FLORENCE NIGHTINGALE

- Modern Nursing
Credentials and background
- Founder Of Modern Nursing

Environmental Problems
1. Lack of sanitation
2. Presence of filth – contaminated
water and bed linens
3. Soldiers exposure to frostbite,
louse infestations, wound
infections and opportunistic
diseases.

Florence Nightingle
- The lady of/WITH the lamp –
because she made ward rounds
during the night
- In Scutari she became critically ill
with crimean fever – typhus or
brucellosis
- After the war – she established
st. thomas hospital and kings
college hospital In London.

Major Assumptions

The role of nursing is to facilitate "the

body’s reparative processes" by
manipulating client’s environment.

Theoretical Assertions
- Disease was a reparative process

MAJOR CONCEPTS & DEFINITIONS

 Theory focused on environment.
(Surroundings)
 Five essential components of
environmental health
- Pure air
- Light
- Cleanliness
- Efficient drainage
- Pure water
 Jean Watson
- Philosophy and Theory of
Transpersonal Caring

- Margaret Jean Harman Watson

- Born and grew up in Welch, West
Virginia
- University of Colorado BSN in
1964, Master’s Degree in 1966 and
doctorate degree in 1973.

Books
- Nursing: The Philosophy and
Science of Caring (1979) – 10
Carative Factors

Theoretical Sources
- Caring moment can be
transpersonal – each person feels
a connection with the other at the
spirit level.
- Healing – directly related to the
individual’s evolving personhood.
- She uses handwashing as a ritual to
pause for a moment and become
receptive to interactions with the
patient.

- “the Caring Moment is most

evident within the transpersonal
Caritas energetic field model.”

Theoretical Assertions
- Nursing
- PERSONHOOD
- HEALTH
- ENVIRONMENT
Marilyn Anne Ray
- Theory of Bureaucratic Caring

- Marilyn Anne Dee Ray was born in

Hamilton, Ontario, Canada.
- Graduated from St. Joseph Hospital
School of Nursing in 1958.
- She finished her BSN and MSN at
University of Colorado School of
Nursing – she met Dr. Madeleine
Leininger.

Theoretical Sources
- Ray’s interest in caring as a topic
was stimulated by her work with
Leininger in 1968 focusing on
transcultural nursing and
ethnographic-ethnonursing
research methods.
- she used ethnographic methods in
combination with phenomenology
and grounded theory to generate
substantive and formal grounded
theories, resulting in the theory of
bureaucratic caring.
Patricia Benner - NURSING
- Caring, Clinical Wisdom and Ethics in - PERSON
Nursing Practice - HEALTH
- ENVIRONMENT
- Patricia E. Benner, R.N., Ph.D.,
FAAN is a professor emerita at the
University of California, San
Francisco.
- Born in Hampton, Virginia.
- Ba in Nursing - Pasadena
College/Point Loma College
- MS in med/surg nursing from
UCSF
- Phd -1982 from UC Berkeley
- AN AMERICAN MULTI
AWARDED NURSE LEADER,
WRITER, &RESEARCHER,
RANKED AS THE 4TH MOST
INFLUENTIAL NURSE BY THE
READERSHIP OF THE
JOURNAL NURSING
STANDARD IN THE UNITED
KINGDOM.

Philosophy
- A philosophy of nursing who
believes that “ the nurse-patient
relationship is not a uniform,
professionalized blueprint but
rather a kaleidoscope of intimacy
in some of the most dramatic,
poignant, & mundane moments of
life”

- Benner adapted the Dreyfus model

to clinical nursing practice. The
Dreyfus brothers developed the
Skill Acquisition model by
studying the performance of chess
masters and pilots in emergency
situations.
- Benner’s model is situational and
describes five levels of skill
acquisition and development: (1)
novice, (2) advanced beginner,
(3) competent, (4) proficient, and
(5) expert.

Major concepts
KATIE ERIKSSON
- THEORY OF CARITATIVE CARING

- Eriksson was born on November

18, 1943, in Jakobstad, Finland.
- 1965 graduated at the Helsinki
Swedish School of Nursing,
- 1967 completed her Public Health
Nursing specialty education.

Caritative Caring
- Caritas refers when caring for the
human being in health suffering.
- True caring, occurs when the one
caring in a spirit of caritas
alleviates the suffering of the
patient.
- It is not equated to service with
quality and compensation.
- Love- Charity-faith-hope

Published Books
- The Idea Of Caring
- The Suffering Human Being

THE BASICS IN CARITATIVE

CARING ETHICS ARE:
- HUMAN DIGNITY
- CARING COMMUNION
- INVITATION &
RESPONSIBILITY

Major Assumptions
- Nursing
- Person
- Environment
- Health
Karl Marie Martinsen
- Philosophy of Caring

- A NORWEGIAN NURSING
THEORIST STANDS
PROVOCATIVELY IN THEIR
COUNTRY ON A DEBATE
THAT NURSING EDUCATION
CURRICULUM WILL BE
CHANGED TO 4 year degree.
- A philosophy of nursing which
stand for “nursing’ is founded on
caring for life, on neighbourly love.
- One of her major social & nursing
concerns while practicing was
social inequalities in general & in
the health service in particular .

