THEORETICAL FOUNDATION OF NURSING 10 CARATIVE FACTORS

● 10 caring needs
(Watson’s theory of Transpersonal Caring)
● Need to be addressed by nurses with their
patients when in a caring role
● Clinical caritas processes
Human caring model
● Nursing is the application of the art and science
1. Formation of a humanistic
of human caring
- Altruistic values
2. Instillation of faith
TRANSPERSONAL CARING THEORY
- Hope
Objectives:
3. Cultivation of one’s sensitivity to self and others
1. Explain the metaparadigm of Watson's
4. Development of a trusting, caring relationship
philosophy.
5. Promotion and acceptance of the expression of
2. Discuss the conceptual framework of watson's
the positive and negative feelings
philosophy & theory of transpersonal caring
6. Systematic use of a problem solving caring
3. Apply watson's philosophy in nursing nursing
process
practice through a case situation
7. Promotion of transpersonal teaching-learning
8. Provision for a supportive, protective and
MATEPARADIGM OF THE TRANSPERSONAL
CARING THEORY corrective mental, physical, societal and spiritual
● Human being/ person environment
- Valued person to be cared for, 9. Assistance with gratification of human needs
respected, nurtured, understood and 10. Allowance for existential-phenomenological
assisted spiritual forces
- Fully functional integrated self
● Society/ environment TRANSPERSONAL CARING RELATIONSHIP
- Values that determine how one should ● Humans cannot be treated as objects
behave - Cannot be separated from self, other,
- What goals one should strive toward nature, and the larger workforce
- “Caring has existed in every society. ● Emphasis placed on the interpersonal process
Every society has had some people who between the care giver and care recipient
have cared for others.
● Health ● Centrality of human caring-to-caring
- Unity and harmony within the mind, transpersonal relationship and it’s healing
body, and soul potential for both the one who is caring and the
- Associated with the degree of one who is being cared for
congruence between the self as
perceived and as experienced CARING OCCASION
● Moment when the nurse and another person
- High level of overall physical, mental,
came together in such a way that an occasion
and social functioning
for human caring is created
● Nursing
- Human science of persons and human
INPUT – ten carative factors (caring with love)
health-illness experiences
– holistic approach (mind, body, soul)
- Mediated by professional, personal,
THROUGHPUT – transpersonal caring relationship
scientific, aesthetic, and ethical human
– caring occasion
care transactions
OUTPUT (GOAL) – patient and family centered care
MAJOR CONCEPTS
1. 10 carative factors THEORETICAL FOUNDATION OF NURSING
2. Transpersonal caring relationship (Eriksson’s theory of caritative caring)
3. Caring occasion

● Patient centered care ● The act of caring contains the caring elements
- Fath, hope, love, tending, playing, and
learning
 ● Involves the categories of infinity and eternity, ● Violation of patient’s dignity
and invites to deep communion - Suffering related to life
● “The act of cat=ring is the art of making ● Situation being of a patient
something very special out of something less ● Entire life of a human being
special
“Suffering that occurs as a result of caritative care is a
THEORY OF CARITATIVE CARING violation of human dignity”
Objectives:
1. Explain the metaparadigm of Eriksson’s MAJOR CONCEPTS
Philosophy. 1. Caritas
2. Discuss the Conceptual Framework of
Eriksson’s Philosophy of Caritative Caring. 2. Caring communion
3. Apply Eriksson’s Philosophy in nursing practice 3. Caritative caring ethics
through a case situation.

