Metapardigm concepts of nursing Essay

Introduction.The purpose of this assignment is to distinguish and explore one of Jacqueline Fawcetts (1984) metapardigm concepts of nurse that she identifies as cosmos concepts primaeval to nursing and explore how this is show in Judith Christensens (1990) Nursing fusion Model. The following discussion seeks to analyse the metaparadigm concept of psyche fit in to Christensen (1990).To facilitate this, it is important to disc everywhere what is dream upt by metaparadigm and to further explore what a abstract imitate is. This bequeath lead to a better understanding of what Fawcett cogitates by the 4 metaparadigm concepts of nursing.Within the development of nursing theories, there is recognition of common themes and concepts. A concept of a subject is related to the focusing it is viewed and arouse be a way of classifying a theme when applied to a particular argona (Pearson, Vaughan & Fitzgerald, 1997). Fawcett (1984) identifies the cardinal main concepts or themes ce ntral to nursing as including wellness, environment, someone and nurse. These four concepts, the recurring themes and the inter-relationships between them are described as nursings metaparadigm.Metaparadigm is the combination of two words, meta and paradigm. According to Mosbys (1994) definition, Meta, washstand mean either after or next or change or exchange. Mosbys (1994) defines Paradigm as a pattern that may serve as a model or example. Chin & Jacobs (1987) variantiate paradigm as, a gener whollyy accepted world view or philosophy, a framework or structure at heart which theories of the written report are organized. According to Fawcett (1984), a metaparadigm of a discipline is a grouping of statements identifying its phenomena in a global rather than specific way. Metaparadigm is the most global perspective of a discipline and acts as an encapsulating unit or framework, within which the more restrictive structures work (Fawcett, 1984, p.5).A conceptual model focuses on the main points of relevance whilst rulingothers to be less important within the metaparadigm. A conceptual model has a set of concepts and statements that allow integration of them into a meaningful configuration. Mosbys (1994, p.273) description of conceptual model (framework) as, a group of concepts that are broadly defined and systematically organised to provide focus, rule and a tool for the integration and interpretation of information.In seeking to clarify the meaning and what is meant by the four metaparadigms, Fawcett (1984) describes the wellness concept as the relationship of a somebodys degree of illness or wellness. The concept of environment is and includes the skirts or scene the person moves in and interacts with e.g. home, work, roles, socio-economic status and the pattern of the persons life in relation to these issues. The concept of person is any identity that receives health care, and may include an individual, a family (whanau) or a community (hapu or iw i). Lastly, the concept of nursing is the giver or provider of health care and the activities the nurse undertakes that enables this giving to breathe. This may include an individual or a system (Fawcett, 1984).Metaparadigm conceptPerson -the work of the breakuring.Normal life for a person encompasses the ability to effect a wide range of activities, including those activities of daily living such as for caring for ones own individual(prenominal) take, activities that allow social interaction and other activities which enable the person to live and grow (Pearson et al. 1997). If however, when a person becomes hospitalised and the hospital in turn becomes the persons home, the person necessitate to relinquish roles and norms and put themselves in the care of hospital staff. The person leaves their familiar surroundings and subsequently withdraws from the full expression of the persons usual social roles (Christensen, 1990).The Beginning phaseIn reaching the point where the per son finally reaches the closing to become dependent on a medical expert outhouse be a long and stressful process. complaint is not seen to begin merely when the person encounters a health professional, rather in this lies a signifi flush toilett period of stopping point making and self directed treatment in an run by the person to control the illness, bring about symptomatic relief and leading to self ameliorate (Morse & Johnson, 1991). The person may have lived with a period of suffering from ill health for some metre be get along it may not have appeared to be life threatening and one just coped with the symptoms.Christensen (1990, p.50) quotes an example of a person with a history of childhood urinary tract infections. I just get pestiferous kidney infections -you know -I can hardly walkI just know when its coming and when its goneI used to go to the Dr. all the timefeed me some more attack -antibiotics and stuff Reaching the point were the person initiates medical hel p might be something they have considered and deliberated all over for some time, because they known that something just isnt quite right, besides might have put off due to a fear of the unknown.When the person decides to engage in some form of intervention, the person becomes concern putting their life of