Assignment 6.1: Application of Nursing Theory to Clinical Practice Paper
Assignment 6.1: Application of Nursing Theory to Clinical Practice Paper
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Introduction
The demands of current nursing practice require clinical reasoning and complex decision–
making skills at every level of care to optimize quality health outcomes for patients. In so far,
nurses are important stakeholders who integrate nursing knowledge into clinical practice
depending on the health situations manifested by patients (Arif & Nasir, 2019). However, even
though nurses are considered independent practitioners, they require standardized guidance on
quality improvements regarding patient safety especially in scenarios that demand complex care.
Information piece by Brandão et al. (2018) affirms that nursing theories are considered as a
common thread in nursing practice as they act as a foundation of knowledge for clinical practice.
Through the theories, nursing care turns out to be knowledge–based as they are used to develop
orientations, commitments, and attitudes that are fundamental features in nursing practice.
Several nursing theories influence nursing practice during patient care. Neuman’s
systems model has been singled out as the theory of concern in this study (Montano, 2021). The
model as developed by Betty Neuman views a patient as an open system that directly responds to
stressors in an environment. The theory breaks down patient variables as psychological,
developmental, physiological, spiritual, and sociocultural all of which determine how we respond
to environmental stressors. According to the theory, the client system is made up of basic core
structures which are protected by lines of resistance in a person (Ahmadi & Sadeghi, 2017). In
this regard, the usual health level of a client is recognized by normal lines of defense which are
protected by lines of resistance as defined by the integrity of the immune system in a person.
However, stressors are considered intra, extra, and inter–personal but arise from both internal and
external influences in the environment (Montano, 2021). According to Neuman’s System Model,
when stressors from the environment invade the flexible lines of defense, the lines of resistance
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Kathleen Hendricks
in a client are activated to fight back. The scenario is known as the wellness–illness continuum
and if the system of a client has sufficient energy, it will be reconstituted and restored to a
normal defense line.
According to Montano (2021), nurses use Neuman’s System Model to provide
interventions where necessary as approaches to restore normal defense lines when stressors break
or are about to invade the lines of defense of a client. Nursing intervention occurs in three
different prevention modalities. In the first approach, nurses provide primary intervention which
occurs before a stressor invades the defense system of a client (Leoni‐Scheiber, Mayer & Müller‐
Staub, 2019). The second approach involves secondary prevention which is an intervention
administered to a client’s system upon reacting to an invading stressor. The final approach
involves tertiary prevention which are adjusted processes resulting from the reconstitution of
secondary prevention and moves the client back in readiness for primary prevention.
Betty Neuman’s Systems Model consists of four metaparadigms as outlined below:
Human being: Described as an open system that directly interacts with both internal and
external forces (also known as stressors) in an environment (Montano, 2021). As a system,
humans are constantly changing by moving towards illness or a state of stability.
Environment: This constitutes the platform or all factors that affect a system. The
environment can be internal, external, or created.
Health: This is defined as a degree of system stability viewed as a continuum from
wellness to illness. According to Ahmadi and Sadeghi (2017), optimal wellness exists when the
needs of a system are met. However, illness exists when the needs of a system are unsatisfactory.
Nonetheless, when energy needed to support the life of a system is not available, then death
occurs.
Nursing: The main role is to identify relevant actions that can be taken to address
stressors that affect a system (patient). The primary concern of nursing is to offer interventions
that help a system to adjust, restore or maintain a degree of stability. It also focuses on
conserving energy to avoid the death of a system.
Philosophy of Nursing Practice
As a nurse practitioner stationed at the emergency department of a care facility, I want to
make my clients (system) feel respected, confident, and comfortable as they transit to different
departments of the care facility. In this approach, I will provide individualized nursing care to
patients whose lines of defense have been compromised by environmental stressors (Arif &
Nasir, 2019). I will also offer self–care education on how they can cope with the pain associated
with the ailment. The philosophy is defined by three tenets of ethics in nursing practice which
include but are not limited to:
Autonomy: In this belief, I will allow patients to decide on a range of options of care
available for them. This means that patients are respected for the decision they make on how
they expect health services to be administered to them.
Beneficence: As for this tenet, I will strive to provide care in the best interest of the
client. In other words, I will only administer nursing care that brings positive outcomes to the
patient to support healing.
Nonmaleficence: Using this tenet will allow me to administer nursing services that do
not cause harm to patients. As such, I will avoid any nursing procedure that causes harm by
omission to a patient (Brandão et al., 2018). I purpose to administer medication in its correct
dosages to avoid causing harm by commission to a patient.
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Kathleen Hendricks
5
Clinical Scenario
In my practice as a nurse, I have provided care at different sections of a health facility.
