Module On Nurse Theorist I

Continuation ….
Different Views of Person, Health, Environment and nursing by Various Nursing

Theorists
THE LIVING TREE OF NURSING THEORIES
Types of Nursing Theoretical Works
Nursing Philosophies Nursing Theories

Nightingale Boykin and Schoenhofer
Watson Meleis
Ray Pender
Benner Leininger
Martinsen Newman
Eriksson Parse
Erickson, Tomlin, and Swain
Husted and Husted
Nursing Conceptual Models Middle-Range Nursing Theories
Levine Mercer
Rogers Mishel
Orem Reed
King Wiener and Dodd
Neuman Eakes, Burke, and Hainsworth
Roy Barker
Johnson Kolcaba
Beck
Swanson
Ruland and Moor
NURSE THEORIST & THEORETICAL WORKS
1. Florence Nightingale
- first nurse theorist
- English social reformer, statistician and the founder of modern nursing.
- Nightingale came to prominence while serving as a manager and trainer of

nurses during the Crimean War, in which she organized care for wounded
soldiers at Constantinople. She significantly reduced death rates by improving
hygiene and living standards
- described nursing 150 years ago as establishing an environment that allows

persons to recover from illness (Nightingale, 1860/1969).
Theory : Environmental Theory
- The foundation of Nightingale’s theory is the environment- all the external

conditions and forces that influence the life and development of an organism.
According to her, external influences and conditions can prevent, suppress, or
contribute to disease or death.
- She inked health with five environmental factors:

(1) pure or fresh air,
(2) pure water,
(3) efficient drainage,
(4) cleanliness, and
(5) light,
- Deficiencies in these five factors produced lack of health or illness.
- These environmental factors attain significance when one considers that sanitation
conditions in the hospitals of the mid-1800s were extremely poor and that women
working in the hospitals were often unreliable, uneducated, and incompetent to care for
the ill.
- Nightingale also stressed the importance of keeping the client warm, maintaining a
noise-free environment, and attending to the client’s diet in terms of assessing intake,
timeliness of the food, and its effect on the person.
- Nightingale set the stage for further work in the development of nursing theories.
- Her general concepts about ventilation, cleanliness, quiet, warmth, and diet remain
integral parts of nursing and health care today
2. Hildegard Peplau
- mother of psychiatric nursing
- introduced her interpersonal concepts in 1952.
Theory : Interpersonal Relations Model
- Central to the theory is the existence of a therapeutic relationship between the

nurse and the client.
- Nurses enter into a personal relationship with an individual when a need is
present.
The nurse–client relationship evolves in four phases:
1. Orientation.
- The client seeks help and the nurse assists the client to understand the problem
and the extent of the need for help.
2. Identification.
- The client assumes a posture of dependence, interdependence, or independence
in relation to the nurse (relatedness).
- The nurse’s focus is on ensuring the individual that the nurse understands the
interpersonal meaning of the client’s situation.
3. Exploitation.
- The client derives full value from what the nurse offers through the relationship.
- The client uses available services based on self-interest and needs. Power shifts
from the nurse to the client.
4. Resolution.
- In the final phase, old needs and goals are put aside and new ones adopted.
- Once older needs are resolved, newer and more mature ones emerge.
- To help clients fulfill their needs, nurses assume many roles: stranger, teacher,
resource person, surrogate, leader, and counselor.
- Peplau’s model continues to be used by clinicians when working with individuals
who have psychological problems (Draucker, Cook, Martsolf, & Stephenson,
2012).
3. Ernestine Weidenbach
Theory : Prescriptive Theory / Helping Art of Clinical Nursing

• she explains that nursing is the practice of identification of a patient’s need for
help through the observation of presenting behaviors and symptoms, exploration
of the meaning of those symptoms with the patient, determining the cause of
discomfort, and determining the patient’s ability to resolve the discomfort or if the
patient has a need for help from the nurse or other health care professionals.
• The goal of nursing consists primarily of identifying a patient’s need for help.
• The need for help is defined as “any measure desired by the patient that has the
potential to restore or extend the ability to cope with various life situations that
affect health and wellness.”
The theory is based on three factors:
1. The central purpose which the practitioner recognizes as essential to the

particular discipline.
2.The prescription for the fulfillment of the central purpose.
3.The realities in the immediate situation that influence the central purpose.
• theory identifies the patient as “any individual who is receiving help of some kind,
be it care, instruction or advice from a member of the health profession or from a
worker in the field of health.”
• A patient is any person who has entered the healthcare system and is receiving
help, which means he or she does not need to be ill.
• A person receiving health-related education would qualify as a patient.
• The theory identifies four main elements in clinical nursing:
1. philosophy,
2. purpose,
3. practice, and
4. art.
4. Virginia Henderson
“Henderson’s Definition of Nursing”
“The unique function of the nurse is to assist the individual, sick or well, in the
performance of those activities contributing to health or its recovery (or to peaceful
death) that he would perform unaided if he had the necessary strength, will, or
knowledge; and to do this in such a way as to help him gain independence as rapidly
as possible” (Henderson, 1964, p. 63).
Henderson’s definition of nursing was adopte
- Virginia Henderson’s definition of the unique function of nursing was a major

stepping stone in the emergence of nursing as a discipline separate from
medicine.
- Like Nightingale, Henderson describes nursing in relation to the client and the
client’s environment.
- Henderson sees the nurse as concerned with both healthy and ill individuals,
acknowledges that nurses interact with clients even when recovery may not be
feasible, and mentions the teaching and advocacy roles of the nurse.
- emphasis on the importance of nursing’s independence from, and

