Review and Reflect Essay

During this module, you will complete Milestone Three of the final project, in which you continue to review and reflect on the identified problem and analyze the current theories that are utilized in your practice setting to address your previously identified problem. This milestone paper must include the following critical elements:

Analyze the theories that you feel are currently being used by your practice setting to address the specific nursing problem you identified earlier. Provide specific evidence to back up your claims (Section IIF of the final project).
How amenable do you feel the problem is to a theoretical solution? In other words, is a theory-based solution the best response, or would another approach be more appropriate? Be sure to substantiate your claims (Section IIC of the final project).
Must be done in word for editing
APA 7th edition
SEE attached milestone paper and rubric
MUST include stress/nursing shortage

Research has revealed that there exists a positive bidirectional relationship between stress among nurses and nursing shortage. The extent of the stress and the perception of nurses on of staffing inadequacy would differ depending on their work settings and demography (Alenezi, et al., 2018). Particularly nurses with higher positions and qualifications working in inpatient settings and who worked full‐time and in non-magnet hospitals have been found to be at a higher likelihood of attributing staffing inadequacy as a man contributing factor to their stress as was my experience while working in a hospital setting. Review and Reflect Essay .

Orem’s Self-Care Deficit Theory is based on the premise that every person is capable of self-care. According to Dorothea Orem, “self-care” will consist of actions that a person deliberately and freely initiates and carries out on their on for the purposes of maintaining their health, life and well-being. The actions of a nurse in this context are directed towards helping the patient assume their responsibility for self-care.

According to Orem, there are two steps in the nursing process that help in achieving the above goal. The first of these steps involves the identification and prioritization of the patient’s unmet needs in self-care or their deficits. The second step involves the selection of methods of helping the patient compensate and to overcome their deficits (Luodan et al., 2020).

This theory works to eliminate stress resulting from nursing shortages by placing the bulk of care on the patient rather than on the nurse. While the reasoning behind this theory is that patients will be better able to recover when they maintain independence over their own care, the theory also benefits nurses in that less effort and time is spent on assisting patients in mundane tasks. This will reduce the work load on nurses thereby eliminating the need for additional staffing (Glińska et al., 2016).

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References

Alenezi, A. M., Aboshaiqah, A., & Baker, O. (2018). Work‐related stress among nursing staff working in government hospitals and primary health care centres. International journal of nursing practice, 24(5), e12676.

Glińska, J., Brzezińska, E., Lewandowska, M., & Borowiak, E. (2016). The role of the theory of nursing in improving the quality of nursing care. Nursing Problems/Problemy Pielęgniarstwa, 24(3), 177-181. Review and Reflect Essay .

Luodan, F. A. N., Hua, Y. U., Hong, C. H. E. N., Anqi, W. A. N. G., & Qi, L. U. O. (2020). Research progress of Orem’s self-care theory in clinical nursing research. Chinese Journal of Integrative Nursing, 6(1), 181.

Section IIA

            Since I work in a single nurse unit, it is hard for me to identify theories that other nurses apply. But thinking back when I worked in a hospital setting, the main nursing theories I did see nurses apply when caring for patients, included the theory of comfort in nursing, theory of human caring, and theory of self-care in nursing. The theory of comfort in nursing was proposed by Katharine Kolcaba in the 1990s as a middle range theory, and posits that comfort should be an immediate outcome of nursing care (Yoost & Crawford, 2019). Nurses apply this theory by ensuring that patients achieve comfort through ease, transcendence, and relief. One of the way I observed nurses at the workplace practicing this theory is when they administer pain medication for patients in post-operative care, hence, helping the patients achieve relief.

Nurses practice the theory of human caring, which was proposed by Jean Watson, and posits that the nursing process is concerned with restoring health, preventing illness, and promoting health. The theory focuses on disease treatment (Masters, 2015). At the workplace, the nurses apply this theory by respecting the patient’s autonomy, wishes, and trying their level best to understand the patients and their needs, while offering them care and comfort. For instance, one of the patients admitted at the hospital wished to only speak to a specific nurse, and the management ensured the patient’s wishes were fulfilled.

