Theoretical Model Analysis: Lydia Hall Theory - Assignment Example

? Theoretical Model Analysis: Lydia Hall Theory (School March This paper serves to address what the Lydia Hall Theory is, howthe theory has evolved, and what the theory is at present. It will serve to examine the strengths and weaknesses of the Lydia Hall model, and how this can be applied to induce therapeutic hypothermia in the post cardiac arrest patient. Keywords: Lydia Hall Theory, Lydia Hall model, therapeutic hypothermia, post cardiac arrest, patient Theoretical Model Analysis: Lydia Hall Theory The Lydia Hall Theory, also known as the Core, Care and Cure Theory was developed by Nurse Lydia Eloise Hall in the late 1960’s. Lydia Eloise Hall was born in New York City on September 21, 1906 (Currentnursing.com, 2012); she received her basic nursing education in 1927, her Bachelors in Public Health Nursing in 1937, and her Masters in teaching Natural Sciences in 1942 (Banda, Amadasun, Angoma & Howe, 2009). Lydia Hall established and directed the Loeb Center for Nursing and Rehabilitation at Montefiore Hospital in the Bronx from 1963 to 1969 (ANA, 2013). It was at the Loeb Center for Nursing and Rehabilitation in the late 1960’s that Hall developed her theory, known as Care, Core, and Cure. “She postulated that individuals could be conceptualized in three separate domains: the body (care), the illness (cure), and the person (core)” (Nurses.info, 2010). These separate domains, or aspects of the person as a patient were envisioned as overlapping circles, and that each circle influenced the others. Hall stated that “Everyone in the health professions either neglects or takes into consideration any or all of these, but each profession, to be a profession, must have an exclusive area of expertness with which it practices, creates new practices, new theories, and introduces newcomers to its practice” (Parker, p. 117). The core aspect of the theory is in regards to the patient as a person to whom the nursing care is directed and needed. The cure aspect of the theory is the attention given to patients by the medical professionals and the care aspect of the theory explains the role of nurses in regards to the patient, and helping the patient meet their needs where help is needed. Hall believed the care aspect was exclusive to nursing, and while nurses played a part in the other two circles, they shared those circles with other professions and the patient themselves. The core aspect of the theory focuses on the patient themselves, and the relationship that the professionals who are working with the patient have with the patient themselves. Nurses share this circle with all of the helping professions that have a relationship with the patient; it emphasizes “the social, emotional, spiritual, and intellectual needs of the patient in relation to family, institution, community, and the world” (Nursing Theories, 2013). Essentially, the core aspect helps the patient learn what their role is in the healing process, and works to provide the patient with enough information to be able to make an informed decision in regards to their situation. The care aspect of the theory focuses on the hands on bodily care of the patient, and is considered by Hall to be exclusive to the nursing practice. It is comprised of the teaching and learning activities, and the patient may explore and share their feelings with the nurse; the nurse’s goal is to comfort the patient. It is considered to” include the “motherly” aspects of care, which comprises of helping the patient meet their needs, where help is needed.” “Hands on care for patients produces an environment of comfort and trust and promotes open communication between nurses and patients” (Nursing Theories, 2013). The third and final aspect of the theory is the cure aspect. It consists of the application of medical knowledge. It is based on the pathological and therapeutic sciences. The nurse is the patient’s advocate with the other disciplines that may be included in this circle. The nurse assists the patient in their rehabilitation through the application of medical knowledge of the disease the patient has been diagnosed with, and works to assist with the plan of care set out for the patient themselves. It is the “interventions or actions geared on treating or curing the patient from whatever illness or disease he may be suffering from” (Currentnursing.com, 2012). The Core, Care, and Cure Theory can be applied to all aspects and all medical practices that the field of nursing touches, including, but not limited to, the induction of therapeutic hypothermia in the post cardiac arrest patient. To best see how this theory may be applied, a closer look at the application of the theory to the post cardiac arrest patient, and the induction of hypothermia as a part of the treatment process, will be reviewed. The patient themselves, the core, will have a different role in participating depending on whether or not they were coherent enough to make a decision at the time of admittance. Patients of Saint Mary’s who report having a cardiac episode outside of the hospital, for example, are provided with a form to fill out upon check in that details whether or not they may wish hypothermia/cardiac arrest surface cooling; it details the inclusion criteria, a description of the practice, blood pressure information, and medications, as well as exclusion