METAPARADIGM OF THE NURSING THEORY CARITAS

● Person ● Love and charity
- Based on the axiom (fundamental truth) ● Unconditional love
- Human being is an entity of body soul, ● Fundamental motive of caring science, motive
and spirit
- Religious being for all caring
● Environment ● Caring is an endeavor to mediate faith, hope
- Concept of ethos and love through tending, playing and learning
- Refers to home, or to place where a
human being feels at home
- Alleviate suffering CARING COMMUNION
- Suffering related to illness, care, and ● Form of intimate connection that characterizes
related to life
● Health caring
- Health as soundness, freshness, and ● Characterized by intensity and vitality, and by
well-being warmth, closeness, rest, respect, honesty and
- Implies being whole in body, soul, and
spirit tolerance
● Nursing ● Cannot be take for granted
- Caritas means love and charity ● Pre-supposes a conscious effort to be with the
- Unconditional love
- Caring is something natural and original other
- ,ission of the human being is to serve, to ● Seen as the source of strength and meaning in
exist for the sake of others caring
- Purpose is to bring the human back to
its mission
CARITATIVE CARING ETHICS
THEORY OF CARITATIVE CARING ● Dals with the basic relation between the patient
and the nurse
● Caritative caring consists of love and charity ● Nurse meets the patient in an ethical sense
- Caritas ● Approach that nurses have towards the patient
● Respect and reverence for human holiness and
dignity “Nursing ethics are ethical principles that guided a
● Manifestation of the love that “just exist” nurse’s decision making skills”
● True caring occurs when the one caring in a
spirit of caritas alleviates the suffering of the INPUT
patient - Caritative caring
- Caritas
SUFFERING RELATED TO ILLNESS, CARE, LIFE - Respect and reverence for human holiness and
- Different forms of suffering dignity
- Suffering related to illness THROUGHPUT
● Experienced in connection with illness - Application of nursing ethics
and treatment - Maintain dignity and well being
- Suffering related to care - Caring communion
● Exposed to suffering caused by care or OUTPUT (GOAL)
absence of caring - Alleviation of suffering
THEORETICAL FOUNDATION OF NURSING - Experienced-based skill acquisition is safer and
quicker when it rests upon a sound educational
(Benner’s from novice to expert model)
base
- Skill and skill practice as implementing skilled
interventions and clinical judgment skills in
“Caring, clinical wisdom, and ethics in nursing practice”
actual clinical situations
FROM NOVICE TO EXPERT MODEL
Objectives: STAGES OF CLINICAL COMPETENCE
1. Explain metaparadigm
NOVICE
2. Discuss conceptual framework
● Has no background experience of the situation
3. Apply in nursing practice
in which he or she is involved
METAPARADIGM IN NURSING
● Nursing student in his or her first year of clinical
● Person
education; behavior in the clinical setting is very
- Self -interpreting being
limited and inflexible
- The person does not come into the
● Very limited ability to predict what might happen
world predefined but gets defined in the
in a particular health situation
course of living a life
- Has an effortless and non-reflective
- Student nurse
understanding of the self in the world
- Working to acquire nursing knowledge and skill
ADVANCE BEGINNER
● Aspects that make up a person
● The nurse can demonstrate marginally
1. The role of the situation
acceptable performance
2. The role of the body
● Guided by rules and oriented by task completion
3. The role of personal concerns
● New grads in their first jobs
4. The role of temporality
● Have the knowledge and the know-how but not
● Environment
in-depth experience
- Situation
- Phenomenological terms of being
● Difficulty establishing priorities
situated
- Newly qualified nurse
- Person’s past, present, and future which
- 6 months experience
include their own personal meanings,
- Reliance on protocol & oversight from
habits, and perspective, influence the
colleagues
current situation
● Health
COMPETENT
- On the lived experience of being healthy ● Sense of mastery is acquired through planning
and ill and predictability
- Health as what can be assessed ● Lack speed and flexibility
- Well-being is the human experience of ● Advance planning and organizational skills
health and wholeness ● Recognize patterns and nature of clinical
- Person may have a disease and not situations more quickly and accurately than
experience illness advanced beginners
● Illness is the human experience
of loss or dysfunction ● Organized
● Disease is what can be ● Plans and sets goals
assessed at a physical level - 2 year experience
● Nursing - Able to provide independent care
- Enabling condition of connection and - Assumes greater responsibility
concern
- Caring is primary PROFICIENT
● Sets up the possibility of giving ● Perceives the situation as a whole
help and receiving help ● Performance is guided by maxims
- Performance that requires certain level
FROM NOVICE TO EXPERT MODEL of experience to recognize implications
of instructions
 ● Identifies most significant aspects THEORETICAL FOUNDATION OF NURSING
● Better understanding of the situation
(Martha Rogers’ science of unitary human beings)
● Learn from experience
● Able to modify plans in response to different
events
● Believes that a patient can never be separated
from their environment
● Views patient holistically
● Focuses on long term goals
SCIENCE OF UNITARY HUMAN BEINGS
- 3+ years experience
Objectives:
- Recognise and respond rapidly
1. Explain metaparadigm.
2. Discuss conceptual framework
EXPERT
3. Apply through a case situation
● No longer relies on analytical principles like
rules, guidelines and maxims
METAPARADIGM OF THE THEORY
● Key aspects
● Person
- Demonstrating a clinical grasp and
- “The human energy field and the
resource-based practice
universal energy field are constantly
- Possessing embodied knowledge
interacting
- Seeing the big picture
- Patient experience: perception of
- Seeing the unexpected
importance and judgment from the
nurse
● Performs fluidly
- Patient role: practicing self-awareness
● Expertise comes naturally
of verbal and nonverbal communication
- Expert nurse
● Engage the patient to participate
- 5+ year experience
in care
- Intuitive management of complex cases
● Environment
- Patient advocate
- Person and environment are integral to
each other
CONTRIBUTION TO NURSING PRACTICE
- Patient can’t be separated from
Used in the development of clinical promotion ladders, environment
new graduate orientation programs, and clinical ● Physical surrounding
knowledge development seminars. ● Therapeutic environment
● Safety
INPUT ● People physically in the
- Stages of clinical competence environment (family, friends,
THROUGHPUT staff), are influences/ synergy to
- Skills acquisition and understanding of patient healing
care ● Health
OUTPUT (GOAL) - Patterns of living in harmony with the
- Skills development and improvement of environment
performance - Wellness in the mind, body and spirit is
influenced by perception and the
background of social interaction and the
environment
- Nursing exists to serve people
- Safe practice depends on the nature
and amount of scientific nursing
knowledge the nurse brings to their
practice
- Nurses apply theory to assess and
develop unique patient interventions
● Nursing
- The nurse is a factor of the healing
environment
 - Therapeutic use of self: THROUGHPUT
● Allow yourself to be present in - Therapeutic use of self
the patient’s environment - Non-invasive nursing interventions
● Through active listening OUTPUT (GOAL)
● Acknowledging patient concerns - Realization of maximum potential
● Practice kindness and empathy

