provides instructions for analyzing a photograph by Jonathan Bachman titled "Bachman, Ieshia Evans, Baton Rouge (2016)". Students are asked to select three rhetorical elements from a provided list and write three paragraphs analyzing how each element contributes to the overall meaning or message of the photograph. Additional context is provided about when and where the photo was taken, and that it was a finalist for a Pulitzer Prize. Students are then given similar instructions to analyze a political advertisement, and to watch and take notes on the documentary film "Advertising and the End of the World" by Sut Jhally. A folder of additional images is also provided for future analysis.
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1.Some say that analytics in general dehumanize managerial activities, and others say they do not. Discuss arguments for both points of view.
2.What are some of the major privacy concerns in employing intelligent systems on mobile data?
3. Identify some cases of violations of user privacy from current literature and their impact on data science as a profession.
4.Search the Internet to find examples of how intelligent systems can facilitate activities such as empowerment, mass customization, and teamwork.
Note: Each question must be answered in 5 lines and refrences must be APA cited.
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1.What is the psychological term for the symptoms James experiences after abstaining from consuming
alcohol? How do changes in the functioning of neurotransmitter systems produce these symptoms?
2.With reference to associative learning principles/models/theories, why does James consume alcohol
to alleviate these symptoms? What motivates his drinking behaviour given that he no longer enjoys this
activity (most of the time)?
3.How do these factors prevent James from quitting his drinking, and lead to a cycle of relapse when he
attempts to do so? Why are these processes important for our understanding of addiction and
substance use disorders.
1 Page
at least 3 sources
APA
.
1.Write at least 500 words discussing the benefits of using R with H.docxcroysierkathey
1.Write at least 500 words discussing the benefits of using R with Hadoop. Use APA format and Include at least 3 quotes from your sources enclosed in quotation marks.
2.Write at least 500 words discussing how insurance companies use text mining to reduce fraud. Use APA format and Include at least 3 quotes from your sources enclosed in quotation marks.
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1.What is Starbucks’ ROA for 2012, 2011, and 2010 Why might focusin.docxcroysierkathey
1.What is Starbucks’ ROA for 2012, 2011, and 2010? Why might focusing specifically on ROA be misleading when assessing asset management (aka management efficiency)?
2.Why is ROE considered the most useful metric in measuring the overall ability of a business strategy to generate returns for shareholders?
3. How do the financial statements reveal company strategy (i.e., what story do the numbers tell and does that story align with the strategy of Starbucks?)?
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1. Discuss the cultural development of the Japanese and the Jewis.docxcroysierkathey
This assignment requires discussing the cultural development of the Japanese and Jewish heritage in regards to their health care beliefs and how those beliefs influence evidence-based health care delivery. At least two references no older than five years must be used, and the paper must be a minimum of 600 words excluding the cover page and references.
1. Discuss at least 2 contextual factors(family, peers, school,.docxcroysierkathey
1.
Discuss at least 2 contextual factors(family, peers, school, community, work, etc.) that might make young people more or less likely to experience adolescence as a period of storm and stress.
2. How might the dramatic physical changes that adolescents undergo—and the accompanying reactions from others—influence other aspects of development, such as social or emotional development?
3. Describe some ways in which adolescent decision making is a product of interactions among puberty, brain development, cognitive growth, and contextual influences such as parents, peers, and community.
.
1.Write at least 500 words in APA format discussing how to use senti.docxcroysierkathey
1.Write at least 500 words in APA format discussing how to use sentiment analysis how political speech affects voters. Use at least 3 references in APA format.
2.Read the below article(link below) on statistics for categorical variables. Write at least 500 words in APA format discussing how to use these statistics to help understand big data.
Link: https://uc-r.github.io/descriptives_categorical
.
1.The following clause was added to the Food and Drug Actthe S.docxcroysierkathey
1.The following clause was added to the Food and Drug Act:
“the Secretary [of the Food and Drug Administration] shall not approve for use in food any chemical additive found to induce cancer in man, or, after tests, found to induce cancer in animals.”
After this clause was adopted, no new additives could be approved for use in food if they caused cancer in people or animals.
The public loved this and industry hated it.
What do you think of this clause? Do you support it or do you oppose it?
At the top of your post, please indicate SUPPORT or OPPOSE and then give your rationale. Then after you can view your classmates' posts, make your case to your fellow students.
2.There was a law that individuals who were indigent and who wished to litigate could apply to the courts for a total waiver of the normal filing fee. In the legislative session, however, a statute was enacted which limits the courts' authority to waive filing fees in lawsuits brought by prisoners against the state government.
Under this new law, a court has to require the prisoner to pay a filing fee "equal to 20 percent ... of the average monthly deposits made to the prisoner's [prison] account ... or the average balance in that account", whichever is greater (unless this calculation yields a figure larger than the normal filing fee).
A prisoner (who was indigent) wanted to appeal his case and was to be charged this fee. He filed suit claiming it was unconstitutional to charge this fee to prisoners.
Choose the side of the prisoner or the side of the state and tell why you would rule for the side you chose.
At the top of your post, please indicate SUPPORT PRISONER or OPPOSE PRISONER and then give your rationale. After you can view your classmates' posts, make your case to your fellow students.
