...Mishel’s Uncertainty in Illness Theory Mark A. Seymour, II Millersville University How has nursing evolved? What are the components that have turned nursing into what it is today? We all ask these questions at some point in our career of nursing. The history of nursing can all be traced back to the very first theorist, Florence Nightingale. She helped begin to formulate the nursing practice describing, predicting and formulating the basis of what nursing would become. Several others have researched and developed their own theories of nursing, some which lead us to question even further thoughts, provoking new ideas or even developing better understandings as to why nursing is what it is today. But there are some things that still provoke uncertainty, which was described by Mishel, as the inability to determine the meaning of illness related events, occurring when the decision maker is unable to assign definite value to objects or events, or is unable to predict outcomes accurately (Mishel, 1988). This is what sparked the concepts of Mishel’s uncertainty in illness theory, which could...
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...important for nurses to study the development of nursing theory because without an idea of where you have been, how can you know how, why, when, or where to go “ (Cherry and Jacob, 2014, p.75). Theory leads to research, research leads to science, science leads to practice, and practice then cycles back to theory. New theory emerging from practice will generate new studies that will, in turn, produce new knowledge for practice. All of this contributes to improving nursing practice. It is a very sad situation when nurses and nursing students feel that studying and applying nursing theories is irrelevant and a waste of time. Often nurses and nursing students are not very interested in educating themselves about various nursing theories. They much rather be more concerned about the technical and administrative end of nursing. The scenario with Mary Jane and her coworkers is a very good example of how many nurses show lack of interest in the studying and application of nursing theory. I believe Mary Jane should have responded by telling her coworkers that nursing theory is just as important and vital to nursing practice as anything else you learn in nursing school. She should have asked them if they both would agree that the major aim in nursing is to see your client reach his or her highest attainment of health. Next, she should go on to explain how Imogene King’s theory of goal attainment was beneficial to her and her client. Nursing is highly focused on client outcomes. However...
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...CRITIQUE OF A NURSING RESEARCH STUDY Critique of a Nursing Research Study Research Critique 2 Critique of a Nursing Research Study The nursing research study, A comparative study of uncertainty, optimism and anxiety in patients receiving their first implantable defibrillator for primary or secondary prevention of sudden cardiac death. Is a research project where the problem being addressed is, "To determine if patients receiving their first Implantable Cardioverter Defibrillator (ICD) for primary prevention (pp) versus secondary prevention (sp) differed in uncertainty, anxiety, and optimism before, one week, and one month after implant”(Carroll & Arthur,2009). The research purpose of this study is "to determine if patients receiving their first ICD for primary or secondary prevention of sudden cardiac death from ventricular arrhythmias differed in their level of uncertainty, anxiety, and optimism before ICD implant and further explore uncertainty and anxiety both one week and one month past ICD implant”(Carroll & Arthur, 2009). This is done using three different types of surveys to collect data from a two groups of 15 participants, before, at one week and at one month regarding their uncertainty, anxiety and optimism. The research does discover a higher incidence uncertainty score in SP patients versus PP patients after one month. This knowledge about a patient’s uncertainty, anxiety and optimism can direct nurses when implementing nursing interventions...
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...Nursing is a diverse and dynamic profession, with many layers that influence how care is ultimately delivered. This paper will explore some of these influences, and outline a Professional Nursing Mission Statement, with a keen look at nursing organizations, ethics, accountability, and professional practice. Mishel’s Theory of Uncertainty in Illness will be explained as a support to the mission statement and support of my personal professional practice. Additionally, two personal anecdotes will be shared regarding the ethical principles of respect for autonomy and beneficence. Functional Difference between Regulatory Agency and Professional Nursing Organization The major functional difference between a regulatory agency like a board of nursing and professional nursing organization is that a regulatory agency governs the education and licensing of nurses; actual nurse practices on the job, and discipline if the nurse falls short of governing practices (National Coumcil of State Boards of Nursing, 2015). The rules and regulations enacted by the board of nursing, after public review, “have the full force and effect of law.” (National Council Board of Nursing Nurse Practice Act 2) In contrast, a professional nursing organization is comprised of voluntary groups of nurses which provide educational opportunities, share information, and promote the profession. (Matthews, 2012) According to the National Council of State Boards of Nursing website, each state board of nursing...
