Escolar Documentos
Profissional Documentos
Cultura Documentos
Richard Sagasag
RN, MAN, USRN
After the war Florence went back to
England, a grateful English public
gave her an honorarium of £4,500.
Richard Sagasag
RN, MAN, USRN
The school served as model
for other training school.
OTHER AWARDS
Richard Sagasag
RN, MAN, USRN
HEALTH
• Died in 1999
Richard Sagasag
RN, MAN, USRN
Publications
Environment
• Being and occurring in the context of
the nurse client relationship
• A significant therapeutic
interpersonal process
Richard Sagasag
RN, MAN, USRN
FOUR PHASES OF A NURSE CLIENT
RELATIONSHIP
ORIENTATION
IDENTIFICATION
EXPLOITATION
RESOLUTION
Richard Sagasag
RN, MAN, USRN
Orientation Phase
Nurse and patient meet as two
strangers
Individual has a felt need
Seeks professional assistance
Trust and empowerment
Encourage active participation
Nurse determines what help client
Richard Sagasag
needs Let’s REVIEW
RN, MAN, USRN
If you are a nurse
and patient comes
to you for the first
time, how do you
entertain the
client/patient?
Richard Sagasag
RN, MAN, USRN
Factors influencing the blending of the
nurse-patient relationship
Identification Phase
Identify problems to be worked on
during the relationship
Clarify perceptions and expectations
Level of dependence/independence
Richard Sagasag
RN, MAN, USRN
ResolutionPhase
Richard Sagasag
RN, MAN, USRN
ExploitationPhase
Richard Sagasag
RN, MAN, USRN
Role of the Stranger
Nurse should treat the patient
courteously.
Richard Sagasag
RN, MAN, USRN
Surrogate Role
The patient dependency for his
care gives the nurse a surrogate
(temporary care giver) role.
Richard Sagasag
RN, MAN, USRN
Counseling Role
Has the greatest emphasis in psychiatric
nursing
Richard Sagasag
RN, MAN, USRN
Scenario:
Richard Sagasag
RN, MAN, USRN
ORIENTATION PHASE
- During admission/Assessment
Role of a stranger
- Nurse accepts client regardless of the
economic status.
Counseling Role
- Nurse listens to the client and gives
emphatic advises
- Nurse helps client understand problems by
explaining the fracture obtained as well as
the multiple injuries
Richard Sagasag
RN, MAN, USRN
IDENTIFICATION PHASE
Problem Identified: Multiple injuries (Risk
for infection)
- Nurse & client together plan for the
activities that help the client in his
recovery
Example:
- Ways of preventing of infection
- Procedures ordered by doctor (x-ray)
- Medications (ordered by doctor)
Richard Sagasag
RN, MAN, USRN
Exploitation Phase (Implementation)
Leadership Role
- Nurse motivates the patient to
actively participate and cooperate in
all the activities rendered by nurses and
physicians
Teaching Role
-Nurse teaches and demonstrates to
the client proper hand washing to
prevent infection.
Richard Sagasag
RN, MAN, USRN
Exploitation Phase (Implementation)
Resource person
-Courteously explain to the client the
reasons why client has to undergo x-ray
-Explains the importance of the
medications and how it could help in his
recovery
Surrogate Role
-Nurse serves as the temporary care giver
and treats the client like his own family
- Nurse attends to his need
Richard Sagasag
RN, MAN, USRN
Resolutiontion Phase
Admission/
ORIENTATION Assessment
EXPLOITATION Implementation
RESOLUTION Evaluation/
Termination/Discharge/
VIRGINIA HENDERSON
“14 Basic Human Needs”
PERSON
Referred person as the patient
that requires assistance to
achieve health & independence
and/or peaceful death
The mind and body of the person
are inseparable.
He must maintain physiological
and emotional balance to function
Richard Sagasag,RN, MAN
efficiently.
4 METAPARADIGM IN NURSING
HEALTH
Health is a quality of life and is basic
to for a person to function fully
ENVIRONMENT
Healthy individuals may be able to
control their environment but as illness
occurs, this ability is diminished or
affected.
Nurses must be aware of the different
social customs & religious beliefs to
assess dangers.
NURSING
The nurse functions independently
from the physician, but promotes the
plan prescribed by the physician.
“ Virginia Henderson
stated that there are
THREE LEVELS
compromising the
NURSE-PATIENT
RELATIONSHIP”.
Nurse as a
SUBSTITUTE for the patient
Analysis: Constipation
According to Henderson‘s 14 basic needs the
problem fall under “Eliminating body waste”
Richard Sagasag,RN, MAN
PLANNING PHASE
Involves giving the plan of
care to meet the needs and
personality of the patient.