3.A defendant pleaded guilty to receiving and possessing child pornography and was sentenced to 108 months in prison. The sentencing judge raised the defendant’s base offense level….by two levels because "a computer was used for the transmission" of the illegal material.
The appeal filed challenged the punishment enhancement (not his guilt of the base punishment.)
The defendant argued the law did not apply to him because he did not use a computer to transmit the material. (ie He was the receiver, not the sender, of the child pornography.)
Do you believe that the sentence enhancement should be upheld? Give an economic analysis and rational for your choice.
At the top of your post, please indicate SENTENCE UPHELD or SENTENCE REVERSED and then give your economic analysis/rationale. After you can view your classmates' posts, make your case to your fellow students.
4.The ordinance was enacted that gives tenants more legal rights including:
the payment of interest on security deposits;
requires that those deposits be held in Illinois banks;
allows (with some limitations) a tenant to withhold rent in an amount reflecting the cost to him of the landlord's v.
1.What are social determinants of health Explain how social determ.docxcroysierkathey
1.What are social determinants of health? Explain how social determinants of health contribute to the development of disease. Describe the fundamental idea that the communicable disease chain model is designed to represent. Give an example of the steps a nurse can take to break the link within the communicable disease chain.
Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.
2. Select a global health issue affecting the international health community. Briefly describe the global health issue and its impact on the larger public health care systems (i.e., continents, regions, countries, states, and health departments). Discuss how health care delivery systems work collaboratively to address global health concerns and some of the stakeholders that work on these issues.
Resources within your text covering international/global health, and the websites in the topic materials, will assist you in answering this discussion question.
.
1.This week, we’ve been introduced to the humanities and have ta.docxcroysierkathey
1.
This week, we’ve been introduced to the humanities and have taken some time to consider the role of the humanities in establishing socio-cultural values, including how the humanities differ from the sciences in terms of offering unique lenses on the world and our reality. Since one of the greatest rewards of being a human is engaging with different forms of art, we’ve taken some time this week to learn about what it means to identify and respond to a work of art. We’ve learned about the difference between abstract ideas and concrete images and concepts like structure and artistic form. To help you deepen your understanding of these foundational ideas, your Unit 1 assignment will consist of writing an essay addressing using the following criteria:
Essay Requirements:
• 1,000 words or roughly four double-spaced pages.
• Make use of at least three scholarly sources to support and develop your ideas. Our course text may serve as one of these three sources.
• Your essay should demonstrate a thorough understanding of the READ and ATTEND sections.
• Be sure to cite your sources using proper APA format (7th edition).
Essay Prompt:
• In this essay, you will consider the meaning of art and artistic form by responding to these questions:
o To what extent does Kevin Carter’s Pulitzer Prize-winning photograph (figure 2-5) have artistic form?
o Using what you’ve learned in Chapters 1, 2 and 14 explain if you consider Carter’s photograph a work of art? Be sure to point to specific qualities of the photograph to support/develop your response.
o How do you measure the intensity of your experience in response to Carter’s photograph? What does it make you see/feel/imagine and how does your response/reaction support Carter’s image as a work of art?
.
1.What are barriers to listening2.Communicators identif.docxcroysierkathey
1.
What are barriers to listening?
2.
Communicators identified the following as major listening poor habits. Search what each poor habit means and try to set an example using your own experience.
Poor listening habit:
Pseudo-listening, Stage hogging, Filling in gaps, Selective listening, Ambushing (
Definition & Example)
.
1.Timeline description and details There are multiple way.docxcroysierkathey
1.
Timeline description and details
: There are multiple ways to construct a timeline. Find one that fits you and your information.
Include 10-15 events, each including the following descriptors:
- titles of books or writings or some sort of identifier
- your age or some time reference
- and whether it was a positive or negative experience
.
1.The PresidentArticle II of the Constitution establishe.docxcroysierkathey
1.
The President
Article II of the Constitution established the institution of the presidency. Select any TWO Presidents prior to 1933 and any TWO Presidents since 1933 and for EACH one:
a.
Discuss
any
expressed
power used by each president and the
impact
that decision had on American society at the time of its use
b.
Explain
whether you
agree/disagree
with the presidential action taken and
WHY
c.
Describe
one
legislative initiative
promoted by each president and the
impact
on America at the
time of its passage
as well as what the impact of that legislation is
TODAY
d.
Discuss
one
executive order
issued by each president and whether you
agree/disagree
with the order and
WHY
1.
Select any FOUR United States Supreme court decisions related to Civil Rights/Civil Liberties and for
each one
:
a.
Describe
the facts of the case
b.
Discuss
the arguments of each side as it pertains to the
Constitutional issue
being addressed
c.
Explain
the decision citing
Constitutional rationale
of the court including any dissenting opinion if not a unanimous verdict
d.
Explain
whether you
agree/disagree
with the court’s decision and
WHY
.
1.What other potential root causes might influence patient fal.docxcroysierkathey
1.
What other potential root causes might influence patient falls?
2.
Equipped with the data, what would you do about the hypotheses that proved to be unsupported?
3.
Based on the correctly identified hypothesis in the case scenario, what would be your course of action if you were the CEO/president of St. Xavier Memorial Hospital?
