My role is that of an orthopedic nurse and I am entitled with the responsibility of caring for all patients who suffer from a range of diseases, disorders, and different musculoskeletal injuries. Thus, the primary responsibilities involve performing a plethora of musculoskeletal examinations, monitoring vital signs, providing assistance with traction and casting, educating the patients, and implementing theoretically informed plan of care (Salmond & Echevarria, 2017). This essay will elaborate on the different nursing concepts that are relevant to the scope of nursing practice and will also elucidate the diverse ontological traditions that are true to the concepts.
The four main nursing concepts that are relevant to the discipline are namely, (1) the person and/or patient, (2) the environment, (3) health, and (4) nursing goals and role functions. The person is considered as the one who receives care, commonly referred to as the service user. In other words, person can be defined as the recipient of the delivered healthcare services. The term also encompasses the friends, community, and family members of the client. The environment is not just restricted to the external setting but also comprises of the internal state of the person. It comprises of a range of social, internal, and external factors that have the potential of creating an impact on the health status of the client (Finkelman & Kenner, 2014). This commonly includes immune function, culture, genetics, economics, interpersonal relationships, geography, politics, educational attainment, and employment status. The health concept is defined with respect to the client’s perspective and refers to the state of overall wellbeing in the client. It is also referred to as the health/wellness-illness continuum and covers several domains like mental, physical, psychological, intellectual, spiritual and emotional (Cook & Peden, 2017). The fourth concept of nursing encompasses the art and science of the entire discipline. It is chiefly made up of the nursing interventions and actions and includes the professional knowledge and clinical skills the nurses apply while caring for the patients.
Dorothea Orem, a 20th century theorist and nurse developed the self-care theory, which focused on the concept of person. The theory principally comprises of three different components such as, the self-care deficit theory, the theory of self-care, and the theory of nursing system (Riegel, Jaarsma & Stromberg, 2018). Hence, the concept of person is essential in educating all patients on their status and teaching them the usage of different nursing tools, which in turn is imperative in self-care management. The primary concept of health governs the Nightingale’s theory that elaborates on the fact that thorough cleanliness, caring and preparedness, in addition to medical needs. The health concept is allied with the need theory that was developed by Virginia Henderson who placed a due focus on the role of nurses to help patients in maintaining health, recovering from injuries, and achieving a peaceful death (Ahtisham & Jacoline, 2015). The concept of environment influenced Watson to hold the belief that it is imperative in the nursing process and also influences the healing ability of the patients, besides directly affecting the clients. In regards to the concept of nursing, nurses are entitled with the duty of not only gaining a sound understanding of the physiology and science behind different disorders, but also have the duty of providing genuine care for enhancing patient wellbeing (Hall, 2015). The nursing concept is in alignment with the humanistic nursing theory that focused on the idea that most patients are able to grow in creative and healthy ways.
The ontology of critical theory is based on Marxist philosophy and elaborates on the idea of self-clarification that should be gained in relation to struggles and desires. Implementation of this ontology in nursing helps in achieving a dialectic vision and allows the usage of logic while caring for people. Thus, this is in contrast to the concept of health. Critical theory was in accordance to the nursing concept that allowed the nurses to offer culturally appropriate care, identify social inequalities, and implement innovative knowledge in practice (Gathercoal et al., 2017). The ontology of post-positivism is a metatheoretical stance that amends and critiques positivism. It holds the belief that the knowledge, values, background and theories of the researcher are directly responsible for influencing the observations (Panhwar, Ansari & Shah, 2017). The post positivist theory also encompasses certain empirical indicators that help in establishing a correlation between the observable phenomena and the theory, thus showing accordance to the health concept. This ontological tradition can also be evaluated on the basis of its consistency, accuracy, and fruitfulness. This is in clear contrast to the complexity ontology that helps in understanding the role of communities and organisations for healthcare management of a person. It is defined as a collection of individual agents that freely act and are unpredictable, the actions of which are associated with each other (Thompson et al., 2016). This can be allied with the concept of environment. The final ontological tradition encompasses human science nursing, which focuses on the health and life as humanly experienced (McIntyre & McDonald, 2013). Thus, nursing is positioned as a human science that views patients/people as subjects who govern their own life, rather than mere objects, thus elaborating on the person concept.
