NR 510 Theory and the APN Role
NR 510 Theory and the APN Role
According to Karnick (2014), nursing theory provides the ethics and beliefs that guide practice and help generate nursing knowledge. When nurses purposefully form their care around a particular theory, clinical practice takes place (Karnick, 2014). Karen should learn nursing theories because she will need the information to guide her care of the patient. Nursing theory is very important to APN practice because it provides nurses with the foundation and principles of the profession. The four main paradigms— person, health, environment, and nursing—that drive nursing theory aim to promote patient wellness. Also, learning nursing theory encourages critical thinking and suggests ways to relate the fundamentals of nursing to the actual practice of nursing (Karnick, 2014). Nursing theory is useful in many areas of nursing to include clinical, community health, legislative, administrative, educational, legal, etc. These theories provide invaluable knowledge that Karen can use to construct new knowledge. Nursing theory will teach Karen about the importance of evidence-based practice and how it relates to the decision-making process for patient care and patient values.
Karen’s concerns about the nursing theory being too broad should be addressed. While she is right, let’s put the reason why into context. As a new graduate nursing student, Karen will learn the theories are broad because there is more than one way to explain how to administer patient care or how to communicate with colleagues. There are multiple ways to display leadership and to educate oneself about new health processes, diseases, patient concerns, and all things dealing with nursing. Nursing theory is confusing at times because there are so many theories to learn. However, this should be viewed as a positive because it inspires a sharing of ideas and nursing practices. There is no singular way to provide the best patient care, and Karen can use many of the theories to enhance her clinical expertise. She can also compare nursing theories with current external clinical evidence and research to extract the most useful information to provide better patient care. The lack of agreement in the professional literature on nursing theory does not diminish the value of the theories nor does it make the theories irrelevant to practice. What the lack of agreement does is create dialogue and promote more evidence-based research. Karnick (2014) states eliminating nursing theory in the classroom will “degrade nursing as a viable profession.” The discipline of nursing needs these theories to guide effective patient care, or nursing will be just another set of actions or tasks that is not valued or needed by patients and their families (Karnick, 2014).
Karnick, P. M. (2014). A case for nursing theory in practice. Nursing Science Quarterly, 27(2), 117. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/0894318414522711
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The Theory of Modeling and Role-Modeling states nurses should care for each patient with an understanding and
respect for the patient’s uniqueness (Currentnursing.com, 2018). This is the basis of Erickson’s theory, which focuses on the patient’s needs and what should be the core of clinical practice. To apply this theory to family practice, the role of the FNP is to facilitate care, nurture the wellness of the client, and to accept the patient’s need for autonomy. The five goals of the theory apply to the practice of nursing, as well as leading nursing organizations’ missions and purposes. One of the first theories that nurses learn is the Code of Ethics. When put into practice, the code is the ethical obligations and duties of every nurse (Judge-Ellis & Wilson, 2017). Erickson’s theory and the Code of Ethics align with each other because both state that nursing goals and interventions should be to build trust between the patient and the nurse, to promote the patient’s autonomy and privacy, and to set health goals that promote the client’s strengths and respects cultural practices. As FNPs engage in family practice, they must apply these values to provide the best care to families.
Currentnursing.com. (2018). Modeling and role modeling theory. Retrieved from http://currentnursing.com/theory/modeling_and_role-modeling_theory.html
Judge-Ellis, T., & Wilson, T. R. (2017). Time and NP Practice: Naming, claiming, and explaining the role of nurse practitioners. The Journal for Nurse Practitioners, 13(9), 583-589. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2017.06.024
I smiled at your post because it also took me awhile to develop an appreciation of nursing theories and to apply them to patient care. Applying theory to patient care is still challenging to nurses who have been in the field for awhile. Yet, I have learned there are many advantages to understanding various nursing theories. These theories serve as reminders or guides to what we should do as nurses. As nurses, it is important that we use critical thinking skills when applying nursing theory to real-world clinical application. Niederriter, Eyth, and Thoman (2017) propose that nursing instructors need to help students understand how nursing practice and patient outcomes differ when nursing theory is used. The role of nursing instructors is imperative because of the body of knowledge they have. If nursing students accept the academic guidance and clinical expertise of their instructors, they will grow into successful, productive nurses (Niederriter et al., 2017). When nursing instructors “intentionally” connect theories to nursing practice, nurses are empowered to make a difference to patients, families, and the health organization (Niederriter et al., 2017).
Niederriter, J. E., Eyth, D., & Thoman, J. (2017). Nursing students’ perceptions on characteristics of an effective clinical instructor. Open Nursing, 3. Retrieved from https://doi.org/10.1177/2377960816685571
I think work Erikson’s is very important, yet classical model to look at when discussing how it relates to family practice. A nurse practitioner that specializes in family nurse practitioner practice, will have education that goes across the board. During clinical, one will do pediatrics, women’s health, adult and geriatric health. It is important to understand the psychological needs and accomplishments of each age group. Healthcare tries to now look into a patient as a holistic person and not just a person with signs and symptoms and a illness or disease to treat. When caring for a patient, one has to look at the patient mentally, physically, emotionally and even sometimes spiritually. For example with 45 to 65, according to Erickson, they are experiencing generative vs stagnation. People experience a need to create or nurture things that will outlast them, often having mentees or creating positive changes that will benefit other people. Success will equal to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world. 65 and older will be experiencing ego integrity vs despair. This stage takes place after age 65 and involves reflecting on one’s life and either moving into feeling satisfied and happy with one’s life or feeling a deep sense of regret.Success at this stages leads to feelings of wisdom, while failure results in regret, bitterness, and despair. For a nurse or nurse practitioner will do a thorough assessment to examine all avenues of the patient. A patient who is 55 years old might be going thru depression because her only son is in jail and she might feel as though she failed her son. This might cause her to eat less, grow weaker and become non compliant with blood pressure medication. If the NP did not look into this, she would have missed this important factor and just aimlessly order different interventions without examining the psycho social aspect of it. One patient in a clinic who is 69 years old, is generally healthy for their age, happy, compliant with medications might have been satisfied with life, vs the 70 year old patient that did not work in a profession he/she wanted, divorced and has been lonely may be unhappy, unsatisfied and non compliant with medication. Often, nurses and nursing practice becomes busy with different task and interventions to do, however, it is still important to look at the patient holistically. (Dunkel & Harbke, 2017)
Dunkel, C., & Harbke, C. (2017). A Review of Measures of Erikson’s Stages of Psychosocial Development: Evidence for a General Factor. Journal Of Adult Development, 24(1), 58-76. doi:10.1007/s10804-016-9247-4