Plan:
Goal: Help client eliminate body waste
Objective:
- Increase water intake
- High fiber diet
- Exercise
Richard Sagasag,RN, MAN
IMPLEMENTATION PHASE
1926 - 1973
Richard Sagasag,RN, MAN
Background
-Born in 1926
PERSON
HEALTH
ENVIRONMENT
- Not clearly defined but he associated illness,
pain, or sufferings to the environment
NURSING
- Defined nursing as an “interpersonal process
whereby the nurse assist an individual, family or
community to prevent or cope with the
experience of illness and suffering and if
necessary to find meaning in these experiences
1. Original Encounter
2. Emerging Identities
3. Empathy
4. Sympathy
4. Rapport
Illness
Suffering
Pain
Hope
Communication
Interaction
Empathy
Sympathy
Rapport
Therapeutic Use-of-Self
Original Encounter:
Maria & the nurse meet for the first time and both
are not yet comfortable talking and expressing
deep thoughts & feelings.
Emerging Identities:
Closeness between the nurse and Maria is being
established. They are both aware of their
Richard Sagasag,RN, MAN differences in thoughts and feelings
Example:
Maria, a 24 year old sales lady is confined in the
hospital because of depression brought by the
break up with her boyfriend.
Empathy:
This phase depicts Maria’s experiences
that were shared to the nurse. Similarities
such as their age and gender will give a
deeper understanding on the patient’s
behavior and help the relationship to
become therapeutic.
Sympathy:
The nurse will use intellectual approach and
therapeutic use of self to alleviate the distress of
Maria
Rapport:
All actions that lessen the Maria’s distress have
been implemented, thus result would be a good
and trusting relationship and achievement of the
therapeutic goal by the nurse
Richard Sagasag,RN, MAN
Nurse
&
Patient
Nurse Patient
Sympathy
Nurse
Empathy Patient
Nurse
Emerging Identities Patient
PERSON
- An individual, family, group,
community or society
- Dynamic composite of
interrelationships among
physiological, psychological,
socio-cultural, developmental,
and spiritual factors
Richard Sagasag,RN, MAN
4 METAPARADIGM IN NURSING
PERSON
- Neuman sees a person as an
open system that works
together with other parts of its
body as it interact with the
environment.
HEALTH
HEALTH
ENVIRONMENT
- Environment can be an internal, external
forces that interacts which a person
exists.
-These forces are what Neuman termed
as stressors.
-Stressors are tensions that produce
alterations in the normal flow of the
environment:
Intrapersonal – occurs within the self
Richard Sagasag,RN, MAN
Interpersonal – occurs between individuals
4 METAPARADIGM IN NURSING
NURSING
Note:
Physiologic,
psychologic,
sociologic,
developmental, &
spiritual
FLEXIBLE LINE OF
DEFENSE
Flexible Line
of Defense
1. PRIMARY PREVENTION
2. SECONDARY PREVENTION
3. TERTIARY PREVENTION
Richard Sagasag,RN, MAN
1. PRIMARY PREVENTION
-To encourage optimal health and to
increase the person’s resistance to illness.
- Health promotion
Activities include the following:
Quit smoking
Avoid/limit alcohol intake
Exercise regularly
Eat well balanced diet
Reduce fat and increase fiber intake
Take adequate fluids
Wear hazards device in work site
Complete immunization program
Richard Sagasag,RN, MAN
2. SECONDARY PREVENTION
-Health maintenance
- Seeking to identify specific illnesses or condition at
an early stage with prompt intervention to prevent
or limit disability.
- Early diagnosis/detection/screening
Activities include the following:
- Have annual physical examination
- Regular Pap smear test
- Monthly BSE for women 20 years & above
- Sputum examination for tuberculosis
- Annual Stool Guaiac Test and Rectal
examination for clients over age 40 years
- Testicular Self Examination (TSE) for early
detection of testicular cancer for clients
age 15-35 year old
Richard Sagasag,RN, MAN
3. TERTIARY PREVENTION
Activities include:
Two days after the term exam where he got a low grade
because he did not follow the instruction set in the test
paper, her family reported having seen Pedro with sudden
outburst of laughter with known reason, staring blankly on
Richard Sagasag,RN, MAN
the wall, and refusing to eat. This prompted his family to
bring him in the hospital for confinement.
ASSESSMENT:
IMPLEMENTATION:
EVALUATION:
Evaluate the result of the nursing interventions
that the nurse implemented.
