Nursing Theory

post has two assignments

Application of Nursing has a major impact in the development of nursing practice. It influences many different aspects of the profession. Theory provides nurses with concrete concepts that can be applied in clinical practice. In applying nursing theory to practice, specific issues and problems found in the clinical realm can be addressed. Nursing theory provides a framework, in which adequate nursing interventions can be promoted and implemented into practice. Some of the areas in which nursing theory is frequently applied are: nursing education, nursing informatics, and nursing leadership. Overall in applying nursing theory to practice, patient care is improved and delivered more effectively. The benefit of applying theory to address a nursing practice problem can be observed in applying Watson’s caring theory, concerning the issue of nurse staffing (Shea, & Cavan, 2014). Jean Watson’s caring theory is a grand theory that has been applied in numerous areas of nursing. This theory proposes that caring is at the center of nursing practice. Caring involves viewing the patient in a holistic manner taking into account the patient’s physical, psychological, and spiritual necessities. Through caring the nurse reacts to patients and ensures their needs are being met. The theory of caring establishes that nurses have the moral imperative to care and promote wellness in the patient population entrusted to them. When nurses integrate the concept of caring in their practice, they provide their patient with their invaluable presence at the bedside. Watson identified ten carative factors that are essential, in order to create a caring relationship between patients and nurses. This relationship fosters an environment of health promotion and wellness (Morrow, 2014). The following is an analysis of Jean Watson’s caring theory and its application in nursing practice. The paper will specifically identify how the caring theory of nursing can be applied in the resolution of nurse staffing problems. The area of nursing in which the problem will be discussed is in nursing leadership. A strategy to solve nurse staffing issues will be discussed and evaluated, supported by scholarly literature. This analysis will also include concluding statement and a summary of the key concepts displayed. The Problem of Nurse Staffing Throughout the literature, nurse staffing has been identified as a vital element in the delivery of patient care. Drastic reductions in nursing budgets and a growing nursing shortage, has resulted in less nurses caring for sicker patients. Unhealthy working environments and overwhelming stress have caused many nurses to leave bedside nursing. All these elements have caused serious staffing issues in the profession of nursing. A recent research study presented a direct link between nurse staffing and patient outcomes. It was established that supporting nurse staffing ensures quality nursing care for patients. The issue of nurse staffing has been on the rise and an ongoing challenge for nursing leadership. At times, Nurse Managers seek to be cost effective and promote minimum staffing accommodations in their respective units (Sales, 2015). A recent research study revealed that inadequate nurse staffing negatively affected the work environment. Each additional patient per nurse was associated with an increase in nurse dissatisfaction. The study also demonstrated an increase in emotional exhaustion and needle stick injuries for nurses. The study clearly displayed how staffing levels influence the nursing care outcomes of a unit. The study also identified that inadequate staffing levels were linked to miss care events. Miss care events occur when the nurse is so overwhelmed with the amount of patients and tasks needed to be perform, that she misses to perform a needed intervention for the patient (Castner, Wu, & Dean-Baar, 2015). Nurse staffing has also been linked to patient mortality. A recent study found that an increase in one additional patient per nurse was associated with a 5% increase in the odds of patient death, within thirty days of a patient being admitted to a hospital (Eunhee, Sloane, Eun-Young, Sera, & Miyoung, 2015). Another study demonstrated that when nurse staffing is increased, there were significant improvements in patient mortality following surgical or medical complications. The study also demonstrated a decrease in sepsis, deep vein thrombosis, and pulmonary embolism, all complications that can arise while the patient is hospitalized. Higher nurse staffing was also related to shorter length of stay for the patient. Improving hospital nurse staffing and work environments, promotes an increase in preventable deaths in the hospital setting. This is why it’s important that nurse staffing is adequate and appropriate for the unit setting. Adequate staffing ensures patient safety and the reduction of missed care events in the delivery of nursing care. Managers need to understand the importance of staffing and its direct influence on clinical outcomes (Spetz, Harless, Herrera, & Mark, 2013). In the patient population who is critically ill, improved survival rates are related to higher number of nurses. In spending more time with the patients, nurses are more likely to detect early signs of complications and deterioration in the patient’s health. The study demonstrated that seven additional lives could be saved for every hundred patients, if nurse numbers increased. The study also rationalized that fewer permanent staff members might cause a greater need to invoke agency staff, who have less expertise and familiarity with the unit (Duffin, 2014). Staffing plans are also a major concern. They are developed annually and based on data from the past. Staffing plans take into consideration: acuity, patient volume, nursing skill mix, regulatory standards, and budget. Sometimes the staffing plans do not reflect the staffing needs of a unit in real time, affected by variations in acuity and volume. Research has identified that best staffing practices promote the use of a central staffing office, to allocate staff members throughout the hospital system. This provides management with a plan in case