Personal Theoretical Framework for Advanced Practice Nursing
The nursing practice maintains an important position in the general provision of healthcare. Attainment of better-quality healthcare services, therefore, requires that nurses do their duties optimally and with full dedication towards this course. Optimal productivity, however, is intrinsic and individually driven. Nursing philosophies are intended to bring the best out of individual nurses. These philosophies are expressions of one’s driving force towards not only becoming a better nurse but also creating the work environment they envision themselves to be having. Philosophy statements in this regard encompass beliefs, values, and ethics that guide the practice of nursing as well as motivate individual nurses to fully dedicate their lives towards the betterment of their patients’ lives. This paper seeks to discuss a theoretical framework for a philosophy that guides nursing practice.
Nursing is not only a course towards remedying illness and disease states but also the utilization of nursing values of kindness, integrity, caring as well, and knowledge to better the lives of individuals and their communities. This philosophy statement highlights a greater scope of nursing practice beyond the conventional patient care responsibilities. By challenging nurses to utilize the respective nursing values and knowledge base to better the lives of communities, this statement is aimed at ensuring that nurses take part in other community activities that are targeted at ensuring safer and better communities. Such activities as community outreach programs and community health education, among others, have the benefit of enlightening community members about better living. Nurses being ambassadors of health promotion, are challenged to take up these activities and utilize them to champion a better and safer living environment for the individual members of these communities.
Conventional nursing practice is often targeted at enhancing the safety of the patients by ensuring the provision of quality care to the patients. While efforts have been made by nurses in this regard, as evidenced by improved quality of care as well as patient outcomes, much has not been achieved outside the clinical scope of nursing practice. Nurses are critical components of the general healthcare provision system, and their input in community health promotional activities retains great significance. This philosophy acts as a wake-up call that urges nurses to get out of their comfort zones of clinical practice and reach out to individual communities.
Health attainment and maintenance require a collaborative approach that draws both the individual community members as well as their healthcare providers. The role of communities is often to participate in activities that ensure that they promote their health. Healthcare providers like nurses, on the other hand, are expected to share knowledge on these health promotional activities and their significance towards health promotion. Activities such as community screening for diseases, health education on chronic disorders, and education on the significance of proper hygiene and sanitation have the benefits of promoting the health of entire communities. Nurses are well poised to handle these activities since they possess the knowledge base required for such activities. These activities will also reinforce the position of nurses in community health promotion. The philosophy statement above is targeted towards ensuring this.
Nursing theories define a structure of ideas that gives a tentative perspective of a nursing phenomenon. Nursing theories will explain the why in nursing practice. Nursing theories isolate nursing practice from other health disciplines by defining specific aspects of practice that are unique to nursing practice (Rosa et al., 2020). These theories offer frameworks to which nurses’ roles are distinguishable from other healthcare roles and also reinforce the vitality of nursing care provisions for individual nurses. Nursing theories are coiled around near similar conceptual frameworks that are fundamental to nursing practice. The four major conceptual frameworks on which these theories are based are collectively known as the nursing metaparadigm and include nursing, environment, health, and person (Mudd, Feo, Conroy & Kitson, 2020). Various theories have been postulated by historical theorists, examples of which are the philosophy of caring by Jean Watson, the environment theory by Florence Nightingale, and the Theory of Interpersonal Relations by Hildegard Peplau, among others.
Jean Watson, in 1979, coiled the philosophy of human caring. This theory highlighted how the humanistic aspects of nursing practices are interlinked with the scientific knowledge required in nursing practice. Jean postulated that caring science offers a strong foundation for nursing professional study by defining ethical and moral frameworks for nursing science as well as the human phenomenon of caring and healing (Watson & Smith, 2002). According to Jean Watson, caring promotes the self-regeneration of a care provider and potentiates their intrinsic capabilities, thus enabling them to attain self-actualization. Caring in this regard is a two-way dual-benefit phenomenon that confers considerable benefits to both the nurse and the patient.
The postulation of Watson’s theory of caring was based on several theoretical frameworks and assumptions. The first assumption is that caring is based on Caritas processes that promote self-regeneration, wholeness, and human evolution. This assumption reinforces the need to care for those who need care. It is quite in line with the provision of the philosophy statement that requires nurses to go out to the communities and stretch their helping hand toward health promotion.
Another assumption is that caring will promote health and healing as well as the overall growth of individuals and their communities and that inner peace attributable to caring will promote wellbeing by eliminating the fear of illness and disease. This, as well, is in concert with the philosophy statement stated above since the benefits of health promotional activities advocated for by this philosophy statement are evident in not only healthy communities but also wellbeing communities with freedom from illness and disease states.
