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Concepts of nursing knowledge
Nursing theories and knowledge
Nursing theories and knowledge
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Empirical knowing is designated as the science of nursing and is expressed as scientific competence (Carper, 1978). A study was conducted to analyze the perception of nursing students when faced the process of death and dying (Silva Oliveira et al., 2016). It was reported that the students shared feelings of fear, sadness, and anxiety in relation to patient deaths due to their level of emotional immaturity and absence of academic preparedness (Silva Oliveira et al., 2016). My feelings of sorrow and grief were consistent with those of the nursing students conducted in the study. Gillan, van der Riet, and Jeong (2014) believe that the insufficient amount of content about palliative care in nursing textbooks is the main contributor to the incompetent
preparation of nursing students. As a result, nursing students need time for reflection and discussion after a death, in order for them to be able to deal with the situation throughout their professional career (Silva Oliveira et al., 2016). According to Touhy, Jett, Boscart, and McCleary (2011, p. 466), “Nurses are professional grievers”. It has been acknowledged that nurses who work with the grieving or dying have an art because they portray special coping skills that enable them to disengage from a death (Touhy, 2011). Nurses must possess emotional maturity to be willing to deal with the disappointment of a loss and in order to provide comfort to others (Touhy, 2011). Although mourning is a natural reaction after death, knowledge has informed me that nurses must remain strong, not only for themselves but for their patients and their patient’s families as well.
Carper’s (1978) pivotal work of identifying nursing’s ways of knowing was a seminal work that laid the foundation for further analysis. Her ways of knowing have identified methods that have allowed the nursing discipline to further its own knowledge as well as the profession. Two other ways of knowing have emerged, Munall’s (1993) “unknowing” pattern; and also sociopolitical knowing by Zander (2011, p. 9) or emancipatory pattern (Chinn & Kramer, 2011, p. 5). Here these patterns are discussed through experiences in my personal practice.
According to Orem, nursing science is a practical science, in that knowledge is developed for the direct purpose of nursing practice itself (Barbara, 2011). The goal of nursing science is to look for an understanding of the actual realities that are concerning to nurses and the nursing practice (Orem, 2001). We can do this through both research and producing scholarly articles. “Nursing science is the science of which knowledge is developed for the sake of the work to be done” (Barbara, 2011, p. 44). Without the nursing science as the backbone of nursing, the nursing practice would seize to exist, or at least have difficulty staying alive. Nursing science offers nurses the knowledge, skills and competency to develop order and direction in their nursing care (Malinowski, 2002). Models of case studies, rules and standards of practice along with the various
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
Kübler-Ross, Elisabeth. On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy and Their Own Families. London: Routledge, 2009. Print.
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
“Persons intentionally choose to become nurses to help patients meet their health needs,” even when the patient is actively dying. (Wu & Volker, 2012) Hospice nursing and palliative care nursing are both considered end of life care. However, hospice nursing is typically given to patients with a terminal illness and who have less than six months to live. Palliative care is typically given to patients with a life threatening illness, and is used to increase the patient’s quality of life. Choosing a nursing career in either hospice or palliative care can be extremely difficult, but will provide an opportunity for great personal growth. At times, an end-of-life caregiver may feel responsible for their patient’s death, or they may feel isolated due to a lack of support. Nurses new to this field should “feel that their unit acknowledges death as a difficult event and that discussion of death is acceptable in the workplace.” (Lewis, 2013) The most rewarding, and also most difficult, part of being a hospice or palliative care nurse is the ability to be a part of your patient and their family’s life, including their loss, grief, and death. (Wu & Volker, 2012)
My earliest experiences of observing nursing in action occurred during my last two years of high school. My father was diagnosed with cancer during the spring of my junior year and died right before my senior year. During that short time I watched as the nurses cared for him and I could see compassion and empathy in the way they looked at him. It never occurred to me until after I had raised my children that I wanted to be able to help people in the same way those nurses helped my dad. But now when I tell people that I want to be an oncology nurse, people often respond by saying that they would never choose that type of nursing. They say that they could not stand to watch their patients die so frequently. Their reactions, along with this course in death and dying, have made me question how I might be able to bear the challenges of nursing in an area where death of my patients may be common. I believe that oncology will be a positive specialty to work in because of the consistent advances in prevention, early detection, and treatment of cancer. Furthermore, I believe that William Worden’s four tasks of mourning as presented in our text book is a good framework for the oncology nurse to use in order to cope with the repeated losses inherent in this type of nursing (Leming and Dickinson, 2011).