4.
What do you think of the CNO’s (Sara Mullins) position of “waiting and seeing what the data tells us” instead of immediately jumping to conclusions?
.
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Key Words Holism, nursing theory, painmanagement, caring,.docx
1. Key Words: Holism, nursing theory, pain
management, caring, relationship-centered
care, theory-practice gap, nursing practice,
holistic theory, client-centered care
Introduction
The use of theory to guide practice
has been advocated for decades, but the
translation of theory into practice has been
difficult for clinicians. Poor understanding
of theory and its purpose inhibits the nurse’s
ability to apply theoretical constructs in
practice, thus reducing practice to a task-
oriented enterprise rooted largely in habit.
Dossey’s (2008) theory of integral nursing
has recently emerged as a new holistic
theory that provides opportunities for
2. clinicians to invest in a worldview that
embraces the caring behaviors central to
the delivery of nursing care and encourages
nurses to design care that is relationship
centered and focused on healing. This
theory holds promise for application in
many care situations, though the client
experience of acute pain presents itself
as a uniquely universal opportunity to
demonstrate the prospective value of the
theory’s application.
It is widely known that pain is one of the
most common symptoms experienced by all
clients and that knowledge about effective
pain-relieving strategies is important
and essential in guiding practice. Despite
numerous advances in pain management,
pain continues to be insufficiently managed.
3. Inadequate understanding and use of theory
to guide pain management practice may
obscure nurses’ ability to rely on theoretical
knowledge as a basis for pain management
care. Insufficient knowledge about the
theory of integral nursing precludes
effective application of its theoretical
concepts in clinical practice, thereby
inhibiting nurses’ ability to improve pain
management practice while also inhibiting
clients’ ability to participate in the co-
creation of personalized interventions to
relieve pain. Failure of the nurse to engage
in holistic care, to capture the client’s
perspective in the design and delivery of
care, and to create a sacred space for
carrying out the holistic caring process
thwarts achievement of the mutually sought
4. after goal of healing. By embracing the
broader and deeper view of care offered by
the theory of integral nursing, the nurse and
client collaborate in the development of
trusting relationships as they intentionally
strive to improve client outcomes and
ultimately enhance client, nurse, and
provider satisfaction with care.
Background
Pain management has remained enigmatic
for clients and healthcare professionals for
decades. When caring for clients, pain is the
most common symptom for which nurses
need to intervene, yet it continues to be one
for which they may be least prepared to
successfully mediate (Lui, So, & Fong,
2008; Montes-Sandoval, 1999; Wilson,
2007). Pain is a multidimensional,
5. subjective phenomenon and experience.
As such, the meaning and impact of any
pain experience differs for each client,
family member, nurse, and provider. Many
definitions of pain have surfaced over
the last four decades and offer multiple
interventions to alleviate clients’ pain. At the
2007 council meeting for the International
Association for the Study of Pain (IASP),
in Koyoto, Japan, the council confirmed its
1992 definition of pain as “…an unpleasant
sensory and emotional experience
associated with actual or potential tissue
damage, or described in terms of such
damage” (www.iasp-pain-org). In its
monograph on understanding, assessing,
and treating pain, the American Pain Society
supports both the IASP definition of pain
6. and McCaffery’s definition of pain as
“…whatever the experiencing person says
it is, existing whenever s/he says it does”
(APS, 2006, p. 4; McCaffery & Passero,
1999, p. 17). While the IASP definition
has been described as the most widely used
definition of pain, McCaffery’s definition
has gained substantial support over the past
30 years and is widely used in clinical
practice as a foundation for all types of pain
management care. Both definitions help
capture the intricate nature of the pain
experience. The IASP definition infers the
multidimensionality of the phenomenon
of pain by stating it is both physical and
emotional, though an emphasis is noted
on the sensory nature of pain. McCaffery’s
definition emphasizes the subjective nature
7. of the pain experience and situates clients
Exploring the Theory of Integral Nursing
with Implications for Pain Management
Practice
Susanne M. Tracy, PhD, RN and Pamela P. DiNapoli, PhD, RN,
CNL
University of New Hampshire
26 International Journal for Human Caring
abstract
Inadequate attention is paid to the role of theory in guiding
practice. three main factors
affect the use of theory to guide clinical practice: insufficient
theory knowledge, insufficient
administrative support to encourage the development of theory-
based interventions, and
the busy task-oriented climate of many nursing settings. Pain
management is a vexing
problem confronting clients and healthcare professionals. the
primary purpose of this
paper is to introduce scholars and clinicians to the basic tenets
of Dossey’s (2008) theory of
integral nursing to aid nurses in designing client-centered pain
management interventions
grounded in the theory’s main constructs of holism and healing.
8. 272012, Vol. 16, No. 1
as the primary authority on the pain
experience, thereby prompting clinicians
to pay closer attention to clients’ description
of their lived experience of pain rather than
relying on a standardized definition of pain.
