Reflective Practice and Evidence-Based Practice in Nursing - Essay Example

? Generating theory from Practice Introduction Nursing is a profession in the health care sector, which takes care of individuals and families, so that they can maintain healthy and a quality life. Reflective-based practice initiates reflective thinking within the nurses, which signifies care by the nurses on the basis of individual care needs. Reflection within nursing context is represented as ‘art of nursing’, which involves “creativity and conscious self-evaluation over a period of time” (Jones & Bartlett, n.d.). Reflective-based practices assist nurses in mitigating unique situations. Wherein, Evidence based practice provides high quality patient care by the nurses based on research and knowledge, rather than on the basis of traditions, myths and outdated books among others. . These two practices frame an important part of the nursing theory and further help in the development of prevailing nursing theories. Nursing theory can be defined as “a logically interrelated set of confirmed hypotheses” (Brown, 1997). Furthermore, it has been discussed that to utilize the nursing theory effectively, it is necessary to derive a better understanding about the description, analysis and the evaluation of the theory. According to the aforesaid discussions, it can be stated that nursing theory must involve care for the patients to build up confidence in them. Furthermore, nurses must be well acquainted with medical ailments to deal with critical situation, whenever necessary. In this stand, these theories if implemented in future, it can assist patient and their families to keep faith upon the medical department and to maintain a cooperative atmosphere for better results. “Reflective practice can be defined as the process of making sense of events, situations and actions that occur in the workplace” (Nursing Times Awards, 2013). Evidence based practice involves research outcomes, qualitative inclusion of data and valuable opinions of the experts for identifying the improvement methods for effectual development of this particular theory (Health Leaders Media, 2013). Reflective practice aims at asserting the team to become more effective and innovative for accelerated well-being of the patients. In this stand, this practice can be implemented to strengthen the shared thinking and can also be applied for the purpose of bringing alignment between various healthcare activities (Amulya, 2011). In case of Evidence-based practice, it inculcates, qualitative project, which mainly contributes to the other research initiatives. This paper intends to evaluate efficiencies of nursing theories. This paper will also critically analyze the Reflective Practice (RP) and the Evidence Based Practice (EBP), which is applied in the development of nursing theories. A proposition is a statement about a concept or the relation between two or more concepts. EBP is a quality assurance activity, which involves low cost and high relevance within medical context. It requires team involvement and collaborative actions (French, 1999). The RP is a dynamic process, which is associated with individuals need for care, which inculcates the emotional and personal feelings of the patients. Thus this assignment intends to evaluate the necessity of RP and EBP in the study of nursing. Discussion Nursing is a profession in health sectors which takes care of people to live a healthy and longer life. The ability of nursing to look after the need of the people depends on the way in which the nursing job is managed in health care systems (NHS Careers, 2012). It also depends on the way in which nursing practice is regulated and the quality care is assured. Thus to make the nursing study a clear concept, various practices have been introduced. This assignment mainly focuses on the two types of practices Reflective Practices (RP) and the Evidence Based Practice (EBP), which is required for the effectual development of the nursing theory. ‘Reflection on Practice’ signifies an important skill of the nurses. Nurses getting engage within the regular reflections enables them to efficiently manage personal and the professional impact by addressing the patients’ health and well-being needs with regard to daily basis (University of Ulster, 2013; Nursingtimes, 2004). Another practice is the EBP, which can be denoted as the integration of the best research evidence with clinical expertise and patient values. This practice aims at providing evidence-based qualitative data to the nurses, with a view to deliver effective care, solve the problems in clinical setting, and achieve excellence in care delivery and surpassing in quality assurance standards among others (Spector, N.d). EBP is beneficial for the patients, nurses, health care organizations and also for the community as it includes knowledge and professional view point. Usually the patients accept the care recommended by the nurses as they lay their full confidence upon them. EBP concept is pretty new for the patients. EBP encourages the nurses to communicate efficiently with their patients as well as the healthcare team in order to make effective decisions and to take better care of the patients. A nurse enduring ensures effectual health care to the patients on the basis of factual notes rather than myths and habits. The EBP study allows the health care organizations to rank them in providing quality care to their patients. This practice is suitable for organizations, which are frequently struggling to meet the budgetary limits and requesting the government for allocation of additional funds. In this stand, this particular practice ensures effective care, wherein, it also limits the amount of disability and chronicity throughout the community (Courtney & McCutcheon, 2010). In case of Reflective practices with