The theory is also based on the assumption that the science of caring remains to be the core of professional nursing practice and offers a foundation to which nursing principles are established. This assumption requires nurse practitioners to be caring as a fundamental necessity in their practice. In this regard, they are expected to take part in all efforts targeted at showing care to patients and any other person who may need care. This is also in concert with the philosophy statement stated. The statement urged nurses to step out of the convention clinical care boundaries and reach out to communities who need care provisions. This is not only because of the need to reinforce their position as caregivers within the healthcare provision system but also because of their moral obligation, as narrated by this theoretical framework. The benefits are, however, evident with healthy communities being the result.
Another assumption is that the sense of humanity is kept alive by interhuman subjective processes, relations, and interactions and that these interactions aid in identifying oneself with others and with communities. According to these theoretical provisions, the caring process brings fulfillment in the care provider and enables them to identify with other people and in the process gaining a sense of humanity. Therefore, when nurses are involved in community outreach programs, they not only gain a sense of humanity but they as well identify with these communities and ultimately attain the human fulfillment so adored. The philosophy statement described above is targeted at ensuring this. In this regard, the statement prescribes activities that are geared towards care provision and, in the process, will enable nurses to identify with their communities and also gain a sense of humanity as described in the Watson theoretical framework of caring.
The theoretical frameworks described under the Jean Watson theory and the philosophy statement described above are comparable in many aspects. Both are targeted towards exploiting the science of caring at various levels of nursing practice. Additionally, both express the beneficial nature of caring as a necessity to nurses not only in bettering the health of others but also in their gains. Both are also concerned with the position of nursing practice in the contemporary healthcare provision systems and define it as being unique and significant. In this regard, both postulations express the need for reinforcement of these positions by participating in the caring processes.
However, various variances exist between the theoretical postulates as drawn by the Jean Watson theory and the postulates drawn from the philosophy statement drawn above. The philosophy statement focuses mainly on the nurses’ caring roles outside the conventional clinical setting, while the postulates by Jean’s theory focus on the mainstream clinical care provision setting. Jean’s theory postulates are also robust and touch on many aspects of human caring, as opposed to the postulates of the philosophy statement drawn above, which focuses on a narrower spectrum of human caring with a net emphasis on community wellbeing.
Although the differences between the two theoretical postulates are minor, they may be significant in some aspects. The assumption that the caring process often brings self-regeneration and that it promotes healing and communal well-being is not always the case and may, in some instances, confer considerable differences to the postulates drawn by the philosophy stated above. This is often the case when the providers don’t realize the dual benefits of caring as described in Jean’s theoretical postulates. This can be the case when other factors, such as government forces as well as finances, come to play. Poor government policies and regulations on healthcare services, inadequate funds for remuneration, and poor management have been implicated in a lack of motivation among nurses (Lee & Kim, 2020). These factors can significantly lower the quality and efficiency of care processes and thereby prevent the attainment of self-healing.
Nursing philosophies are significant in enhancing the nursing care processes and optimization of care outcomes. Philosophies are, however, individualized and dependent on the individual’s picture of nursing practices. Nursing theories, on the other hand, are replicative of what nursing practice should look like. These theories define the various aspects of nursing practice. Various theories have been coiled by various theorists over time. Of significance is Jean Watson’s theory of caring described above. This theory underlines the science of caring as a fundamental component of nursing practice.
References
Lee, E., & Kim, J. (2020). Nursing stress factors affecting turnover intention among hospital nurses. International Journal Of Nursing Practice, 26(6). DOI: 10.1111/ijn.12819
Mudd, A., Feo, R., Conroy, T., & Kitson, A. (2020). Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts. Journal Of Clinical Nursing. DOI: 10.1111/jocn.15420
Rosa, W., Dossey, B., Koithan, M., Kreitzer, M., Manjrekar, P., & Meleis, A. et al. (2020). Nursing Theory in the Quest for the Sustainable Development Goals. Nursing Science Quarterly, 33(2), 178-182. DOI: 10.1177/0894318420903495
Watson, J., & Smith, M. (2002). Caring science and the science of unitary human beings: a trans-theoretical discourse for nursing knowledge development. Journal Of Advanced Nursing, 37(5), 452-461. DOI: 10.1046/j.1365-2648.2002.02112.x
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Question 
Present a personal nursing philosophy. Apply what you have read throughout the course and explore the literature on nursing philosophy. While Fawcett was not a nursing theorist, she was a nursing philosopher, and her Metaparadigm of Nursing approaches philosophy over theory.
Personal Theoretical Framework for Advanced Practice Nursing
Once you have discussed your philosophy, identify a theoretical framework (not the middle-range theories but the underlying assumptions in that framework) that fits your philosophy. Compare and contrast your philosophy and the chosen framework. Describe a possible situation in which the framework may conflict or not fit your philosophy. While it is an important skill to be able to match a theory with a situation, it is also critical to understand when a theory or framework does not fit a situation.