normality on hold. They reach a point where they believe the right decision has been reached and they are ready to hand themselves over to the health experts. The person continually recounts and relays each new bring to others. This may include, friends, family or other people who are sharing similar experiences. Such information is share many times with added information shaping and retesting issues as further information is discussed with the health care professionals. By the time the hospital admission takes place, the person has shared and thus interpreted their experience (Christensen, 1990). This does not mean that a person undergoing hospitalisation suffers no anxiety level(p) when that person has become prepared for the output.Taylor, Lillis & LeMone (1993), comprise that even from the point of admission into a health care setting, the individual experiences a range of emotions including, anxiety, muddiness and concern related to unmet and unfulfilled role obligations left behind.Settling In phaseIt takes courage and durability to assurance other, for the unhurried this faith is often placed in a stranger, this can be a trying experience and can jeopardise emotional security. While the person may have met their regenerate to begin with, it is remedy a burden to place such trust in someone elses work force. unrestrained stability, trust and security are desirable and need to be met for the persons admission into the health care setting (Taylor et al. 1993). Assisting the person to understand and identify ward routine can supportively work out this. Christensen (1990, p.66) quotes a patients response after having been shown round a ward. Im decision it some(prenominal) easier.I know whats sort of going to happenI think cognize what the routine was is quite helpful. It becomes necessary for the person to reveal significant information of a personal disposition to members of the health care team. Such disclosure becomes an accepted norm even though this may occur between the person and many strangers numerous times each day. Being able to shed solitude and attend to personal activities in front of others and submitting to intrusion, shows that the person acknowledges the legitimacy of health care workers (Christensen, 1990). The partnership real between the person and nurse further compounds this, creating a olfactory perception of goodwill and concern for one another (Christensen, 1990).Negotiating the Nursing Partnership phaseThe person now looks for techniques that establish a sense of control and project inclusion in what is going on. The person now reaches a point whereby there is sense of trust a nd acquiescence, however the person may attempt to give legitimacy to the situation by trying to cover inhibitions or lack of control by taking personal responsibility for the outcome of the intervention (Christensen, 1990). In doing so, the person becomes part of the health care team.The person accepts submission to necessary rules and procedures of the health care environment, but it is not always passive. Christensen (1990, p.87)highlights this by quoting one of several patients. My priorities are to make sure I do my bit to make sure this works out because the surgeon has done his bit and the nurse can put drops in. I think the main thing is my own action -not being stupid over the thing, not bending down or jerkingThe person is required to meet many different health care workers. In doing so, the person attempts to co-operate and affiliate with these people while acquiescing to their expertise, fitting in and retaining liberty (Christensen, 1990). Health professionals and the person must establish a partnership and involvement with one another needs to recognise multiple identities and these need to fit together and be complimentary (Beck, 1997).However, acquiescing may be associated with a sense of powerlessness in the presence of the expert person, particularly the surgeon. (cited in Christensen, 1990 p.97). If a person has trust and confidence in that expert then submission is willingly given (Christensen, 1990). It could be said that the person is the real expert as they are the only one who really knows the role of the patient and context with which that experience occurs. The person has a life foreign the health care setting that they will insure when they leave. The health care team in turn, will remain behind (Christensen, 2001, personal communication).Even though a person enters into the health care setting, there can be no assumption that they are totally prepared or agreeable to intervention. New or conflicting information or coping with a n unknown environment can raise doubts and that the former consent obtained was quite tenuous (Christensen, 1990). Christensen (1990, p.90) quotes one patient as saying it came as bit of a surprise to me when I saw him hospital before the operation, the very day before, when he explained about this vision and that night I didnt sleep to well. I thought about it quite a bit and thought am I doing the right thing?Additionally, communication between health care personnel and the person is of great importance, anxiety can chair if there is a sense that information is being withheld. The person may adopt the good patient role, which is then