Modern nursing theories have presented many grand theories models, frameworks and beliefs to guide or orient nursing practice. Nightingale stressed that the unique role of nursing was to place the patient in the best stipulation to assists nature in the healing process. This was to be accomplished by assisting the management of internal and external environments in a way that was dependable with nature’s laws. Jean Watson Human Caring Theory is an endeavor to find and deepen the language specific to nurse caring relations and it’s many meanings.
Her 10 creative factors are measurements that provide structure and guide to the theory.
Preference described ways in which nursing administrators can embrace nursing science theories, particularly care theories to provide nursing services with in health care organizations. She suggested that the application of nursing science theories occur in a reciprocal process for administration as well as practice. Patricia Banner’s Novice to Expert framework is another example of levels of progress.
The progression from novice to advanced beginner, to competent, proficient and expert is developmental, requiring (but not guaranteed by) time and experience.
The hallmark of an expert is someone who views a situation holistically that challenges the limits of objective descriptions. Lavabo- Trembler, O’ Bribe- Pales, Salinas, Disgorges (2008) estimate by 2020 the United States will have a projected shortage Of 808,400 full time nurses at 29% (Lavabo- Trembler et al, 2008). Lavabo – Trembler et al (2008) highlight the changes that need to be made with in the organizational structure that will positively impact work environments for new graduates by making more incentives (Lavabo- Trembler et al, 2008).
New graduate Urn’s need knowledge pertaining to issues that affect transition to be able to speak to them n upcoming interviews and job opportunities. Banner’s model is very valuable, now as nursing in acute care settings has expanded more multifaceted, and it is difficult to retain experienced nurses and there is an intensified need to prevent nurse turnover. Borrowed Theorist Biography Kenneth Earl ” Ken” Wilier 11 was born on January 31, 1949 in Oklahoma City, Oklahoma, graduated from high school in Bellevue, Nebraska. In 1967 he enrolled as a pre – med student at Duke University.
He became inspired, like many of his generation, by Eastern literature, particularly the Tao Et Chining. He left Duke and enrolled in the University of Nebraska at Lincoln, completing a bachelor’s degree in chemistry and biology and a master’s degree in biochemistry. He has been termed ” the Einstein of consciousness research” (Spiritual & Practice, n d Para. 2) due to the original and revolutionary concepts that he developed and has incorporated into Integral Theory. In 2000 Wilier founded the Integral Institute, whose mission is to awaken humanity to full self – awareness (Integral Institute, 2009,Para 1).
Wailer’s work has been referenced as support for Jean Watson theory of human caring in several of her books, including: Nursing: The philosophy and science of caring and Caring science as sacred science”. Theory Applied in Practice Integral theory synthesizes Western and non -Western understanding of consciousness and has been functional to business, politics, art, ecology, spirituality, education, medicine and psychology and researchers have established applications in leadership, coaching and organizational development (Integral Institute, 2009).
In leadership, this theory provides a unification of available leadership theories and applies them from a variety of perspectives. The holistic model described by Wilier focuses on a fundamental interconnectedness (Reams, 2005). Which is described in a four – quadrant model that examines self and collective aspects as well as internal and external aspects. Integral leadership theory has been applied at West Point with cadets and instructors and at Notre Dame University’s Mendoza College of business ( Reams, 2005).
A brief history of the borrowed theorist origin His integral model is an elegant, four- quadrant model that has been developed over 35 years. Wilier synthesizes in his monumental achievement the best known and most influential researches, theorist, theories and schools of Houghton to show that no individual or disciplines can determine reality or has all the answers. He explains the need for an Integral Approach in the following way: In our current post- modern world, we possess an abundance of methodologies and practices belonging to a multitude of fields and knowledge traditions.
What is utterly lacking however is a coherent organization, and coordination, of all these various practices. What is needed is an approach that moves beyond this indiscriminate eclectic- pluralism, to “Integral Methodological Pluralism” driving toward a genuine ” theory of everything” that helps to enrich and deepen every lied through an understanding of exactly how and where each one fits in relation to all the others.
Through the Integral approach, we reveal the previously unseen possibilities for a better, coordination, more compassionate, more sustainable future for all of us, and harmonistic of all the relevant practices, methodologies and experiences, available to human beings. An Integral framework provides a general orientation from which models of perspectives can be equated and synthesized. Overview of the core elements of an Integral approach: quadrants, levels, lines, states and types. An integral function of nursing as situated caring is presented with implications for a unifying theory of nursing.