THEORY OF UNITARY HUMAN BEING

THEORETICAL FOUNDATION OF NURSING
- Man is an energy field, in constant contact with (Imogen King’s theory of goal attainment)
the environment
- Man is more than and different from his
component parts ● Nursing is a process of action, reaction and
interaction whereby nurse and client share
information about their perception in the nursing
● Man is an energy field, in constant contact with situation
the environment
- Man is an open system because he THEORY OF GOAL ATTAINMENT
exchanges matter and energy with the Objectives:
environment 1. Explain metaparadigm.
- Man may be affected by good news 2. Discuss conceptual framework
- Man may be affected by bad news 3. Apply through a case situation

METAPARADIGM IN NURSING
● Man is more than and different from his
● Person
component parts - Existing in an open system
- Not only composed of cells, tissues, - Spiritual being and rational thinker who
organs, systems makes choices, selects alternative
- More than the sum of its parts courses of action
- Ability to record their history
- Endowed with intellect, will,
● Health
decision-making abilities, virtues, - Ability of a person to adjust to the
talents, and many factors stressors
- Different from the sum of his parts - Maximal use of potentials
● Generous, non-generous ● Person can perform to achieve
balance in one’s health
● Forgiving, unforgiving
● Environment
● Rational, irrational - Process of balance involving internal
and external interactions
HUMAN/ ENVIRONMENT ENERGY FIELD ● Nursing
CHARACTERISTICS - The nurse interacts and communicates
● Openness with the client
- No boundaries - Helps identify the existing health
condition
● Pattern
- Promotes help
- Distinguishing characteristics
● Pandimensionality MAJOR CONCEPTS
- No temporal ordering of lives ● Interacting systems
● Resonancy ● Process of human interaction
- Change between human & environment ● Mutual goal
fields
● Helicy INTERACTING SYSTEMS FRAMEWORK:
- System is continually different The nurse interacts in the system simultaneously at
● Integrality three different levels:
- Constant mutual change of human
● Personal
beings and environment
- How the nurse views and integrates self
- Based from personal goals and beliefs
INPUT
● Interpersonal
- Care of unitary human beings (characteristics)
 - How the nurse interrelates with a - Individuals, families, groups and communities
coworker or patient need to be taught self - care
- Nurse-patient relationship
SELF-CARE DEFICIT THEORY
● Social
Objectives:
- How the nurse interacts with coworkers,
1. Explain metaparadigm.
superiors, subordinates
2. Discuss conceptual framework
- Client environment 3. Apply through a case situation