of drastic changes in acuity or an emergency. Staffing plans have been identified as an important component in the staffing of a unit and promoting effective patient outcomes (Castner, Wu, & Dean-Baar, 2015). Strategy In reviewing the literature, nurse staffing has been identified as a vital element in the delivery of patient care. Nurse staffing has become a very complex problem in the clinical realm, with several factors needed to be taken into consideration. A lot of the current strategies used to handle the problematic issue of nurse staffing, have focused on the economic and workflow components of the issue at hand (Sales, 2015). In integrating Jean Watson’s theory of caring in nursing leadership, an innovative approach to the current issue of nurse staffing can be promoted. The fundamental assumptions of the theory of caring can be applied and integrated to the leadership principles of an institution. In applying the concepts of caring to the staffing issues confronted in clinical practice, nursing leadership can improve clinical outcomes (Morrow, M. 2014). In utilizing Watson’s theory of caring, nursing leadership is provided with moral and ethical standards in reference to staffing. The theory of caring provides an ethical framework, in which caring is seen as a right the patient has. In order to ensure caring occurs, managers must provide adequate staffing and advocate that appropriate patient- nurse ratios are maintained. In promoting caring, the presence of the nurse at bedside will be valued and appreciated. This will encourage nursing leadership to maintain adequate staffing of nurses in the clinical setting. Nursing management will also grasp the ethical duty they have to ensure that nurses are providing effective care to patients. As a moral imperative, the caring of patients and staff members will supersede the economic and administrative needs of the unit. In providing a caring vision in nursing management, nurse leaders will gain consciousness of what their true vocation is. They will understand the importance of insuring adequate care is provided to patient and staff members (Shea, & Cavan, 2014). In utilizing the theory of human caring in their practice, nursing leadership can address nurse staffing issues from an innovative perspective. The vision of the institution can shift to quality management. Policies and procedures regarding nurse staffing would be formulated and implemented, utilizing a caring vision. Nurse Managers can integrate a caritas process, guided by the principles of Watson’s caring theory. The caritas process can be applied and viewed as nursing interventions in relation to staffing. This can be implemented by supporting staff nurses and engaging them in self care activities. In doing this staff satisfaction and retention will be drastically increased. This in turn will ensure that the unit has permanent adequate staffing on a daily basis. The nurses will also be more experienced and promote competent nursing care to their patients (Spetz, Harless, Herrera, & Mark, 2013). In promoting caring policies, staffing will not only be viewed as a required number of nurses needed to work on the unit. A holistic understanding of the need and important of staffing will be promoted throughout the institution. Management would seek to take into consideration all the factors influencing adequate staffing and the resources available. Safe quality patient care relies on properly trained, educated and skilled nurses. In incorporating the theory of caring as a nurse leader, staff nurses will begin to integrate caring in a more thoughtful way in their own practice. Ultimately in order to effectively care for patients proficient staffing must exist. In turn a safer work environment will be promoted, ensuring the best possible patient outcomes (Castner, Wu, & Dean-Baar, 2015). Conclusion In completing this analysis, I have gained great insight regarding the issue of nurse staffing. Nurse staffing is a vital element and component in the delivery of patient care. In reviewing the literature, I have come to understand that nurse staffing can influence patient mortality and nursing care outcomes on a unit. The problem of nurse staffing has been addressed mostly taking into consideration the economic factors involved. Watson’s theory of caring, provides an innovative approach to the problematic of nurse staffing. This theory can provide a framework in which nurse leaders and organizations, can embed caring principles in the delivery of patient care. In promoting caring concepts in nursing leadership, long term solutions can be implemented in the area of nurse staffing. Overall, adequate nurse staffing promotes quality patient care and better clinical outcomes. References Castner, J., Wu, Y. B., & Dean-Baar, S. (2015). Multi-level model of missed nursing care in the context of hospital merger. Western Journal of Nursing Research, 37(4), 441-461. doi:10.1177/0193945914535670. Duffin, C. (2014). Increase in nurse numbers linked to better patient survival rates in ICU. Nursing Standard, 28(33), 10. doi:10.7748/ns2014.04.28.33.10.s8. Eunhee, C., Sloane, D. M., Eun-Young, K., Sera, K., & Miyoung, C. (2015). Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies, 52(2), 535-542. doi:10.1016/j.ijnurstu.2014.08.006 Hodgson, H. (2014). Nurse-patient ratios – time for a target? Clinical Medicine, 14(2), 99-100. Retrieved from http://web.b.ebscohost.com.proxy.chamberlain.edu:8080/ehost/pdf viewer/pdfviewer?sid=b14df098-0ab3-4f26-8e12-2c9b37f1f278%40sessionmgr110&vid Morrow, M. (2014). Caring Science, mindful practice: Implementing Watson’s human caring theory. Nursing Science Quarterly, 27(3), 263-264. doi: 10.1177/0894318414534468. Sales, A. (2015). Nurse staffing matters: now what? BMJ Quality & Safety, 24(4), 241-243. doi:10.1136/bmjqs-2015-004050. Shea, L., & Cavan, N. (2014). Application of integral theory in holistic nursing practice. Holistic Nursing Practice, 28(6), 344-352. doi: 10.1097/HNP.0000000000000050 Spetz, J., Harless, D., Herrera, C., & Mark, B. (2013).Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Medical Care Research and Review, 70(4), 380–399. Retrieved from http://www.ncbi.nlm.nih.gov/pub med/23401064.

