Nursing Change Theory Essay.

Nursing Science

Defining nursing science is complicated by a dispute as to whether nursing is a pure science or an applied science. Pure science refers to seeking and discovering new knowledge. Scientists studying the human eye to understand vision is an example of a pure science endeavor. On the other hand, applied science refers to the practical use of knowledge. Developing contact lenses and eyeglasses is an example of an applied science endeavor.Nursing Change Theory Essay.

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More recently, nurse experts have concluded that nursing is a pure science that possesses its own body of knowledge. Our knowledge focuses on factors that affect human wellness. Nursing science is comprised of more than facts. It embraces multiple paradigms of knowing beyond traditional empirical research such as creativity, debate, diversity, and open inquiry.Nursing Change Theory Essay.

The definition of nursing science that has always made the most sense to me is written by Stevenson and Woods in 1986. They wrote, “Nursing science is the domain of knowledge concerned with the adaptation of individuals and groups to actual or potential health problems, the environments that influence health in humans, and the therapeutic interventions that promote health and affect the consequences of illness.”Nursing Change Theory Essay.

More on nursing science can be found in Roy and Jones’ Nursing Knowledge Development and Clinical Practice: Opportunities and Directions and Zaccagnini and White’s Doctor of Nursing Practice Essentials Nursing Change Theory Essay.

Definition of Nursing

To understand nursing science, you must understand the definition of nursing itself. The American Nurses Association defines nursing as, “The protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.”Nursing Change Theory Essay.

Depending on their personal philosophical perspective, nurse experts have defined nursing in different ways. Other nurse theorists have defined nursing as:

• Actions taken by nurses and the outcomes achieved by those actions (Fawcett)
• A performing art centered around nursing knowledge (Parse)
• The use of nursing knowledge to improve the human condition (Rogers)
• A process of nursing interactions within and between systems (King)
• The study of promoting wellbeing (Reed)Nursing Change Theory Essay.

The American Association of Colleges of Nursing elaborates upon these definitions by describing the four key focus areas of nursing practice. These focus areas differentiate the nursing discipline; we possess a special knowledge of human beings, human behavior, health, and human interaction with the environment. Nursing Change Theory Essay.The four focus areas include:

• Principles that govern life-process, well-being, and optional function of human beings;
• Patterns among human interaction and the environment in critical life situations;
• Actions or processes that make positive changes in health statuses; and,
• Wholeness and health of human beings.

For more information on the definition of nursing, read Cody’s Philosophical And Theoretical Perspectives For Advanced Nursing Practice.Nursing Change Theory Essay.

Is Nursing Science Different than Medical Science?

The answer to this question is, “Yes, well kinda, I guess not really, but yes.” Medical science emphasizes the concepts of diagnosis and treatment of disease. Nursing science emphasizes the concept of a human’s response to sickness. I would argue that both professionals emphasize both concepts. We overlap at many points and the largest difference lies in our scope of practice.

So what does this mean for nurse practitioners? We diagnose and treat disease, and we focus on a person’s response to their illness. Some experts assert that when nurse practitioners treat a patient they uniquely begin with the human being rather than the disease, and they place the patient’s values and goals ahead of their own. I have known physicians who do the same.Nursing Change Theory Essay.

So, does being a nurse practitioner fundamentally differ from being a physician? The cheeky response would be, “Depends on what state you live in.” Something that is beautiful about being a nurse practitioner is that our field grew from the principles that overlap between nurses and physicians. We’ve got the best of both worlds!

For more information on this topic please see Chapter 1 of Zaccagnini and White’s Doctor of Nursing Practice Essentials.Nursing Change Theory Essay.

Nursing Epistemology

Nursing science has its foundations in various forms of knowledge: philosophical, ethical, historical, biopsychosocial, and organizational. Epistemology refers to the study of knowledge. A mature nurse practitioner understands the value of different forms of knowledge and uses each one to inform his or her daily practice. This section elaborates upon each type of knowledge and lists resources for further reading.Nursing Change Theory Essay.