regard to the development of the nursing theory, inculcates certain advantages and disadvantages. Likewise, EBP also carries certain disadvantages. It is a time consuming process and also requires resources to develop the skills to undertake effective EBP. Some of the disadvantages of EBP are seen in the recent problems that are common to all health care sectors such as scarcity of evidences or adequate resources needed to provide effective care to the patients care (Cluett, 2006). Reflective practice is essential for everyone, especially for the nurses. Nurses are responsible for providing care to the patients and the others at the best of their ability. They need to emphasize on the knowledge and skills to meet the demands expected from them. Nurses must adopt this practice to update their professional skills. Annual reviews will help the nurses to identify the strengths and the scope for opportunities which may be beneficial for future development. Nurses must always judge the ways in which they communicate or interact with their colleagues. They must have the motive of becoming self aware and to be in touch with their working environment. These goals or the objectives can be met by the nurses with the application of RP in their work procedure (Nursingtimes,, 2004). The nursing theory is a vast theory which represents the science and art of nursing. The early development of nursing education can be understood better by the analysis or review of this subject from the following data. The National League for Nursing Education (NLNE) was formed in the early 1893. Again in the year 1917, the first standard curriculum for the schools of nursing was established. Since the year 1918-1934 several publishing was carried on. A Goldmark Report was prepared assessing the nursing education. Various books named as “Nurses, Patients and Pocketbooks” and “Nursing Schools Today and Tomorrow” were published for the betterment for the nursing education (Jones & Bernett Publishers, N.d). The nursing education was developed many years back. It was developed to enhance the quality of the service provided to the patients and also improve their health conditions (Woodward, 2000). There are several nursing theories established in the past with various forms or practices involved in it. One of the theories is the Watson’s Theory of caring which states caring as a human science orientation, human caring processes, phenomena and experiences. The other is the Orem’s theory which comprises of theory of self care, theory of self care deficits and theory of nursing systems (Gonzalo, 2011). The Roy’s theory which states, the goal of nursing is to assist the patients to become accustomed to illness so as to respond to other stimuli (Minnesota State University, 2013).The last theory, Margaret Newman’s theory which is used in working with the cancer patients and provides a conceptualization of intervening in a meaningful way. Gary Rolfe is a professor of Nursing in the school of Health Science. He had brought about a new theory of practice gap (Elseiver, 2013). The aim of nursing research is generally denoted to be the creation of knowledge abstracted from the research. It has been suggested that the nursing requires an example of clinical research which focuses on the individual remedial meet in order to harmonize the existing sociologies, for instance, hypothetical research. It is best fitted for the age group of knowledge and theory. In this stand, on further discussions, it was revealed that, nursing theory is not limited to relationship between the nurses and the patients, but to focus on the duties and the responsibilities to be performed by the nurses. These practices make a person aware about his behaviors, situation and the actions to be carried on by him. The EBP provides information from the research with adequate data. These practices create a sense of responsibility among the nurses regarding their work process. The EBP practice makes the nurses aware regarding their duties towards the achievement of the goals and objectives. Reflective practices are the events which make the nurses know about their duties and responsibilities in accordance to provide quality health care to their patients. Nursing theory was developed to describe the process, occurrences or the event related to nursing. There are four common theories in relation with the nursing theory (Ahmad, N.d). The professional nurses apply nursing theories to collect and classify patient data for understanding and scrutinizing the patient’s health situation. Nursing theory concept provides data for determining information, which will assist in the examination and evaluation of the nursing analysis within a healthcare sector. There are three different theories in relevant to the sufficient specificity. It can thus be named as the grand theory, middle range theory and the micro range theories. A grand theory comprises of concepts representing universal and compound situation. It is broadest in scope and also represents the most abstract level of development. The middle range theory defines concrete and narrowly defined phenomena than the grand theory. This theory provides a sensitivity from which compound situations and a new direction towards the intervention can be viewed. The macro range theory is the most tangible in comparison to the other two theories of nursing. Further it can be divided into the other models such as the practice model, mid range model and the practice based model which are very much different from each other. There are many conceptual models of nursing by different theorists. According to Dorothea E. Orem’s Self care deficit theory in nursing related to conceptual model, stated about the caring activities to be performed by the nurses as well as the patients themselves. . “Helping the patient to do for himself” means