Please tell me. At your work place do you have a specific nursing theory that guides your individual practice or your institution's practice? What theory is it and why and does it make a difference?
Oct 2, '99
I don't work in a health care agency and I am influenced daily by nursing and non-nursing theory background. I work in a school doing substance abuse prevention. I would say that three theoretical bases upon which I draw are Dorothea Orem (self-care concept), Margaret Newman (health as growth even in the face of chronic health problems) and Prochaska and DiClemente (who are non-nurses but have a theory of behavioral change that has been central to the way I approach and work with students.)
Let's take a theoretical client. This is a student who is using marijuana and alcohol in a harmful way and has legal and school implications occurring. He has come under my view because of being under the influence at school. He has had a drug and alcohol eval and parents have agreed with his decision to not take any of the counselors suggestions for undergoing treatment. In talking with him, I may determine that he is pre-contemplative (Prochaska and Diclemente) and doesn't see a problem at all with his usage. He may need me to build a therapeutic supportive relationship with him as he permits (he is self-determining). I may work with him to get him to express his concerns about his usage and build upon this. A student in treatment is, in fact, learning many many self-care techniques (Orem), such as time management, life/social skills he missed out on learning while using. I am supporting another in learning and may directly teach and may role play techniques with a student at this stage. A student who continues to use needs acceptance, accountability and a belief that this is simply the stage where they are. I think Newman has applicability in helping student with a history of usage to integrate their difficult and shameful past; it is simply where they were. (Though I have never seen Newman applied in this way in the literature.)
One of my collegues in grad school thought that nursing theory was the ultimate in the emperor's new clothes, but I have found it to be useful and applicable in a practice level setting.
Oct 4, '99
Remember Helen Ura? She is the author of The Nursing Process which we all use every day. APIE...Assess,plan,intervene,evaluate.We all do it! Business borrowed this visionary nurse's theories because they are so practical. I had the privledge to sit in one of her lecture classes before she retired from Old Dominion University in Norfolk, Va. I am a critical care nurse working 12 hour shifts short staffed and I am still inspired by nurse scholars who are researching,writing, and attempting to keep our profession moving against all odds. What does not inspire me are nurse managers who sell bedside nurses out(and ultimately patients) for their own comfort and advancement.
Oct 6, '99
Golly, you are an inspiration to me. You, as a critical care nurse faced with the challenges of work, still respect the nurse types who write and research. Geat! Tell me more about the problems of Supervisors and advancing nursing.
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