From a holistic perspective, all elements that
comprise the pain experience are equally
important and frame clients’ perception of
pain, the behaviors clients use to manifest
the impact of the pain experience, and
clients’ responses to varied methods used
to treat pain. Being knowledgeable about
pain management practice is an expected
competency of every registered nurse, yet
many nurses continue to describe barriers
that impede the management of clients’ pain
9. (Rejeh, Almadi, Mohammadi, Kazemnejad,
& Anoosheh, 2009). The literature supports
the notion that nurses’ knowledge and
attitudes about pain management is linked
to their ability to help clients successfully
manage pain; updating knowledge about
methods for relieving pain is key to improving
practice (Duignan & Dunn, 2008; Lui, So,
& Fong, 2008; Matthews & Malcolm, 2007;
Xue, Schulman-Green, Czaplinski, Harris,
& McCorkle, 2007).
Many strategies have been developed
to help bridge the gap between what nurses
know and what they actually do in practice
to help manage clients’ pain (Dihle,
Bjølseth, & Helseth, 2006). The problem
of under-treated pain persists and is likely
complicated by the lack of application of
10. theory to guide pain management practice.
When coupled with nurses’ uncertainty
about how to autonomously treat clients
in pain, pain relief outcomes are often
unsatisfactory. Theories, particularly
theories that have the potential to resonate
with clinicians and impact care of the whole
client, may be particularly powerful in
narrowing the theory-practice gap and
providing clues to more effective,
comprehensive pain management. The
application of a holistic philosophy of
care emphasizes the role of clinicians in
partnering with clients in the design and
implementation of mutually agreeable plans
for the relief of pain—plans that sufficiently
address the dimensions of the whole
person’s lived pain experience. Holistically,
11. the ultimate goals for the nurse are to better
understand the pain experience from the
client’s perspective, foster healing, and
deliver care that strives to provide the
greatest extent of pain relief possible.
Anchored in the Scope and Standards of
Holistic Nursing (2007), the five foundational
concepts of Dossey’s theory of integral
nursing articulate the qualities and way of
being that characterize the holistic, integral
nurse and prompt the nurse to attend to the
many dimensions of pain affecting the whole
client. In this way, the nurse invites the client
experiencing pain to participate in the
development of potentially transformative,
relationship-centered interactions and to
provide feedback on interventional success
or the need for further improvement.
12. The primary purpose of this paper is
to introduce the basic tenets of the theory
of integral nursing to aid clinicians in
designing caring interventions focused
on healing and grounded in the theory’s
holistic, relationship-centered approach.
Following the unfolding of the basic tenets
of this theory, examples of the application
of the theory to pain management are
proposed. A secondary purpose is to
stimulate scholarly interest in designing
studies that test the theory’s concepts and
holistic framework in practice. A peripheral
aim of the paper is to suggest how
application of the theory’s main concepts,
especially the concept of healing, may be
used to help define the emerging role of
the nurse in the 21st century regarding the
13. holistic care of the client experiencing pain.
the theory of Integral nursing
The experience of pain transcends the
physical body and requires a theory-driven,
tailored, whole-person approach to ensure
all effects of the pain experience on and in
the person; body, mind, and spirit are
addressed. The theory of integral nursing is
a composite theory developed by Barbara
Dossey in 2008 and built largely on the
work of Wilber (2000), whose integral
theory outlined the four dimensions of all
that is and represent what Wilbur believed
to be the true realities of life. Wilber posited
that understanding of these four dimensions
influences a person’s interpretation of reality
and carries the potential to affect one’s
relationships with others. Many of the
14. concepts within Dossey’s theory stem from
an amalgamation of concepts pivotal to
theories from within and outside of nursing.
The following commentary is a paraphrased
interpretation of Dossey’s theory with the
intent of aiding clinicians, academicians,
students, and others in understanding the
overall thrust of the theory. In this way,
partners in healthcare may find ways to
apply the theory’s core concepts to guide
the design of interventions in all areas of
practice, but especially in the area of pain
management practice. The concepts that
provide the organizing structure for the
theory of integral nursing are healing,
recognition of the metaparadigm of nursing,
patterns of knowing, quadrants, and all
quadrants/all levels (AQUAL). Appreciating
15. the richness and complexity of the theory
is a longitudinal process that begins with
unpacking each of the theory’s main
concepts and developing ways to apply
the concepts in clinical practice.
Healing
The central concept in the theory
of integral nursing is healing and is
conceptualized as a process that includes
“knowing, doing, and being” (Dossey &
Keegan, 2009, p. 21), as part of a life-long
journey toward increasing personal
harmony, harmony that is conveyed to
clients through caring actions and integral
dialogues. Integral dialogues are
transformative and visionary explorations
of ideas and possibilities within and
across disciplines. The healing process
16. brings clinicians to a place where they
introspectively encounter their fears, search
for and manifest their full self, and express
their full self through creativity, trust in life,
zeal, and love. No single aspect of healing
is any more important than any other. The
Exploring the Theory of Integral Nursing
28 International Journal for Human Caring
interplay between and among aspects of
healing brings greater understanding and
meaning about the complexity of illness,
wellness, and healing to interactions with
clients, families, colleagues, and others’
in one’s life. The concept of healing is
informed and transformed by the four
dimensions of reality that exist at any
moment, also known as quadrants: (a)
17. Individual interior (personal/intentional)—
the “I” space, (b) individual exterior
(physiological/behavioral)—the “It” space,
(c) collective interior (shared/cultural)—
the “We” space, and (d) collective exterior
(systems/structures)—the “Its” space
(Table 1). The dimensions of reality
examine values, beliefs, assumptions,
meaning, purpose, and judgments related to
how the individual structures action based
on the nature of the experience at hand
and the quadrants of reality that are most
influenced by a given situation. A personal
examination of each aspect of reality
enables the individuals to be more in touch
with their authentic self in many different
types of situations and/or environments.