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...Historical Development of Nursing Timeline 1850s The history of theoretical and scientific approach in nursing evolution rooted in mid-1800s by the founder and pioneer of modern nursing; Florence Nightingale. She was considered “The Lady with the Lamp” and “The Mother of Modern Nursing “. Florence Nightingale was born in Florence Italy on May 12, 1820. She grew up with the belief that her religious calling was to take care of other people. She started her work during the Crimean war. Her amazing management skills and her ability to provide nursing care to the healthy and wounded soldiers, using her great base knowledge and understanding about the cause and effect of disease and the influence of the environment in healing process, provided a major impact in healthcare and started the beginning of the nursing profession. Her satisfaction however did not end alone in taking care of her patients. She broadened the concept of nursing by research and studies on how to come up with more effective care using statistics, cases and data. Her dedication and the positive outcomes influenced many peoples around the globe and inspired the continuation of her great work. In 1859, Florence Nightingale published her views on nursing care in “Notes on Nursing”. The basis of nursing practice was based on this theory. 1960s Theorist Year Nursing Theories V. Henderson 1960 Basic...
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...University RUP1 A. Functional Differences State boards of Nursing (BRN) are state agencies with regulatory powers to enforce laws and establish licensure requirements. (McDaniel, 2014) Jurisdiction limitations pertains to pre-licensure nursing education, (Schultz, 2014) licensure exams and disciplinary action against nurses who violate the law. Nursing organizations and associations are dedicated to the practice of nursing and its many specialties. These organizations offer education opportunities for Certifications, practice resources and professional development. (AMSN, 2013) Nursing organizations have no regulatory power. B. Nursing Code Examples Two examples of the Nursing Code of Ethics influencing my daily practice would be provision seven and provision eight. Provision seven states, “The nurse participates in the advancement of the profession through contributions to practice, education, administration and knowledge development.” (“Code of Ethics,” 2001, p.12) My position as Core Measures Specialist charges me as reporter of Core Measures compliance and educator of staff and physicians. As a member of the Clinical Affairs team, I Present Core Measures education/updates to several monthly and quarterly committees. I also provide a monthly scorecard related to physician compliance with the measures. As well as a monthly performance improvement forum/workshop for nursing Core Measures education. I created the original power point presentation...
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...In nursing care, comfort is described as an immediate and desirable outcome (Kolcaba, 2010). Comfort is an extremely important component when an individual is receiving palliative care. “Palliative care is given to improve the quality of life of patients who have a serious or life threatening disease, such as cancer” (National Cancer Institute, 2010). Katharine Kolcaba is a nursing theorist who created the Comfort Theory. It focuses on providing relief, ease, and transcendence when providing nursing care (Kolcaba, Tilton, & Drouin, 2006) Mrs. X (pseudonym) is an 85 year old woman struggling with Ovarian Cancer. The client’s mass on her ovary cannot be treated with surgery or chemotherapy. The client has chosen palliative care measures, and...
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...e-mail pubpermissions@ons.org. FEATURE ARTICLE Building Comfort With Ambiguity in Nursing Practice Kalli Stilos, RN, MScN, CHCPN(C), Shari L. Moura, RN, MN, CONC(C), CHCPN(C), and Frances Flint, RN, MN Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice. ...