to assist the patient to learn self caring and highlight on the importance of nurse’s job. Myra Estrin Levine’s, conservation model, proposes about implementation of principles with regard to protection of social integrity, client’s energy and the structural integrity by the nurses (Current, 2012). Dorothy E.Johnson’s Behavioral system model states that a person maintains balance through adjustments with the services that affects them. Correspondingly, another model represents the Betty Neuman’s; Health care systems model. In accordance to this particular model, the nurses reveal about the factors that affects the client’s reaction towards the others. Imogene King’s Goal attainment theory, states that transaction is provided with an outline in order to accomplish the desired objective and goals related to the conceptual models. According to the conceptual model of Hildegard E. Peplau, Psychodynamic Nursing Theory, it divides the nurse and patient’s relationship into four phases such as resolution, exploitation, orientation and identification. He has also given the nursing roles which are named as counselor, leader, surrogate, stranger, teacher and resource person. He mentioned that suffering can be removed through interpersonal process. Furthermore, the conceptual model given by Ida Jean Orlando’s Nursing Process Theory stated that the nurses must always be in touch with the patients and make them sure that they are getting what they need and should reveal on the reaction towards the patient’s behavior to remove the stress. Another model of nursing is the Joyce Travel bee’s Human to Human Relationship Model. Here nursing is said to be proficient with inter human relationship that start with the prior meeting and continues through various stages of rising identities. Kathryn E. Barnard’s Parent Child Interaction Model basically focuses on the growth and development of the relationship between the children and the mother. A very concrete theory was developed to explain the factors affecting the development of maternal role over numerous time periods. In this stand, this particular theory was named as Ramona T.Mercer’s, Maternal Role Attainment. Madeleine Leininger’s Transcultural nursing, culture-care theory believes that care is the essence and a leading feature of nursing. Caring also serves to improve the health situation of an individual. Rosemarie Rizzo Parse’s theorygives much attention on the theory of nursing abstracted from the Roger’s conceptual model. The nurses help the patients to communicate or adjust with the environment and help them to get rid of the health issues. The last that have been discussed in the assignment is the Nola J.Pender’s: The Health promotion conceptual model. It promotes health remedies against various diseases. It detects the factors among the clients which can result from the biological and demographical characteristics (Current, 2012). Now discussing about the middle range theory, it is the theory which contains a limited number of factors. It is useful for a variety of clinical research (Smith & Leihr, 2013). It has mentioned various nursing philosophies describing the important points of the theory. It focuses on the nurse and the patient relationship. Caring is a social process which is only effective when practiced interpersonally. Basically middle range theory emphasizes on the Florence Nightingale’s Legacy of caring (ICRC, 2010).Thus it can be concluded that these models have a positive impact in the past and also in the coming future. It is relevant for the nursing studies. Through these models and concepts, the nursing studies can be made efficient. Conclusion Reflective practice and the evidence based practice aims at developing individual theories of nursing and create knowledge of nursing among the nurses (Sagar, 2012). This practice also allows identifying and resolving the practical problems through adequate validation. It encourages the nurses to understand the nature of their role and of other health practitioners. The nurses can develop themselves to accept the responsibilities of the professionals. It develops the understanding of the situation under which the medical practitioners carry on their research. From the above mentioned studies it can be clearly analyzed about the importance of the RP and EBP in the nursing study. Although EBP has a scarcity of time and inadequate support from administrators but it is accepted as the general form of research carried on by many of the clinical researchers. The medical practitioners need technical assistance in using evidence based practices. It can enhance the quality of health care provided by the nurses to their patients and furthermore, it will also assist the nurses to be sure about the services they are providing i.e. proper care to their patients. It develops a sense of responsibility towards the patient which in turn improves the nurse and patient relationship. The approaches of RP and EBP can be concluded to be same in the nature of their studies. It adds some relevant benefits to the study as well as the nurses in identifying their objectives, duties and responsibilities (Roussel, N.d). RP and EBP can run effectively side by side within the context of nursing theory. There occur certain positive signs of relation between these two practices which can reflect a simultaneous relation between the practices. If the RP and EBP are considered side by side by the nurses, it can help them in providing their patients with quality care and effectual fulfillment of duties and the responsibilities. The nurses must remain in contact with their clients or patients so that they can understand the needs of the patients. This habit can be achieved from the effective implementation of the above mentioned practices in their study. It will also assist them in maintaining the no gap theory