Health sciences and nursing

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Question 1

After watching the video, Falk-Rafael's Theory of critical caring is the middle-range Theory that

I resonate with. Falk's TheoryTheory emphasizes the importance of nurse-patient relationships in

healthcare and acknowledges the power dynamics within these relationships. The TheoryTheory

posits that caring is not only a behavior but also a way of being. The nurse must be empathetic,

attentive, present, and respectful of the patient's needs and values.

In the clinic scenario seen in the video, the TheoryTheory of critical caring is particularly

relevant as the nurse is shown to be engaging in a conversation with the patient trying to

understand his needs and providing emotional support Falk-Rafael, (2020). The nurse is present,

empathetic, and attentive toward the patient's concerns, demonstrating a deep sense of care. The

nurse's approach aligns with Falk's TheoryTheory, as caring is ethical and moral, with the patient

being the core of the care process.

nurse’s behaviors and communication can demonstrate 'caring consciousness .'This concept

emphasizes the importance of nurse's mindfulness and awareness of their own biases,

assumptions, and values, thus demonstrating the importance of patient-centered care, which is

another key concept of the TheoryTheory the nurse uses the power in the nurse-patient

relationship to give emotional support and advocate for the patient’s needs.

In conclusion, the TheoryTheory of critical caring can inform and guide nurses in the clinical

scenario by emphasizing the importance of the nurse-patient relationship, the need for patient-

centered care, and the nurse's role to be empathetic, present, and attentive to the patient's needs

and wants. By following the principles of this TheoryTheory, nurses can provide high-quality

care that can improve the patient's emotional, psychological, and physical well-being Falk-

Rafael, (2020). Past research studies have shown that the TheoryTheory leads to better patient

satisfaction, decreased anxiety, and improved coping mechanisms. Falk's TheoryTheory has been

found to positively impact nurses' job satisfaction and professional practice leading to a strong

sense of fulfillment in their profession.

Question 2

Fawcett conceptualization of the nursing metaparadigm includes four concepts which

include: person, environment, health, and nursing remain significant to the discipline of nursing

today. These four concepts provide a foundation for nursing knowledge, education, and practice.

They guide nursing research and practice by providing a common language and sharing an

understanding of the essential factors of nursing. The concept of a person refers to people or

groups of individuals receiving nursing care. The environment concept is the external and

internal factors that influence the health and well-being of the individual under care. The health
concept is the individual's state, including physical, emotional, mental, and social dimensions.

Finally, the nursing concepts are the nurse's actions and responsibilities in promoting the

patient's health and well-being.

However, some crucial insights may need to be added to the Conversation about nursing.

Bender argues that there is a need to re-conceptualize the nursing metaparadigm by stating the

philosophical ontology of the nursing disciple that educates inquiry and practice. This would

involve touring the key assumptions, beliefs, and values underpinning nursing knowledge and

practice (Bender, 2018).

In addition, Kalogirou, Olson, and Davidson suggest that the nursing metaparadigm

should be enlarged to include the concept of planetary health, which refers to the

interconnectedness between human health and the planet's health.

Another study highlights the need to disimpact debates around nursing’s metaparadigm

concepts. The authors suggest a need to move beyond debates about the relative importance of

each concept and instead focus on the relationships and interconnections between them. This

would involve investigating how the concepts interact with and influence each other in different

nursing contexts Thorne et al., (1998).

To sum up, while Fawcett’s conceptualization remains significant to the nursing

discipline, there is a need to expand and re-conceptualize this meta language. Which involves

imploring the philosophical ontology of nursing, expanding the metaparadigm to include new

concepts such as planet health, and moving beyond debates about the importance of each concept

to investigate their interrelationships in different nursing contexts

There is a growing demand to colonize nursing knowledge development because

colonialism, imperialism, and white supremacy have historically shaped the discipline

knowledge base. Like several other fields, the nursing profession has been built on the

exploitation of marginalized communities, including enslaved people, Indigenous peoples, and

people of color Smith (2021). The Eurocentric perspective has led to the exclusion of necessary

knowledge and practices from non-western cultures and the domination of western knowledge.

The results have been a lack of diversity and inclusion in nursing education and practice, which

has negatively impacted patient care and outcomes.

As nurses, we can contribute to the call to action by educating each other about the

history and impact of colonization on nursing knowledge and practice. Our own biases and

privilege and work can be examined to dismantle structures that perpetuate inequities, which

include incorporating diverse perspectives and voices in our curriculum development and

research, recognizing and valuing knowledge and expertise of non-western cultures, and

challenging systems of oppression that exist in nursing education and practice (Stake-Doucet

(2020). It is vital to acknowledge the contribution of African nurses in the decolonization process

and learn from their experiences( Carey et al., 2020). As nurses, we should work together to

create a more inclusive and equitable nursing profession that recognizes the value of diverse

knowledge and perspectives in improving patient care and outcomes.

