Question

In a single document complete the following: A. In one to two pages, discuss how the development of Peplau's theory of interpersonal relations has helped to frame nursing knowledge and influence the practice of nursing. Provide an example that llustrates your thoughts/answer (25%). B. I n one to two additional pages, discuss how has the development of Leininger's theoretical perspective, with its emphasis on culture, has influenced professional nursing practice? Again, provide an example that ill ustrates your thoughts answer 20% ly, provide a one page discussion on how Orlando's nursing process theory is useful in allowing the nurse to meet the standards of care practice requirements for assessment, planning implementation, and evaluation (20%). D. This assignment should be submitted in APA format 25%). Make certain that your font, margins, running head, references and page numbers are correct along with the other components of APA formatting. Utilize appropriate APA level headings to accurately describe and delineate the sections of your paper E. Evidence of proofreading including spelling, grammar, and sentence structure (10%). F. Submit this assignment to the Module 4 Part 1 drop box by the due date. G. The above APA assignment should have at least one reference in addition to your textbook that you obtained from the Cornette Library, Do not utilize web sites as your references

Answer 1

A. Discuss how the development of Peplau's theory of interpersonal relations has helped to frame nursing knowledge and influence the practice of nursing.Provide an example?

Peplau's formulations and, in particular, her seminal Interpersonal Relations in Nursing can provide direction. Peplau's transformative idea that nursing is, at its core, an interpersonal process both to acknowledge an idea that has shaped our past and can guide us into our future.

Rigorous and detailed insistence on interpersonal relationships as the foundational framework for nurses' work quickly became the rhetoric, if not the reality, of nursing education and practice, in general, and psychiatric nursing, in particular (Manfreda 1982). Interpersonal Relations was reissued without revisions through 1996, and it has been translated into six languages (Calloway 2002, 325).

True to the commitment of nursing as an interpersonal relationship of mutuality, Peplau placed as many demands for reflection and change on the nurse as on the patient. The nurse had to know her/himself as well as he/she did the patient. In Peplau's mind (and in her italics), it was ‘the kind of person each nurse becomes (that) makes a substantial difference in what each patient will learn as he is nursed throughout his experience of illness’ (Peplau 1952, xii). Self‐awareness, personal identity, and individuality were established as dominant, guiding concepts for nursing.

The relational changes that Peplau set in motion ushered in an even more fundamental change (Sills 1978). The nurse-patient relationship has become the center of nursing practice. The quality of the nurse-patient relationship has become a moral compass by which nurses find their ways to experiences of satisfaction or distress in their work (D'Antonio 2004).

These ideas find renewed relevance within nursing and health‐care as concepts such as ‘patient-centered care’, ‘partnering with patients’ and ‘strengthening the autonomy of patients and families’ are emphasized in healthcare reform standards.

Peplau's seminal Interpersonal Relations in Nursing can provide some direction.

Explore Peplau's transformative idea that nursing is at its core an interpersonal process, to acknowledge this idea that has changed the discipline and as an idea that may guide us toward future refinement of nursing interventions.

Peplau's Interpersonal Relations in Nursing found both its voice and its audience in this heady brew of expectations and resources. It called upon nurses and, as importantly, nursing students, to use their relationships with patients, relationships whose examples almost always drew from inpatient not, as in the past, community contexts, as templates for the deliberations and discussions that would lead to the maturing forces necessary for full citizenship.

Peplau's sensitivity to the emotional nuances of clinical nursing practice also allowed her to reframe two of the most common, and most disquieting, reactions of nurses toward their patients: that of frustration and anger. Frustration, she reminds them, is the result of any interference with, blocking off, or barrier to a need or desired goal before satisfaction of those urges has been felt; it is a perceived psychological state that gives rise to a particular behavior that can be characterized as directly or indirectly aggressive.

In the first, a 9‐year‐old boy forthrightly tackles the anxiety of upcoming surgical procedures; in the second, a 22‐year‐old man seeks escape in a constant stream of complaints. For both, the end goal is the same: safety and security. For each, the outcome is unique. The process, however, not the behaviors, is that to which nurses must attend. The need for safety and security, Peplau writes, ‘creates tension and tension create energy that is transformed into some form of behavior’.The task of nursing is to identify underlying needs for, in her mind and in her italics, only ‘when needs are met new and more mature ones emerge’

B. In a world of non-stop innovation and constant travel, the ability to recognize and embrace cultural diversity is of utmost importance to all healthcare providers today, but especially in the nurse’s scope of care. While most nursing students’ education merely touches upon the importance of recognizing and understanding diverse cultures, nurses inevitably come into very intimate contact with people from all walks of life. Madeleine Leininger’s theory proves useful early on in nursing education and has provided the author with insight that he otherwise would have lacked in the clinical setting. Nurses are capable of being models for embracing patients’ cultural needs in healthcare, and as a result, it is of high priority that nursing professionals recognize and understand the Transcultural Theory of nursing illustrated by Madeleine Leininger.

