Advanced Practice Nursing Essay Example

Theory-Based Nursing Practice

Theory plays a pivotal role in nursing since it helps in differentiating what is already known and what nurses need to know. Theory also forms the basis of nursing practice through describing, predicting and explaining nursing phenomena. According to Paley (2001), nursing theory helps in the generation of further knowledge and suggesting the future direction of nursing. There are numerous benefits associated with having a clear body of nursing theory such as improved patient care, guiding education and research, enhancing communication between nurses, and improving the professional status of nursing and nurses. It is impossible to measure caring, which is the main aspect of nursing; therefore, theory is needed for the purposes of explaining and analyzing the actions of nurses. With the medical profession gradually moving towards embracing a multidisciplinary approach, nursing should attempt to build a distinctive body of knowledge, which is evident by the nursing profession trying to establish and uphold its professional limits (Fawcett & Desanto-Madeya, 2013). Owing to the importance of theory in nursing, the purpose of this paper is to discuss the theory-driven advanced nursing practice. To this end, this paper discusses how Jean Watson’s theory of human caring and Marlaine Smith’s theory of unitary caring embodies globalization, healthcare disparity and cultural relevance. The paper also provides an example of a nursing situation in which the identified frameworks could be used, and provides a description of a specific example of how this role will be used in guiding advanced nursing practice.Advanced Practice Nursing Essay Example

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Nursing Metaparadigm

A metaparadigm refers to a set of ideas or theories outlining the structure that determines the functioning of a particular discipline. In the context of the nursing discipline, there are four basic components of metaparadigm, which include the patient as a whole, the patient’s environment, the patient’s wellbeing and health, and nursing responsibilities. Despite the fact that numerous nursing theories exist, the aforementioned four nursing paradigms offer a holistic approach to care characterized by the patient’s health and well-being being interconnected to the four components (Fawcett & Desanto-Madeya, 2013). The person component of the nursing metaparadigm places emphasis on the individual receiving care. Nevertheless, the person component also encompasses family members as well as other people who are important to individual receiving care. The structure of care takes into consideration the social, spiritual and healthcare needs. The subsequent health outcome depends on how interactions between the patient and the social and physical needs (Masters, 2012). The underlying presumption is that the patient is empowered to be able to manage his/her wellbeing and health with dignity as well as self-preservation using positive personal relationships. Acuity is part of the person component of the nursing metaparadigm. In this respect, acuity, specifically, patient acuity can be used to denote the extent of needs of the person receiving care including the health, spiritual and social needs (Abualrub, 2007). The magnitude of these needs (patient requirements) will determine the amount of nursing care required for the patient, and the intensity of care required. In addition, acuity in the person component of the nursing paradigm could be used to denote the level of patient dependency on nurses to meet their needs (Arling, Kane, Mueller, & Lewis, 2007).Advanced Practice Nursing Essay Example

The environment component of the nursing metaparadigm places emphasis in the surroundings having an effect on the person receiving care (Paley, 2001). The environment comprises of both external and internal influences. The manner in which the person interacts with his/her environmental influences determines his/her wellness and health. In addition, interactions with friends, families and other people are also considered part of the environment. Other aspects of the environment include technology, social connections, culture, geographic location and economic conditions – all of these comprise of social and physical factors. The environment component of the nursing metaparadigm assumes that an individual has the capability of modifying his/her environmental factors in order to enhance his/her health and wellness status (Watson & Smith, 2002). Acuity is not a component of the environment domain of the nursing metaparadigm. From the concept analysis of acuity, there is no attribute of the concept that has is directly or indirectly related to the environment of the patient. The concept analysis of “acuity” showed that the concept could be applied in various settings including patient-related acuity, non-patient related acuity, provider-related acuity, and system-related acuity (Habasevich, 2012). However, in all these settings and uses, there is reference to the environment of the patient; therefore, it can be inferred that acuity is not related to the environment component of the nursing metaparadigm.

The health element of the nursing metaparadigm denotes the degree of wellness of the patient and his/her access to healthcare (Watson & Smith, 2002). The health aspect is often typified with manifold dimensions that are dynamic. The underlying assumption is that these factors have an effect on the state of wellbeing of an individual. Health and wellbeing is needed for existence in one’s environment. In addition, health various throughout one’s lifespan through the interaction between environmental factors and genetic factors, and is determined by the ability of an individual to access care and meet his/her healthcare needs (Fawcett & Desanto-Madeya, 2013). Acuity is related to the health aspect of the nursing paradigm, especially the provider-related acuity, which denotes the intensity of care required for a patient (Rischbieth, 2006). In this respect, acuity can be used to represent the magnitude of the health needs of the patient. It can also be used to refer to the seriousness of the illness, which determine the state of health and wellness of the patient. Therefore, the degree of health represents acuity such as the functional status of the patient.Advanced Practice Nursing Essay Example

