Nursing theorists and their contributions to the field of nursing.

Full Answer Section

           

• Main Concepts:
  • Environment: This is the central concept of Nightingale's theory. She believed that a healthy environment was essential for physical and mental well-being and recovery. Key environmental factors included fresh air, pure water, efficient drainage, cleanliness, and light.
  • Health: She viewed health as not merely the absence of disease but the "state of being well and using every power to the fullest extent." Health could be influenced by external and internal factors.
  • Nursing: Nightingale saw nursing as putting the patient in the best possible condition for nature to act upon them. It involved manipulating the patient's environment to promote healing and prevent disease. Nurses were responsible for observing, documenting, and providing direct care focused on environmental control.
  • Person: Implicitly, the person was seen as a passive recipient of care, affected by their environment, but possessing a natural reparative process.
• Significance of Their Work in Nursing: Nightingale's work was revolutionary. She shifted nursing from an unorganized, often disreputable occupation to a respectable, professional discipline based on scientific principles of observation and sanitation. Her emphasis on the environment remains a core tenet of nursing practice, influencing infection control, hospital design, and public health initiatives. Her meticulous data collection and statistical analysis paved the way for evidence-based practice in nursing.

 

Theorist 2: Hildegard Peplau

 

• Historical Context: Hildegard Peplau (1909-1999) was an American nurse theorist, educator, and psychiatric nurse. Her work developed in the mid-20th century, a period when psychoanalytic theory was gaining prominence and mental health care was shifting towards more interpersonal approaches. Her seminal work, "Interpersonal Relations in Nursing" (1952), established the theoretical framework for psychiatric nursing.
• Main Concepts:
  • Interpersonal Relations (Nurse-Patient Relationship): This is the core of Peplau's theory. She conceptualized nursing as a therapeutic interpersonal process, emphasizing the importance of the relationship between the nurse and the patient. This relationship evolves through distinct phases.
  • Phases of the Nurse-Patient Relationship:
    • Orientation: Patient seeks help, nurse helps patient understand the problem.
    • Identification: Patient gains independence, nurse clarifies roles.
    • Exploitation: Patient uses nurse's help, nurse provides resources.
    • Resolution: Patient's needs are met, relationship terminates.
  • Four Roles of the Nurse: Peplau identified various roles a nurse might assume in the relationship: Stranger, Resource Person, Teacher, Leader, Surrogate, and Counselor.
  • Health: Viewed as a forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.
  • Person: An individual with unique needs, who is continuously striving to reduce tension produced by needs. The person develops through interpersonal relationships.
  • Environment: The external forces that influence the person. Peplau acknowledged the environment but focused more on the psychological and social aspects of the patient's immediate situation.
  • Anxiety: A key concept, recognized as an energy that can be constructive or destructive.
• Significance of Their Work in Nursing: Peplau's theory moved nursing beyond purely physical care, establishing it as a psychodynamic process. She provided a framework for understanding and utilizing the nurse-patient relationship as a therapeutic tool, particularly in psychiatric nursing but also across all specialties. Her work highlighted the nurse's role as a counselor and educator and emphasized the importance of self-awareness for effective nursing practice. She is credited with significant contributions to psychiatric nursing education and practice.

 

Theorist 3: Dorothea Orem

 

• Historical Context: Dorothea Orem (1914-2007) was an American nursing theorist and educator who developed her theory in the latter half of the 20th century, a period marked by increasing complexity in healthcare and a growing emphasis on patient autonomy and self-management of chronic conditions. Her work, notably "Nursing: Concepts of Practice" (1971), provided a framework for understanding patients' capacities for self-care.
• Main Concepts: Orem's theory is composed of three interrelated theories:
  • Theory of Self-Care: Describes why and how people care for themselves. It defines Self-Care Requisites (universal, developmental, health deviation) as actions required to maintain life, health, and well-being.
  • Theory of Self-Care Deficit: Explains why nursing is needed. It occurs when an individual's ability to perform self-care (Self-Care Agency) is insufficient to meet their known self-care requisites.
  • Theory of Nursing Systems: Describes how the nurse helps the patient. It outlines three types of nursing systems based on the patient's self-care capabilities:
    • Wholly Compensatory System: Nurse provides all care (e.g., comatose patient).
    • Partially Compensatory System: Nurse and patient share care responsibilities.
    • Supportive-Educative System: Nurse provides guidance and teaching, patient performs self-care.
  • Health: A state of structural and functional integrity of the human being, indicating wholeness and soundness.
  • Person: A human being in continuous self-organization, moving toward self-actualization, characterized by the ability for self-care.
  • Environment: Physical, social, and psychological surroundings that can affect the individual's ability to perform self-care.
  • Nursing: The art of helping individuals to provide self-care to maintain or restore health, or to cope with illness and injury.
• Significance of Their Work in Nursing: Orem's Self-Care Deficit Nursing Theory (SCDNT) is widely used in nursing practice, education, and research. It empowers patients by focusing on their strengths and capabilities for self-care, promoting independence and active participation in their health management. It provides a clear framework for assessing patient needs, planning interventions, and evaluating outcomes, particularly relevant in chronic disease management, rehabilitation, and patient education.

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Part 2: Comparison Matrix

Sample Answer

         

Part 1: Chosen Theorists and Overviews

For this assessment, I will analyze and compare the contributions of Florence Nightingale, Hildegard Peplau, and Dorothea Orem. These theorists represent distinct yet foundational contributions to nursing, spanning from the profession's inception to its modern psychosocial and self-care dimensions.  

Theorist 1: Florence Nightingale

 

• Historical Context: Florence Nightingale (1820-1910) is widely regarded as the founder of modern nursing. Her work emerged from the mid-19th century, most notably during the Crimean War (1853-1856), where she observed deplorable sanitary conditions and high mortality rates among soldiers. Her subsequent reforms in military hospitals and her establishment of the Nightingale Training School for Nurses at St. Thomas' Hospital in London laid the groundwork for professional nursing education and practice.