A fundamental assumption of the theory
18. is that every human is born with healing
capabilities, so that it is not the clinician
who heals the individual but the individuals
themselves. By being open to opportunities
for healing, clients create a space for healing
to occur. Through creation of trusting, client-
centered relationships, nurses facilitate the
client’s ability to invest in self-healing. Self-
healing is not seen as some magico-religious
phenomenon, but as the process of
addressing issues that block personal
wellness. Self-healing allows the person to
be centered in the potential for the body,
mind, and spirit to work synergistically to
enhance the combined benefits of prescribed,
complementary, and safe alternative
therapies, all of which are focused on
improving health. Intentionality is a key
19. factor in healing and a quality of the healer
and healee that speaks to a determination or
commitment to achieve a higher level of
wellness. Without intentionality, healing
progresses less efficiently.
The Meta-Paradigm of Nursing
The theory of integral nursing
encompasses the meta-paradigm of nursing
(Fawcett, 2005), which includes person,
environment, health, and nursing. The
meta-paradigm also captures the essence
of Wilbur’s previously described quadrants
of reality, embracing both the fullness of the
human experience and the fullness of the
experience of nursing. The meta-paradigm
of nursing—person, environment, health,
and nursing—surround the theory of
integral nursing’s core concept of healing
20. in overlapping circles to demonstrate the
continuous nature of interactions that occur
between healing and the meta-paradigmatic
aspects of the theory of integral nursing.
Within the theory, the integral nurse
engages in care-related actions that foster
client wellness while also striving to create
a deeper, more meaningful connection
with the Divine, however interpreted
or recognized.
The concept of integral person captures
how the client interrelates with
the nurse in ways that value and respect
the life experiences of each member of the
relationship, be that of an individual, family,
colleague, or group. The idea of integral
health is viewed as a process that helps
convey ways of restructuring basic
21. assumptions and beliefs about well-being,
to include perceiving death as a natural part
of life. One metaphor for integral health
may be the notion of a helix, which can
be transformed into more or less complex
forms depending on the situation and one’s
personal growth. Symbolically, a more
complex helix would represent greater
growth toward higher levels of
consciousness and an increasing awareness
of the essence of the human experience of
“being.” From this view, the unique pattern
of one’s energy fields and one’s expression
of wholeness is manifested through a higher
personal and collective understanding of
the physical, emotional, mental, social,
and spiritual dimensions of health, a
homeodynamic view similar to that
22. espoused by Rogers (1983, 1992) in her
theory of unitary human beings. Important
to understanding integral health is the
understanding that various types of health,
such as mental health, physical health,
emotional health, and spiritual health, are
not to be viewed as separate and equal, but
as unique structural strands that create and
frame the wholeness and stability of the
metaphorical helix of health. The integral
environment consists of both internal and
external aspects. The internal aspects of
environment relate to clients’ feelings
and emotions, the meaning of events, and
the way in which the client enacts their
understanding of spirituality and caring.
Through flashes of memory, sounds,
dreams, images, and/or smells the internal
23. environment acknowledges and is
influenced by current and past relationships
with living and non-living people and
things, such as family members, pets, or
precious possessions. The external
environment consists of things that can be
objectively measured in the physical and
social realms of reality, such as one’s pulse,
the level of adrenaline present in one’s body
in a specific situation, skill development,
and anything one can touch or observe
scientifically in time and space. The
inextricable links between the internal
and external aspects of clients’ integral
environment shape the context in which
the client exists and help frame the meaning
of the reality of the client.
Patterns of Knowing
24. Rooted in Carper’s (1978) depiction of
the four fundamental ways of organizing
nursing knowledge and nursing’s pattern
of knowing—personal, empirics, aesthetics,
and ethics—the additional pattern of “not
knowing” proposed by Munhall (1993)
and the pattern of “socio-political knowing”
described by White (1995) create the six
patterns of knowing applied in the theory
of integral nursing. These six patterns are
superimposed on the quadrants of reality
and work to bring nurses to the fullness of
knowing and expression of being in each
caring experience. By acknowledging the
Exploring the Theory of Integral Nursing
292012, Vol. 16, No. 1
integration of science and aesthetics,
25. knowing and not knowing, and the influence
of socio-political knowing, nurses confirm
the value of patterns of knowing in clinical
practice. Through the patterns of knowing,
nurses are encouraged to develop a flow of
ethical experience through thinking and
acting in ways that promote self-assessment
and self-healing while generating a sacred
space for care that promotes client healing.