Nursing knowledge is categorized into four different fundamental patterns of knowing. These patterns are empirics, esthetics, personal knowledge in nursing, and moral knowledge in nursing. The patters of knowing are important when it comes to both the teaching and practice of nursing and are crucial within the discipline of nursing as a whole. This paper will summarize the science of nursing, the art of nursing, personal knowledge in nursing, and moral knowledge in nursing and will also apply moral knowledge to nursing practice today. Each of the patterns has equal significance in nursing and all are required to give adequate care to the vast uniqueness of patients.
Theory can be defined and be significant differently for each individual. Theory can be explained as concepts that assist with clarifying, foreseeing or intervening. As Nestel & Bearman (2015) explain “ theory is offered as a framework of ideas, which illuminates simulation-based education practice” (p.349). The framework gives individual complex ideas that transforms over time. Theories are adapted and utilized in different settings such as health care professions. IT motivates and suggests new interventions. Nursing theory is explained as nursing ideas of knowledge, research and practice. The importance of nursing theory has evolved throughout the years and has
The question of existence of the human being is a complicated question, which requires a long discussion. The question of death is sometimes even more complicated. Working as a nurse requires full dedication and a lot of patience. One of the most hard and responsible part of nurse’s work is taking care of the dying patients. This work contains review of the article Phenomenological Study of ICU Nurses’ Experiences Caring for Dying Patients by Phyllis Ann King and Sandra P. Thomas and critique of the phenomenological research.
As nurses enter into the practice of nursing, they recognize the importance of using their education to guide their actions within the clinical setting. “Theories are pattern that guide the thinking about, being and doing, of nursing” (Parker, 2006, p.8). Comparing theories allows the core structure of the theories to be brought to light, as well as display the merits of using a particular theory while practicing nursing. The theories of Martha Rogers and Betty Neuman were developed at roughly the same point in time, which means that different theories can arise out of the same general world situation. Rogers Science of Unitary Beings illustrates a truly holistic view, as it hypothesizes that human beings and their environment are energy fields which are irreducible elements of the universe. On the other hand, Neuman uses a systematic model to describe human-environment interaction. While these theories have similarities, their differences as models for nursing and in clinical use provide great insight into how important theories are to nursing practice and research. This paper will discuss the theories of Rogers and Neuman, their implications in practice and research, and the future of these theories in nursing. These two theories were chosen because they provide differing perspectives on how humans interact with the world, community and healthcare.
As a nurse it is important to use a framework to which all your care is guided by. Critical aspects that should compose the framework to guide a nurses actions and decisions include the fundamental patterns of knowing, the bioethical principles and the Nursing and the Midwifery Board of Australia codes and guidelines. In the case scenario provided had the nurse Emma considered and used this framework in her actions and decisions the outcome for her patient could have possibly been avoided.
During my early years in practicing nursing, if asked what my thoughts were on nursing and how I know what I know, my response would have been that nursing was the act of caring for others and the knowledge we learned in nursing school. But throughout the years of education, experience and life my definition of nursing has evolved. I would define nursing as knowledge from inside us that grew and changed as we continue to change and grow in our profession. Nursing knowledge is the knowledge that is important to nurses and patients in understanding human health, which can be used for scientific, ethical and political knowledge. (Clarke, 2011) Knowledge can be learned by caring for the ill, preforming procedures, providing education, support,
Nursing is a demanding job, requiring a significant amount of knowledge in a multitude of areas including a strong knowledge base of human relationships. Relational practice is an inquiry that is directed by mindfully partaking in a relationship with the client/patient and is the foundation of all nursing practice (CRNBC, 2015). A significant portion of this relationship is my ability to engage in self-observation and reflection that aids me in recognizing and acknowledging what I know and do not know (Berragan, 1998, p. 216, Hartrick Doane & Varcoe, 2015). Hartrick Doane and Varcoe (2015) recognize the difference between knowing and not knowing as imperative to a responsive and safe nursing practice (p. 22). As a student nurse, I recognize the importance of reflection as a means to evaluate how I interact on intrapersonal (internal), interpersonal (external), and contextual (environmental) levels. To grow in my role as a nurse, I must develop strategies that combine my knowledge and my
1. Utilizes in its practice a unique and well-defined body of knowledge that is intellectual in nature and describes its phenomena of concern.