Personal Theoretical Framework for Advanced Practice Nursing

Personal Theoretical Framework for Advanced Practice Nursing

Nursing theoretical models significantly impact the nursing profession. They guide the values of advanced registered nurses and the implementation of evidence-based care in healthcare organizations. The importance of personal theoretical frameworks cannot be understated in nursing. These frameworks guide nurses in clinical practice to provide safe, quality, and cost-effective healthcare services that consider patient preferences and needs. Personal nursing philosophies may have similarities and differences with nursing theoretical frameworks. One nursing theory that fits the author’s nursing philosophy is Dorothea Orem’s Self-Care theory. However, this theory may conflict with the author’s nursing philosophy.

Personal Nursing Philosophy

The author’s nursing philosophy is based on an advanced nurse practitioner (APRN) role, which involves providing patient-centered and holistic care to enhance patients’ physiological, psychological, and mental well-being. Since starting my nursing career, I have viewed nursing as a profession that puts patient needs at the center of care. Nurses prioritize patient needs above all. Due to this fact, I have always strived to help my patients meet their unique healthcare needs. I prioritize implementing patient-centered care to improve patient well-being and quality of life.

Patient-centered care is providing care that respects and responds to patient’s values, preferences, and needs (Kuipers et al., 2019). This type of care ensures that unique patient needs guide clinical decision-making. Patient-centered care has allowed me to develop therapeutic care with my patients. My patient’s needs and aspirations guide healthcare decisions and measurement of healthcare outcomes. Under patient-centered care, I work in a multidisciplinary healthcare team to develop individualized treatment plans.

My primary objective as an APRN is to help individuals who cannot help themselves to prevent conditions that may lead to short-term or long-term disabilities. According to Maslow’s hierarchy of needs, humans have five categories of needs. The first category is physiological needs, including food, clothing, and shelter (Logan & Everall, 2019). These needs are critical for human survival. The second category is security needs. Humans must be free from harm (Logan & Everall, 2019). The third category is love and belonging. In this category, human beings need a sense of acceptance in social groups (Logan & Everall, 2019). The fourth category is esteem needs. Accordingly, individuals require respect from others and self-respect (Logan & Everall, 2019). These needs include accomplishment and self-worth. The final category of needs is self-actualization. This is the pinnacle of Maslow’s triangle. People in this category have achieved their life goals and maximum potential (Logan & Everall, 2019). Individuals in self-actualization can help others to actualize their goals and potential.

My nursing philosophy involves implementing holistic care that helps individuals meet the hierarchy of needs. My nursing care considers the stages patients are in Maslow’s triangle. The first department I was assigned to in my career was pediatrics. My roles included caring for infants, feeding them, cuddling them, and changing their dirty diapers. I ensured that I met all their physiological needs. This facilitated the optimum growth and development of my pediatric patients. Even though nurse practitioners work in a multidisciplinary team with pediatricians to diagnose and treat children, registered nurses should help patients meet their physiological needs.

Healthcare professionals should meet patient needs and demands to help them have a competitive advantage in the healthcare delivery industry (Stawasz, 2019). In addition, my nursing education emphasized the importance of nursing theoretical frameworks in nursing practice. Nursing theories are the foundation of quality, cost-effective, and safe nursing care. However, most nurses do not integrate nursing theoretical frameworks into their clinical practice. Many nurse practitioners believe nurses play second fiddle to physicians instead of being partners in the multidisciplinary healthcare team. This is guided by historical perspectives that consider nurses as helpers of physicians. Nurse shortage is a pandemic affecting the nursing profession. It compromises patient safety, resulting in adverse healthcare outcomes.

Negative healthcare outcomes such as patient morbidity and mortality are linked to low nursing staffing (Shin et al., 2018). Most nurses do not receive adequate payment proportional to the services they offer. I am, however, opposed to the idea that nurses are helpers of doctors. I focus on my nursing philosophy, which involves helping patients meet their physiological needs when their functional abilities are affected by medical conditions. Holistically Caring for patients will foster faster recovery and improve their well-being and quality of life. Patient self-care deficits can be addressed through patient-centered care to restore functionality and good health. I address these deficits through empathy, compassion, and dignified care.

My nursing philosophy involves considering patient preferences, culture, values, interests, and beliefs in providing holistic care. Holistic care involves providing care to patients based on understanding their emotional, physiological, spiritual, and physical dimensions (Albaqawi et al., 2021). It allows the nurse practitioner and the patient to negotiate healthcare needs and foster patient recovery. This philosophy has guided me throughout my nursing career. I will continue implementing it even after becoming an APRN. After gaining full practice authority, I will utilize this philosophy to diagnose and treat my patients. In addition, I will consider physicians as my equal partners, not supervisors. As an APRN, I will acknowledge Maslow’s hierarchy of needs and recognize that different patients have different physiological and psychological needs. Medical conditions affect the ability of patients to meet their basic needs.

Aspects of Dorothea Orem’s Self-Care Theory that Fits My Philosophy

Dorothea Orem’s theory fits my nursing philosophy. This theoretical framework focuses on helping individuals manage their self-care to improve or retain their human functioning effectively. It focuses on the capacity of individuals to implement self-care (Hartweg & Metcalfe, 2021). Subsequently, this theory focuses on the activities and interventions individuals can implement and perform independently to improve health status, well-being, and quality of life. Orem’s theory has three intertwined theories: “theories of self-care, nursing system and self-care deficit” (Hartweg & Metcalfe, 2021). The self-care theory concentrates on why and how individuals take care of themselves. In contrast, the nursing systems theory concentrates on the therapeutic relationship between nursing staff and patients and the effect of this interaction on the quality of care provided (Hartweg & Metcalfe, 2021). On the other hand, the self-care deficit theory focuses on how nursing provision helps individuals (Hartweg & Metcalfe, 2021).