Richard Sagasag
RN, MAN, USRN
Goal is met if the Pedro recovered from his illness
DOROTHY JOHNSON
“Behavioral System Model”
Richard Sagasag
RN, MAN, USRN
Introduction
Richard Sagasag
RN, MAN, USRN
OVERVIEW OF THE THEORY
Output of intraorganismic
structures and processes as
they are coordinated and
articulated by and responsive to
changes in sensory stimulation.
Richard Sagasag
RN, MAN, USRN
SYSTEM
Is a whole that functions as a
whole by virtue of the
interdependence of its parts
adjustments + adaptations
= balance
Richard Sagasag
RN, MAN, USRN
BEHAVIORAL SYSTEM
Encompasses the patterned,
repetitive, and purposeful ways of
behaving = organized and
integrated functional unit
Richard Sagasag
System is usually flexible enough
RN, MAN, USRN rac/2008
4 METAPARADIGM IN NURSING
PERSON
HEALTH
ENVIRONMENT
Richard Sagasag
RN, MAN, USRN
4 METAPARADIGM IN NURSING
NURSING
Richard Sagasag
RN, MAN, USRN
SEVEN BEHAVIORAL SYSTEM
Richard Sagasag
RN, MAN, USRN
ATTACHMENT / AFFILIATIVE
Most critical = basis for all social
organization
Provides survival and security
Consequences:
social inclusion
intimacy
formation and maintenance of
strong social bond
Richard Sagasag
RN, MAN, USRN
DEPENDENCY
Promotes helping behavior that
calls for a nurturing response
Consequences:
approval/consent
attention or recognition
physical assistance
Richard Sagasag
RN, MAN, USRN
INGESTIVE
Relates to the behaviors surrounding
the ingestion of food.
“Has to do with when, how, what,
how much, and under what
conditions we eat”
It serves the broad function of
appetitive satisfaction
Associated with social, psychological
and biological considerations
Richard Sagasag
RN, MAN, USRN
ELIMINATIVE
Richard Sagasag
RN, MAN, USRN
SEXUAL
Has the dual functions of
procreation and gratification
Richard Sagasag
RN, MAN, USRN
ACHIEVEMENT
Areas of achievement:
intellectual
physical
creative
mechanical
Richard Sagasag
social
RN, MAN, USRN
AGGRESSIVE
Relates to behaviors concerned
with defense & self preservation
Richard Sagasag
RN, MAN, USRN
OVERVIEW
IMOGENE KING’S Theory derived
from her conceptual framework
which shows the relationship of
personal systems (individuals),
interpersonal systems (nurse-
patient), social systems
(educational system, health care
system)
Richard Sagasag
RN, MAN, USRN
OVERVIEW
King’s Theory offers insight to
nurse’s interactions with individuals
and groups w/in the environment.
PERSON
- is social being who has the ability to :
Perceive
Think
Feel
Choose
Set goals
Select means to achieve goals and
To make decision
Richard Sagasag
RN, MAN, USRN
4 METAPARADIGM IN NURSING
PERSON
- is social being who has the ability to :
Perceive
Think
Feel
Choose
Set goals
Select means to achieve goals and
To make decision
Richard Sagasag
RN, MAN, USRN
4 METAPARADIGM IN NURSING
PERSON
According to King, human being has three
fundamental needs:
HEALTH
Richard Sagasag
RN, MAN, USRN
4 METAPARADIGM IN NURSING
ENVIRONMENT
Process of balance involving internal &
external interactions inside the social
system.
NURSING
Richard Sagasag
RN, MAN, USRN
INTERACTING SYSTEM FRAMEWORK
Personal – how the nurse views and
integrates self based from personal
goals & beliefs
Richard Sagasag
RN, MAN, USRN
INTERACTING SYSTEM FRAMEWORK
Actions are aimed towards setting goals
through communication between the
nurse and the client then exploring and
agreeing means to perform thereby
achieving the set goals
Reaction
In her theory reaction is not specified
but somehow relate reaction as part of
action or a form of response to a certain
Richard Sagasag
stimuli
RN, MAN, USRN
INTERACTING SYSTEM FRAMEWORK
Interaction
Any situation wherein the nurse relates
& deals with a client or patient
Open System
The absence of boundary existence,
where a dynamic interaction between
the internal & external environment can
exchange information without barriers
or hindrances.
Richard Sagasag
RN, MAN, USRN
KING’S GOAL ATTAINMENT THEORY
10 essential KNOWLEDGE for use by nurses in concrete situations:
Self, Role, Perception, Communication, Interaction, Transaction, Growth &
Development, Stress, Time & Personal Space
Perception Feedback
Judgment
Action
Nurse
Reaction Interaction Transaction
Patient
Action
Judgment
Perception
Feedback
DOROTHEA OREM
“Self Care Theory”
Reference:
http://currentnursing.com/nursing_theory/self_care_deficit_theory.