In designing a new nursing curriculum, it is essential to consider the teachings of

Florence Nightingale and her environmental model. The Environmental model emphasizes the

importance of the environment in promoting health and well-being, emphasizing the need for

water, sanitation, and clean air. This is specifically relevant today given the global concerns

around climate change and planetary health, as stated in Kalogirou, Olson, and Davidson’s

article of 2020 article, including Nightingale’s teachings in the curriculum which provides

opportunities for the nursing students to understand the broader social, environmental and

economic determinants of health.

Nevertheless, there are controversies and challenges surrounding Nightingale’s teachings.

Bender's (2018) article highlights the arguments around the nursing metaparadigm concepts,

including the environment concept. Some intellectuals debate that the environment is too

narrowly defined, while some argue that it is too broad and does not adequately capture the

social determinants of health. Furthermore, Nightingale’s emphasis on a hierarchical, patriarchal

nursing model has been criticized for enforcing traditional gender responsibilities and limiting

the scope of practicing nursing.

To address these challenges and controversies, it is vital to consider the broader context

of nursing, including the economic, social, and political factors that shape healthcare delivery.

The nursing curriculum should be designed to address the complex and interconnected

challenges of our time, including climate change, social inequalities, and world pandemics.

Integrating Nightingale's teachings into the nursing curriculum can provide a foundation for

understanding the role of the environment in promoting health and well-being while encouraging

reflection on the broader political and social context of nursing practice.

For instance, nursing students can learn about the importance of environmental sustainability and

its part in promoting health. They can also investigate the social determinants of health and the

impact of structural inequalities on health outcomes (Thorne et al., 1998). In addition, nursing

students can learn about the role of community engagement in promoting health and the

importance of working collaboratively with other medical professionals to address complex

health challenges. By integrating Nightingale's model's teachings, we can create a more holistic

approach to practicing nursing that addresses our time's complex and interconnected challenges.

Question 5

Two-eyed seeing is a theoretical approach that combines Western and indigenous

worldviews to promote cultural safety and respect in medical practice. Wright and colleagues

(202) identified three key strategies to provide positive healthcare experiences for indigenous

families in the NCIU using Two-Eyed Seeing: establishing rapport and trust, embracing cultural

humility, and engaging in family-centered care.

I would similarly use Two Eyed Seeing to promote cultural safety and respect by

integrating indigenous families by acknowledging the trauma and injustices they have

experienced and demonstrating a commitment to culturally safe care. Embracing cultural

humility would involve recognizing the diversity and complexity of indigenous cultures and

engaging in ongoing self-reflection to ensure that the practice is culturally safe and responsive.

Lastly, engaging in family-centered care would involve recognizing the central role of

family and community in indigenous cultures and working with families to identify their needs

and goals for care. Using the Two-Eyed Seeing approach in my practice, I can work towards
providing culturally safe care that is responsive, respectful, and compassionate. This approach

aligns with Bender's (2018) call to re-conceptualize the nursing metaparadigm by incorporating

cultural safety and responsiveness as crucial aspects of practicing nursing.

References
Wright, A.L., Ballantyne, M., & Wahoush, O. (2020). Caring for Indigenous families in the

neonatal intensive care unit. Nursing Inquiry, 27(2), 1–12.

Foronda, C. (2020). A theory of cultural humility. Journal of Transcultural Nursing, 31(1), 7–12.

https://doi.org/10.1177/1043659619875184

Bender, M. (2018). Re-conceptualizing the nursing metaparadigm: Articulating the

philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing

Inquiry, 25(3) https://doi.org/10.1111/nin.1224

Kalogirou, M.R., Olson, J., & Davidson, S. (2020). Nursing's metaparadigm, climate change,

and planetary health. Nursing Inquiry, 27(3) https://doi.org/10.1111/nin.12356

Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham S.R. (1998).

Nursing’s metaparadigm concepts: Disimpacting the debates. Journal of Advanced Nursing, 27,

1257-1268.

Stake-Doucet, N. (2020, November 5). Beyond Florence. The racist lady with the lamp. Nursing

Clio.

https://nursingclio.org/2020/11/05/the-racist-lady-with-the-lamp/

Smith, K. (2021, February 4). Moving beyond Florence: Why we need to decolonize nursing

history. Nursing Clio. https://nursingclio.org/2021/02/04/moving-beyond-florence-why-we-

need-to-decolonize-nursing-history/

Carey, T.A., Binagwaho, A., & Khanyola, J. (2020, July 9). Beyond Florence Nightingale: How

African nurses have decolonized the profession. The Conversation.

decolonised-the-profession-141900

Falk-Rafael, A. (2020, March 3). The community as client: A critical caring exemplar.

Nursology. https://nursology.net/2020/03/03/the-community-as-client-a-critical-caring-

exemplar/?amp=1

Falk-Rafael, A. (2020). Adeline Falk-Rafael's critical caring Theory Theory. In M.C. Smith

(Ed.), Nursing theories and nursing practice (5th ed., pp. 509-522). F.A. Davis Company