1.
Compare
and contrast McEwen & Wills chapter
21commentary about future issues in nursing theory with chapter 15 in Shelly
& Miller.
The major contrast
that I see between chapter twenty-one in McEwen and Willis and chapter fifteen
in Shelly and Miller is what the two authors believe about the future issues of
nursing. The McEwen and Willis text believes that the future of nursing lies in
the development of nursing theory and research (McEwen & Wills, 2011). The
Shelly and Miller text believes that for nursing to survive, the profession has
to go back to its original foundation: God (Shelly & Miller, 2006).
The text written by
Shelly and Miller focuses on the personal qualities that nursing professionals
need to survive in the twenty-first century of health care. These traits are
compassion, competence, faith, commitment, integrity and responsibility (Shelly
& Miller, 2006). The authors of the call to care talks about how with the
economic driven health care, many of the underserved populations are lacking
care and this will lead the church to expand to provide care to the most needy
populations (Shelly & Miller, 2006). The text states one of the areas that
has fallen to the wayside in nursing practice is the relationship with the
patient (Shelly & Miller, 2006). For nursing to thrive as a profession,
they must have a sense of love for their fellow human being and believe that
nursing is a higher calling to serve God (Shelly & Miller, 2006). Through
professional nursing reestablishment to its first foundation; their
relationship with God and calling to do his work, the profession will continue
to thrive.
By contrast the McEwen
and Miller text focuses on the continued development of the nursing profession
through theory development and research. Through the continued development of
knowledge specific to the nursing profession, nursing will continue to evolve
to meet the challenges of the future of health care (McEwen & Wills, 2011).
Through the continued development of research, theory and the application of
evidence based practice, health care errors and cost can be better controlled
allowing affordable health care to the entire population (McEwen & Wills,
2011).
2.
How has your view of nursing theory, practice, and nursing knowledge changed
because of this course?
When I began this
course, I was not sure as to how nursing theories could be applied to practice.
I thought nursing theories were abstract ideals about nursing that were not feasible
to use in every day practice. I have found that nursing theories are practical functional
structures from which to draw insight to guide my professional practice (McEwen
& Wills, 2011).This class has made me evaluate and question the way I am
providing patient care. I am a better nurse because of this class.
This class has also
made me realize that I have been using the ideas of many nursing theorist over
the years in my everyday practice, totally unaware. I have found that the
hospital I work at has a philosophy based on Watson’s grand theory. This class
has made me understand the importance of practicing nursing on evidence instead
of tradition (McEwen & Wills, 2011). I will never say to a novice nurse
again that is just the way we have always done it (Shelly & Miller, 2006). I have really learned to appreciate that
nursing theories provide frameworks for nursing interventions and predict
outcomes that impact nursing practice (McEwen & Wills, 2011). I have also
learned how to evaluate, critique, and utilize nursing theories for future use
in my practice (McEwen & Wills, 2011).
The call to care has
made the most significant impact on my nursing practice. I have come to learn
that I can still maintain my own beliefs, while protecting the beliefs of my
patients (Shelly & Miller, 2006). My responsibility as a Christian nurse is
to evaluate the health related practices that I engage in (Shelly & Miller,
2006). I thought that a good nurse removed their belief system from their
practice. Through this course I have come to the understanding that the
frustrations that I felt towards the nursing profession were often because I
was not centering my practice on God. The call to care made me have a major
paradigm shift. My profession no longer was a career but a calling (Shelly
& Miller, 2006). I find the parts of my profession that I used to dread
almost appealing because it is an opportunity to serve God.
One example of this
new attitude shift is dealing with difficult patients. I often dread when I
come in on shift and a nurse says, “I sorry you have to take care of Mr. X.,”
Well I heard this dreaded statement the other day and I decided to approach the
person not as a problem, but as a person God had placed in my path for a
purpose. I walk into the room, Mr. X begins with” all you nurses do is bug me.”
“I can’t get any sleep around here” followed by a string of very colorful
words. I said a little prayer. I sat down next to Mr. X and said, “You seem a
little tired. I will get you a set of ear plugs and will do my best to do
everything at one time to let you rest. I have to check on you but, I will try
not to wake you.” Another set of colorful words came from his mouth. The patient began to tell me that he had
terrible pain all over his body. I looked at his chart it stated he had been told
he had metastatic cancer two days ago and had no pain medication ordered.
I obtained orders for
pain medication and followed through with the other promises. I was his nurse
for the next several days and spent my extra time in his room talking with him.
He expressed his fear of dying. Mr. X
asked me if I had fears of death. I told him about my relationship with Jesus
Christ. He wanted nothing to do with what I had to say. The next shift I came
in, all the nurses were talking about how at peace Mr. X was since he let the
Chaplain in his room to visit. I was not
his nurse that night, but I later learned he accepted Jesus Christ as his Savior
that day. All the constant yelling and cussing I had experienced over the last
few days seemed very worthwhile. This is the first time in my twenty year
career I have shared my faith with a patient. I was taught good nurses keep
their faith to themselves. I will never approach a disgruntled patient the same
way again.
3.
If a colleague were to ask you, "Why is nursing theory important to
practice?" how would you respond?
Nursing theory is imperative to the
practice, because the nursing profession is in its infancy of establishing itself
as a profession (McEwen & Wills, 2011). In order for nursing to establish
itself professionally, it must have a body of knowledge that is unique to the
practice of the profession (McEwen & Wills, 2011). Theory is the framework
from which that body of knowledge is derived (McEwen & Wills, 2011). Theory
is what generates research and adds to the body of professional knowledge.
Nursing theory gives
organization and structure to nursing practice (McEwen & Wills, 2011) .Theory
is also essential in the creation of new knowledge for the nursing profession
(McEwen & Wills, 2011).Theory presents concepts about the work nurses do,
sustaining research that is practical to the nursing profession. Theory is also
the profession of nursing, asserting itself professionally. In generations past,
much of nursing practice was dictated by doctors (McEwen & Wills, 2011).The
development of theory has led to research creating specific professional
knowledge, allowing nurses to have control of how they care for their patients (McEwen
& Wills, 2011). Nursing theories provide ideas, philosophies and
assumptions that can be functional in many areas of health care (McEwen &
Wills, 2011).Theoretical structures can function as a foundation for education,
administration, research and patient care (McEwen & Wills, 2011).