It can be stated that the ontological tradition of Complexity theory is the best of all. This can be attributed to the fact that the nursing speciality is ambiguous, complex and paradoxical. Owing to the fact that the nursing setting is influenced by both internal and external contexts and survival is associated with the capability to capture social changes, besides reacting rapidly, the tradition of complexity theory is most relevant (Mitchell, Jonas-Simpson & Cross, 2013). Complexity encompasses a kind of thinking that does not isolate, but bonds and pursues the essential and interdependent associations of all facets of human life, thus assimilating different methods of opposing reductionist, disjunctive, thinking, and shortening mechanism.
Conclusion
The scope of nursing practice refers to the roles, responsibilities, activities and functions that are required to be performed by a registered nurse. A metaparadigm is found to be composed of a wide range of philosophical concepts and worldviews that are unique to a profession and are able to clearly define boundaries that separate the profession from others. To conclude, the different nursing concepts are vital to the nursing profession and when taken into consideration, would enhance the overall health and wellbeing of all service users.
References
Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice; Virginia’s Henderson Need Theory. International Journal of Caring Sciences, 8(2). Retrieved from https://web.b.ebscohost.com/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=17915201&AN=102972280&h=Zkm0Fwc3NxcQaCaupGoAn9NPcN%2bSUey1bPiOmaKuKWIgoUL6MKtLePOMlJ0m1GJ41tbNZA6kqSuEETx%2fSGZGXA%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d17915201%26AN%3d102972280
Cook, L. B., & Peden, A. (2017). Finding a Focus for Nursing: The Caring Concept. Advances in Nursing Science, 40(1), 12-23. doi: 10.1097/ANS.0000000000000137
Finkelman, A., & Kenner, C. (2014). Professional nursing concepts. Jones & Bartlett Publishers. Retrived from https://books.google.co.in/books?hl=en&lr=&id=3Vv3BQAAQBAJ&oi=fnd&pg=PR5&dq=4+nursing+concepts&ots=T-_8Wr0JP2&sig=XN2AsCHbpNQB_9zf8PXDaKXLIJE#v=onepage&q=4%20nursing%20concepts&f=false
Gathercoal, R. O., Gathercoal, K. A., Seegobin, W., & Hadley, S. (2017). Nurturing constructive change that works: a critical theory-informed model for transforming health service psychologists’ views of people with disabilities. Qualitative Research in Medicine & Healthcare, 1(1). https://doi.org/10.4081/qrmh.2017.6391
Hall, C. (2015). Introduction to Nursing Theory. Essentials of Nursing Practice, 157. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=2vsaCAAAQBAJ&oi=fnd&pg=PA157&dq=nightingale+nursing+theory&ots=SmrDNt8cwX&sig=G_IJII8n5g2OE6C08E1_9Ob1jf0#v=onepage&q=nightingale%20nursing%20theory&f=false
McIntyre, M., & McDonald, C. (2013). Contemplating the fit and utility of nursing theory and nursing scholarship informed by the social sciences and humanities. Advances in Nursing Science, 36 (1), 10-17. doi: 10.1097/ANS.0b013e31828077bc
Mitchell, G. J.., Jonas-Simpson, C., & Cross, N. (2013). Innovating nursing education: interrelating narrative, conceptual learning, reflection and complexity. Journal of Nursing Education and Practice, 3 (4), 30-39. https://doi.org/10.5430/jnep.v3n4p30
Panhwar, A. H., Ansari, S., & Shah, A. A. (2017). Post-positivism: an effective paradigm for social and educational research. International Research Journal of Arts & Humanities (IRJAH), 45(45). Retrieved from https://sujo.usindh.edu.pk/index.php/IRJAH/article/view/3371/2447
Riegel, B., Jaarsma, T., & Stromberg, A. (2018). Theory of Self-Care of Chronic Illness. Middle Range Theory for Nursing, 2017341. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=XN1JDwAAQBAJ&oi=fnd&pg=PA341&dq=orem+theory+of+self+care&ots=hd62HvkUnA&sig=Jw7AttsGrVtN–kwLWwsmolyIBw#v=onepage&q=orem%20theory%20of%20self%20care&f=false
Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12. doi: 10.1097/NOR.0000000000000308
Thompson, D. S., Fazio, X., Kustra, E., Patrick, L., & Stanley, D. (2016). Scoping review of complexity theory in health services research. BMC health services research, 16(1), 87. https://doi.org/10.1186/s12913-016-1343-4
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