Contributions and Writings

- CARING, NURSING &
MEDICINE: HISTORICAL-
PHILOSOPHICAL ESSAYS.
- MORAL PRACTICE &
DOCUMENTATION IN
PRACTICAL NURSING.

Philosophy of Caring
- THE METAPARADIGM THAT
REFERS: NURSING COULD BE
CALLED THE “ TRINITY OF
CARING”
- CARING IS FUNDAMENTAL
TO NURSING & TO OTHER
WORK OF A CARING NATURE
– metaparadigm

- ACCORDING TO THIS
THEORY, THE THREE
COMPONENTS OF “TRINITY
OF CARING” ARE OF THE
FOLLOWING.
- relational
- practical
- moral

Major Concepts
- Person
- Health
- Environment
NURSING CONCEPTUAL MODELS in degree, and not all are
successful. Conservation is the
Myra Estrin Levine outcome.Adaptation has three
characteristics
- Myra Estrin Levine proposed four
principles of conservation. - Historicity
- Specificity
- The process by which conservation - Redundancy
is achieved is adaptation and the
desired outcome is integrity or Conservation Model of Nursing
wholeness. - Adaptation – critical for
conserving wholeness in the midst
of constant environmental change.
- Adaptation includes responses
based on past experiences - Nursing care focuses on the
(historicity), specific to the need management of integrated hoslistic
(specificity), and with a variety of responses like:
levels of possible response - 1. Fight or flight
(redundancy). - 2. Response to stress
- 3. Sensory response
Three major concepts
- Wholeness (Holism) - Trophicognosis – the proposal of
- Adaptation the usage of the term to use as the
- Conservation scientific method to develop a
nursing care judgment as an
- psychosocial assessment should alternative to nursing diagnosis.
focus on – information needed to
plan appropriate treatment Conservation
- nursing diagnosis – need for - “Conservation describes the way
conservation complex systems are able to
continue to function even when
Wholaceness severely challenged (Levine,
- To understand the whole person, 1973).The primary goal of
one must first understand the parts conservation is maintaining
of the whole. Levine used wholeness and uniqueness.Nursing
Erickson’s description of actions reflecting this model are
wholeness as an open system she directed at helping the client
believed that humans respond in “ conserve
an integrated, singular fashion to - principles:
environmental changes”
- this should be the goal of all - Energy - fatigue
nursing care. - Personal Integrity – losing control
of the situation
Adaptation - Structural Integrity
- Adaptation is the process of change - Social Integrity – sharing your
whereby the individual retains his feelings to supportive people
integrity within the realities of his
internal and external
environment” .All adaptations vary
Martha Rogers
- Science of Unitary Beings

Major Concepts
- Rogerian model – abstract system
of ideas from which from which to
approach the practice of nursing. It
stresses the totality of experience
and existence that is relevant in
todays health care system.
- critical thinking pattern three
components:

The Science of Unitary Human Beings

- It specifies a worldview and
philosophy used to identify the
phenomena of concern to the
discipline of nursing .
- She postulated that human beings
are dynamic energy fields that are
integral with environmental fields
- Today she is thought of as “ahead
of her time, in and out of this
world.

- unitary human beings - The term

that refers the irreducible,
indivisible, pandimensional energy
field identified by pattern and
manifesting characteristics that are
specific to the whole.

- environmental field - The term that

refers the irreducible, indivisible,
pandimensional energy field
identified by pattern and integral
with the human field.
passive health - terms to symbolize
wellness and the absence of disease and
major illness.
Imogene King - Social system - organization,
- Theory of Goal Attainment authority, power, status, and
decision making.
“Nursing is a process of action, reaction
and interaction by which nurse and client
share information about their perception in
a nursing situation” and “a process of
human interactions between nurse and
client whereby each perceives the other
and the situation, and through
communication, they set goals, explore
means, and agree on means to achieve
goals.”