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...Project M. Ryan Western Governors University RUP1 Project Nursing as a profession is an incredibly varied field, with as many opinions on how and why as there are nurses. It is therefore incumbent on each nurse to determine what aspects of nursing research and history will influence her practice. This work is presented as a Professional Nursing Mission Statement for the author. In the following pages, the governing bodies, ethical code, professional traits, nursing theorist and theory, and historical figure that guide personal nursing practice are presented with scenarios demonstrating their effects. Providing the building blocks for an individual approach to nursing will result in a deeper understanding of practice. A. Functional Differences In practice a nurse has two important guides for legal, ethical and competent nursing: regulatory agencies, such as the California Board of Registered Nursing, and professional nursing organizations, such as the American Nurses Association, While both entities provide frameworks for nursing practice, their functional differences vary. The California Board of Registered Nursing (2013) is responsible for the licensure and regulation of nursing practice of all registered nurses in the state of California. The agency implements and enforces laws governing nursing practice in its jurisdiction as outlined in the state’s Nursing Practice Act. This includes the definition of nursing in the state, which actions may or may not be performed by a...
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...likely to experience in response to a newly diagnosed condition with a poor prognosis. Imagine a person newly diagnosed with a poor prognosis and what the person response would be? Prognosis is a medical prediction of the future course of a disease and the chance for recovery.This essay will attempt to discuss responses from four aspects which are physical, emotional, cognitive and behavioral when person diagnosed with a poor prognosis. Essay will identifies response of each aspect and give examples. Identify the most of responses associated with grief. Essay introduces Kubler Ross’s Stage of dying theory and use theory to demonstrate emotional responses. A new diagnosis of life-threatening disease has a broad impact on a person's emotional, cognitive, social, spiritual, and physical well-being (Hill, Muers, Connolly, & Round, 2003) When someone confronts life-threaten illness that exceed coping resources, the reaction from emotional, cognitive, behavioral, and physiological is psychological stress. Responses are dependent on wide range of factors, such as the nature of the stressor, individual's physical and emotional capabilities, life experiences, social environment, coping skills, resources, and so on. (N.A. Kasparian.2013) Physical responses depend on disease such as painful, insomnia, headache, tachycardia, hyperventilation, anorexia, and diarrhea and so on. Other responses come with the grief. “Grief can be represented by physical sensations, such as a lump in...
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...State Boards of Nursing (NCSBN) and the American Nurses Association (ANA) shall be utilized for this paper in describing their differences in function. Two examples from the NCSBN code of ethics will be provided and how they have influenced my practice. I will choose four traits from the ANA and discuss them in reference to an interdisciplinary team of healthcare professionals. A Nursing Theory will be discussed as well as a nursing figure that is important me. Two safeguards will be presented in a scenario from my nursing experiences. The American Nursing Association (ANA) was originally founded and named the Nursing Association Alumnae in 1896; it became the ANA in 1911. It is a professional organization devoted to the advancement and protection of the nursing profession. The ANA establishes standards of nursing practice, promotes rights of registered nurses (RN) in the workplace and advances the economic health and general welfare of RNs. According to the ANA, nursing is the protection, promotion and optimization of heath and abilities, it prevents illness, injury and alleviates suffering through diagnosis and treatment of human response and advocates the care not only of the individual but the whole family, community and populations. The ANA has three sub organizations: 1. American Academy of Nursing-it serves the public and nursing profession by the advancement of health policies and practices through generation, synthesis and dissemination of nursing knowledge. ...
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...Middle Range Theory Continues to Guide Nursing Practice Judy John Maryville University Middle Range Theory Continues to Guide Nursing Practice Nursing theory has three distinct categories to describe the level of abstraction: Grand, Middle-Range, and Situation-Specific (Meleis, 2012, p. 33). Hugh McKenna (1997) defined these three categories, stating: Grand theory is highly abstract and is broad in scope. Middle-range theory is more focused and is normally the end product of a research study. Narrow-range theory is even more specific and while also being based on research findings, it guides specific actions in the achievement of desirable goals (p. 17). When thinking about nursing theory, one might ask: What is the purpose of theory? Is it even relevant to current nursing practice? The best response to answer these questions I have found is from Meleis (2012): The primary uses of theory are to provide insights about nursing practice situations and to guide research. Through interaction with practice, theory is shaped and guidelines for practice evolve. Research validates, refutes, and/or modifies theory as well as generates new theory. Theory then guides practice (p. 35). This explanation of theory by Meleis identifies nursing as a profession. Without theory to shape and guide nursing practice and research, nursing would not evolve and would remain stagnant. Additionally, without theory could nurses really claim that we are a profession...
