Nursing 211 midterm exam

Midterm exam NU500-7A Theoretical Foundation for Nursing

Question 1

  1. From the Chinn and Kramer reading, define emancipatory knowing, emancipatory knowledge and praxis. How does each of these elements relate to and build upon the other? Provide an example of praxis in the patient care environment.

Emancipatory knowing is defined as human’s ability to critically examine the current status quo and to determine why it currently exists. Emancipatory knowledge is expressed in actions that are directed toward changing existing social structures and establishing practices that are more equitable and favorable to human health and well-being (McEwen, 2014). Praxis is the application of a theory to cases encountered in experience. Emancipatory knowing addresses the social and political context of nursing and healthcare. Midterm exam NU500-7A Theoretical Foundation for Nursing. Emancipatory knowing recognizes genuine social obstructions to wellbeing and prosperity while praxis is the process of emancipatory knowing requiring critical reflection and action. It involves the way you usually do your job. An example of praxis in the patient care environment is a very complicated patient in ICU requiring concentration, focus and critical knowledge. Such a patient will be triaged to a praxis nurse who enjoys the thrill of complicated situation. Praxis can also be defined as a synthesis of thoughtful reflection, caring, and action within a theory and research-driven practice (Enzman Hagedorn 2004) Midterm exam NU500-7A Theoretical Foundation for Nursing.

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McEwen, M. (01/2014). Theoretical Basis for Nursing, 4th Edition. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781469899992/

Enzman Hagedorn, M. L., RN, PhD, CNS, CPNP, AHNC. (2004). The Art of Caring as a Philosophical Model for Nurse Practitioner Praxis. Retrieved September 29, 2016, from http://www.medscape.com/viewarticle/496372_2

Question 2

McEwen and Wills discuss the difference between science and philosophy. Identify three characteristics of science, and three characteristics of philosophy. How do science and philosophy complement each other in nursing theory?

3 characteristics of science:

  1. Science must show a certain coherence.
  2. Science is concerned with definite fields of knowledge.
  3. Science is preferably expressed in universal statements.
  4. Midterm exam NU500-7A Theoretical Foundation for Nursing

                           3 characteristics of philosophy

  1. Establishes the meaning of science through an understanding and examination of nursing concepts, theories, laws, and aims as they relate to nursing practice.
  2. It seeks to understand truth; to describe nursing; to examine prediction and causality; to critically relate theories,
  3. It seeks to understand models, and scientific systems; and to explore determinism and free will

Science and philosophy complement each other in nursing theory because they directly affect each other. Philosophy cannot be developed without the support of science and science cannot work without philosophy. Midterm exam NU500-7A Theoretical Foundation for Nursing.

Question 3

  1. Match the following terms to the correct definitions
Construct The most complex type of concept. Comprised of more than one concept and built to fit a purpose

 

Concept C. Elements or components of a phenomenon necessary to understand the phenomenon. They are abstract and derived from impression the human mind receives from sensing the environment. Midterm exam NU500-7A Theoretical Foundation for Nursing.

 

Ontology A. The study of existence and the nature of reality

Taxonomy D. A classification scheme for defining or gathering various phenomena. Range in complexity from simple dichotomies to complicated hierarchical structures
 

 

Question 4

  1. Based on McEwen and Wills, what are the four requirements for a metaparadigm.
  1. A metaparadigm must identify a domain that is distinctive from the domains of other disciplines … the concepts and propositions represent a unique perspective for inquiry and practice.
  2. A metaparadigm must encompass all phenomena of interest to the discipline in a parsimonious manner … the concepts and propositions are global and there are no redundancies.
  3. A metaparadigm must be perspective-neutral … the concepts and propositions do not represent a specific perspective (i.e., a specific paradigm or conceptual model or combination of perspectives).
  4. A metaparadigm must be global in scope and substance … the concepts and propositions do not reflect particular national, cultural, or ethnic beliefs and values.

