Annotations on Nursing Theories

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

* B. .F Skinner (1904-1990) argued that these concepts are not needed to explain behavior. One can explain behavior, he claimed, by analyzing the conditions that are present before a behavior occurs and then analyzing the consequences that follow the behavior. (operant conditioning: reinforcement)

The concept of environment and its integral role in the delivery of nursing care was among the first identified and documented nursing theory since its early days. Florence Nightingale pioneered the profession of nursing and along with it, pioneered the concept of nursing theory. Her environmental theory was patient focused and incorporated five environmental components needed to promote health. Jarrin (2012) supported that the role of nursing is to promote the best possible environment for the patient to assist in their natural reparative process. According to Rahim (2013), as considered as the profession’s first nurse theorist, Florence Nightingale provided the essential foundation in environmental theory. She believed

Theory development stems from personal experiences, intuition, and knowledge of the theorist (Burns et al., 2013). When a scholar develops a theory, it has to be tested through research. The findings of the study are then presented to experts in the area of academics and the field of practice (Burns et al., 2013). The presentation of the findings allows experts to provide constructive criticism, highlight the pros and cons of the theory, and acknowledge whether or not the theory can be accepted as a guide to practice. This theory evaluation paper will give the reader a theory description, theory analysis, and an assessment of Dorothea Orem’s self-care deficit theory of nursing (Alligood et al., 2010).

The environment theory of nursing is a patient-care theory. The delivery of patient centered care is the best delivery of care a patient can receive. Applying Nightingales environmental care theory of manipulation of the patient environment can affect the patient and assist in the delivery of quality of care. The concept of a clean patient environment has an effect on the patient’s recovery and the prevention of spread of diseases (Harvard Libraries, 2012). Using Florence Nightingales environmental theory and concepts will give a

Selanders, 2010 (as cited in Rahim, 2013) concluded that, “Environment is the umbrella concept in the Nightingale theory of nursing. It was her contention that the environment could be altered in such a manner as to improve conditions so that the natural laws would allow healing to occur”. The five environmental components identified by Nightingale, which are necessary to a person’s health, are: clean air, pure water, efficient drainage, cleanliness, and light. These five components are further divided into the following canons: ventilation and warming, health of

The nursing profession entails core values and commonalities that link those in the profession. A comprehensive study of the literature identifies key components of the profession as the provision of technical care, defending the vulnerable, taking care of the ill, as well as establishing systems for the delivery of care. Different models have been developed which describes and guides the nursing profession. The two nursing theories: the Theory of Nursing as Caring by Boykin and Schoenhofer and the Transition Theory of Afaf Ibrahim Meleis are constructive theories and serviceable in the nursing field. This paper gives an analysis of two nursing theories, comparing and contrasting their values.

The nursing theory consists of four major concepts including person, health, environment, and nursing. According to the Fundamentals of Nursing, these four concepts “… give nurses a comprehensive perspective that allows you to identify and treat patient’s health care needs at all levels and in all health care settings.” (Potter & Perry, 2009, p. 40) Florence Nightingale’s theory was one of the first models for nursing. The focus of this theory was that nursing consists of caring through the environment and helping the patient overcome their symptoms and changes in function related to their prevailing illness. It also focuses on the manipulation on the environment for the potential benefit of the patient. Florence “… had always seen to the heart of things- that the real nurse must be a dedicated being- that

According to nursing-theory (2013), “Florence Nightingale is attributed with establishing the modern practice of nursing. She also contributed to the field with nursing theories still used today. One of her nursing theories is Environmental Theory, which incorporates the patients’ surrounding environment in his or her nursing care plan.” As a registered nurse, I will not take lightly to assess my clients’ nutrition, be aware of the client’s environment and how both of these things can greatly affect their well-being and recovery. It is my duty as a registered nurse to provide outstanding nursing

(Bair, 2012) The idea of caring for every aspect of the patient, rather than just the physical body, is one that dates back to Florence Nightingale herself, a British nurse, statistician, and social reformer who was the founder of modern nursing. (Selanders & Crane, 2012) One of her nursing theories is the Environmental Theory, which focuses on the inclusion of the patients' surrounding environment in their nursing care plan. Nightingale’s observations taught her that unsanitary environments contribute greatly to poor health, and slow recovery times. (Petiprin 2016) This theory provided a basis for holistic care, and is still applicable today. (Medeiros, Enders, Lira 2014; Pirani 2015)

Florence Nightingale developed the environmental model theory of nursing. Nery, (2015) states that Florence Nightingale’s environmental theory of nursing, “focus primarily on the environment, interpreted as all external conditions and influences that affect the life and development of an organism, that are able to prevent, suppress or contribute to disease and death.” The four metaparadigm concepts of this theory consist of person, environment, nursing, and health. Within this theory, the patient is being cared for by the nurse, has been influenced by the environment, and has reparative powers (“Nursing Theories, 2011). Nightingale’s theory does not have a clear definition of the person; however, it can be inferred that the person correlates “in relation to the environment and the impact of the environment on the person’s health status” (Butts & Rich, 2018). The highlight of Nightingale’s theory is the environment. Both the external and internal environment needs to be in sanitary conditions. The environment concept of this theory contains “physical, psychological, and social” factors (“Nursing Theories, 2011). The goal of the nurse is the control the patient’s environment to achieve ideal health for the patient. Nightingale’s theory did not define health; however, she stated that nature itself can heal ailments (Butts & Rich, 2018). Nightingale (1859) stated that health is ‘not only to be well, but able to use well every power we have to use it.”

Volition is believed to govern over the lower subsystems of the hierarchy (Kielhofner & Burke, 1980). The middle subsystem is defined as habituation. Habituation is responsible for organizing behavior into roles, patterns, and routines. Roles reflect a group of behaviors with which an individual may have certain expectations of performance. The individual's beliefs and society influence these expectations. Roles contribute to self-identity and influence behavior. This organization allows for certain behaviors to be performed automatically and adapted to various environments. Performance, the lowest subsystem within the hierarchy, consists of the skills necessary for producing behavior. These include perceptual-motor processing skills, cognition, and communication. The function of the performance subsystem is to produce behaviors called

Nursing has made much advancement since Nightingale Environmental Theory but the focus on a healthy environment has remained the same. Pulliam (1997) noted in her article that Nightingales’ theory formed a solid foundation for nursing: fresh air, cleanliness, clean water, warmth, proper drainage, plenty of light, and stress free environment provided an optimum environment for healing.

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Alice Petiprin, 2014). It involves the nurse’s initiative to make environmental settings appropriate to aid in the recovery of the patient’s health. According to Nightingale all external factors are somehow associated with the patient and affects their life physically, mentally, and socially (Alice Petiprin, 2014).

Secondly is the idea of directness, which assumes that a person's behaviour when caused is directed towards something, i.e., it is goal orientated. Thirdly is the belief that underlying behaviour there is always a motivation, a need or a want. By using these assumptions a model can be developed for understanding an individual's conduct. It was thought that if motive influences a behaviour, which allows an individual to arrive at a goal, when the goal is