Nursing theories have been developed by research nurses as a way of improving patient care process (Snowden, Donnell & Duffy, 2014). Nursing theories from research are woven in the current practice of nursing and throughout the healthcare sector covering a wide range of aspects in patient care. This paper will discuss my nursing autobiography and career background as well as my experience in healthcare. Moreover, the paper will explore the four metaparadigms and concepts of patient care as well as five propositions that connect the environment and nursing concepts related to my nursing practice.
Since my childhood days, my fantasy has always been to end up as a family practice nurse by calling with an essential craving to provide intimate care to patients. At the age of twelve years, I was admitted to the hospital at the children’s ward with a bacterial infection for a couple of days. My stay at the hospital opened my eyes to a whole new experience because of the compassionate and good care provided by the nurses. I was greatly moved by their courtesy, respect, professional conduct, accorded to everyone in my ward. This experience stirred my passion to become a nurse and give back to the society. My parents have always reminded me how I would imitate professional nurses by pretending to take body temperatures and putting a pen in the pocket.
My journey to becoming an advanced practice nurse as a family nursing practitioners has been exciting if not fulfiling. I obtained a Bachelor’s degree in nursing upon which I became a registered nurse by the state board of nursing. However, because becoming an advanced practice nurse was my ultimate goal, I started working as a licensed and registered practice nurse in the medical-surgical unit. According to the regulation of nursing practice, as a licensed practice nurse I worked under the supervision of experienced advanced nurses and physicians. This enabled me to gain sufficient nursing skills and knowledge necessary for timely, quality and cost-effective care. I am a family person, as such, this role enabled me to work closely with care for family members, including infants and babies. This role prepared me for my future advanced role as a family nursing practitioner. Later, I also worked as home care RN. In this role, I helped take care of patients with complex health conditions who needed close monitoring and follow up.
I also worked with family members to evaluate the needs of patients, coordinate and monitor multiple patient care services at the home care facility. This role proved to be one of the most successful ones in my experience as it prepared me for my advanced role as a family practitioner, than I could ever imagine. As I continue to specialize as a family nursing practitioner, this advanced role is enabling me to provide comprehensive and continuous care through health promotion, disease management, health education and preventative healthcare services to patients with acute and chronic conditions. Moreover, my experience in this role has continued to equip me with nursing skills necessary to avail episodic care across all ages. I am fascinated and looking forward to availing the best care even as I continue to gather experience.
My personal philosophy in nursing practice and especially in my specialization as a family nursing practitioner, is to use my skills, knowledge and competencies in nursing to provide quality care to patients so that their illnesses are alleviated. I also plan to take my experience to a whole new level by partnering with fellow professionals to set up private practice clinics to assist patients more intimately.
Francis (2017) point out that metaparadigms are a group of interrelated concepts in nursing practice that provide a conceptual framework for most theories of nursing They offer a universal view of functions in nursing practice on which structures can be developed. The fundamental concepts of nursing include the person, environment, nursing, and health. These metaparadigms refer to individuals who receive care, the state of the person receiving care, interactions, and the environment in which care is provided. It also includes nursing actions taken by nursing practitioners during care of patients. The metaparadigms are based on presuppositions and values of the four concepts. While various developments have continued to emerge in care of patients, metaparadigms concepts and theories of nursing will help provide a better understanding of personal nursing care philosophies.
The concept of a patient usually refer to the person receiving nursing care, caregivers, family members, friends and the community. When caring for patients, the primary goal of nurses should be to nature and empower patients to manage the health status of patients in the best way possible. Additionally, nurses have a sole responsibility to treat patients in a way that they feel cared for (Zerwekh & Garneau, 2015). The person component also weighs on intimate needs, social and therapeutic needs concerning care and family ties and those who they view as fundamental to them. Care provision to a patient requires an understanding that people have different dimensions such as psychological, biological, physical and social aspects. There is an intricate collaboration between these components in thought, feelings, social interactions, and self-concepts determine the wellbeing and health status of a patient. Nurses must integrate all these components of a person when offering holistic care. By assessing the needs of patients, I am able to fully address their most intimate care needs.
The environment refers to the setting and area around the patient that influence their wellness and illness. Simply put, the environment determines the wellbeing of a patient. The environment setting includes both external and internal factors. The environment concept concentrates on the connection within and around the patient that influence their health status as all patients require a conducive environment that facilitates, enhance and maintain their recovery. Therefore, nurses should ensure that patients are put in a safe and positive environment to aid in their recovery. In Nightingale’s theory of nursing advocate that nurses should improve the cultural, economic, and physical conditions to enhance the health of an individual (Snowden, Donnell & Duffy, 2014). Manipulating the environment would include improvements in sanitation, hygiene, water, and compassionate care to patients. The concept of the environment refers to the immediate context of the patient. Geographical location, financial factors, and cultural factors also play a fundamental role in the wellbeing of patients. The surrounding of a patient includes resources that shape the personality and impact of the wellness by urging adaptations to the surrounding circumstances. Thus, in my practice as a nurse taking care of patients, the surrounding that patients exist is my main concern as creating a healing environment at all subtle levels in the environment of energy and consciousness where beauty, wholeness, peace, comfort and dignity are potentiated.
