"the nursing process says nothing about the content of nursing - it is
merely a sequence of steps passed through in order to achieve a
desired end" pearson vaughan & fitzgerald 1996.
the implications of the above ststement for nursing care delivery? how
can the nursing process and a nursing model together enhance patient
care delivery? what are the advantages and limitations of using the
nursing process in patient care planning? |
Request for Question Clarification by
sublime1-ga
on
13 May 2003 18:03 PDT
golftee...
The quote you cited seems applicable to what is usually called
the nursing 'model', which is a series of steps designed to
arrive at a mutual perception with the patient of a clear
picture of the state of a patient's health and the optimal
direction for resolution. This is described in the following
document from the Australian Catholic University (the actual
document has been removed, but can be seen in Google's cache
in the link that follows:
"This model reflects a dynamic series of interrelated phases,
which are designed to achieve optimal resolution of health
issues. The following characteristics are inherent in the model:
*Nursing contributes to a collaborative approach to address
health issues facing the client.
*The nurse has an intent to assist the client throughout the
implementation of the model, and utilises attention,
perception, and intuition to do so.
*Throughout the clinical decision making process, the nurse
utilises knowledge of the broader context of professional
practice: for example, ethics, code of conduct, and research.
This model has four phases:
* Discovery
* Deliberation
* Strategy
* Praxis"
http://216.239.53.104/search?q=cache:fO9R-YApJEoC:www.acu.edu.au/fhs/nursing/qld/docs/cdmm.rtf+nursing+model&hl=en&ie=UTF-8
The nursing 'process' commonly refers to a theory of effective
interpersonal interaction with the patient put forth by
Ida Jean Orlando, described on this page from the University
of Rhode Island:
"The role of the nurse is to find out and meet the patient's
immediate need for help. The patient's presenting behavior
may be a plea for help, however, the help needed may not be
what it appears to be. Therefore, nurses need to use their
perception, thoughts about the perception, or the feeling
engendered from their thoughts to explore with patients the
meaning of their behavior. This process helps the nurse find
out the nature of the distress and what help the patient needs.
Orlando's theory remains one the of the most effective practice
theories available. The use of her theory keeps the nurse's
focus on the patient. The strength of the theory is that it is
clear, concise, and easy to use. While providing the overall
framework for nursing, the use of her theory does not exclude
nurses from using other theories while caring for the patient.
http://www.uri.edu/nursing/schmieding/orlando/
This 'process' has more to do with the subtleties of 'how' a
nurse walks through the steps of the 'model' which is more
concerned with 'what' to do than 'how' it is done.
Since Ms. Orlando's 'process' is about improving rapport and
communication with the patient, and 'humanizing' the steps
of the 'model', it seems obvious that there are advantages
in combining the two.
Minimizing the value of either the 'model' or the 'process'
by stating they are "merely a sequence of steps passed through
in order to achieve a desired end" seems to me to be coming
from the point-of-view of, say, a doctor who is more interested
in having a nurse follow his orders and perceptions of the
patients' needs.
I am hoping you can clarify whether we are using our terminology
to mean the same things, and expand on your question in light of
the above for the sake of a more insightful answer to your question.
sublime1-ga
|
Clarification of Question by
golftee-ga
on
15 May 2003 13:50 PDT
< hello,
< Thank you for your response re;nursing process. Indeed we are talking
< about the same thing but using different terminology. The nursing
process
< I was referring to was first described by Alfaro- LeFevre 1998 " A
< systematic method of giving humanistic care that focuses on achieving
< desired outcomes (results) in a cost effective fashion".This method
< involved five steps 1.assessment 2.diagnosis/problem identification
< 3.planning 4.implementation 5.evaluation. I currently work in large
< emergency dept. where Roper, logan &Tierney is the model of use for
< years.I currently interested in introducing a new model e.g. orem. I
would
< greatly appreciate your assistance.
<
<
|
Request for Question Clarification by
sublime1-ga
on
15 May 2003 17:23 PDT
golftee...