On the theory of self-care proposed by Dorothea Orem, the nurses at the workplace apply it by engaging patients in telehealth, where they guide them on self-care at home, and the various activities they can undertake to enhance their health. For instance, nurses teach the diabetic patients how to inject themselves with insulin, instead of having to visit the healthcare facility each time they require insulin shots.

Section IIB

            Dorothea Orem’s theory of self-care provides the nursing practice with a strong base, where it is applicable in a variety of nursing fields (Barry et al, 2015). Nurses from different fields can apply this theory successfully on their patients. Another major strength of this theory is that it is applicable in nursing advocacy, where the nurse can use this theory to advocate for patient autonomy. Review and Reflect Essay .For instance, if a patient prefers to receive treatment and interventions from home, and their health is not in critical condition, nurses can use this theory to advocate for the patient and their autonomy.

However, this theory is limited because it can be ambiguous within nursing practice; whereby it may not encompass all aspect of nursing practice. For instance, the definition of family care givers may be unclear, and areas that require public education are weak. Additionally, applying this theory in nursing practice is limited because patients have varying needs and levels of care, that self-care may not fulfill.

One experience I remember as an ED nurse, was a patient who presented very ill, but had family members by their side for support. After a physical exam and laboratory finding, the patient was diagnosed with hypochromic anemia secondary to upper GI bleeding. The patient needed an urgent blood transfusion. They declined the transfusion and it was hard for me to understand the rationale. Lack of information about different cultural backgrounds causes misunderstanding of the patient and the care provider.

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Section IIC

            At the master’s level nursing practice, nurses require skills to implement evidence-based practice, and offer mentorship and guidance to the junior nurses. As such, applying these theories would be effective at master’s nursing level. For instance, by applying the theory of comfort, nurses use evidence-based practice to offer patients comfort through advanced relief methods, such as advanced drugs. Within the theory of self-care, nurses at this level can promote their professional growth by using evidence-based studies to determine the patients eligible for self-care treatments, to enhance their overall health outcomes.  As a CNL in occupational health, I hope to improve the relationship between occupational safety officers and employees. Occupational health and safety officers are on the norm strict with employees. While their approach is sensible, it builds a barrier between themselves and the employees. Review and Reflect Essay .I hope to modify the culture by allowing more communication from the employees to the occupational safety team. Their contributions will also help manage and accommodate the techniques of their work, when implementing new plans and processes. My future practice goal is to evaluate evidenced based health promotion and disease prevention strategies. Looking ahead as an OHN, I will need to have more impact with employees prevention and health promotion programming services, along with employee engagement and productivity. My recognition of cultural consideration in my practice, has developed through education, experience and personal perspective.

Section IID

            The theory of human caring and theory of comfort promote quality in healthcare because they both promote holistic nursing (Smith & Gullet, 2019). The two theories focus on the patient as entity, and help the patient achieve comfort through transcendence, relief, and ease, all which ensure that the patient receive holistic treatment physically, mentally, and spiritually. My future practice goal is to evaluate evidenced based health promotion and disease prevention strategies. Looking ahead as an OHN, I will need to have more impact with employees prevention and health promotion programming services, along with employee engagement and productivity. My recognition of cultural consideration in my practice, has developed through education, experience and personal perspective. Review and Reflect Essay .

References

Barry, C., Gordon, S., & King, B. (2015). Nursing case studies in caring. Springer Publishing Company.

Masters, K. (2015). Nursing Theories: A Framework for Professional Practice. Jones & Bartlett Learning.

Smith, M., & Gullett, D. (2019). Nursing theories and nursing practice. F.A Davis.

Yoost, B., & Crawford, L. (2019). Fundamentals of Nursing E-Book: Active Learning for Collaborative Practice. Elsevier Health Sciences. Review and Reflect Essay.