McEwen, M. (01/2014). Theoretical Basis for Nursing, 4th Edition. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781469899992/

Question 5

As discussed during the module 3 lecture, according to Peplau there are 3 phases to the nurse patient relationship:

Peplau stated that relationships are characterized by “personalities, moods, concerns, needs, personal values and views which a person brings into each interpersonal encounter” (Peplau, 1994). Understanding these elements and addressing them in the nursing process will ensure a greater likelihood of therapeutic interaction. For Peplau’s theory of interpersonal communication to work, the nurse must engage in all three phases of interaction. During the orientation phase, the nurse must first recognize the problem. Midterm exam NU500-7A Theoretical Foundation for Nursing. After determining what the issue is, the nurse must then identify the type of services the patient or client requires. During the orientation phase, the nurse assesses the patient needs, health and current situation. During this phase, the patient also builds a rapport with the nurse, explains to the nurse what the needs are and then proceeds to ask questions.

During the working phase, the patient feels like an integral part of the care team. Here, the patient can voice out opinions and ideas that will aid in his or her recovery and well-being. During the working phase, the patient is more open to patient education and skill acquisition. This is the time the nurse can impact her knowledge, and the patient will be receptive to the information Midterm exam NU500-7A Theoretical Foundation for Nursing.

The last phase deals with the termination of the relationship between the nurse and patient. Before the termination phase, the goals of the patient should have been addressed, evaluated and met. An article titled “The Impact of Peplau’s Therapeutic Communication Model on Anxiety and Depression in Patients Candidate for Coronary Artery Bypass” reinforced the active role of therapeutic communication had in reducing anxiety and depression of the patients. This clinical trial had 74 patients and divided into 2 groups; one group consisted of the intervention group and the other was the control group Midterm exam NU500-7A Theoretical Foundation for Nursing. Anxiety and depression levels were assessed before, and two and four months after intervention using the Hospital Anxiety and Depression Scale (HADS). All 74 patient had seven therapeutic sessions over four stages. Results concluded that the average anxiety and depression levels decreased in the intervention group after the therapeutic communication versus the control group. Conclusively, therapeutic communication in patient care is evidence-based and recommended as a simple, cost-effective and efficient method for reducing depression and anxiety.

Therapeutic communication is a vital and fundamental instrument tool that ought to be utilized in all events when caring for a patient in any clinical setting. An ideal approach to see precisely what a therapeutic nurse-patient relationship is to investigate the qualities of the relationship. As already expressed, the therapeutic relationship concentrates on the patient and their objectives or goals. In my practice, I will ensure that therapeutic relationship focuses on the client and their goals, maintain the defined parameters of the working relationship, and finally assess my patient in the termination phase for goals attained. Midterm exam NU500-7A Theoretical Foundation for Nursing.

References

Zarea, K., Maghsoudi, S., Dashtebozorgi, B., Hghighizadeh, M. H., & Javadi, M. (2014). The Impact of Peplau’s Therapeutic Communication Model on Anxiety and Depression in Patients Candidate for Coronary Artery Bypass. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 10, 159–165. http://doi.org/10.2174/1745017901410010159

McEwen, M. (01/2014). Theoretical Basis for Nursing, 4th Edition. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781469899992/

 

Question 6

  1. Nursing managers are often faced with the challenge of motivating their staff. Consider the following example: Midterm exam NU500-7A Theoretical Foundation for Nursing.

John is a nurse who has been working on your department for nine months. He is currently half way through a mandatory six month night rotation. Midterm exam NU500-7A Theoretical Foundation for Nursing. Last week you overheard him complaining in the hallway that he was unhappy with night shift, found it boring and had a hard time staying awake. He made one medication error a week ago which he immediately brought to the nursing supervisor’s attention and the patient was not harmed. You are concerned that his attitude made bring down the morale of other staff members and possibly affect his ability to provide patient care Midterm exam NU500-7A Theoretical Foundation for Nursing.