Philosophical Knowledge

A philosophical framework serves as a foundation and structure for any body of knowledge. Your personal philosophy is the way you explain your world and the enduring set of principles you hold. A philosophy frames the manner in which you approach problems, and it underpins science, theory, and research.Nursing Change Theory Essay.

Nursing science is primarily directed by three philosophical orientations: positivism, antipositivism, and postpositivism. These orientations are defined as follows.

• Positivism (also known as empiricism) encompasses hard or natural sciences
• Antipositivism embraces soft or interpretive human sciences
• Postpositivism (also known as contemporary empiricism) acknowledges that social and historical contexts affect knowledge and that a complete understanding of knowledge includes both observable reality and the human experience.Nursing Change Theory Essay.

Nurse practitioners may vary in their individual philosophies, but looking at the profession as a whole reveals the common themes of (1) holism, (2) quality of life, and (3) the relativity of truth based on each person’s perceptions. Both the nurse practitioners of today and tomorrow have the opportunity to define and refine the philosophies that shape our theories, research, and practice: an awesome responsibility!Nursing Change Theory Essay.

For a more detailed exploration of nursing philosophy consider reading Philosophies And Theories For Advanced Nursing Practice by Butts and Rich or Philosophical And Theoretical Perspectives For Advanced Nursing Practice by Cody. You can also read a quick summary of nursing philosophy in Doctor of Nursing Practice Essentials by Zaccagnini and White.Nursing Change Theory Essay.

Ethical Knowledge

In health care, ethical concerns are complex and varied. Through their MSN and DNP programs, nurse practitioners are prepared to address ethical dilemmas that may arise within our profession or in clinical practice. The core of modern nurse practitioner ethics rejects the old medical ethics of paternalism and instead promotes respect for individual autonomy.Nursing Change Theory Essay.

Ethical knowledge applies to nursing research as well. In their Code of Ethics for Nurses with Interpretive Statements, The American Nurses Association asserts that nurse practitioners have the ethical obligation to protect human rights. Specifically, when conducting scientific research, nurse practitioners must protect their participant’s right to privacy, fair treatment, and self-determination.Nursing Change Theory Essay.

To learn more about nursing ethics, I suggest reading Butts and Rich’s Nursing Ethics: Across the Curriculum and Into Practice. Another great read that focuses on general bioethics is Vaugn’s Bioethics: Principles, Issues and Cases. My personal favorite text on this topic is Orentlicher, Bobinski, and Hall’s Bioethics Public Health Law.Nursing Change Theory Essay.

Historical Knowledge

As George Santayana shrewdly stated, “Those who cannot remember the past are condemned to repeat it.” History provides context to our discipline, and information interpreted without an understanding of its context results in misinformation and erroneous conclusions.Nursing Change Theory Essay.

Only 50 years ago, Dr. Loretta Ford, a public health nurse, established the first nurse practitioner school and broke ground on a new, revolutionary profession. Dr. Ford envisioned an innovative role for nurses where they could assess, diagnose, and even treat medical conditions without physician oversight.Nursing Change Theory Essay.

Like a true trailblazer, her vision was a radical one: at that time, nurses could not even use stethoscopes! Fortunately, her idea was just crazy enough to work. In 1965, Dr. Ford and the University of Colorado started the nation’s first nurse practitioner program. Today, nurse practitioners act as independently licensed health care providers. They offer an high-quality, cost-effective solution to increasing access to healthcare for millions of Americans.Nursing Change Theory Essay.

For detailed information on nursing history read Fairman’s Making Room in the Clinic: Nurse Practitioners and the Evolution of Modern Health Care. A succinct overview of our history can be found in Part I of Nurse Practitioners: The Evolution and Future of Advanced Practice. One of my favorite texts on historical knowledge is A History of Nursing Ideas by Andrist, Nicholas, and Wolf.Nursing Change Theory Essay.

Biopsychosocial Knowledge

What is extraordinarily special about nurse practitioners is that they are educated in both biophysical and psychosocial knowledge. Our profession integrates information accumulated from a variety of disciplines including biology, physiology, psychology, and sociology. In fact, this beautiful, holistic blend of knowledge is what brings many people to the field.Nursing Change Theory Essay.