between their academic and the practical tasks during their nursing studies. Therefore it can be said that there is a no gap theory prevalent between the practices required in the nursing courses or the study (Abbott, Sherry & Simmons, 2013). Nursing is related with the caring techniques of an individual, family or the community. It has provided the human beings with a great contribution since decades (Crossan & Robb, 1998). As known it was inspired globally from the time of Florence Nightingale. She had contributed a lot to the study of nursing. She had also given several theories which now are termed as the middle range theory of nursing (Stockwell, 2010). The two tools of nursing study that is RP and EBP is the main focus area of the assignment. The paper has intended to show a positive relation between these two theories and the process by which nursing is benefited from this. It has shown the advantages and disadvantages of both the practices. But the fact abstracted from the assignment is that both the practices have a great impact on the nursing study. Through the implementation of the practices the level of nursing study can be raised to a certain standard. It also emphasizes on the relevant findings and provides accuracy to the nurses, patients and to the other medical professionals. Using these practices the nurses can learn and understand their responsibilities towards the care of the patients and to have a positive interaction with their clients. The study will develop the professional skills in the nurses which in turn will prove as a benefit for the nursing. Thus it can be concluded that the RP and EBP is a vital tool in the study of nursing (Jasper, 2008). References Abbott, P. Sherry, R. M. & Simmons, M. (2013). Evidence-informed nursing. USA: Routledge. Ahmad, S. A. (N.d). Theories and models of nursing practice. Retrieved from http://www.conursing.uobaghdad.edu.iq/uploads/others/conursing/leacture/theory.pdf Amulya, J. (2011). What is reflective practice? Retrieved from http://www.communityscience.com/images/file/What%20is%20Reflective%20Practice.pdf Brown, S.L.D.( 1997). The evaluation of nursing theory: a method for our madness. Int. J. Nurs. Stud 34(1), pp. 76-83. Cluett, E. R. (2006). Evidence based Practice. Retrieved from http://www.midwiferycollege.org/AcademicProgram/Downloads/BSM/BSMSyllabi/BSM-MW460Resource-04-Cluett_Principles&PracticeOfResearchInMidwifery.pdf Courtney, M. & McCutcheon, H. (2010). Using evidence to guide nursing practice. Retrieved fromhttps://www.us.elsevierhealth.com/media/us/samplechapters/9780729539500/Courtney_Sample_Chapter.pdf Crossan, F. & Robb, A. (1998). Role of the nurse: introducing theories and concepts. British Journal Of Nursing 7 (10), pp. 608-612. Current. (2012). Nursing theories. Retrieved from http://currentnursing.com/nursing_theory/introduction.html Elseiver. (2013). Reflective practice: where now? Retrieved from http://www.journals.elsevierhealth.com/periodicals/ynepr/article/PIIS1471595302900478/abstract French, P. (1999). The development of evidence based nursing. Journal of Advanced Nursing 29 (1), pp. 72-78. Gonzalo. (2011). Theoretical foundations of nursing. Retrieved from http://nursingtheories.weebly.com/dorothea-e-orem.html Health Leaders Media. (2013). Evidence-based practice and nursing research: avoiding confusion. Retrieved from http://www.healthleadersmedia.com/content/NRS-245879/EvidenceBased-Practice-and-Nursing-Research-Avoiding-Confusion ICRC. (2010). Florence Nightingale: her legacy continues. Retrieved from http://www.icrc.org/eng/resources/documents/feature/2010/florence-nightingale-feature-110810.htm Jasper, M. (2008). Vital notes for nurses: professional development, reflection and decision-making. US: John Wiley & Sons. Jones & Bartlett Learning. (n.d.). The essence of nursing: knowledge and caring. Retrieved from http://samples.jbpub.com/9781449649029/46066_CH02_6031.pdf Hart, V. A.(n.d.).Communication and nursing: historical roots and related theory. Jones & Bernett Publishers , pp. 2-3. Minnesota State University. (2013). College of allied health & nursing. Retrieved from http://ahn.mnsu.edu/nursing/facultyformsandinfo/nursingprocessandram.pdf NHS Careers. (2012). Careers in nursing. Retrieved from http://www.nhscareers.nhs.uk/media/1487628/careers-in-nursing.pdf Nursing Times Awards. (2013). Using reflective practice in frontline nursing. Retrieved from http://www.nursingtimes.net/using-reflective-practice-in-frontline-nursing/5045779.article Nursingtimes. (2004). A practical approach to promote reflective practice within nursing. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/educators/a-practical-approach-to-promote-reflective-practice-within-nursing/204502.article Roussel, L. (N.d). Concepts and theories guiding professional practice. Retrieved from http://www.jblearning.com/samples/0763757144/57144_CH02_018_049.pdf Sagar, P. (2012). Transcultural nursing theory and models. Retrieved from http://www.springerpub.com/samples/9780826107480_chapter.pdf Smith, M. J. & Leihr, P. R. (2013). Middle range theory for nursing: third edition. US: Springer Publishing. Spector, N. (N.d). Evidence-based health care in nursing regulation. Retrieved from https://www.ncsbn.org/Evidence_based_HC_Nsg_Regulation_updated_5_07_with_name.pdf Stockwell, F. (2010). A contemporary perspective on Florence nightingale's writings in notes on nursing and Florence nightingale to her nurses. Retrieved from http://www.felicitystockwell.com/wp-content/uploads/2010/08/Florence-Nightingale-modern-nursing.pdf University of Ulster. (2013). Unit three: reflection on and in the work place. Retrieved from http://www.science.ulster.ac.uk/nursing/mentorship/docs/toolkits/Reflection.pdf Woodward, C. A. (2000). Improving provider skills. Retrieved from http://www.who.int/hrh/documents/en/improve_skills.pdf Read More