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Running head: NUR-300 FINAL PROJECT 1

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NUR 300 FINAL PROJECT

Milestone 4: Theoretical Foundations and Conclusion

Lisa Oll-Adikankwu

Southern New Hampshire University: NUR 300

April 7, 2019

Professions such as nursing are based on distinctive theories. Kearney-Nunnery (2016) defined theory as “a set of interrelated constructs (concepts), definitions, and propositions that present a systematic view of phenomena by specifying relations among variables, with the purpose of explaining and predicting the phenomena” (p. 20). Nursing theories affect everyday nursing practice. Ideally, nursing theories serve to provide a foundation to nursing care in every patient encounter. They help nurses improve their thought process and comprehension and use critical thinking and decision-making skills that are concentrated on the patient. Furthermore, nursing theories improve patient care, patient outcomes, nurse-patient communication and communication between all healthcare providers.

Through the use of nursing theories in practice, new knowledge and data are obtained influencing the future of nursing practice. Two theorists whose framework preserves the heritage of these principals are Myra Levine and Imogene King. However, as most health care systems around the world are changing, nurses are challenged with abiding by these principals, as we expose ourselves to the risk of desensitizing patient care as the responsibilities and workloads for nurses have intensified. Nurses must now deal with patients’ increased awareness and complications in regard to their health care situation.

Theory One

Imogene King developed the theory of Goal Attainment in 1981. King’s Conceptual System focuses on the continuing ability of the individuals to meet their basic needs so that they may function in their socially defined roles (Keanery-Nunnery, 2016, p. 36). Here, King theorizes that individuals are goal seeking within the framework of a three open, dynamic, interacting system – the personal system, the interpersonal system, and the social system. Within this system, King developed a ten step Interaction-Transaction Process that was essential in her theory of Goal Attainment. This included perception, judgment, action, reaction, disturbance, mutual goal setting, exploration of means to achieve goals, agreement on means to achieve goals, transaction and attainment of goals. As Keanery-Nunnery (2016) states under King’s theory of practice, “nursing practice is directed toward helping individuals maintain their health so that they can function in their roles” (p. 36). A nurse cannot properly uphold this framework with the continuous arising issues of decreased nurse retention. Decreased Nurse retention may inhibit a nurse's ability to meet basic needs, such as sleeping, eating and having a break to reduce stress level. It can also have adverse outcomes for nurses; many of these are fatigue-related - for example, nurses working short staffed are found to be at increased risk of occupational hazards, potentially harming patients causing staff injuries amongst themselves.

Theory Two

Myra Levine’s Conservational Model of nursing practice is directed toward promoting wholeness for all people, well or sick and focuses on conservation of the person’s wholeness. According to Kearney-Nunnery (2016) her theory outlines that, “Adaptation is the process by which people maintain their wholeness or integrity as they respond to environmental challenges and become congruent with the environment” (p.37). In order to maintain wholeness and adapt to environmental changes, an individual must respond to the challenges using Levine’s four essential integrated principals that constitute an organismic response: fight-or-flight mechanism, inflammatory-immune response, stress response and perceptual awareness, which includes the basic orienting, haptic, auditory, visual, and taste-smell systems. Levine’s goal is for “nurse’s to end the dependence as quickly as possible, as patients are partners or participants in nursing care and are temporarily dependent on nurses” (p. 38). As Levine’s Model guides the nurse to focus on the influences and responses at the organismic level and accomplish the goal of model through the conservation of energy, structure and personal and social integrity, the issue of decreased nurse retention may obstruct that. If a nurse fails to adapt to continuous low nurse retentions, this hinders their ability to meet the patients’ needs. As the nurse isn’t effective due to matters like burn out, errors like incorrect judgments or assessments can occur and patient outcomes suffer.

Concluding Reflections

Working in long-term care, a nurse can be responsible for an average of twenty-two patients to forty-five patients depending on the unit one’s working on. This is very taxing and overwhelming for a nurse to manage. Between medication administrations, prescribed treatments, admitting and discharging patients, and simply providing basic care, the workload intensifies and it can be easy for errors to occur at any moment. This also in turn creates job dissatisfaction, which is another factor that is behind increased nurse turnover. With decreased patient load, good leadership, proper collaboration and communication, the stress level of a nurse would be at a minimum, hence improving nurse retention, allowing for nurses to practice to the best of their ability and improving patient outcomes.

Final Conclusions

Nursing theories can be helpful at all stages of the nursing process and may guide a nurse to perform specific actions or make certain decisions during patient care. As matters such as decreased nurse retention continues to arise, in researching King’s and Levine’s conceptual and conservational theories, I am able to see the practicality and application of the theory. Despite such hardships, nurses must find ways to preserve their caring practice and Myra Levine and Imogene King’s conceptual and conservational theories can be seen as indispensable to this goal.

References

Mcqueen, L., Cockroft, M., & Mullins, N. (2017). Imogene Kings Theory of Goal Attainment

and the Millennial Nurse: An Important Mentoring Tool for Nurse Educators. Teaching and Learning in Nursing, 12(3), 223-225. doi:10.1016/j.teln.2017.03.003

Kearney-Nunnery, R. (2016). Advancing your career: Concepts of professional nursing.

Philadelphia: F.A. Davis Company.