The nursing aspect in the metaparadigm focuses on delivering optimal patient outcomes in a caring and safe environment (Parker & Smith, 2010). The nursing component makes use of the principles of communication, professional judgment, collaborations, technology, skills and knowledge in executing responsibilities and duties in order to achieve the most optimal patient outcome. The nursing component emphasizes on high degree of care service and integration with other components of the nursing metaparadigm in order to enhance patient wellbeing. In addition, nursing is considered both a practice profession and an academic discipline. Nursing has been defined as the science and art associated with offering holistic healthcare based on the values of human responsibility, choice and freedom. Nursing science composes of the vast body of knowledge obtained via development of theories, logical analysis and research. Therefore, nursing theories are considered essential in guiding and advancing nursing practice (Paley, 2001). Nursing practice involves the creative application of the nursing knowledge to enhance human care. As a result, nursing makes use of clinical judgment as well as critical thinking in offering evidence-based healthcare to people, families, groups and communities with the aim of achieving optimal client wellness in various nursing contexts. As a result, clinical judgment skills are considered a crucial requirement for professional nursing practice. Acuity is related to the nursing component aspect of metaparadigm. In this respect, acuity is used in determining the intensity and type of clinical care required by the patient, which requires the use of clinical judgment. Acuity in the context of the nursing element of the paradigm can also be used in representing the care burden that a patient imposes on nursing, the complexity of the care needs, the difficulty of the medical and nursing care needs of the patient, and the intensity and severity of care needs. In this respect, nurses are supposed to make use of clinical judgments based on acuity in order to determine aspects such as surveillance, mental concentration, skills needed in satisfying the needs of the patient. Acuity has direct implications for nursing practice in the sense that high acuity requires more nursing care, increased workload, and complex patient needs; the case is opposite for low acuity patients (Abualrub, 2007).Advanced Practice Nursing Essay Example

Application of Definitions

The central theme of nursing is human caring. As a result, nursing actions should focus on showing empathy and concern as well as being committed to the lived experience of the patient regarding human health, and how it relates to disease, illness and wellness (Fawcett & Desanto-Madeya, 2013). In such a case, the nurse is perceived to be a person who plays an active role in human care transactions with patients throughout their lifespan. In addition, human care transactions have the main objective of protecting, enhancing and preserving human dignity and worth. Therefore, human caring entails commitment and will to healthcare, values, caring actions, and their resulting outcomes. Moreover, human care is considered an endeavor that needs action, reflection and research. Moreover, human caring depends on context and is individual specific (Parker & Smith, 2010). Essentially, caring is the centerpiece of nursing. To this end, nurses work independently and utilize power in shaping the profession and empowering patients using caring relationships. In addition, nurses should use up-to-date scientific research and critical thinking in order to be able to translate technologies, skills and knowledge into nursing practice. Other pertinent nursing actions and behaviors include evaluation and selection of alternative course of actions, communication, empowering, reflection, intuition and observation. With respect to the client outcomes pertinent to nursing practice, nursing should focus on enhancing the health potential and caring for all people including those who are all, those who are all, and those who are dying.

Philosophy

The ethical principles used in guiding the nursing practice comprise of beneficence, justice and autonomy. The principle of beneficence focuses on promoting what the nurse deems best for the client. As aforementioned, the central theme in nursing is human caring; therefore, the principle of beneficence focuses on doing well to other people, which is underpinned by developing a professional caring relationship (Fawcett & Desanto-Madeya, 2013). Defining “what is best” for the patient depends on the professional judgment of the nurse or the wishes of the client.Advanced Practice Nursing Essay Example In most cases, nurses’ judgment and patient wishes are often consistent, although cases of divergent views are likely to be witnessed. During cases whereby the patient and nurse have differing opinions, nurses should decide to act in a manner that they deem is for the “own good” of the patient” instead of allowing patients to use their autonomy. The intentional superseding of the client’s autonomy (paternalism) is consistent with the earlier assertion that clinical judgment and critical analysis skills are important for nursing practice (Masters, 2012).

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The principle of autonomy denotes the capacity to act, decide and think based on free will. As a result, family members and caregivers have the obligation of helping the patient make their own decisions by ensuring that patients are provided with full information. In addition, this principle asserts that medical practitioners must uphold the adult patient’s competent decision even when the decision seems medically wrong. Nevertheless, based on the human caring principle, nurses might embark on paternalistic actions (Paley, 2001). In such a case, it is imperative for nurses to carefully evaluate the value associated with such paternalistic actions and establish whether they are genuinely in the best interest of the patient. Paternalistic actions can be justified when it is concerned with patient safety, which is also one of the important aspects of human caring (Fawcett & Desanto-Madeya, 2013).Advanced Practice Nursing Essay Example

With respect to justice, there is no doubt that resources are often limited, which implies that nurses are not in a position to cure every patient. In such cases, it is important set priorities. During the allocation of care resources and service, the principle of justice maintains that patients under the same conditions must be provided access to the same care. In addition, the principle of justice states that, when allocating healthcare resources to a given patient group, it is important to evaluate the impact of the allocation to others. This entails determining if the decision is fair and whether it will burden others (Paley, 2001). The fair distribution of burdens and benefits by nurses require the use of professional judgment and critical analysis skills. Overall, owing to the potential conflicts between the principles of autonomy, beneficence and justice, nurses have to rely significantly on their professional and clinical judgment as well as critical analysis skills in order to result in the most optimal patient outcomes. Such an approach to nursing practice requires nurse to embrace human caring as the central theme in practice (Fawcett & Desanto-Madeya, 2013). Advanced Practice Nursing Essay Example