In Orem’s theory, there are three assumptions regarding self-care requirements. The first assumption opines that all individuals have common needs and thus require similar materials to sustain their lives (Hartweg & Metcalfe, 2021). The second assumption is that all individuals need multiple activities to improve their growth and development in the stages of life (Hartweg & Metcalfe, 2021). The third assumption is that the tendency of human beings to deviate from normal functional well-being requires actions to reduce the occurrence of deviations and regulate the adverse effects linked to the deviations (Hartweg & Metcalfe, 2021).

Individuals who lack the skills and knowledge to implement self-care will have self-care deficits. Thus, Nurses must provide nursing care to individuals with limited self-care needs and knowledge to improve their health and well-being (Hartweg & Metcalfe, 2021). The assumptions of Orem’s theory fit in my nursing philosophy. Holistic and patient-centered care allows nurses to participate in their self-care. It will improve their physical, psychological, and mental well-being, especially for individuals who do not have the skills and knowledge to implement self-care.

Comparison Between My Nursing Philosophy and Orem’s Theory

Similarities

Self-care involves measures and activities implemented to meet the requirements of individuals lacking the adequate skills and knowledge to perform self-care. Patients who lack the knowledge and skills include geriatric patients, infants, mentally disabled patients, and patients with functional and cognitive impairments. APRNs must thus offer care to these patients to aid them in meeting their most basic physiological needs. This aspect of self-care theory matches the author’s nursing philosophy. My philosophy is to provide patient-centered holistic nursing care to enhance the patient’s physical, psychological, mental, and emotional well-being.

In my nursing practice with some populations, I have noticed that infants, geriatric patients, mentally disabled patients, and patients with dementia require extra attention from nurses since they cannot perform self-care. Nursing must transform nursing practice to boost care safety, quality, and efficiency in primary healthcare settings (Abou Malham et al., 2020). This will help meet the unique healthcare needs of individual patients, families, and communities. I will thus strive to provide patient-centered care to help patients address their healthcare needs.

Orem’s theory further outlines two deliberate actions. Nursing practice is a deliberate action done by members of the nursing profession to benefit individuals (Hartweg & Metcalfe, 2021). This means that actions implemented by nurses are aimed at addressing the self-care deficits of patients. This aspect is similar to my nursing philosophy. My philosophy involves providing patient-centered and holistic care to meet the unique care needs of my patients and improve their well-being. My nursing care is provided to various patients, such as infants, babies, adolescents, and geriatrics.

Differences

Orem also outlines deliberate actions and individuals. Patients are required to know their challenges and conditions. They should strive to address the challenges they face in the best possible way. This aspect of Oreom’s theory is different from my nursing philosophy. It involves providing holistic and patient-centered care to all patients to enhance their physical, emotional, and mental well-being regardless of their ability to address these issues and implement solutions to address them.

Conclusion

Theoretical frameworks guide the clinical practice of registered nurses and APRNs. Nurses can utilize many theoretical frameworks, such as Orem’s self-care theory. In addition to nursing theoretical frameworks, nurses should be guided by their philosophies during care provision. Orem’s self-care theory has three intertwined theories:  self-care, nursing systems, and self-care deficit theories.” Orem focuses on the capacity of an individual to implement self-care.

Further, her theory focuses on the actions and practices individuals can initiate and implement to maintain and improve their health and well-being. This theory has similarities and differences with my nursing philosophy. The similarity is that nursing action should improve individual well-being. My theory involves providing patient-centered and holistic care to improve my patients’ physical and mental well-being. The contradiction is that my philosophy helps individuals who cannot perform self-care, while Orem requires individuals to recognize challenges and perform actions to resolve them.

References

Abou Malham, S., Breton, M., Touati, N., Maillet, L., Duhoux, A., & Gaboury, I. (2020). Changing nursing practice within primary health care innovations: The case of advanced access model. BMC Nursing, 19(1). https://doi.org/10.1186/s12912-020-00504-z

Albaqawi, H. M., Butcon, V. E., Albagawi, B. S., Dayrit, R. D., & Pangket, P. (2021). Holistic nursing care among operating room nurses: Strengthening the standard of practice in Saudi Arabia. Belitung Nursing Journal, 7(1), 8-14. https://doi.org/10.33546/bnj.1279

Hartweg, D. L., & Metcalfe, S. A. (2021). Orem’s self-care deficit nursing theory: Relevance and need for refinement. Nursing Science Quarterly, 35(1), 70-76. https://doi.org/10.1177/08943184211051369

Kuipers, S. J., Murray Cramm, J., & Nieboer, A. P. (2019). The importance of patient-centered care and Co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. International Journal of Integrated Care, 19(4), 315. https://doi.org/10.5334/ijic.s3315

Logan, J., & Everall, K. (2019). First things first: Exploring Maslow’s hierarchy as a service prioritization framework. Weave: Journal of Library User Experience, 2(2). https://doi.org/10.3998/weave.12535642.0002.201

Shin, S., Park, J., & Bae, S. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273-282. https://doi.org/10.1016/j.outlook.2017.12.002

Stawasz, M. (2019). Employment satisfaction and Maslow’s hierarchy of needs expansion theory by the pastoral care department. J. of Health Science, 7(6). https://doi.org/10.17265/2328-7136/2019.06.005

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You have spent six weeks exploring theories of nursing. These represent the “how” of what we do as nurses. This week, we enter a higher level of thought and explore the “why” of our actions. 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. 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 situation where the framework may conflict or not fit your philosophy. While it is an important skill to match a theory with a situation, it is also critical to understand when a theory or framework does not fit a situation.