Quadrants
Quadrants in the theory of integral
nursing can be understood as dimensions
of reality that are permeable, integrally
transforming, and empowering to all other
quadrant experiences. Each quadrant is
intricately linked and bound to each other
quadrant, carrying along its own truths and
language. The language of “I,” “We,” “It,”
26. and “Its” that characterizes the concept
Exploring the Theory of Integral Nursing
Table 1
Dimensions of Reality within Quadrants in Pain Management
Dimension
or perspective
Focus of the dimension Aspects included in the dimension
Sample pain management questions by dimension
Individual
Interior
Personal/intentional
The “I” space—the individual’s
internal sense of reality
Self-consciousness
Self-care, self-esteem
Feelings, beliefs, values
Moral development
Cognitive capacity
Emotional maturity
Personal communication styles
27. Am I feeling stressed? Thinking clearly?
Am I open to the client’s assessment of their own
pain?
Am I ethically assessing the client’s pain and making
moral decisions about options for pain management?
Am I communicating clearly and compassionately?
Individual
Exterior
Physiology/behavior
The “IT” space—objective or
tangible aspects of the individual
that influence reality
Brain and organisms
Pathophysiology
Physical sensations
Neurotransmitters
Chemistry and biochemistry
Behaviors and skill development
Am I able to envision by bodily presence changing?
Can I fully describe the sensations I feel?
Can I feel my open presence changing my client’s
28. responses to my pain management efforts?
Do I feel more able to do my pain management work
skillfully?
Collective
Interior
Shared/cultural
The “WE” space—the collective
sense of engagement within the
individual’s reality
Relationships to others’ cultures
and worldviews
Shared visions
Shared leadership
Integral dialogues
Morale
How am I relating to others involved in pain
management efforts?
What is the meaning of my pain management
relationships with my clients? My peers? My
supervisors? Other healthcare professionals?
Am I fully engaged in using integral dialogues to
enhance my pain management relationships with
others?
29. Collective
Exterior
Systems/structures
The “ITS” space—the broader
sense of being part of an external
reality whose systems and
structures govern practice
Relations to social systems and the
environment
Organ structures and systems
Financial systems
Policy development
Regulatory structures and systems
Information technology
How do pain management policies and procedures
influence my connection with my clients?
What is my group role in meeting or changing pain
management regulatory guidelines?
How do I use systems and structures to improve pain
management practice?
Do I allow technology to help me deliver better pain
relief care or does it interfere?
Adapted from Dossey, B., & Keegan, L. (2009). Holistic
30. nursing: A handbook for practice (5th ed.). Sudbury, MA: Jones
& Bartlett.
30 International Journal for Human Caring
of quadrants are terms used in everyday
language to convey the direction of our
communication and the direction of one’s
experiences in the world. Each quadrant
helps provide a framework for interpreting
the theory and is guided by four main
principles: (a) Nursing requires the
development of the “I,” (b) the discipline of
nursing is built upon the “We,” (c) “It” is
about behavior and skill development, and
(d) systems and structures are embedded in
and frame the understanding of “Its.” Each
principle continues to remind us that being
an integral nurse is first, more than being a
holistic nurse, and, secondly, an evolving
31. process that becomes clearer and more
meaningful over time through ongoing
practice and reflection.
All Quadrants, All Levels (AQUAL)
The final concept in the theory of
integral nursing is all quadrants, all levels
(AQUAL). Wilber (2000) recognized that
the quadrants of reality are connected to
levels, lines, states, and types that help
the individual create a comprehensive map
of reality. Levels refer to aspects of the
self that change over time and become
permanent as one moves through stages
of growth and development. Lines refer
to the complex aspects of self that enrich
and enhance one’s development, such
things as multiple intelligences, cognitive
awareness, etc. States refer to temporary
32. and changing forms of awareness, such as
consciousness, unconsciousness, dreaming,
waking, meditative states, recollection
of peak experiences, etc. Types refer to
differences in personality and expression
that may mediate one’s experiences of
reality. Because interpretation of reality
is fluid, many human experiences, both
temporary and permanent, affect one’s
movement toward higher levels of
consciousness. Aspects such as physical
growth and development, dream states,
multiple intelligences, peak experiences,
personality, gender, shifts in physiology,
moods, etc. are considered. Through the
application of the dimensions of AQUAL,
as depicted in Table 1, individuals open
themselves to evolving insights about the
33. complexity of the human experience and
about the ongoing quest for higher levels
of consciousness that characterize the
integral person.
relevance to Clinical Pain
management Practice
Client reliance on the internet to provide
knowledge about care is becoming a more
common phenomenon in a technological
world. Returning to basic notions about
centering care on the client is an important
issue for the nurse in the 21st century whose
clients are becoming increasingly impatient
with the faceless, computerized nature of
care. The nurse of the 21st century must
take advantage of the power of technology
to search for and create evidence for
emerging holistic practices, understanding
34. that practice increasingly relies on a
growing knowledge base and a willingness
to risk implementing novel changes in
practice targeted on improving both client
outcomes and clinical nursing practice. The
theory of integral nursing offers nurses the
opportunity to act on their desire to create a
healing environment for clients through the
synthesis and application of knowledge
rooted in metaparadigmatic and quadrant
realities. Relationship-centered communication
anchored in the theoretically driven holistic
caring process is essential, especially when it
comes to the very personal experience of pain
management care.