2:Earth (Gaia) and Theogony

Classical Mythology

Write a brief analysis of how Earth (Gaia) is characterised at Theogony, lines 154-66 (from ‘And these most awful sons of Earth and Heaven…’ to ‘Who first began devising shameful acts.’)

Tip: Pay particular attention to how Earth is compared and contrasted to Sky both in her own words to her son and in the narrator’s voice. Consider what the characterization of Earth suggests about the cosmos and the natural world. You should chiefly address the set lines (154-66) in detail, and make sure you keep to 750 words.

Assessment Criteria for the Document Analysis Task:

What is expected from your paper:

Concision. This task tests your ability to provide clear analysis of the text within a very strict word limit.

Use of appropriate primary evidence. Your analysis should directly employ appropriate citation of lines from the set passage (Theogony, 154-66) to explain and support the points you make.

Prioritisation of most important points. This task does not ask you to be comprehensive (to say everything it is possible to say about lines 154-66). Rather you should identify what you think are the main characteristics of Earth as presented in this passage. Your ability to identify the most significant characteristics is part of what is being tested in this exercise.

Clarity of expression and presentation. As with all assignments for this course, the Document Analysis is an exercise in the clear communication of complex ideas and arguments. These need to be expressed in clear and correct English and presented in a manner that directly conveys your meaning.

What is not expected from your paper:

Background detail. Do not provide any background on Earth/Gaia, Hesiod, the Theogony generally, the Archaic Greek society that produced the poem, etc.. That sort of contextual detail is unnecessary for a task such as this, and there is simply not the scope within 750 words to provide this background and still complete the analysis required successfully.

Essay structure. This is not a structured essay task (i.e. with an introduction, developed main paragraphs and conclusion). While you need to make your points very clear, and you should certainly avoid bullet points or other abbreviated styles of presentation, you are not expected to form each point into a full paragraph.

Bibliography. While you are free to use secondary sources that you believe appropriate, you are not required to consult sources for this task beyond the seminar reading for Unit 2 and, most importantly, the Theogony itself. If you do choose to use secondary sources, however, you must cite them correctly according to the Style Guide for this subject.

Earth (Gaia) and Theogony