Nursing Theory - Transcultural Nursing - Assignment Example

? Nursing Theory - Transcultural Nursing The art and science of nursing is a multidisciplinary approach to providing care for people who arein various stages of health; wellness, illness, and the dying process. This paper attempts to explore the aspects of nursing through the metaphors of a telescope, a periscope, and a microscope; hence the term, “the scope of nursing.” Nursing theory is the telescopic view, taking large amounts of information and postulating correlations between events and occurrences. Nursing knowledge, while comprising both nursing theory and nursing practice, takes data, and research to formulate concepts for models of care. It is more of a surface view of nursing without the practical application, the periscope view. Nursing practice is the fine tuning of all that has been studied and theorized into a microscopic view and applied to the reality of patient care. All three aspects of nursing are equally important and must continually be refined and researched to provide best practices for all patients everywhere. Nursing Theory - Transcultural Nursing Although nursing theory has been around since Florence Nightingale, the most progress in identifying and articulating nursing theory has occurred in the last twenty years. It is through the commitment of those in nursing that the ongoing work of nursing theory continues to be refined and actualized. It is concept oriented and aimed at explaining, describing and predicting various aspects of nursing practice and research. Contextually, there are three basic approaches to nursing theory which each describe the scope of nursing theory. Nursing knowledge is very similar to looking through a telescope; there are many conceptual theories which provide insight, however lack the empirical testing to prove them. Nursing as a discipline is considered a mid-range theory in that it somewhat bridges the gap between the grand theories and the actual nursing practice; much as looking through a periscope would provide a view for the world around us. Nursing as a professional practice gives the most in-depth view of all, providing practical solutions and information to help direct nursing interventions and outcomes, much like looking through a microscope. (Life Nurses, 2009) There are four basic paradigms that comprise a nursing theory: the person, the environment, the health, and the nursing. Each of these has associated with it various concepts, assumptions, and definitions. The view through the telescope takes the big picture, the Grand theory, and researches the concepts and constructs. This produces a proposition that connects the theory to knowledge gained, providing a surface view of the potential for nursing application. This proposition leads to a conceptual model which further defines and refines the practical application of this theory to give a microscopic view of the theory in action. (Current Nursing, 2011) The entire concept of nursing theory works as a circular phenomenon. Grand theories are postulated to improve nursing practice. It is for this reason that nursing research is ongoing to provide the knowledge and insight to help direct practice and effect outcomes. They predict and explain information that is crucial to outcomes that maximize potential for quality nursing care and cost effectiveness. They also help assess and improved practice by providing criteria for measuring outcomes and rationales for nursing practice. This research yields information, conclusions and recommendations for practical nursing applications. (Life Nurses, 2009) Nursing knowledge is the bridge between the theory and practical applications of nursing. It is an area of common ground that helps give definition to the profession as distinguishing it from other professions. It provides the answer to “why” nurses perform certain actions, as well as “how” they do them. It allows nurses to question practices and redefine care to act based on criteria and rationale that have a sound base in nursing research. Nursing knowledge gives nurses professional accountability. This knowledge is accountable in the actual nursing practice. It provides a way to ensure that nursing, as a profession, will continue to develop and grow; that patient care will become more refined and patient oriented with positive outcomes. It allows nurses to become holistic in their approach to care, as opposed to being just task oriented and ritualistic. (Hall, 2005) Nursing theory is the propositional knowledge that gives a general direction in which to explore and research issues. It takes the problem at the practical level to see if there is a way to further gain insight into what would be best practice. Nursing practice is the practical application of research brought down to the level of nursing care. Both are forms of nursing knowledge; they define the art and science of nursing. As a result, nursing is thought of as both an academic as well as practical discipline, which is constantly under construction to define and refine itself and its practices. As patients become more informed and pro-active, the nursing profession is called upon to use critical thinking and application to answer their questions and provide insight into their care. Furthermore, nurses must continue to learn from and educate each other in order to keep the profession progressive and qualitative. (Hall, 2005) Dr. Madeleine Leininger was a transcultural researcher as well as professional nurse who in the 1950's began to research and develop the area of cultural diversity in health care. She was the first to develop and use an ethnonursing research method and produced a "culturally congruent concept of care" called the Sunrise Enabler model which today is being used globally to impact health care. This model of care trained health care professionals to become informed and culturally sensitive to the needs of patient diversity, providing maximum quality of care through understanding of that patient's cultural traditions and norms surrounding health care as well as in general. She postulated that a nurse can’t possibly provide care for a patient when that patient’s specific beliefs and needs are not understood. (Leininger, nd.) The result of her anthropological research resulted in the Cultural Care Theory. This theory stated that prior to 