Richard Sagasag
html
RN, MAN, USRN
Orem’s general theory of nursing in
three related parts:
Richard Sagasag
RN, MAN, USRN
Theory of Self Care
Richard Sagasag
RN, MAN, USRN
Self-Care
Richard Sagasag
RN, MAN, USRN
Self-Care Agency
Human ability which is "the
ability in engaging self
care" -conditioned by age,
developmental state, life
experience, socio-cultural
orientation, health and
available resources.
Richard Sagasag
RN, MAN, USRN
Self-Care Requisites
Actions directed towards provision
of self care.
Richard Sagasag
RN, MAN, USRN
8 Self-Care Requisites common in men,
women and children:
a. Maintenance of sufficient intake of air
b. Maintenance of sufficient intake of
food
c. Maintenance of sufficient intake of
water
d. Provision of care associated with
elimination
e. Maintenance of balance between
Richard Sagasag activity & rest
RN, MAN, USRN
8 Self-Care Requisites common in
men, women and children:
a. Maintenance of balance between
solitude & social interaction
Richard Sagasag
RN, MAN, USRN
Therapeutic Self-Care Demand
Richard Sagasag
RN, MAN, USRN
Theory of Self Care Deficit
Richard Sagasag
RN, MAN, USRN
Theory of Self Care Deficit
- Specifies when nursing is needed
- Nursing is required when a person is
incapable or limited in the provision of
continuous effective self care.
Richard Sagasag
RN, MAN, USRN
Theory of Nursing Systems
Describes how the patient’s self care
needs will be met by the nurse , the
patient, or both
Support-Educative System
Accomplishes self-care
Patient’s
action
Nurse Regulates the exercise &
Action development of self-care
agency
FAYE GLEN ABDELLAH
“Twenty-one Nursing Problems”
Richard Sagasag
RN, MAN, USRN
INTRODUCTION
Faye Glenn Abdellah, pioneer nursing
researcher, helped transform nursing theory,
nursing care and nursing education
Birth:1919
Richard Sagasag
RN, MAN, USRN
“ I never wanted to be a
medical doctor because
I could do all I wanted
to do in nursing, which
is a caring profession.”
Richard Sagasag
RN, MAN, USRN
ABDELLAH’S THEORY
HEALTH
NURSING PROBLEMS
PROBLEM SOLVING
Richard Sagasag
RN, MAN, USRN
Nursing Problems
Richard Sagasag
RN, MAN, USRN
Nursing Problems
Overt (Objective)
Apparent, obvious or can-be-
seen condition
Covert (Subjective)
Concealed, hidden, unseen or
masked one
Richard Sagasag
RN, MAN, USRN
Typology of 21 Nursing Problems
3 areas:
Physical, sociological and emotional
needs of the patient
Types of interpersonal relationships
between the nurse and the patient
Common elements of patient care
Richard Sagasag
RN, MAN, USRN
Problem Solving
Richard Sagasag
RN, MAN, USRN
Problem Solving
Problem solving process
c. Devising hypothesis (PLANNING)
- Nurse & patient formulate a plan
of care based on the identified
problems
d. Testing hypothesis through the
assortment of data (INTERVENTIONS/
IMPLEMENTATIONS)
- Nursing actions provided to the
client that leads to solving the
Richard Sagasag problem .
RN, MAN, USRN
Problem Solving
Problem solving process
e. Revising hypothesis (EVALUATION)
- Evaluate the client’s response to
nursing interventions and compare
to your goals & desired outcomes
Richard Sagasag
RN, MAN, USRN
TEN steps to identify the client’s problems
1. Learn to know the patient
2. Sort out relevant and significant data
3. Make generalizations about available data in
relation to similar nursing problems
presented by other patients
4. Identify the therapeutic plan
5. Test generalizations with the patient and
make additional generalizations
6. Validate the patient’s conclusions about his
nursing problems
Richard Sagasag
RN, MAN, USRN
10 steps to identify the client’s problems
7. Continue to observe and evaluate the
patient over a period of time to identify any
attitudes and clues affecting his behavior
Richard Sagasag
RN, MAN, USRN
1. To maintain good hygiene and
physical comfort
Richard Sagasag
RN, MAN, USRN
10. To facilitate the maintenance of regulatory
mechanisms and functions
Richard Sagasag
RN, MAN, USRN
19. To accept the optimum possible goals in
the light of limitations, physical and
emotional
Richard Sagasag
RN, MAN, USRN
SISTER CALLISTA ROY
“Adaptation Model”
Richard Sagasag
RN, MAN, USRN
INTRODUCTION
Richard Sagasag
RN, MAN, USRN
Sr. Callista had the significant
opportunity of working with Dorothy
E. Johnson
Johnson's work with focusing
knowledge for the discipline of nursing
convinced Sr. Callista of the
importance of describing the nature of
nursing as a service to society and
prompted her to begin developing her
model with the goal of nursing being
to promote adaptation.
