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 Unit Four

Theoretical Foundations of Nursing

10% - Weeks 7, 8 and 9

(8-14 Oct, 15-21 Oct, & 22-28 Oct)

There are two Assignments in Unit Four. Must be completed by midnight, Sunday, of Week 9 of the course.

Use the forum in WebCT for Questions for Instructor on Unit 4 to ask me questions about anything in Unit 4.

Use the forum for Student Resources to post URLs to links of interest to the entire class.

Post suggestions about the way the course works in the Suggestion Box.

Use the Student Lounge to talk about whatever you like; it isn't course-related.

Assignment 4A: How Theory Is Used in Nursing

The terms "theory," "theoretical framework," "theoretical model," and "theoretical rationale" are frequently used interchangeably. They are defined pretty much the same way: a theory explains the relationships or connections between and among concepts in a set. A theory explains something. We all have theories about lots of things: e.g., from how best to heal decubiti to how to raise children. Each theory presents a particular perspective about a phenomenon or subject of interest, such as a theory about who the recipient of nursing is, or a theory about what constitutes the environment, or theories about how health is defined, or theories about how a step in the nursing process should be defined and implemented. In the past 50 years of nursing, many theories have been formulated and tested to explain and direct nursing practice.

A nursing theory describes, explains, predicts, or prescribes some phenomenon. For instance, there are theories about what is pain (description), what causes pain (explanation), under what circumstances pain is likely to occur (prediction), and what can be done to ameliorate the pain (prescription).

You will also hear the terms "conceptual model," and "conceptual framework." A conceptual model or framework is a more general, organized arrangement of concepts and their relationships.

Step One (Wk 7):

Browse the Nursing Theory Page.

Select the theory of one nurse theorist and study it. If necessary, go to the library to find out more about this theory.

Step Two (Wk 8):

Prepare an article for the Inservice Page of a staff newsletter. Your purpose is to educate the nurses on your unit about the theorist and theory that you selected in Step One of Assignment #4A. Your article should briefly explain who the theorist is/was. What are the major concepts inn this person's theory? How are they related to one another? For what kinds of patient care situations is this theory most applicable?

Write your article carefully; it should have enough information in it for your classmates to complete Step Three below.

Post your article in the forum for Assignment 4A (Nursing Theory).

Step Three (Wk 9):

Discussion Holiday! You need only to read the articles of your classmates!!!!

Optional:

Check out these interesting sites related to nursing:

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Assignment 4B: Applying Critical Thinking Skills in Professional Communication

One of the designated learning outcomes from earning a baccalaureate degree is a refinement of one's critical thinking skills. Surely the ability to apply the skills of critical thinking is preeminent for professional nurses. One's ability to apply these skills would be manifest throughout one's behavior--in oral communication, in writing, in clinical judgments and decision-making, and in interpersonal relationships. Indicators of critical thinking in one's writing are:

  • clarity
  • accuracy
  • precision
  • relevance
  • breadth
  • depth
  • logic

Add to these the ability to:

  • provide new information
  • demonstrate a solid understanding
  • critically analyze
  • competently express one's thoughts--orally as well as in writing

Further indicators of the application of critical thinking in external behavior are manifest in one's ability to be:

  • open-minded
  • flexible
  • rational
  • inquisitive
  • intuitive
  • reflective
  • self-regulative

Critical thinking and professional communication go "hand in hand." There is much merit in the old adage, "THINK before you speak!"

Step One (Wk 7):

Use the following links to review the principles of critical thinking. Pay special attention to the kinds of questions a skilled critical thinker generates in a given situation.

Use the following sites (or find your own) to refresh your study of communication. You may wish to augment these by consulting textbooks that you have from your ADN program, and/or by going to a library to find appropriate resources:

Step Two (Wk 8):

As you think about how the principles of critical thinking are operationalized in professional behavior and communication, post an essay in the forum for Assignment 4B (Communication) that addresses the following questions:

1. Reflect on the application of critical thinking skills in your own behavior as a nurse--and as a student. Briefly explain your "critical thinking strengths"? ...and briefly explain areas of critical thinking that you need to refine and develop. Illustrate with brief examples.

2. Explain why communication is an essential determinant in the success/failure of a nurse-client relationship.

3. Metacommunication represents an integration of verbal and nonverbal communication. The nurse must search for the content (central idea), mood (emotion communicated), and the interaction (dynamics). Analyze the metacommunication in the following vignette by examining the content, mood, and interaction:

The home health nurse arrives at Mr. Smith's home. She has three more visits to make today. Her last visit took twice as long as she anticipated.
Mr. Smith is a complex client with CHF, COPD, and peripheral vascular disease. The nurse hurriedly walks into his home and puts her bag down.
Nurse (stressed): "How are you doing Mr. Smith?"
Mr. Smith (dark circles under his eyes, appears fatigued, picking at his sweater with nervous hands): "Oh...fine."
Nurse (glances at her watch): "Great, let me check your blood pressure today."
Mr. Smith (quiet, eyes cast downward towards the floor): "OK."

4. Professional literature identifies four principles of communication: presence, empathy, respect, and genuineness. Use a very brief example to define each.

5. After reading the following vignette, what would you say to Jane? How could you apply the 4 principles of communication to Jane's situation?

Jane has spent 2 days in the ICU following extensive face and neck surgery for cancer. Although she will have reconstructive surgery in the future, she has suffered significant disfigurement. As Jane's nurse, you discover that she has cried frequently over the last two days and received morphine routinely. At the change of shift the nurse reported that she gave Jane additional doses of morphine whenever she cried. You have never taken care of Jane before; as you approach Jane's bed her daughter is leaving the ICU. She pulls you aside and confides that her mother and father are recently divorced. You walk up to Jane, her ET tube has just been removed, and she is crying. What will you say?

Step Three (Wk 9):

Discussion Holiday! But read the essays of your classmates.

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Assignment 4C: (Wk 9):

Click here to evaluate how the course is working so far.

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