Assumptions
- (1) The focus of nursing is the care
of the human being (patient).
- (2) The goal of nursing is the
health care of both individuals and
groups.
- (3) Human beings are open
systems interacting with their
environments constantly.
- (4) The nurse and patient
communicate information, set goals
mutually, and then act to achieve
those goals. This is also the basic
assumption of the nursing process.
- (5) Patients perceive the world as a
complete person making
transactions with individuals and
things in the environment.
- (6) Transaction represents a life
situation in which the perceiver and
the thing being perceived are
encountered. It also represents a
life situation in which a person
enters the situation as an active
participant.
Major
Nursing,health,environment,person

Interacting System
- Personal system - perception, self,
growth and development, body
image, space, and time.
- Interpersonal system -
interaction, communication,
transaction, role, and stress.
Dorothea Orem
- Theory of Self-Care- (grand theory)

- Self care - it demonstrates

practices of all the activities that
individual’s initiate and perform on
their behalf in maintaining life,
health and well being.
- The ability to perform self-care
actions is called Basic
Conditioning Factors.
- What is the condition that indicates
that a person needs nursing care?

Universal self-care requisite:

- Maintenance of sufficient intake of
air.
- Maintenance of sufficient intake of
food.
- Prevention of hazards to human
life, human functioning, and
human well-being.
- NURSING SYSTEM - is
considered to be the unifying
theory that includes all of the
essential elements of self-care
deficit nursing theory.

Major Concepts

- Human being
Health nursing environment
DOROTHY JOHNSON are successful in some way and to
- BEHAVIORAL SYSTEM MODEL some degree.”.

- Dorothy first proposed her model

of nursing care in 1968 as fostering
of “the efficient and effective
behavioral functioning in the
patient to prevent illness".

- She also stated that nursing was

“concerned with man as an
integrated whole and this is the
specific knowledge of order we
require”.

- In 1980 Johnson published her

conceptualization of “behavioral
system of model for nursing”where
she explains her definitions of the
behavioral system model.

4 ASSUMPTIONS OF THE SYSTEM

- First, there is “organization,
interaction, interdependency and
integration of the parts and
elements of behaviors that go to
make up the system ”

- A system “tends to achieve a

balance among the various forces
operating within and upon it', and
that man strive continually to
maintain a behavioral system
balance and steady state by more or
less automatic adjustments and
adaptations to the natural forces
impinging upon him.”

- A behavioral system, which both

requires and results in some degree
of regularity and constancy in
behavior, is essential to man that is
to say, it is functionally significant
in that it serves a useful purpose,
both in social life and for the
individual.

- Last, “system balance reflects

adjustments and adaptations that
Sister Callista Roy
- Adaptation Model of Nursing

- Sister Callista Roy model sees the

individual as a set of interrelated
systems who strives to maintain a
balance between various stimuli.

Major Concepts
- Person
- Health
- Environment
- nursing

Betty Neuman
- Neuman System Model

- Is a nursing theory based on the

individual's relationship to stress,
the reaction to it, and reconstitution
factors that are dynamic in nature.
- the concept of a whole person and
an open system approach.
- The concept is aimed towards the
development of a person in a state
of wellness having the capacity to
 function optimally by adaptation disorganization of the system
with environmental stimuli causing producing illness
illnesses back to a state of wellness 7. Prevention
prevention is used to attain balance
Major Concepts within the continuum of health
- 8. Reconstitution
System Model in Nursing Practice A state of returning back to old
- 1. Client variables health self.
- Physiological, sociocultural
developmental and spiritual— Three Levels of Prevention
function to achieve stability in - A. Primary prevention – focuses
relation to the environmental on foreseeing the result of an act or
stressors experienced by the client. situation and preventing its
2. Lines of resistance unnecessary effects as possible. It
- acts when the normal line of also aims to strengthen the capacity
defense is invaded by too much of a person to maintain an optimum
stressor causing alteration in the level of functioning while being
normal health pattern to facilitate interactive with the environment.
coping and overcome the stressors Ex. Health promotion and disease
that are present within the prevention.
individual. - B. Secondary prevention –
3. Normal line of defense focuses on helping alleviate the
- acts in coordination with the actual existing effects of an action
normal wellness state. It is the that altered the balance of health. It
normal reaction of the client in aims to reduce environmental
response to stress – the baseline influences that cause an alteration
determinants of wellness within the in the stability of the client. Ex.
health continuum. Early diseases detection and
- 4. Flexible line of defense prompt treatment.
- helps the body to adjust to - C. Tertiary prevention – focuses
situations that threaten the on the actual treatments or
imbalance within the client's adjustments to facilitate
stability. strengthening of person after being
exposed to stressor. Aims to
- 5. Stressors prevent regression and recurrence
stressors are forces that produce of the disease. Ex. Rehabilitation
tensions, alterations or potential
problems causing instability within
the clients system.
6. Reaction
reactions are the outcomes or
produced results of certain stressors
and actions of the lines resistance
of a client. It can be positive or
negative depending on the degree
of reaction the client produces to
adjust and adapt with the situation.
A. Negentropy is set towards
stability or wellness
b. Egentropy is set towards