Richard Sagasag
RN, MAN, USRN
System-a set of parts connected to
function as a whole for some purpose.
Richard Sagasag
RN, MAN, USRN
Focal Stimuli-internal or external
stimulus immediately affecting the
system. Ex: Immobility
Richard Sagasag
RN, MAN, USRN
The adaptation level is modulated by
persons coping mechanism & control
process. Thus person does not respond
passively to environmental stimuli.
Richard Sagasag
RN, MAN, USRN
Regulator Subsystem- automatic
response to stimulus transpires through
neural, chemical, and endocrine.
Ex: (increase vital signs)
Richard Sagasag
RN, MAN, USRN
“The Four Adaptive Modes are
interrelated through perception. An
adaptive response in one mode can
influence adaptation in the other
modes” ….Sister Callista Roy
Richard Sagasag
RN, MAN, USRN
1. Physiological-Physical Adaptive Mode
Goal: Physiological Integrity
two components:
Physical Self = body sensation & body image
Personal Self = self consistency, self ideal &
moral ethical spiritual self
Richard Sagasag
RN, MAN, USRN
3. Role Function Adaptive Mode
-Different roles that a person performs in
the society
Richard Sagasag
RN, MAN, USRN
4. Interdependence Adaptive Mode
Coping mechanism from close relationship
which results to giving & receiving of love,
respect and value.
Richard Sagasag
RN, MAN, USRN
Nursing Process:
Richard Sagasag
RN, MAN, USRN
Nursing Process:
Richard Sagasag
RN, MAN, USRN
Nursing Process:
Step 5: Intervention
- determination of how best to assist the
person in attaining the established goals
Step 6: Evaluation
- Judging the effectiveness of the nursing
intervention in relation to the behavior after
it was performed in comparison with the goal
established.
Richard Sagasag
RN, MAN, USRN
Application of Roy’s
Adaptation Theory utilizing
the Nursing Process
Richard Sagasag
RN, MAN, USRN
Mang Goryo, a 50-year-old driver has
diabetes for 5 years and has not followed
the prescribed treatment regimen.
Step 5. Intervention
a. Encourage to participate in self-care
activities & rehabilitation
b. Demonstrate proper use of crutches
c. Allow Mang Goryo to do return
demonstration of proper use of crutches
d. Emphasize safety measures in using the
Richard Sagasag assistive device
RN, MAN, USRN
Physiologic Adaptive Mode
Step 6. Evaluation
a. Mang Goryo was able to verbalize
understanding of the importance of
rehabilitation
Richard Sagasag
RN, MAN, USRN
CONTROL EFFECTOR
INPUT OUTPUT
PROCESS
Physiological Adaptive
or
Coping Mechanism: Self-Concept
Stimuli ineffective
Adaptation Role Function responses
a. Regulator
level
b.Cognator Interdependence
FEEDBACK
MADELEINE LEININGER
“Transcultural Theory”
(Current Title: Culture Care or Culture
Care Diversity & Universality
Richard Sagasag
RN, MAN, USRN
Madeleine Leininger was born in Sutton,
Nebraska
Richard Sagasag
RN, MAN, USRN
In 1954 earned an M.S. in psychiatric and
mental health nursing from the Catholic
University of America in Washington, D.C.
Richard Sagasag
RN, MAN, USRN
“For a nurse to successfully provide care
for a client of a different cultural or
ethnic to background, effective
intercultural communication must take
place.
Richard Sagasag
RN, MAN, USRN
Culture is learned by each generation through
both formal and informal life experiences.
Richard Sagasag
RN, MAN, USRN
PURPOSES OF KNOWING THE
PATIENTS CULTURE AND RELIGION
FOR HEALTH CARE PERSONNEL
Richard Sagasag
RN, MAN, USRN
Culturally Congruent Care
Richard Sagasag
RN, MAN, USRN
Nursing Decisions (Nursing Actions)
Richard Sagasag
RN, MAN, USRN
Nursing Decisions (Nursing Actions)
1. Cultural Preservation or Maintenance:
Retain and or preserve relevant care values
so that clients can maintain their well-being.