Thinking Integrally Quadrants Represents the four most fundamental perspective- dimensions of our being – in – the world. They are the upper-Left quadrant, or the individual- interior realm of self and consciousness; the upper- Right quadrant, or the individual exterior realm of the organism and brain; the lower- Left quadrant, or the collective – interior realm of the culture and worldview; and the lower- Right quadrant, or the collective- exterior realm of social system and environment. It is important to toe that all quadrants are to be considered holistically similar to the principle of homicidal in the science of Unitary Human Beings.
Levels/ Stages Forms a natural hierarchy, stages are enduring, dynamic patterns of thought and behavior that emerge in an order that cannot be altered by any amount of social conditioning. One example of level or stages is of Patricia Banner’s Novice to Expert framework, based on Dresses and Dresser’s typology of developing expertise. Lines An Integral framework also recognizes that there is many specific areas of “lines” of development in each of these areas may proceed at different rates.
The lines, are represented as helical in nature, and when viewed together form a pattern of an individual or organization, which is subject to change over time and under different condition. Examples: Watson Clinical Caracas Processes. States A similar principle in the unitary paradigm is that of synchrony, such as guided imagery, biofeedback, hypnosis, prayer, and energetic methods like therapeutic touch. Integral theory takes this broader view of causality into consideration, providing a framework for asking questions about increasingly subtle phenomena in a way that can appropriately be answered through ” scientific” experiments.
Types An Integral Exploration of the Nursing Meta Paradigm is the central focus of the profession of nursing is using the art and science of caring to improve the health of human beings within their environment. When understood through an Integral perspective the meta- paradigm concepts are a powerful unifying core for the profession of nursing to translate amongst us the importance of our work, even when conceptualized and carried out in so many different ways. The meta- paradigm concepts provide common ground for communicating between nursing theories that are based on divergent philosophical underpinnings.
As Wilier put it: How a culture (AL) [Lower- Left quadrant) views a particular illness- with care and compassion or division and scam- can have a pro fund impact on how an individual copes with that illness (LU) [Upper- Left quadrant) which can directly affect the course of the physical illness itself (OUR) [Upper- Right quadrant]. The Lower-Left quadrant includes all of the enormous number of inter subjective factors that are crucial in any human interaction – such as the shared communication between doctor and patient; the cultural acceptance (or derogation) of the particular illness (e. . AIDS); and the very values of the culture that the illness itself threatens. All of these factors are to some degree causative in any physical illness and cure because every occasion has four quadrants. Practice Change Hypothesis with Theory Implementation Implementation of integral theory in the leadership of nurse managers challenged with nurse staffing shortages can be a positive method to promote a more holistic approach to remedy toe root causes of staffing issues. By utilizing the four – quadrant model Wilier has developed (Reams, 2005, p. 20) leaders can benefit from understanding the interconnectedness of decisions made y organizations and leaders and the impact on nurse staffing and patients. Attaining an understanding and consciousness of the leader’s self-development and the impact of this level on the strengths and weakness of the leader is also important (Reams, 2005). Potential Challenges with Application of Theory to Practice Application of theory to the practice challenge of staffing is fraught with some potential challenges.
Some objections to using these theories to address nurse staffing and leadership development are that it requires significant education and change. It does not rely on old familiar methods for recruitment and detention, which although unsuccessful in resolving issues long term, continue to be popular in hospitals and healthcare institutions. Another potential challenge is that leaders not familiar with grounding practice on a theoretical framework may see theory as too abstract.
Implication for Nurses A theory of nursing as situated caring can readily be understood by nurses, nursing students, and the public, regardless of their level of education or experience. The meta-theory of nursing as situated caring will create common ground for nurses in different countries, practice settings and with different educational backgrounds. It also allows them to share ideas and speaks with one coherent voice without threatening the unique contributions of nurses from different specialties or with different levels of education.
Considering the relationship between theory, methods and findings will become, an essential component of the training of researcher in the future. Conclusions A unifying meta- theory of nursing as situated caring succinctly provides a way to connect our profession and create the future we desire, whatever that may be. Nurse staffing challenges are most commonly addressed with short- sighted, cautionary methods such as recruitment bonuses or additional pay incentives that do not address the root cause of the problem.
Applying the theory of human caring, novice to expert framework and integral theory to address the practice problem of nurse staffing offers the opportunity to make real and lasting long term changes that will shape more caring leaders and patient care environments. Utilizing a theoretical framework to transform nursing leadership and organization will improve nurse staffing and improve quality outcomes.
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