While Leininger’s ideals on nursing care revolve principally around the patient, the nurse is also a beneficiary of this approach to treating patients. On a global scale, nurses remain the largest proportion of caregivers, and by learning about cultural strangers and helping patients with their particular lifeways and in their environmental contexts (Leininger & McFarland, 2002, p. 4), nurses have the opportunity to stand out as the most culturally-understanding and demographically-sensitive group of healthcare providers.

For some nurses, however, the transcultural theory of nursing is not highly regarded. Some providers lack exposure to the art of understanding peoples’ specific principles, beliefs, and caring patterns, which in turn affects the quality of care. When patient’s quality of care is in question, the nurse’s role as a caregiver is jeopardized, for his profession is “essential to curing and healing, for there can be no curing without caring” (Leininger, 2001, p. 45).

A familiar example of the lack of transcultural understanding in a healthcare setting is seen of a Mexican-American woman late to her appointment. The patient explained her situation: lack of transportation, child care, and directions. However, the hospital staff did not understand the woman’s hardship and did not accommodate the patient. Consequently, the highly upset patient sought a local healer instead of pursuing mainstream healthcare (Leininger, 2001, p. 64).

Madeline Leininger’s Theory of Transcultural Nursing, one that depends on the communication and care exhibited by the nurse, actively incorporates the patient’s values, beliefs, and background into every step of the nursing process. In instances where the nurse has the chance to make a patient more comfortable according to his or her perceived style of care, the nurse must professionally and effectively pursue this environment on behalf of the patient and make every attempt to understand the motives behind his or her wishes, free from judgment.

The factors before even entering the room of a patient, nurses throughout the entire country should take steps towards cultural competence, a trait that will enhance nursing care in a constantly changing country. As a result, transcultural nursing as defined by Madeleine Leininger is the key to unlocking cultural competence in a healthcare setting for a nation with such a rich historical past and a culturally diverse future.

C. Orlando was one of the first nursing theorists to write about the nursing process based on her own research. Her Deliberative Nursing Process Theory focuses on the interaction between the nurse and patient, perception validation, and the use of the nursing process to produce positive outcomes or patient improvement. Orlando's key focus was to define the function of nursing. The Nursing Process was based on a theory developed by nurse Ida Jean Orlando. This theory delves into the purpose of nurses and their requirements in the medical field.

Theory Assumptions

The theory assumes that a patient who cannot cope with their medical needs without assistance will become distressed and begin feeling helpless. At the base level, nursing can contribute to this distress. However, Orlando theorized that the nurse/patient relationship is one that is decided by both parties. The patient cannot appropriately convey their needs or fears without first establishing a close relationship with the nurse. As such, nurses exist to offer patients a motherly and nurturing presence to relieve distress.

The Role of the Nurse

This theory states that it is the expressed role of the nurse to find out what a patient's immediate needs for help are and fulfill them. Unfortunately, the patient will not always express their distress in a way that determines exactly what kind of help is needed. Therefore, it is the nurse's job to use insight, perception, and intuition to figure out what the patient's true needs are. This process of examining the patient's behavior and discovering its meaning assists nurses in finding out what a client really needs.

Major Dimensions

The nursing process theory dimensions can be summed up using some key terms. Distress is what a patient experiences when their needs have not been met. The Nursing Role is to learn what a patient's immediate needs are and meet them. Nursing Actions are direct or indirect approaches to providing for a patient's immediate need. An Outcome is a change in the patient's behavior that indicates either relief or an unmet need. Outcomes can be observed and interpreted in the patient both through verbal and non-verbal means.

Understanding Patient Needs

Before a nurse can take action, she must first recognize the present situation as a problematic one. In other words, the nurse must understand that the actions of the patient are communicating a plea for help, regardless of how they may appear. Eventually, these cues will become a stimulus for the nurse. Nurses who understand the theory will experience an automatic internal reaction to patient pleas and in turn exhibit behaviors that trigger a response of relief from the patient.

Interacting with a Patient

Nurses must understand that any observations shared and analyzed with a patient are relevant and useful then and there to determine whether or not the patient is in need of assistance. The nurse should also refrain from assuming that her actions and reactions are appropriate or helpful until the patient has confirmed as such. Additionally, she should fall into a pattern of exploring how a patient reacts to her actions. When the nurse stops identifying and deriving meaning from patient behaviors, the communication between nurse and patient immediately stops.

The nursing process theory is all about staying focused on the patient's needs.