Cultural values
& life-ways
Influences care
patterns and
expressions
Health (well-being)
of
Individuals, families, groups, and institutions
Richard Sagasag
RN, MAN, USRN
Introduction
Born: West Virginia
Richard Sagasag
RN, MAN, USRN
Introduction
Richard Sagasag
RN, MAN, USRN
The focus of nursing is
on carative factors that
are derived from a
humanistic perspective
combined with scientific
knowledge base
-------Jean Watson
Richard Sagasag
RN, MAN, USRN
SEVEN
ASSUMPTIONS
1.Caring can be effectively
demonstrated and practiced only
interpersonally
Richard Sagasag
RN, MAN, USRN
1. Formation of Humanistic-
Altruistic System of Values
Richard Sagasag
RN, MAN, USRN
2. Instillation of Faith-Hope
Involves:
Empathy – ability to experience and,
thereby understand the other person’s
perceptions and feelings and to
communicate those understandings
Richard Sagasag
RN, MAN, USRN
4. Development of a Helping-Trust
Relationship
Involves:
Nonpossessive warmth
Demonstrated by a moderate
speaking volume
A relaxed, open posture
Facial expressions that are
congruent with other
communications
Richard Sagasag
RN, MAN, USRN
4. Development of a Helping-Trust
Relationship
Involves:
Effective communication
– has cognitive, affective and
behavior response
components
Richard Sagasag
RN, MAN, USRN
5. Promotion and Acceptance of the
Expression of Positive and Negative
Feelings
Sharing of feelings – a risk-taking
experience for both nurse and patient
Nurse must:
Be prepared for either + or –
feelings
Internal environment:
Mental and spiritual
Sociocultural beliefs
Richard Sagasag
RN, MAN, USRN
8. Provision for Supportive, Protective,
and Corrective Mental, Physical,
Sociocultural and Spiritual Environment
External variables:
Comfort
Privacy
Safety
Clean surroundings
Richard Sagasag
RN, MAN, USRN
9. Assistance with Gratification
of Human Needs
Richard Sagasag
RN, MAN, USRN
INTRODUCTION
Education:
B.A. from Wellesley College in 1922
R.N. from Johns Hopkins School of Nursing in
1925
M.A. from Teachers College, Columbia
University in 1934
Certificate in nurse-midwifery from the
Maternity Center Association School for
Richard Sagasag
Nurse-Midwives in New York in 1946..
RN, MAN, USRN
INTRODUCTION
Career:
Wiedenbach joined the Yale faculty in 1952 as
an instructor in maternity nursing.
Assistant professor of obstetric nursing in
1954 and an associate professor in 1956.
She wrote Family-Centered Maternity Nursing
in 1958.
She was influenced by Ida Orlando in her
works on the framework.
Richard Sagasag
RN, MAN, USRN
KEY ELEMENTS
Richard Sagasag
RN, MAN, USRN
KEY ELEMENTS
a philosophy
a purpose
a practice and
the art.
Richard Sagasag
RN, MAN, USRN
The Philosophy
The Practice
Practice are those observable nursing
actions that are affected by beliefs and
feelings about meeting the patient’s need
for help.
Richard Sagasag
RN, MAN, USRN
The Art
The Art of nursing includes:
Understanding patients needs and
concerns
Developing goals and actions intended
to enhance patients ability and
Directing the activities related to the
medical plan to improve the patients
condition.
The nurses also focuses on prevention of
complications related to reoccurrence or
development of new concerns.
Richard Sagasag
RN, MAN, USRN
PRESCRIPTIVE THEORY
(Situation Producing Theory)
Richard Sagasag
RN, MAN, USRN
Wiedenbach's prescriptive theory is based
on three factors:
Central Realities
Purpose in
Nursing
Prescription
Realities
Richard Sagasag
RN, MAN, USRN
MYRA ESTRINE LEVINE
“Conservation Model”
Richard Sagasag
RN, MAN, USRN
Levine’s Conservation Model is
focused in promoting adaptation and
maintaining wholeness using the
principles of conservation.
Richard Sagasag
RN, MAN, USRN
COMPOSITION OF
CONSERVATION MODEL
Richard Sagasag
RN, MAN, USRN
a. Adaptation is the process of
change, and conservation is the
outcome of adaptation.
Richard Sagasag
RN, MAN, USRN
b. Wholeness is based on Erikson’s
description of wholeness as an open
system: “Wholeness emphasizes a
sound, organic, progressive mutuality
between diversified functions and parts
within an entirety, the boundaries of
which are open and fluid.”