PROCESS OF INTERACTION METAPARADIGM OF NURSING

● Action ● Person
- Towards accomplishment of certain act - Individuals have the potential to learn
● Reaction and be developed
- Response or stimuli ● Environment
● Interaction - External source of influence
- Nurse relates and deals with the - Internal interaction of person’s different
clientele or patient aspects
● Open system ● Health
- Dynamic interaction between the - State of physical, mental, and social well
external and internal environment being and not merely the absence of
disease or infirmity
- Transaction is made when the nurse and the ● Nursing
patient decide mutually on the goals to be - Helping clients to establish or identify
attained, agree on the means to attain the goals ways to perform self care activities
that represent the plan of care, and then - Geared towards the independence of
implement the plan the client
- Evaluation determines whether or not the goals
were attained
MAJOR CONCEPTS
● Theory of self care (self)
- Goal attainment theory
● Nurse and the client communicate ● Theory of self care deficit (you and me)
information, set goal mutually, and then ● Theory of nursing system (we, person,
act to attain those goals community)

Human being has three fundamental health needs: ● Self-care

1. The need for health information
- Initiate and perform independently
2. The need for care that seek to prevent illness
- Maintaining life, health, and well-being
3. The need for care when – unable to help
● Self-care deficit
themselves
- Person needed because the person
cannot carry out self-care
INPUT
● Nursing systems
- Goal attainment
- How the patient’s self-care needs will be
- 3 interacting systems
et by the nurse, patient or both
THROUGHPUT
- 3 classification
- Process of human interaction that leads to
1. Wholly compensatory system
transaction
2. Partially compensatory system
- Action
3. Supportive-educative system
- Reaction
- Interaction
- Wholly compensatory system
- Open system
● Patient is dependent
OUTPUT (GOAL)
● Nurse is to accomplish all the patient’s
- Achievements of clients goal
therapeutic self-care
- Partially compensatory system
THEORETICAL FOUNDATION OF NURSING ● Patient can meet some needs
(Dorothea Orem’s self-care deficit theory) ● Nursing assistance
- Supportive-educative system
● Meet self-care requisites
 ● Needs assistance with decision making THEORETICAL FOUNDATION OF NURSING
or knowledge and skills to learn (Betty Neuman’s Health Care Systems Model)
self-care
● Nursing is a unique profession.
INPUT - Concerned with all the variables
- Self-care versus self-care deficit affecting an individual’s response to
THROUGHPUT stress.
- Meeting self-care requisites - Intrapersonal (within the individual)
OUTPUT (GOAL) - Interpersonal (one or more people)
- Performing self-care activities in order to live - Extrapersonal (outside the individual)
● Prevent stress invasion
● Maintain a maximum level of wellness
● The nurse helps the client through primary,
secondary, and tertiary prevention
- To adjust to environmental stressors and
maintain client stability.

HEALTH CARE SYSTEMS MODEL

Objectives:
1. Discuss the metaparadigm of Neuman’s Theory.
2. Explain the Conceptual Framework of Neuman's
Health Care System Model.
3. Apply Neuman’s Theory in nursing practice
through a case situation.