criteria (Kozik, 2007). If the patient opts for this practice, they must fill out the form itself. If the patient is not coherent at the time they are brought to the hospital, they still have their set needs that must be met, and it is the responsibility of the staff themselves after the patient is coherent to explain and assist the patient in understanding what has been done, why, and what the reasoning behind this particular practice is. The care aspect of the theory as it relates to medically induced hypothermia in cardiac care patients is the domain of the nurses themselves. There are multiple different ways to induce hypothermia in the hospital setting, including, but not limited to,” cooling with IV cold saline, the use of an intravascular heat exchanger to induce and maintain hypothermia, the use of ice packs and either water or air circulating blankets, the use of ice packs alone, the use of cooling blankets, the use of water circulating gel-coated pads, a cold air tent, and a cooling helmet” (Therapeutic Hypothermia after Cardiac Arrest, 2011). Depending on which method is used will determine, to a degree, what the role of the nurse will be in this situation. While the nurse will always be responsible for maintaining vitals, ensuring that catheters are properly inserted, that the urine bags are properly maintained, that all electrodes are in proper place, that the bathing needs of the patient are addressed, that the feeding needs of the patient are addressed, the bedding is properly maintained and so on, the method used will determine the other duties of the nurses themselves. The nurses may be responsible for obtaining and changing out the ice packs, for example, or they may be in charge of feeding the saline into the IV as needed to start and maintain hypothermia, and so on. The nurses are also responsible for fully explaining and providing the patient with the materials and information they need in order to fully answer any questions about the policy, practice or procedure that they may have. The cure aspect is shared by the nurses, the doctors, and any other professions, such as social workers, that may be present and assigned to the particular patient’s case. Doctors cite that the lack of policy or protocol or resources were the most common reasons for not inducing hypothermia (Kennedy, Green, & Stenstrom, 2008), however in places where the policy or protocol, and the resources were in place for inducing hypothermia, the cure aspect is applied, and that is the induction of hypothermia itself, regardless of the method used. There are strengths and weaknesses present in the different aspects of the Core, Care, Cure Theory. The aspects themselves are very abstract; they are open to interpretation due to how general the theory is, and the indicators are used in practice, only once the patient has become ill and when the patient is on the road to recovery. The concepts are clinically relevant because they encompass the necessary factors that a nurse brings to a relationship with their patient, but there are no sub-concepts, which would be helpful when utilizing this particular theory. The theory has clinical significance in regards to nursing, and it helped pave the way for modern nursing, wherein nurses use critical thinking in combination with medical knowledge to teat and heal a patient rather than merely following the doctor’s orders. This is a very medical approach to nursing, but it mainly focuses on the illness and recovery and not prevention or health promotion. The care aspect is, according to Hall, used only by nurses, when in reality it is used by many different professions. The theory is enticing because of its simplicity, but it is too vague, does not address the issues of collaboration with a multidisciplinary team, and does not include all patients, as many patients are concentrating on staying healthy, versus waiting until they are sick enough to need hospitalization. Works Cited ANA. (2013). Lydia eloise hall (1906-1969) 1984 inductee. Retrieved from http://www.nursingworld.org/FunctionalMenuCategories/AboutANA/Honoring-Nurses/HallofFame/19761984/hallle5544.html Banda, E., Amadasun, K., Angoma, K., & Howe, L. (2009, July 22). Lydia hall nursing theory. Retrieved from http://www.authorstream.com/Presentation/libbylou01-219589-lydia-hall-nursing-theory-1-education-ppt-powerpoint/ Currentnursing.com. (2012, January 27). Care, cure and core the three c’s of lydia hall. Retrieved from http://currentnursing.com/nursing_theory/Lydia_Hall_Care_Cure_Core.html Kennedy, J., Green, R. S., & Stenstrom, R. (2008). The use of induced hypothermia after cardiac arrest: a survey of Canadian emergency physicians. CJEM: Canadian Journal Of Emergency Medicine, 10(2), 125-130. Kozik, T. M. (2007). Induced Hypothermia for Patients With Cardiac Arrest. Critical Care Nurse, 27(5), 36-43. Nurses.info. (2010, May 20). Retrieved from http://www.nurses.info/nursing_theory_person_hall_lydia.htm Nursing Theories. (2013). Lydia eloise hall nursing theory: Care core cure model. Retrieved from http://nursingtheories.info/lydia-eloise-hall-nursing-theory-care-core-cure-model/ Parker, M. E. (2005). Nursing Theories and Nursing Practice. F.A. Davis. Therapeutic Hypothermia after Cardiac Arrest. ARC and NZRC Guideline 2010. (2011). Emergency Medicine Australasia, 23(3), 297-298. doi:10.1111/j.1742-6723.2011.01422_16.x Read More