In a world where social capital is
increasingly being lost, clients want to know
that nurses see them as individuals and
35. value their personal experience of pain.
For example, application of the notion of
creating a sacred space for care that is
described in the theory of integral nursing
has the potential to narrow the theory-
practice gap by emphasizing the importance
of dedicating oneself to the personalized
pain relief clients seek and nurses strive to
deliver. In this sacred space, nothing else
is allowed to interfere with the interactions
between the client and the nurse. The nurse
is totally focused on what he/she is doing
and what the client describes as their
experience of that particular episode of pain.
The theory brings a more open vision of the
client-nurse relationship, especially as it
relates to the role of each partner who is
part of the pain management experience.
36. Nursing’s primary role is to carry out
theoretically driven nursing interventions
with and for the client; interventions that
promote health and healing and convey
caring and respect for the individual while
facilitating pain relief. The client’s role is
to remain open to participating in their own
care, to aid the nurse and healthcare team
in the co-creation of care, and to provide
feedback to the nurse about the effects of
co-created care on their overall physical,
mental, and spiritual well-being. Nursing
process has been a blueprint for care for
many decades and is the foundation upon
which the holistic caring process has been
developed. Within the context of the holistic
caring process, the following practice
suggestions are offered.
37. the Holistic Caring Process
The optimal delivery of nursing care is
guided by the theory of integral nursing. The
theory’s holistic caring process expands the
assessment of clients to ensure gathering of
objective and subjective data, not only about
one’s physical status, but also regularly
gathers and integrates data about the
emotional and spiritual status of the client.
Application of the theory’s core concept of
healing facilitates conversations (integral
dialogues) between clients and physicians,
clients and nurses, nurses and physicians,
and nurses and other members of the
healthcare team. Using the pain experience
as an example, the outcomes of such
dialogues have the potential to change
practice by inviting clients to tell their pain
38. story (and history) so that a more useful and
meaningful plan of pain management can be
developed, a plan whose openness respects
and values the voice and experiences of
the client, as well as the knowledge and
expertise of nurses, physicians, and other
Exploring the Theory of Integral Nursing
312012, Vol. 16, No. 1
healthcare team members. Table 1 is an
exemplar that depicts the application of
the dimensions of reality within quadrants
as they apply to pain management. Each
dimension affords nurses opportunities
to center themselves on aspects of pain
management care that foster internal
reflection and wholeness in the delivery
of care. Sample pain management questions
39. for each dimension focus on the internal
self-assessment carried out by nurses as
they prepare to deliver personalized pain
management care anchored in the
dimensions of reality within quadrants.
Central to success in the holistic caring
process approach is a trusting client-
nurse/client-provider relationship. Openness
of each member of the integral partnership to
perceptions about pain and pain management
that may be foreign to them is critical.
When coupled with a determination to find
a mutually beneficial approach to managing
the client’s pain, this non-judgmental
approach invites clients to engage in self-
care initiatives that help free them from
issues and concerns that block healing.
Caregivers must be willing to see the pain
40. experience through the client’s eyes and
frame solutions in such a way as to obtain
outcomes that work to relieve client pain.
For example, in Table 1, one of the sample
questions in the Individual Interior
dimension asks clinicians to reflect on their
openness to believing the client’s assessment
of their own pain. Another question in this
same dimension asks clinicians to reflect
on their moral responsibility to be open
to considering various pain relief options.
This reflective approach requires nursing
decisions about the moral and ethical
delivery of care, as well as decisions
about the safe and responsible use of
complementary and/or alternative methods
desired by clients, even if they do not
possess the strength of evidence so often
41. sought by allopathic practitioners.
Caregivers and clients alike must be
willing to not only talk about, but also
engage in partnerships that foster healing.
Before caring for others, caregivers must
spend time on self-assessment and self-
healing in order to be prepared to engage
clients fully in the delivery of holistic care.
By listening actively and openly to client
communication about the pain experience,
caregivers build trust with clients,
demonstrate caring and “other-
centeredness,” and actively work to
encourage clients to disclose more about
their experience of pain. In so doing,
caregivers demonstrate their willingness to
validate the client’s experience of pain and
open the door for teaching the client about
42. reasonable pain evaluations, safe pain
management strategies, and the benefits
and limitations of pharmacological and non-
pharmacological pain management options.
Without these caring relationships,
teaching seems inconsequential to clients
(i.e., just another task the nurse has to
complete) and its benefits often wither after
discharge. Throughout the care experience,
the use of caregiver intuition expands
opportunities for nursing investigation of
aspects of pain management care that may
not initially be apparent. Practice expertise
fosters the development of intuition. As a
part of pain management, nurses’ use of
intuition may help clients identify and
reveal potential blocks to healing, thereby
promoting active, collaborative engagement
43. in the design and development of solutions
that advance healing. The power of holistic
communication cannot be overemphasized
as a critical activity for promoting healing.
Clients must be open to accepting the
knowledge and expertise of caregivers
regarding the efficacy of various treatments
for pain relief but also have the
responsibility for learning more about pain
management and taking an active role in
decision making that fosters healing. At
the same time, clinicians must remain open
to hearing the client’s “story,” inviting
clients to partner in designing pain relief
interventions, and trusting in the value
of the client’s experiences of pain. Client
openness to describing the meaning of the
pain experience may foster their ability to
44. address issues that have previously blocked
healing. Such breakthroughs contribute
to deeper integral dialogues between client
and nurse, and aid the clinician in seeking
the expertise of other members of the
healthcare team in the restructuring of
transpersonal care.