METAPARADIGM OF BETTY NEUMAN’S THEORY

● Nursing
- Requires a holistic approach
- Approach that considers all factors
affecting a client’s health.
- Depicts the parts and subparts of a
client as a complete system.
● Person
- Concept of a person as an individual,
family, community or the society.
- Sees person as an open system that
works together with other parts of its
body as it interact within the
environment.
● Health
- Health is dynamic in nature
- Depends upon which state of the health
continuum they are in line with,
(maybe with the state of wellness or
illness).
- State of heath varies according to the
degree of reaction a person has to
environmental forces.
● Environment
- Can be internal, external, and created
force that interacts with a person’s state
of health
- STRESSORS
 - Stressors are tensions that produce - Contain chemicals that kill them
alterations. ● Nose, Throat, and Mouth
- Contain mucus that traps pathogens
MAJOR CONCEPTS ● Stomach
CORE STRUCTURE - Juices contain pathogen killing
STRESSORS: pathogens.
● Interpersonal
● Extrapersonal SECOND LINE OF DEFENSE (inflammatory response)
● Interpersonal ● Injured body cells release chemicals called
LINES OF RESISTANCE: histamines, which begin the inflammatory
● Flexible line if defense response
● Normal line of defense - Capillaries dilate
● Lines of resistance - Pyrogens are released, reach
PREVENTIONS: hypothalamus, and body temperature
● Primary rises
● Secondary - Pain receptors are activated
● Tertiary - WBCs flock to infected area like sharks
RECONSTITUTION to blood.

Core structure THIRD LINE OF DEFENSE (immune system)

- Basic survival factors common to all human ● Diversity refers to the ability of the immune
beings. system to deal with millions of invaders
- Include system variables, genetic features, ● self/ nonself recognition refers to the immune
strengths and weaknesses. system’s ability to distinguish the body’s own
molecules from antigens
Stressors
● Failure leads to autoimmune disorders
● Intrapersonal
- Occurs within the patient’s system
Preventions
- Ex. depression, insomnia, guilt
● Primary prevention
● Interpersonal
- Health promotion
- Occur between one or more individual
- Maintenance of wellness
- Social withdrawal and lack of support
● Secondary prevention
● Extrapersonal
- Early detection
- Occur outside the individual
- Prompt treatment
- Lack of social support
● Tertiary prevention
- Actual treatments
Lines of Resistance
● Flexible line of defense
Reconstitution
- Outer barrier to the normal line of - Adjustment state
defense, line if resistance, and core - State of going back to the actual state of health
structure. before the illness occurred.
● Normal line of defense
- Baseline in determining the level of THEORETICAL FOUNDATION OF NURSING
wellness of patient within the continuum
(Dorothy Johnson’s Behavioral System Model)
of health.
● Lines of resistance
● 7 subsystems of a person are: ingestive,
- Protects the basic structure and become
eliminative, attachment-affiliative,
activated when environmental stressors
aggressive-protective, dependence,
invade the normal line of defense.
achievement, sexual and role identity

