TFN - end terms one
Practice
Ernestine Wiedenbach
- born: 08.18.1900 @ Hamburg, Germany
- became nurse midwife in 1946
- developed her theoretical writing entitled
"Clinical Nursing: A Helping Art" in 1964
- retired in 1966 as director of graduate
programs at Yale University School of
Nursing
- never married and died on 08.08.1996 @
age 96 ; Florida, USA
theory: the helping are of clinical nursing
- must be goal directed, deliberately carried
out, and patient centered
4 Elements to Clinical Nursing:
- nurse philosophy
• attitude and belief about life and how
that effected reality for them
3 Essential Components associated with a
nursing philosophy
A. reverence for life
B. respect for the dignity, worth,
autonomy, and individuality of each
human being
C. resolution to act on personally and
professionally held beliefs
Nurse's Purpose
- that which the nurse wants to accomplish
through what she does
- these are activities directed towards the
overall good of the patient or
development of new concerns
practice -> observable nursing actions that
are affected by beliefs and feelings
about meeting the patient's need for
help
1
3 Areas that Nurses must Focus for Effective
A. knowledge
B. judgement
C. skills
- procedural & communication
Components of Practice in Patient Care
1. identification
2. ministration
3. validation
Art of Nursing
- application of knowledge & skill to bring
about desired results
- carried out on a one-on-one relationship
- requires conscious responses to specifies
in the patient's immediate situation
- includes:
• understanding patients needs &
concerns
• developing the activities related to the
medical plan to improve the patient's
condition
• focusing on prevention of complications
related to reoccurrence or development
of new concerns
Metaparadigm
a) person
• any individual who is receiving help of
some ind, be it care, instruction, or
advice, from a member of the health
professions or form a worker in the field
of health
"an individual should want to be healthy,
comfortable, and capable, and ... when
unimpeded, he strives by his own efforts to
achieve such states."
b) health
• definitions of nursing, patient, and need
for help, and the relationships among
theses concepts, imply health-related
concerns in the nurse-patient situation
c) environment
• the environment may produce obstacles
resulting in the person experiencing a
need for help
Need for Help
- any measure that requires & desired by the
individuals which has potential for
restoring or extending his ability to cope
with the demands implicit in his situation
d) nursing
• the nurse has come into being because
there is a patient who needs her help
Key Emphasis
- nurses should identify patients "need for
help" by:
1. observation of patient's behavior
2. understanding patient's behavior
3. identifying cause of his discomfort
or incapability
4. determining if clients can resolve
problems or have a need-for-help
Faye Glenn Abdellah
- birthdate: 03.13.1919 @ NYC
- help transform the focus of the nursing
profession from disease-centered to
patient-centered
- advocate of degree programs
- developed a framework known as
progressive patient care
- developed the patient assessment of care
evaluation
2
- 1981:
• was named deputy surgeon general
making her the first nurse & first woman
to hold the position in the US military
TwentyOne Nursing Problems Theory
- patient needs:
• basic to all patients
• subtenant care needs
• remedial care needs
• restorative care needs
theory: 21 nursing problems
(client-centered nursing interventions)
Nursing Problems
- synonymous to "nursing goals" or
"nursing functions"
Nursing
- the utilization of the problem solving
techniques with chief nursing problems
related to health related to health
requirements of clients
Metaparadigm
a) person
- described as people having physical,
emotional, and sociological needs
- describes the patient as the only
justification for the existence of nursing
- all persons have self-help ability & the
capacity to learn, both of which very from
one individual to another
b) environment
- patients interact with and respond to their
environment
- nurse is part of that environment
c) health
- state that is mutually exclusive of illness
- state when the person has no unmet
needs & no anticipated or actual
impairments
d) nursing
- considered a helping profession
- service to society
Goals of Nursing
A. to meet client's needs
B. to increase or restore his self care
abilities
C. to alleviate an impairment
Abdellah's Typology of 21 Nursing Problems
- one of the forerunners of the nursing
diagnosis (NANDA)
A. Biological/Physical Problems
1. to maintain good hygiene & physical
comfort
2. to promote optimal activity: exercise,
rest, sleep
3. to promote safety through prevention of
accident, injury or other trauma &
through the prevention of the spread of
infection
4. to maintain good body mechanisms &
prevent & correct deformity
5. to facilitate the maintenance of a supply
of O2 to all body cells
6. to facilitate the maintenance of nutrition
of all body cells
7. t o f a c i l i t a t e t h e m a i n t e n a n c e o f
elimination
8. to facilitate the maintenance of fluid &
electrolyte balance
9. to recognize the physiological responses
of the body to disease conditions -
pathological, physiological &
compensatory
10. to facilitate the maintenance of the
regulatory mechanism & functions
11. to facilitate the maintenance of sensory
function
B. Psychological Problems
12. to identify & accept (+) & (-) expressions,
feelings and reactions
13. to identify & accept interrelatedness of
emotions & organic illness
14. to facilitate the maintenance of effective
verbal & non-verbal communications
15. t o p ro m o t e t h e d e v e l o p m e n t o f
productive interpersonal relationships
16. to facilitate progress toward achievement
and personal spiritual goals
17. to create or maintain a therapeutic
environment
18. to facilitate awareness of self as an
individual with varying physical,
emotional, and developmental needs
19. to accept the optimum possible goals in
the light of limitations, physical, and
emotional
20. to use community resources as an aid in
resolving problems that arise from illness
21. to understand the role of social problems
as influencing factors in the cause of
illness