Select one of the following motivational theories. Explain the theoretical background of the theory and how it relates to nursing management. Explain how you would apply the theory to John.

Achievement-motivation theory: Achievement Motivation is characterized as practices devoted to creating and showing higher capacities. According to McEwen and Wills, individuals with a high need for achievement (n-Ach) are not as concerned with the rewards of achievement as they are with the actual achievement. These individuals seek out characteristic situations in which the probability of success is neither too high nor too low, in which success can be achieved through one’s own efforts, and in which personal credit can be received for a good or successful outcome. The individuals who are persuaded by accomplishment have a tendency to have a specific set of features. The first is that they pick their fights admirably. They are not gamblers with regards to setting objectives and won’t set one that is unimaginable.

In fields such as health care in which human health and safety are a top priority, it is important to be aware of research across the disciplines in order to understand the biological, emotional, and motivational processes that influence an individual’s skill and behavioral capacity to engage in astute cognitive decision-making at any given point in time. Midterm exam NU500-7A Theoretical Foundation for Nursing. In regards to john’s situation, it appears that john is getting burnout and lacks any motivation to continue this rotation. When high achievers such as John are placed in an environment that is not stimulating, they tend to fail at everything irrespective of the environment, timing or situation was different. The only option that can yield a positive outcome is John should consult with his manager and voice out his concern in order to avoid detrimental error that can lead to his dismissal.

McEwen, M. (01/2014). Theoretical Basis for Nursing, 4th Edition. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781469899992/ Midterm exam NU500-7A Theoretical Foundation for Nursing.

Question 7

  1. Describe 2 strategies for becoming a transformational leader.

Strategies for becoming a transformational leader are as follows 1) strong commitment to the profession and to the organization 2) the ability to help their followers look at old problems in new ways, as well as the ability to excite and motivate followers to produce extra effort to achieve group goals.

Question 8

  1. How do you envision conceptual knowledge, theory and the practical elements of nursing care interfacing in your practice? List at list at least one theory or theorist that you feel best embodies effective application of theory in practice Midterm exam NU500-7A Theoretical Foundation for Nursing..

In conceptual knowledge, concepts are drafted and relational statements are formulated. Propositional statements are supported by empirical or anecdotal evidence or defended by logical reasoning. Midterm exam NU500-7A Theoretical Foundation for Nursing. Conceptual knowledge uses knowledge from nursing and other disciplines. It incorporates curiosity, imagination, persistence, and commitment in the accumulation of facts and reliable generalizations that pertain to the discipline of nursing. One theorist that utilizes conceptual knowledge in her work is Dorothea E. Orem . Her Self-care deficit theory embodies the idea that patients will recover more quickly and holistically by performing their own self-care within their able capacity. Midterm exam NU500-7A Theoretical Foundation for Nursing.

Question 9

  1. Based on week 3’s supplemental activity link, what are some core components of ANCC’s magnet status program for nursing.
  • Attract and retain top talent
  • Improve patient care, safety and satisfaction
  • Foster a collaborative culture
  • Advance nursing standards and practice

Reference

ANCC. (2016). Magnet Recognition Program® Overview. Retrieved September 29, 2016, from http://www.nursecredentialing.org/Magnet/ProgramOverview.aspx

Question 10

  1. Provide an in-depth explanation the nursing theory you like best. Why is it your favorite?

As a psychiatric nurse, I find Hildgard Peplau’s Interpersonal Theory to be the one I use daily at work. It works effectively due to the type of clientele in my facility.  The first couple hours after my shift begins we begin the orientation phase. I walk in and introduce myself as the nurse. During my three day work week at the facility, I am able to engage all the phases of the interpersonal relationship. It is my favorite because it maintains the relationship within the context of goals. By my third day, the patient and I evaluate the situation based on the goals set and whether or not they were met. If goal were not met, then I am able to refer the patient for a higher level of care. Midterm exam NU500-7A Theoretical Foundation for Nursing.