BODY FIRST LINE OF DEFENSE

BEHAVIORAL SYSTEM MODEL
● Skin
Objectives:
- Effective barrier
● Discuss the metaparadigm of Johnson’s Theory
● Tears
- Wash pathogens away
 ● Explain the Conceptual Framework of Johnson’s Must be stimulated for use to enhance growth and
Behavioral System Model prevent stagnation.
● Apply Johnson’s Theory in nursing practice
through a case situation Equilibrium
- Stabilized but more or less transitory, resting
METAPARADIGM IN NURSING state in which the individuals is in harmony with
● Person himself and with his environment.
- Have two major systems:
- Biological and behavioral system THEORETICAL FOUNDATION OF NURSING
- Role of medicine to focus on the
(Callista Roy’s Adaptation Model)
biological system
- Nursing’s focus is on the behavioral
● Man is a bio-psycho-social system in constant
system
contact with the environment
● Health
● The person is an adaptive system which
- Elusive state that is affected by social,
functions as a whole through interdependence of
psychological, biological, and
its parts.
physiological factors.
- Individual is striving to retain some
ADAPTATION MODEL
balance or equilibrium. Objectives:
● Environment ● Explain the metaparadigm of Roy’s Theory
- Individual’s behavior is influenced by all ● Discuss the Conceptual Framework of Roy’s
the events in the environment Adaptation Model
- Cultural preferences are viewed as ● Apply Roy’s Theory in nursing practice through a
profound case situation.
● Nursing
- Cultivate equilibrium within the individual METAPARADIGM OF THE NURSING THEORY
● Person
SEVEN SUBSYSTEMS OF BEHAVIOR - Adaptive system with coping
1. Attachment-affiliative mechanisms
- Formation and attachment of a strong - Adaptive modes:
social bond ● Physiologic, self-concept, role
2. Dependency function and interdependence.
- Helping or nurturing ● Environment
3. Ingestive - Encompasses all conditions,
- Appetite satisfaction circumstances, and influences
4. Eliminative surrounding and affecting the
- Acceptable behavior for excretion of development and behavior of human as
wastes adaptive systems,
5. Sexual - Particular consideration of person and
- Procreation and gratification earth resources elements: represented
6. Aggressive-protective by stimuli from within the human
- Behavior concerned with protection and adaptive system and stimuli from around
self-preservation the system.
7. Achievement ● Nursing
- Efforts to gain mastery and control - Can either maintain, inv=crease, or
decrease stimuli.
THREE (3) FUNCTIONAL REQUIREMENTS - Promote adaptation for individuals and
Must be protected from noxious influences with which
groups in the four adaptive modes
system cannot cope
- Thus, contributing to health, quality of
life, and dying with dignity.
Must be nurtured through the input of appropriate
● Health
supplies from the environment
- Process of being and becoming an
integrated whole human being.
- Illness is lack of integration.
 ● Physical self and personal self
ADAPTATION LEVEL
- Ability to respond positively to a situation. Role function mode
- Referred to the performance of duties based on
3 TYPES OF STIMULI THAT INFLUENCES given societal norms or expectation
ADAPTATION ● Basic need: social integrity,
Focal stimuli
- The need to know who one is in
- Internal or external stimulus immediately
relation to others so that one
affecting the system.
can act.
● Pricking of skin tissue during injection of drugs.
Interdependence mode
Contextual stimuli
- Close relationships of people and their purpose
- All other stimuli present of contributing factors in
- Ability to give to others and accept from others.
the situation.
● Basic need: feeling of security in
● Inability to explain the procedure and the need
relationships involves ways of seeking
for the drug.
help, affection, and attention,
- Includes people as individuals or in
Residual stimuli
groups-families, organizations, and society as a
- Unknown factors such as beliefs, attitudes or
whole.
traits.
● False belief that a patient cannot bathe after an
injection.

COPING PROCESS
- Innate or acquired ways of interacting with the
environment.

COPING MECHANISMS:
Regulator subsystem
- Transpires through neural, chemical and
endocrine processes
● Increase in vital signs

Cognator subsystem
- Occurs through cognitive-emotive processes,
● Effects of prolonged hospitalization for a four
year old child

4 ADAPTIVE MODES:
Physiologic adaptive mode
- Physical aspect of the human system
determined by physiological needs.
● Sleeping after a day’s work
- Focus on five needs: oxygenation,
nutrition, elimination, activity, rest and
protection
- Four regulatory processes: senses,
fluids, electrolytes, neurologic, and
endocrine functions.

Self-concept mode
- Focus on the psychological and spiritual aspects
of the human system.
- Exist with a state if unity, meaning, and
purposefulness of 2 modes
THEORETICAL FOUNDATION OF NURSING - Patient earns independence over his
care
(Hildegard Peplau’s interpersonal relations theory)
- Out aside old goals and formulate new
ones
- Mother of psychiatric nursing
Nursing roles
- Nursing is an interpersonal process of
Stranger roles
therapeutic interactions between the patient and
- Strangers
the nurse
- Know the patient better
- Must treat with utmost courtesy
- Four phases of nurse-patient relationship
Resource person role
● Orientation
- Answer questions
● Identification
- Interprets clinical treatment data
● Exploitation
- Gives information
● Resolution
Teaching role
- Instructions and trainings
METAPARADIGM OF THE THEORY
● Analysis and synthesis
● Person
Surrogate role
- Man is an organism that lives in an
- Clarify domains to dependence,
unstable balance of a given system
interdependence
● Nursing
- Advocate
- Therapeutic interpersonal process
Counseling role
● Health
- Helps understand
- Movement of the personality and other
- Provides guidance and encouragement
ongoing human process
Leadership role
● Environment
- Assume maximum responsibility for meeting
- (forces outside the organism)
treatment goals
- Vital human social processes are
derived such as norms, customs and
GOAL: PROMOTION OF WELLNESS AND HEALTH
beliefs