Your first question, "the implications of the above statement
for nursing care delivery?", could easily be the subject of
a book. The topic is actually explored by Roper, Logan & Tierney
in their last edition of 'The Roper-Logan-Tierney Model of
Nursing: The Activities of Living Model'. According to one
reader's review, Mr L H Gelling, on Amazon.com:
"The Roper-Logan-Tierney model of nursing has undoubtedly had
a major impact on nursing in the United Kingdom, across Europe
and throughout the world. This stimulating and concise
monograph draws together and describes much of Nancy Roper's,
Winifred Logan's and Alison Tierney's collaborative thinking
from before the publication of the Elements of Nursing, in
1980, until the publication of the fourth edition, in 1996,
and beyond. They review how the model evolved and the changes
that occurred to the text over subsequent editions."
"The authors describe this text as their final account of the
model but they emphasise the continually changing nature of
nursing and that the model will require further assessment
and revision. The final chapter concludes with the suggestion
that although this will be the esteemed trios' final
contribution it may not be the final version of the model.
Interestingly, in the final chapter the authors undertake a
debate into the value, role and relevance of nursing models
to the 21st century."
"The challenge is clearly there for nurses to consider the
ongoing role of nursing models and, if appropriate, to
continue to develop this model to meet the ever-changing
requirements of nursing and individuals requiring nursing
care."
http://www.amazon.co.uk/exec/obidos/ASIN/0443063737/ref%3Dpd%5Fsim%5Fb%5Fdp/202-2625499-3601436
It is also the topic of ongoing discussion at the Forum on
the UK Practice Nursing website:
http://www.practicenursing.co.uk/
...as evidenced by Google's cache of the discussion:
http://216.239.53.104/search?q=cache:9WBybQXDNPEJ:www.practicenursing.co.uk/forum/link.asp%3FTOPIC_ID%3D661+Orem+model+nursing&hl=en&ie=UTF-8
You might benefit by joining the forum and seeking input
from the members there. Unfortunately, for the moment,
the website server is down.
On the Lippincott, Williams & Wilkins 'Connections' site,
there are numerous resources for the nursing arena, many
of which can be viewed online and downloaded. Their Nursing
index page is here:
http://connection.lww.com/servlet/go_ProcServ/dbpage=page&mode=display&gid=01008013540968343411751359
One such resource on their site is a Microsoft PowerPoint
file which is a slide show. The answers to your other two
questions are addressed there. For example, as to the
"advantages and limitations of using the nursing process
in patient care planning":
=====================================================
Benefits of Nursing Process
-Provides an orderly & systematic method for planning &
providing care
-Enhances nursing efficiency by standardizing nursing practice
-Facilitates documentation of care
-Provides a unity of language for the nursing profession
-Is economical
-Stresses the independent function of nurses
-Increases care quality through the use of deliberate actions
Criticisms of Nursing Process
-A linear, rational problem-solving process that is
inconsistent with real world practice
-Focuses on client problems rather than strengths & potential
-Uses elaborate & time-consuming nursing jargon
-Rules supersede interactions
-Diagnoses label clients
-Minimizes or disallows intuition
-May make expert practice questionable
=====================================================
Other contents of the file include:
-An exploration of the nursing process
-A look at the basis of the approach of various models
(Orem's is under 'Models Based on Caring Data Collection
Approaches')
-Nursing care plans
-Intervention & implementation
-Evaluation
-Client care paths
etc.
You can download the entire PowerPoint file, and view
it if you have MS PowerPoint, from this link:
http://connection.lww.com/go/802/FSLO-1045603402-145802.ppt
Or view it in the Google cache, here:
http://216.239.53.104/search?q=cache:FmRknSadaYsC:connection.lww.com/go/802/FSLO-1045603402-145802.ppt+Orem+model+nursing+steps&hl=en&ie=UTF-8
These links came from relatively brief examination of the
results of the Google searches cited and linked below.
Do references such as these constitute the assistance you
need in your efforts to introduce a new model where you work?
sublime1-ga
Searches done, via Google:
Orem model nursing
://www.google.com/search?q=Orem+model+nursing
Orem model nursing steps
://www.google.com/search?q=Orem+model+nursing+steps
"Roper Logan Tierney"
://www.google.com/search?q=%22Roper+Logan+Tierney%22
|
Request for Question Clarification by
sublime1-ga
on
20 May 2003 20:29 PDT
golftee...
In the absence of your feedback, should I assume that the information
I provided satisfies your inquiry, and post it as an answer?
sublime1-ga
|