The health component of the paradigm refers to the wellbeing of patients as well as their ability to have access to healthcare services. It also includes all aspects of good health status of patients that also include the emotional, social, physical and psychological health. It revolves around the body regardless of the presence or absence of a disease. However, Bender & Feldman (2015) state that the health status of patients usually vary depending on age groups. The overall goal of the nursing profession and practice is improving the wellbeing of patients. Moreover, patients have different ways of dealing with their health status. In my clinical experience as a nurse, I appreciate the significance of health and wellness as a significant concept in patient care.
The nursing component includes critical skills that nurses possess to convey quality healthcare services to their patients. These skills include technical competence, hands-on experience, medical knowledge, critical thinking and decision making skills as well as effective communication skills. While applying these skills nurses should have respect, honesty, compassion, empathy to ensure that patients are accorded the highest quality of care. Jean Watson’s theory and science of caring note that the goal of nursing is to facilitate a greater level of harmony within the body, mind and spirit triad, making it possible to potentiate healing and health (Bender, 2018).
Moreover, nursing also includes actions by every caregiver aimed at protecting, promoting and safeguarding human care and dignity. The central duty of a nursing practitioner is to assist patients in restorative services and interpersonal therapeutic interactions for good health status. Indeed, I believe nursing is both a scholarly profession and a calling to serve humanity with the aim of alleviating suffering. Like all other caregivers, I must be guided by ethics, good morals, and standards of practice all the time to promote nursing. Caring for the sick is where I draw my motivation. In delivering quality nursing care, it must always apply critical thinking and reasoning skills, good decision making, collaborative and communication skills.
Theories of nursing care incorporate the interactions between the four metaparadigm concepts namely; nursing, patients, health, and environment. To create a culture of customized care plan, and to avail quality care to patients, these metaparadigms must be consolidated. The idea is to avail patient-centred care with better clinical outcomes.
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The advancements in health include personal encounters of interactions with patients who experience a wide range of diseases, both chronic and acute. Chronic diseases have adverse impacts in the economy. There is an incredible amount of money that goes in the management, treatment and effective prevention of these chronic disorders. More costs are incurred in health promotion and transport. Therefore, health promotion programs created to create public warrens on self-care management and prevention has helped in reducing the effects and incidences of chronic diseases. As such, health promotion is an important practice-specific concept in nursing. Nurses play an invaluable role in ensuring that health promotion programs are tailored to patient specification to reduce the prevalence and progression of these diseases. By establishing therapeutic relationships with the patient, nurses are able to intimately talk to patients to make them aware of all they need to know about their health status (Marchuk, 2014). In my interactions with patients and caregivers as well as experience as a specializing nurse, I have come to appreciate that healthcare involves social equity in health promotion and this should always be incorporated into theoretical frameworks of disease management.
Evidence-based practice consolidates clinical mastery and patient values with the best research information that can be accessed. In my practice of nursing thus far, I see a myriad of favourable circumstances that can utilize evidence-based practice especially in the assessment, diagnosis, prevention, treatment and management of patients. Patients are assured of quality care when nurses make decisions that are informed by already existing evidence and that can be supported by research, fact and logic. From my experience during practice, it is apparent that nursing practitioners are trusted to apply evidence when managing patient conditions. Evidence-based practice bolsters the nursing choices that are made by healthcare providers in the clinical setting. I believe that nurses should be engrained in evidence-based practice so that they are able to make informed decisions about patient care when applying theory and research in nursing practice.
Butts & Rich (2016) point out that nursing propositions are an auxiliary part of nursing theories that propose the connection of ideas. From the metaparadigm concept of patients, health, nursing, environment and health, I can infer propositions as follows;
1. A caring and safe environment leads to improvements in the overall well-being and health of patients
2. During patient care, physical, social, emotional, psychological and spiritual prosperity viewpoints must be taken into account as they impact on prosperity of patients.
3. A good nurse-patient therapeutic relationship enhances the healing process of patients.
4. The collaboration of healthcare givers assists in the provision of holistic care to patients.
5. The use of acquired nursing skills and knowledge helps to improve the wellness of patients.
6. The immediate care setting impact nursing roles and nurses can use in-depth knowledge to adjust the patient’s healing environment.
7. Nursing involves care in the clinical setting as well as a profound comprehension of a plethora of patient factors that determine their health.
In my experience as a family nursing practitioner, I am always ready and willing to create individual viewpoints on nursing theories and practice-specific concepts. There are four major metaparadigms that guide the nursing profession, that is, nursing, patients, health and the environment. They are interconnected and related to the patient care process as their presence or lack thereof determines patient wellbeing and quality of care. Moreover, evidence-based practice and health promotion competencies are important practice specific concepts that have helped the nursing profession advance in availing high-quality care. Propositions in nursing drawn from metaparadigms and practice specific concepts have assisted in portraying nursing theories from research and experience.
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