subsequently reinforced by staff (Curtis, 2000). The good patientrole is seen as being counter productive to a good recovery. If the person does not take an active role in their own care, it may lead the person to not report a change in symptoms (Curtis, 2000).Patients may finger that by maintaining an outward sign of composure they will invoke a si gnificant feeling of control. Endeavouring to maintain such composure underlies many behaviours of the hospitalised person, such as using humour in a frightening situation to mask nervousness (Christensen, 1990). Christensen (1990, p.92) quotes a number of patients with comments similar to the following that utilise humour. cogitate operating all day I certainly wouldnt like to be at the end of the day if he wasOh, whos this one? Arm? Leg?Additionally attending to such activities as personal grooming to the persons usual standard can be another way of maintaining a sense of normality and composure (Christensen, 1990). Roy & Roberts (1981) theory of the person as an adaptive system which puts forrad the idea that each person is a system utilising adaptive behaviours to meet changing environmental needs by assuming coping mechanisms (cited in Fawcett, 1984, p.85).Hardship of a temporary nature whilst the person negotiates the exit is an expectation and is generally accepted as part of the process (Christensen, 1990). Pain experienced within the health care setting is expected and tolerated, where as this might not be the case were such an event to occur within the persons home. Pitts & Phillips (1998) say there is little doubt that surgery will involve prognostication of pain for a person, due to the use of needles or knives, or other discomforts post operatively.These things can cause stress but this combined with anxiety and coping maybe extremely hard for the patient even when expected (cited in Curtis, 2000, p.82). if I sort of move it around, it can ache a bit. Its got a suggestion of a little bit of stingingcertainly nothing uncomfortable that I cant tolerate Christensen (1990, p.104)Once the effects of surgery lessen, the person feels a sense of hope that all is well and the time of discharge is nearing. The person may start to feelthat they are expert tolerable to assist in meeting the persons needs. There is development of expertise and wisdom surr ounding the persons condition and this gives rise to being able to self-care in the future (Christensen, 1990).Going alkali phaseDischarge from the health care setting does not always indicate a return to life as it was before admission. It maybe just a step on the road to recovery, with much work yet to be done (Christensen, 1990). A cardiac rehabilitation study by gaiety Johnson (1988) identified some of the participants as raring to go but were mindful of the need to not overstate it and were aware that life would not be the same (cited in Morse & Johnson, 1991, p.43).Travel arrangements, arranging plans for care, breeding about self medication and understanding what to do and recognition of emergency signs and symptoms are all jobs the person must learn in preparation for discharge. Not all persons being discharged experience positive feelings some negative reactions emerge when a person readies to go home (Christensen, 1990). I think you feel as though you are in a differen t world. That world is going on outside and youre in this one and it takes a little while to adjustyou miss it all Christensen (1990, p.152). coagulate realisation that their own life may in fact be in their own hands can empower the person to plan, anticipate ahead improving their own outcome. Not withstanding the person is still under the influence of the health care professionals who have instructed them in ways to do this.However, the person can decide for themselves just how much and for how long they will be compliant with the doctors orders (Christensen, 1990). The final step is the recommencement of autonomy and self-management for the person. Torvan and Mogadon and aspirin -I was taking those and I thought its one of those that is giving me a head ache so Ive cut them off the last few nights. Christensen (1990, p.155)ConclusionFawcett (1984) identified four central themes of nursing which she described as nursings metaparadigm. Metaparadigm or generally regarded worldview of commonalities of nursing were identified as, including health, environment, person and nurse. The discussion focused on Christensens (1990) Model of Partnership in relation to the concept of person. The reader has been taken through the persons work which has identified within it specific phases. These phases include acceptance of illness or disease, reaching a decision for action, coping with entering and passing through a period within the context of a health care setting, and finally resuming life as it was prior to the episode of contact, or life as it be following such contact.ReferencesAnderson, K. N. Anderson, L. E. & Glonze, W. D. (1994) Mosbys Medical, Nursing and Allied Health Dictionary. (3rd ed.). Mosby, Missouri.Beck, C. S. (1997). Partnership for Health -Building Relationships Between Women & Health Caregivers. Lawrence Erlbaum Associates, London.Christensen, J. (1990). 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