1950; there were two major components missing in nursing; culture and care. Her basic concept revolved around providing care that assisted and enabled a person from another culture to be able to deal with life situations involving their health care by the provider becoming informed and accepting of the cultural differences, thereby affecting the outcome of improvement of the condition. This concept allowed the cultural values and traditions to provide a guideline in decision making regarding the client's care. The belief was that cultural diversity training and acceptance was necessary for nurses to provide quality of care for families, clients, and communities culturally different from their own. The framework of this theory is a commitment to caring based on the patient's responsiveness to that caring. It requires that nurses not only recognize cultural and ethnic features, but also incorporate them into goal-oriented actions aimed at a quality outcome for the patient. (Tonefeleo, 2010) Leininger developed a Four Nursing Metaparadigm Concept of Nursing in 1997 that further defined her approach to transcultural nursing theory. First, care was considered the greatest explanation and definition of nursing. Secondly, person is used to describe not only individuals, but more so families and communities. Thirdly, nursing is not the only discipline to use the term health. Finally, environmental context refers to happenings in diverse sociopolitical and cultural boundaries, as well as ecological and physical settings. (Tonefeleo, 2010) This Culture Care Diversity and Universality has three notable features. It is one of the oldest nursing theories (it was developed in 1950); the only theory focused exclusively on the interrelationships between culture and care as related to wellness, illness and death. It is the first nursing theory to have its own unique research method and design, ethnonursing, with both practical and abstract applications as well as three models for providing culturally congruent care. Finally, it is the first theory to focus on both basic, as well as professional care with regards to ethnohistory, social structure factors, and worldview in contextually diverse environmental settings. (Tonefeleo, 2010) Leininger identified that all cultures have features both in common and specifically related to the culture of the patient; that there are common needs, thoughts and perceptions a well as diverse ones. All cultures have both lay and professional traditions, beliefs, and practices of care, that without the caring, there will be no cure. Clients experiencing nursing care in conflict with their beliefs will experience difficulties in the healing process. Modes to guide nursing intervention need to be focused on these actions and decisions in order to produce culturally congruent care and positive outcomes: culture preservation or maintenance, cultural care pattern accommodation or negotiation, and cultural care or repatterning/restructuring professional actions. (Tonefeleo, 2010) This theory gave nursing a place to start in finding a way to provide quality of care to patients of diverse cultures. It also exposed an area needing definition around the world. Today, as the human family is much more mobile than previously, this model of care has been further refined to train nurses everywhere to provide compassionate care and enhancement for the healing processes around the world, regardless of which culture their patients come from. The research resulting from this theory gave further definition and insight into the health needs on a global scale, which helped to further many other types of research as well. The World Health Organization was able to use it to accommodate health practices in culturally sensitive areas, training nurses to become more effective in providing care. It also stands to reason that not only were nurses more culturally sensitive, but the definition of person in Leininger’s Four Nursing Metaparadigm Concept led to further exploration of various other cultures not necessarily ethnic. By recognizing the needs of these diverse groups, nursing care was more refined to provide quality of care for a wider scope of individuals with specific needs within our own culture. Nursing theory is used as a way to guide research, which improves knowledge and defines the nursing practice. Theories are important for growth as a profession and for guiding the development of new knowledge. With this knowledge, nursing practice continues to improve and take nursing care to new levels with positive outcomes for both the patients and the profession as a whole. It is through the dedication of practicing nurses, nurse educators, and researchers that nursing as a profession continues to become refined and grow. As we continue to research and refine nursing art and science, we are, in essence, refining the way we care for patients who are not only ill, but also well, not only ethnically diverse, but also culturally diverse. The future of health care is becoming more and more pro-active regarding wellness orientation; patients depend on nursing to lead the way. The only way to effectively do that is through continued research and refinement of the nursing knowledge base and nursing as a profession; the art and science of nursing. The whole world looks to us and we cannot let them down! Bibliography Current Nursing. Nursing Theories: Introduction to Nursing Theories. Feb. 21, 2011. Current. Web. March 12, 2011. http://currentnursing.com/nursing_theory/introduction.html Hall, A. Defining Nursing Knowledge. NursingTimes.net. November 29, 2005. Vol:101, Issue:48, Page No:34. Web. March 12, 2011. http://www.nursingtimes.net/nursing-practice-clinical-research/defining-nursing-knowledge/203491.article Life Nurses. Nursing Theory and Nursing Practice. November 7,2009. NA. Web. March 12, 2011. http://www.lifenurses.com/nursing-theory-and-nursing-practice/ Leininger, M. N., PhD, Lhd, DS, Rn, CTN, FRCNA, FAAN, LL. Developing Cultural Competencies in Nurses: Evidenced Based and Best Practices. Cultural -Competence- Project.org. nd. Web. March 12, 2011. http://www.cultural-competence-project.org/en/index.html Tonefeleo. Madeleine Leininger Sunrise Model ppt. Slide Share Inc. September, 2010. Web. March 12, 2010. http://www.slideshare.net/tonefeleo/madeliene-leiningerssunrise-model-ppt . Read More