interdependence with, other health care disciplines is well recognized.
• Henderson (1966) conceptualizes the nurse’s role as assisting sick or healthy

individuals to gain independence in meeting 14 fundamental needs:
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving and maintaining a desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range by adjusting clothing and
modifying the environment
8. Keeping the body clean and well groomed to protect the integument
9. Avoiding dangers in the environment and avoiding injuring others
10. Communicating with others in expressing emotions, needs, fears, or opinions
11. Worshipping according to one’s faith
12. Working in such a way that one feels a sense of accomplishment
13. Playing or participating in various forms of recreation
14. Learning, discovering, or satisfying the curiosity that leads to normal
development and health, and using available health facilities
5. Faye Glenn Abdellah
• Twenty-One Nursing Problems
• According to Abdellah’stheory of nursing
• “Nursing is based on an art and science that moulds the attitudes, intellectual
competencies, and technical skills of the individual nurse into the desire and
ability to help people, sick or well, cope with their health needs.”
• The model has interrelated concepts of health and nursing problems, as well as
problem-solving, which is an activity inherently logical in nature.
• identifies ten steps to identify the patient’s problem and 11 nursing skills used to
develop a treatment typology.
Twenty-One Nursing Problems

The ten steps are:
1. Learn to know the patient.

2. Sort out relevant and significant data.
3. Make generalizations about available data in relation to similar nursing problems
presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the patient and make additional generalizations.
6. Validate the patient’s conclusions about his nursing problems.
7. Continue to observe and evaluate the patient over a period of time to identify any
attitudes and clues affecting his or her behavior.
8. Explore the patient and his or her family’s reactions to the therapeutic plan and
involve them in the plan.
9. Identify how the nurses feel about the patient’s nursing problems.
10. Discuss and develop a comprehensive nursing care plan.
The 11 nursing skills are:
1. observation of health status

2. skills of communication
3. application of knowledge
4. teaching of patients and families
5. planning and organization of work
6. use of resource materials
7. use of personnel resources
8. problem-solving
9. direction of work of others
10. therapeutic uses of the self
11. nursing procedure
Abdellah’s Typology of 21 Nursing Problems

1. To maintain good hygiene and physical comfort
2. To promote optimal activity: exercise, rest, sleep
3. To promote safety through prevention of accident, injury, or other trauma and through
prevention of the spread of infection
4. To maintain good body mechanics and prevent and correct deformity
5. To facilitate the maintenance of a supply of oxygen to all body cells
6. To facilitate the maintenance of nutrition for all body cells
7. To facilitate the maintenance of elimination
8. To facilitate the maintenance of fluid and electrolyte balance
9. To recognize the physiologic responses of the body to disease conditions pathologic,
physiologic, and compensatory
10. To facilitate the maintenance of regulatory mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept positive and negative expressions, feelings, and reactions
13. To identify and accept interrelatedness of emotions and organic illness
14. To facilitate the maintenance of effective verbal and nonverbal communication
15. To promote the development of productive interpersonal relationships
16. To facilitate progress toward achievement and personal spiritual goals
17. To create or maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying physical, emotional, and
developmental needs
19. To accept the optimum possible goals in the light of limitations, physical and
emotional
20. To use community resources as an aid in resolving problems that arise from illness
21. To understand the role of social problems as influencing factors in the cause of
illness
- The model identifies nursing as a helping profession. Nursing care is doing
something to or for a patient, or providing information to the patient with the
intention of meeting needs, increasing self-ability, or alleviating impairment. In
other words,helping patients become more healthy.
6. Jean Watson
Theory : Transpersonal Caring
• Philosophy and Science of Caring

• addresses how nurses express care to their patients.
• Caring is central to nursing practice, and promotes health better than a simple
medical cure.
• She believes that a holistic approach to health care is central to the practice of
caring in nursing.
• According to Watson, caring, which is manifested in nursing, has existed in every
society.
• a caring attitude is not transmitted from generation to generation, it is transmitted
by the culture of the nursing profession as a unique way of coping with its
environment.
• Watson’s 10 Carative Factors & Caritas Factors

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Continuation ….

Different Views of Person, Health, Environment and nursing by Various Nursing

THE LIVING TREE OF NURSING THEORIES

Types of Nursing Theoretical Works

Nursing Philosophies Nursing Theories

- first nurse theorist

- English social reformer, statistician and the founder of modern nursing.

- Nightingale came to prominence while serving as a manager and trainer of

- described nursing 150 years ago as establishing an environment that allows

Theory : Environmental Theory

- The foundation of Nightingale’s theory is the environment- all the external

- She inked health with five environmental factors:

- Deficiencies in these five factors produced lack of health or illness.

Theory : Interpersonal Relations Model

- Central to the theory is the existence of a therapeutic relationship between the

The nurse–client relationship evolves in four phases:

Theory : Prescriptive Theory / Helping Art of Clinical Nursing

The theory is based on three factors:

1. The central purpose which the practitioner recognizes as essential to the

2.The prescription for the fulfillment of the central purpose.

• A person receiving health-related education would qualify as a patient.

• The theory identifies four main elements in clinical nursing:

Henderson’s definition of nursing was adopte

- Virginia Henderson’s definition of the unique function of nursing was a major

- emphasis on the importance of nursing’s independence from, and

• Henderson (1966) conceptualizes the nurse’s role as assisting sick or healthy

• According to Abdellah’stheory of nursing

Twenty-One Nursing Problems

1. Learn to know the patient.

The 11 nursing skills are:

1. observation of health status

Abdellah’s Typology of 21 Nursing Problems

Theory : Transpersonal Caring

• Philosophy and Science of Caring

• Watson’s 10 Carative Factors & Caritas Factors

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