However, the most intriguing part of care occurred in the emergency department which
apparently is the current station of my nursing practice. The scenario occurred when a 32–year–
old Caucasian male presented to the emergency room by a good Samaritan following a fatal
motor vehicle accident that claimed two lives at the scene. The patient sustained multiple injuries
including an obvious deformity to the left thigh and bleeding from the left leg. He was in agony
and unable to bear weight. Immediately I was alerted by a security officer, I rushed to receive
him by placing him on a stretcher in front of the ER. I asked one of my colleagues to activate the
trauma system while I applied some pressure dressings to control bleeding. As I was taking
patient into the trauma bay, I explained to him what to expect, and reassured him that his
condition will be stabilized. Upon arrival to the bay, I established an IV access and medicated
patient for pain while patient was being exposed and assessed simultaneously. I noticed a sigh of
relief on the patient’s face and his satisfaction with the immediate care he received as he awaited
inpatient admission for further medical attention.
The immediate nursing procedures and care provided to the patient have a direct
relationship with Neuman’s Systems Model of care. The premise is based on the argument that
the system represents the patient who was exposed to multiple stressors emanating from injuries
sustained from the accident (Ahmadi & Sadeghi, 2017). The patient variable was his
psychological perception of pain which made him endure a lot of suffering. The environment
was represented by both the internal and external stressors at the emergency department of the
care facility. Health on the other hand was defined by the state of wellness manifested by the
patient and from my observation, the patient experienced acute pain.
My philosophy of nursing practice and care was manifested when I administered
immediate intervention to the patient upon arrival and while in the trauma bay. I provided
ambulatory service in form of a stretcher to make the patient feel comfortable as he moved from
one department to the other (Leoni‐Scheiber, Mayer & Müller‐Staub, 2019). Such an act goes
hand in hand with the tenet of beneficence which advocates that nurse should do good to
patients. After identifying injuries and stabilizing the patient in the trauma bay, I as well
performed a minor dressing procedure on the patient, cleaned him up and applied dressing to his
bleeding wound and wrapping it with a gauze. I also provided him warmth with a clean gown, a
warm blanket, and a pair of footies while in the trauma bay. These actions ensured that the
patient felt respected and that he was cared for at the emergency department of the care facility.
Such an act is consistent with the tenet of autonomy principle of patient care in which the nurse
should display utmost respect to patients regardless of their health status (Arif & Nasir, 2019).
Finally, I reassured the client that his health status would be addressed amicably in the health
facility. The assurance made the patient develop confidence with the healthcare team at the
health facility. Such an act goes hand in hand with the principle of nonmaleficence which entails
not doing any harm to the patient. Providing reassurance does not pose any harm to the patient
but instead, boosts mood and alleviates stress which is important in the healing process of
clients.
Conclusion
Nurses require theories to identify relevant patient needs and understand how to connect
between accurate assessment and interventions needed by these clients to improve the quality of
health outcomes. As illustrated in the preceding illustrations, Neuman’s System Model theory
guided in the identification of metaparadigm related to disease manifested by the client. The first
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Kathleen Hendricks
metaparadigm identified was the patient who was the person affected by the injury and needed
medical attention. The second was the assessment of stressors that were potential in inducing
pain to the client after sustaining injury caused by a motor vehicle accident. The third
metaparadigm was the analysis of both internal and external environments associated with the
ailment of the patient. The environment played a significant role in the diagnosis and treatment
of the client. Finally, the fourth metaparadigm was the nursing procedures which were the
interventions administered to restore the quality of health of the client. These included wound
dressing, provision of ambulatory services and warmth, health education, and counseling to
reassure the client on improved quality of health. Besides, the theoretical model guided in the
selection of nursing interventions which were categorized as primary, secondary, and tertiary
interventions to stabilize the health condition manifested by the client. The theory is essential as
it instills critical thinking and reasoning skills for nurses as they administer care to patients.
However, the role of theories in clinical practice cannot be ignored. Other than providing
knowledge to guide clinical nursing practice, theories offer a foundation for implementing
philosophies of nursing care based on the health situation manifested by patients. As such,
nursing theories provide ethics on codes of practice for professionals in order to optimize quality
care to patients and should never be ignored by nurses during practice.
| Assignment 6.1: Application Paper Rubric | ||
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| Criteria | Ratings | Pts |
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Introduction (no heading needed)
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10 / 10 pts
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Philosophy of Nursing Practice (Level 2 Heading)
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10 / 10 pts
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Clinical Scenario (Level 2 Heading)
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20 / 20 pts
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Conclusion (Level 1 Heading)
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