Richard Sagasag
RN, MAN, USRN
Conservation is the product of adaptation
Richard Sagasag
RN, MAN, USRN
KEY CONCEPTS
(Conservational principle)
Richard Sagasag
RN, MAN, USRN
I. Conservation of Energy
Richard Sagasag
RN, MAN, USRN
II. Conservation Of Structural
Integrity:
Richard Sagasag
RN, MAN, USRN
III. Conservation Of Personal
Integrity
Richard Sagasag
RN, MAN, USRN
ANN BOYKIN & SAVINA SCHOENHOFER
“Nursing as Caring”
Richard Sagasag
RN, MAN, USRN
Seven Major Assumptions
Richard Sagasag
RN, MAN, USRN
a. Persons are caring by virtue of their
humanness
Richard Sagasag
RN, MAN, USRN
To understand the person as CARING one
needs….
Richard Sagasag
RN, MAN, USRN
The focus of nursing is “ nurturing
persons living caring & growing in
caring”
Richard Sagasag
RN, MAN, USRN
The circle represents relating with
The Dance of Caring respect for and valuing of the other in
Persons the basic dance to know self and other
as caring person.
“Humanistic Nursing”
Richard Sagasag
RN, MAN, USRN
“Humanistic nursing practice is
developed from the lived experiences
of the nurse & the person receiving
care”
Richard Sagasag
RN, MAN, USRN
Three Concepts that provide
the basis (or components) of
nursing
Dialogue
Community
Phenomenologic Nursology
Richard Sagasag
RN, MAN, USRN
DIALOGUE
-Nursing is a live dialogue
-Nursing is an INTERSUBJECTIVE
EXPERIENCE in which there is REAL
SHARING
Richard Sagasag
RN, MAN, USRN
COMMUNITY
-Humanistic nursing leads to community, it
occurs within a community, and is
affected by community
Richard Sagasag
RN, MAN, USRN
PHENOMENOLOGIC NURSOLOGY
Richard Sagasag
RN, MAN, USRN
c. Nurse knowing the other
scientifically
Richard Sagasag
RN, MAN, USRN
d. Nurse complementarily synthesizing
known others.
Richard Sagasag
RN, MAN, USRN
e. Succession within the nurse from the
many to paradoxical one
Richard Sagasag
RN, MAN, USRN
MARTHA ELIZABETH ROGERS
“Science of Unitary Human
Beings”
Richard Sagasag
RN, MAN, USRN
Concepts of Roger’s Model
Richard Sagasag
RN, MAN, USRN
1. Energy Field
- Energy field is the fundamental unit of both
the living & non-living
- This energy field “provide a way to perceive
people & environment as irreducible whole
- The energy field continuously varies in
intensity, density, and extent
2. Openness
- Human field & environmental field are
constantly exchanging their energy
3. Pattern
- Defined as the distinguishing characteristic of
an energy field perceived as a single wave
Richard Sagasag
RN, MAN, USRN
Homeodynamic Principles
-The way of perceiving unitary
human beings
a. Resonance
b. Helicy
c. Integrality
Richard Sagasag
RN, MAN, USRN
Resonance
-An ordered arrangement of rhythm
between human field & environmental field
-Field that undergoes continuous dynamic
Helicy
-Describes the unpredictable, but continuous,
non-linear evolution of energy field as
evidenced by non repeating rhythmicities
Integrality
-It covers the mutual, continuous
relationship of the human energy field and
the environmental field
-The fields are one & integrated but unique to
Richard Sagasag each other
RN, MAN, USRN
Margaret Newman
“Health as an Expanding
Consciousness”
Richard Sagasag
RN, MAN, USRN
Background of the theory
Richard Sagasag
RN, MAN, USRN
Margaret Newman believed
human beings as unitary,
health and disease is
inseparable from each other
and they are the part of the
same entity.
Richard Sagasag
RN, MAN, USRN
Humans are open to the whole energy
system of the universe and constantly
interacting with the energy. With this
process of interaction humans are
evolving their individual pattern of whole.
Richard Sagasag
RN, MAN, USRN
The nurse helps to understand people to
use the power within to develop the higher
level of consciousness.
Thus it helps to realize the disease
process, its recovery and prevention.
Time and space are the temporal pattern
(series of events) of the individual, both have
complementary relationship.