To be sure, application of the dimensions
of reality within quadrants does not end with
the individual nurse’s holistic preparedness.
Table 1 also describes the importance of
applying integral knowledge within group
contexts so as to transform pain
management practice through integral
dialogues that promote engagement with
shared interdisciplinary, sociocultural, and
leadership worldviews about the meaning
and value of efforts to collectively address
45. and enhance pain management care. Finally,
application of the dimensions of reality
within quadrants requires nurses to tap into
their social consciousness about regulatory
issues that may influence pain management
care. Through the collective exterior
dimension, nurses are compelled to
work toward systematic changes in
pain management policy and practice
by assessing the current status of pain
management structures and policies,
both locally and nationally, and working
to become more active in addressing
identified gaps; gaps that fail to provide
clients with the highest level of evidence-
based pain care available.
Implications for research
The newness of the theory means many
46. nurses have not yet had an opportunity to
fully understand its meaning and test its
integrity. Nurses must engage in a certain
level of trial and error as understanding
of the theory becomes more prevalent and
its precepts become more integrated into
everyday practice, a process likely to take
time and require the involvement of nurses
who are willing to be leaders and change
agents. Strategies that will facilitate
application of the theory of integral nursing
must be seated in the current world
of healthcare practice—a world often
characterized by timelines, capitation
Exploring the Theory of Integral Nursing
32 International Journal for Human Caring
payment models, and embedded, long-
47. standing practices. The theory brings a more
open vision of the client-nurse relationship,
especially as it relates to the roles of each
partner who is part of the pain management
experience. Many questions remain open for
investigation through both qualitative and
quantitative research, such as: How will
nurses talk about the differences in their
everyday practice when practicing from a
holistic theory that views healing as the
central focus of care? How will holistic
pain management care be perceived by
clients and families? What is the
relationship between care driven by the
theory of integral nursing and quality of
life for clients experiencing pain? To what
extent might the creation of a sacred place
for care produce tangible and satisfying
48. outcomes for clients and nurses? The nurse’s
role is to carry out interventions with and
for clients—interventions that manifest
caring and mutual respect and promote
health and healing, especially in the area of
pain management care. Application of the
theory of integral nursing challenges nurses
to engage clients and families in their own
healing and work collaboratively with
clients, families, and other members of the
healthcare team to design novel initiatives
that advance pain management practice.
Nursing needs this holistic, caring theory
to return the client to the center of care
and to push the envelope of grounding
practice in theory.
Summary
The multidimensional, individualized,
49. and complex nature of the pain experience
requires nurses to design and apply new,
theoretically driven pain management
interventions not only rooted in the
assumptions of holistic nursing, but
grounded in the realities of relationship-
centered care. The theory of integral
nursing offers a unique framework for
nurses to collaborate with clients in
mutually beneficial, interactive, and trusting
relationships centered on healing. The
complex nature of the pain experience
requires nurses to listen carefully to clients
so as to co-create theoretically driven
strategies that guide nursing practice and
are focused on the assumptions of client
and relationship-centered care. By focusing
on the integral nature of client experiences,
50. theory-driven holistic outcomes foster a
closer client-nurse relationship and press
the client and nurse to strive for outcomes
that help unravel the complexity of the pain
experience. By substituting a holistic vision
of care for the habitual, task-driven ways
of managing pain, nurses partner with
clients and families and come to understand
the power inherent in theoretically driven,
autonomous nursing interventions that
create new ways of practicing while
remaining focused on client healing.
Designing individualized nursing
interventions grounded in the assumptions
and concepts central to the theory of integral
nursing requires nurses to be committed to
involving the client in the design of care as
they collectively create new forms of care—
51. care that emerges from the synthesis of
theoretical constructs, client’s experience,
and the nurse’s knowledge and expertise.
Translating integral theory concepts into
practice and disseminating knowledge about
the theory’s usefulness in everyday care is
critical to refocusing 21st century practice.
The novelty of integral nursing theory
mandates additional research that tests the
theory’s propositions in clinical practice
and encourages clinicians to describe the
impact of the theory from their own
perspective. We owe it to our clients to put
them back in the center of care; we owe
it to our profession to honor Nightingale’s
long-standing foundations of practice—
knowledge, care, and compassion. The
theory of integral nursing holds much
52. promise and it is up to us to apply it in
practice as we refocus the humanity of
nursing care in this technological age.
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author note
Susanne M. Tracy, PhD, RN, Assistant Professor and Pamela
DiNapoli, PhD, RN, CNL, Associate Professor, University of
New
Hampshire, Department of Nursing, Durham, New Hampshire.
Correspondence concerning this article should be addressed to
Susanne M. Tracy, PhD, RN, Assistant Professor, University of
New
Hampshire, Department of Nursing, 243 Hewitt Hall, Durham,
NH 03824 USA. Electronic mail may be sent via Internet to
[email protected]
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