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... Historical Development of Nursing Timeline The purpose of this paper is to explain the historical development of nursing science by presenting different theorists and their theories with explicit events and years in the history of nursing, and inform on the affinity between the profession and nursing science. This paper also includes the importance of nursing science of other disciplines such as psychology, anthropology, education, philosophy, religion and the social science. The history of professional nursing starts with Florence Nightingale, who is considered the mother of nursing science. Nightingale placed emphasis on good nutrition and hygiene, efficiency of this practice had a positive impact when this method reduced the spread of infections and made a huge difference in the survival rate of soldiers in the Crimean war in the mid -1850s. In 1859, she published her famous nursing notes “What is and what is not” Although Nightingale wrote this book with the intention to give clues to those taking care of the health of others; ("Florence Nightingale and the Crimean War," 2008) it turned out to be a great educational and role model method which is clinically used to present. And it is a great example of evidence- based practice. In 1860 in London the school of Nightingale was opened, and the American Red Cross was founded by Clara Barton in 1881 ("Nursing Theory Definition”) Abraham Maslow proposed the theory of the “Hierarchy of Needs” in the...
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...Epidemiology Paper: Tuberculosis Sara Abayneh NRS – 427V Grand Canyon University 12/22/2014 Tuberculosis is a multi-systematic infectious disease caused by mycobacterium tuberculosis, a rod-shaped bacterium, which most commonly affects the lungs, as well as any part of the body such as kidney, spine, lymph nodes, bones and, brain. According to CDC (2014), the universal symptoms of TB disease includes sickness, weight loss, weakness, fever and night sweat. The signs of lung (pulmonary) TB also includes coughing, with or without blood, and chest pain. This silent killer disease is primarily airborne, spreading from person to person when tiny microscopic droplets of germs are released into the air when an individual with vigorous tuberculosis infection of the lungs or esophagus coughs, sneezes, communicates, or laughs. These microorganisms can remain alive in the air for some hours, depending on the conditions of the environment (WHO, 2014). Severity of TB ranges from minor to severe complication, which may lead to death. Some severe impediments include damaged lung functions, bone pain, meningitis, kidney and/or liver malfunction or unusual disturbances. According to Mayo Clinic (2014), medications are vital for TB treatments, however if taken much longer time than other bacterial infections for TB treatment antibiotics must be taken for six - nine months where the exact drugs of lengths treatment depend on age, general condition, medicine conflict, the system of TB and...
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...Running Head: COMPARISON AND ANALYSIS Concept Comparison and Analysis Across Theories Paper on Spirituality University of Phoenix Online Developing and Evaluating Educational Programs (NUR/588) Dr. Amy McClune 4 June 2007 Concept Comparison and Analysis Across Theories Paper on Spirituality Spirituality in nursing and medicine has been a conflicting topic because many things have occurred which cannot be explained or proven through scientific experimentation. The only plausible explanation that has been given points to a higher power or being. Florence Nightingale believed she had a calling from God to do her work in nursing not only to physically heal but spiritually heal as well. On the other hand, Dr. Larry Dossey felt medicine alone could not heal and it is the responsibility of the physician to invoke the “power of prayer” to assist with a patient’s healing process. During the mid-nineteenth century, optimism ran high in England. With the rise of empiricism, in which all knowledge is derived from experience, science blossomed and gave rise to high hopes for conquering drudgery and disease. Florence Nightingale went to Crimea and by applying good principles of sanitation, she made a major difference in the death rate of British soldiers – from 42% to 2% (Shelly & Miller, 1999). During this time Florence Nightingale observed that the common people in her day were becoming atheists and losing their basis for ethical...
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