Humans are constantly changing through
time and space and it shows unique
pattern of reality
Richard Sagasag
RN, MAN, USRN
Application of the theory
Richard Sagasag
RN, MAN, USRN
Health as expanding consciousness
is not only focus in treating the
disease but it also helps to
understanding the patient pattern of
interacting with environment and
how to move forward
Richard Sagasag
RN, MAN, USRN
Holistic Nursing:
Richard Sagasag
RN, MAN, USRN
ROSEMARIE RIZZO PARSE
Richard Sagasag
RN, MAN, USRN
Three Assumptions on
Human Becoming
Richard Sagasag
RN, MAN, USRN
a. Human becoming is freely choosing
personal meaning in situations in the
intersubjective process of relating value
priorities
Richard Sagasag
RN, MAN, USRN
PRINCIPLES
Meaning
Rhythmicity
Transcendence
Richard Sagasag
RN, MAN, USRN
Meaning
- Refers to the linguistic and imagined
content of something & the interpretation
that one gives to something
Rhythmicity
- Refers to the paced, paradoxical
patterning of the human-universe mutual
process
Transcendence
- Described as reaching beyond with
possibilities – the hopes & dreams as
seen in multidimensional experiences
- options from which to choose personal
Richard Sagasag ways of becoming
RN, MAN, USRN
LYDIA HALL
“Care, Core, Cure”
Richard Sagasag
RN, MAN, USRN
CARE CORE CURE
Richard Sagasag
RN, MAN, USRN
CARE CORE CURE
Richard Sagasag
RN, MAN, USRN
CARE CORE CURE
Richard Sagasag
RN, MAN, USRN
CARE CORE CURE
Richard Sagasag
RN, MAN, USRN
IDA JEAN ORLANDO
“The Nursing Process Theory”
Richard Sagasag
RN, MAN, USRN
The nursing process discipline is
based on the “process by which
any individuals acts”.
Richard Sagasag
RN, MAN, USRN
Patient Behavior
Richard Sagasag
RN, MAN, USRN
Nurse Reaction
Example:
Nurse sees the patient grimacing. Shen then
thinks that patient is in pain. Then feels
concern about the feelings of the patient
Richard Sagasag
RN, MAN, USRN
Nurse Action
Richard Sagasag
RN, MAN, USRN
JOYCE FITZPATRICK
“Rhythm Model”
Richard Sagasag
RN, MAN, USRN
The primary purpose of nursing is
the promotion and maintenance
of an optimal level of wellness.
Richard Sagasag
RN, MAN, USRN
When assessing health care needs,
the professional nurse
incorporates the physical,
emotional, social, environmental
and spiritual aspects of the
profession into her daily routine.
Richard Sagasag
RN, MAN, USRN
FOUR CONTENT CONCEPTS:
Person
Health
Wellness-Illness
Metaparadigm
Richard Sagasag
RN, MAN, USRN
Person
Richard Sagasag
RN, MAN, USRN
Health:
Richard Sagasag
RN, MAN, USRN
Wellness-Illness
Richard Sagasag
RN, MAN, USRN
Metaparadigm
Richard Sagasag
RN, MAN, USRN
PATRICIA BENNER
“Novice to Expert”
Richard Sagasag
RN, MAN, USRN
Introduction
Example:
Richard Sagasag
Newly graduate nurses
RN, MAN, USRN
COMPETENT
2-3 years experience
Richard Sagasag
RN, MAN, USRN
EXPERT
Richard Sagasag
RN, MAN, USRN
Biographic Sketch
Carmencita M. Abaquin
Richard Sagasag
RN, MAN, USRN
She had served UP college of
nursing, her alma mater, as faculty
and held the position as secretary of
the college of nursing.
Richard Sagasag
RN, MAN, USRN
PREPARE ME Interventions are said
to be effective in improving the
quality of life of cancer patients.
This can be further applied not
only with terminally- ill patients
but also promisingly introduced to
those patients with acute and
chronic diseases and those with
prolonged hospital stays.
Richard Sagasag
RN, MAN, USRN
Basic Assumptions and Concepts
Richard Sagasag
RN, MAN, USRN
This emphasizes a holistic approach to nursing
care. PREPARE ME has the ff. components:
Richard Sagasag
RN, MAN, USRN
Meditation
- encourages an elicit form of
relaxation for the purpose of
altering patient’s level of awareness
by focusing on an image or thought
to facilitate inner sight which helps
establish connection and
relationship with God.
Richard Sagasag
RN, MAN, USRN
Basic Assumptions and
Concepts
Richard Sagasag
RN, MAN, USRN
Retirement
Richard Sagasag
RN, MAN, USRN
Time after having stopped
working
the time that follows the end
of somebody's working life.
Richard Sagasag
RN, MAN, USRN
Physiologic Age
Richard Sagasag
RN, MAN, USRN
Role
Richard Sagasag
RN, MAN, USRN
Change of Life
Richard Sagasag
RN, MAN, USRN
Retiree
Richard Sagasag
RN, MAN, USRN
Role Discontinuity
Richard Sagasag
RN, MAN, USRN
Coping Approaches
Richard Sagasag
RN, MAN, USRN
Health Status
Richard Sagasag
RN, MAN, USRN
Income (economic level)
Richard Sagasag
RN, MAN, USRN