MAJOR CONCEPTS THEORETICAL FOUNDATION OF NURSING

● Nurse-patient interaction (Joyce Travelbee’s human-to-human relationship model)
● Phase of nurse-patient relationship
● Nursing roles
- Human-to-human relationship is the means
Nurse-patient interaction through which the purpose of nursing is fulfilled
- Helping relationship based on mutual trust and
respect - Interpersonal process is a therapeutic
- Through knowledge and skill human-to-human relationship formed during
illness and experience of suffering
Phase of nurse-patient relationship
1. Orientation
METAPARADIGM OF THE THEORY
- Initial reaction between the nurse and ● Person
the patient - Human being
- Assistance - Unique, irreplaceable individual
2. Identification ● Environment
- Explore the experience and needs - Not defined
- Relatedness - Human conditions and life experiences
3. Exploitation encountered by all men as sufferings,
- Moves on from a dependent to hope, pain, and illness
independent ● Health
- Full value of relationship - Subjective and objective
4. Resolution - Subjective health
 ● State of being in accord with ● Nurse reaction
self-appraisal of ● Nurse action
physical-emotional-spiritual - Nurse helps patients meet a perceived need that
status patients cannot meet for themselves
- Objective health
● Absence of discernible disease METAPARADIGM OF THE THEORY
● Disability of defect ● Person
● Assessment by spiritual director - Developmental beings with needs
● Nursing - Has own subjective perception
- Interpersonal process ● Health
- Assists - Well being
- Prevent or cope with the experience of - Fulfilled needs
illness and suffering - Sense of comfort
- Find meaning in these experiences ● Environment
- Immediate context for a patient
Human-to-human relationship - Not defined directly
Interactional phases: ● Nursing
1. Original encounter - Responsive to who suffer
- First impression by the nurse of the - Sense of helplessness
patient, vice versa - Process of care in an immediate
- Stereotypes or traditional roles experience
2. Emerging identities - Goal of nursing
- Relationship begins ● Increased sensed of well being
- Perceives each others uniqueness
3. Empathy MAJOR CONCEPTS
- Ability to share in the person;s - Three elements in a nursing situation
experience - Function of professional nursing
4. Sympathy - Deliberative nursing process
- Lessen the cause of suffering
- Beyond empathy – when one Three elements in a nursing situation
sympathizes, one is involved but not Patient behavior
incapacitated by the involvement - Nurse must first recognize the situation as
- Therapeutic use of self problematic
5. Rapport - Presenting behavior of the patient
- Nursing interventions that lessen the - May represent a plea for help
patient’s suffering
- Relation as human being to human Immediate reaction
being - Perceives with anyone of his five sense organs
- A nurse is able to establish rapport - Stimulate automatic thought
because she possesses the necessary - Thought stimulates an automatic feeling
knowledge and skills required to assist - Person acts
ill persons and because she is able to = Person’s immediate reaction
perceive, respond to and appreciate the
uniqueness of the ill human being. Nursing action
- Directly or indirectly provide for the patient’s
GOAL: MEANINGFUL NURSE-PATIENT immediate need
INTERACTION (COPE WITH ILLNESS)
Nursing process
Assessment
THEORETICAL FOUNDATION OF NURSING - Share and validate the nurse’s direct and
(Ida Jean Orlando’s theory of deliberative process) indirect observation
Planning
- Participation from the nurse and the patient
- Three elements composing nursing situation are Implementation
● Patient behavior
 - Direct and indirect help occur in the
implementation phase
Evaluation
- Change in patient’s behavior
- If no change, nurse continues the process until
improvement occur

GOAL: FIND OUT AND MEET IMMEDIATE PATIENT’S

NEED FOR HELP