As a freshman in college, I was pretty much clueless about what I wanted to do for the rest of my life. I ended up taking a personality test that left me ever more baffled. It told me that the best four professions for me were graphic designer, physician, researcher, and criminal profiler. As I was searching through majors I stumbled upon nursing and noticed that I would be required to take a variety of natural science, social science, and research-oriented courses. Bingo! A perfect blend of empirical and human science.Nursing Change Theory Essay.

Sadly, the public often misunderstands nursing education. I once had a family member criticize my profession for “not taking any real science classes.” Before that moment, I had mistakenly assumed that people regarded my career as highly as I did. My gut response was, “What do you think I studied for 8 years?”Nursing Change Theory Essay.

To set the record straight, nurses and nurse practitioners undergo extensive education in natural, social, and research science. Table 2 lists some of the courses within these categories that I was required to take in my BSN, MSN, and DNP programs.Nursing Change Theory Essay.

Organizational Knowledge

Organizational knowledge and systems thinking add an essential dimension to nursing science. Nurse practitioners understand that organizations are systems in motion with complex relationships between many different parts. Our knowledge encompasses all levels (micro, macro, mega, and meta) of organizational systems, and we integrate this understanding to seek solutions to the major problems impacting patient care.Nursing Change Theory Essay.

• Microsystem: direct patient care
• Macrosystem: hospitals, long-term care facilities, clinics
• Megasystem: American health care system
• Metasystem: economic, political and social level of society

Nurse practitioners use organizational knowledge to function effectively within complex systems and to provide high-quality care. For example, we acknowledge that a majority of medication errors are not the fault of any one person or event. Rather, these errors are the result a flawed system of medication administration used by the entire organization. Nurse practitioner education prepares us to critically analyze the healthcare system, discover inefficiencies and errors, and craft solutions.Nursing Change Theory Essay.

In my DNP program I read a fascinating book about systems thinking by Peter Senge titled, The Fifth Discipline: The Art & Practice of The Learning Organization. Chapter 2 in Zaccagnini and White’s Doctor of Nursing Practice Essentials describes how nurse practitioners can use organizational knowledge to improve the health care system. Finally, a popular book by Clayton Christensen titled The Innovator’s Prescription: A Disruptive Solution for Health Care critiques the current means of healthcare delivery.Nursing Change Theory Essay.

Change Theory was developed by Kurt Lewin and it seeks to explain how change occurs using a three-step model. It makes use of equilibrium, restraining forces and driving forces as major concerns balanced in directing change through the three steps of unfreezing, change and refreezing (Zaccagnini & White, 2017).Nursing Change Theory Essay.

Does change occur according to a theory of change?

Change within the organization occurs according to Lewin’s Change Theory. It begins with unfreezing, which involves shaking up the older procedures and processes having identified them as faulty or somehow counterproductive. At this point, the different stakeholders are convinced that the change is necessary with all forms of resistance identified and addressed. Nursing Change Theory Essay.At this step, the equilibrium is broken. The second step involves implementing the change by focusing on behaviors, feelings and thoughts. The proposed change is implemented at this step then evaluated for performance as intended with revisions made to improve its performance while reducing the negative impacts. Once the change has been determined as having a positive effect, the process moves to the third stage of refreezing. At this point, the change is established as a new habit at the organization and becomes normal habit (Zaccagnini & White, 2017).Nursing Change Theory Essay.

How has organizational change personally effected your work environment in the emergency department?

Change can have different effects on the work environment. Firstly, it introduces change related stress as the personnel must learn the new way of doing things and apply that change. This could even result in some of the personnel experiencing work-life conflict. Secondly, it affects attitudes and experiences to include changes in job satisfaction, trust in the organization and employers, and turnover intentions. Thirdly, it could affect personnel cynicism and skepticism to change outcomes with some of them expecting success while others expect failure (Helming, Shields & Avino, 2020).Nursing Change Theory Essay.