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Nursing theory- Definition-

- Composed of a group of concepts that describe a pattern of reality, explains a process and is based on facts.

Nursing theory- Purpose-

- Provides a focus for nsg care activities, guides nurses by providing a knowledge base , organizes concepts, provides guidelines for practice, identifies nsg care goals that are holistic, promotes health and prevents illness.

Inductive Reasoning-

- builds from multiple ideas to conclude about one general idea.

Deductive Reasoning-

- examines a general idea and considers other actions or ideas.

Concepts-

- describes objectives, properties and events and the relationships among them.

Conceptual Framework/Model-

- a group of concepts that follow an understandable pattern.

Paplau 1952

-Interpersonal relationships model- proper development of a pt.'s personality is important to improve their personal and community living.

Henderson 1955

- definition of nursing- believed autonomous nursing led to self help concepts.

Leininger 1978

-cultural care diversity and universality theory- believed caring is the central theme and foundation for transcultural nsg, improving human conditions and the life process.

Orem 1971

- self-care theory- self care is essential for sustaining health or for recovering from illness or injury.

Roger 1970

- science of unitary human beings- nsg should focus on mobilizing inner resources, the patient is central to the discipline of nsg.

Roy 1974

- adaptation model- nsg is required when the pt. demonstrates poor adaptive responses.

Watson 1979

- human caring theory- promotion of holistic healing and human caring.

King 1971

- goals attainment theory- the nurse and pt. mutually set goals and agree on ways to reach goals.

Neuman 1979

- systems model- less stress can lead to less medical conditions.

Values clarification-

- process which one comes to understand their own values; a belief about the worth of something that guides one's behavior.

Personal values-

- a belief that individualizes a person.

Professional values and characteristics-

- behavior that shows concern for the well being of others ( accountability, altruism, autonomy, human dignity, loyalty)

Codes of Ethics-

- set in place to protect a pt. from incompetent, unethical and illegal practices. (ANA Code of Ethics for Nurses, The ICN Code of Ethics for Nurses 2006)

Consumer rights-

-informed consents, advance directives, autonomy/right to self determination, HIPAA,

Nurses' responsibilities-

-identify professional practice limitations, serve as pt. advocate, maintain professional competenece, inform, supervise and evaluate subordinates.

Teleological/utilitarian theories-

- Jeremy Bentham 1748-1832- An act is right if the outcome is good or does the greatest good for the people involved. example: a deformed baby is allowed to die to not be a burden on society

Deontological theories-

-Immanuel Kant 1724-1804- actions should be based on moral duty to fellow man ( universal, unconditional, imperitive) example: an abused/raped girl does not get an abortion

Egoism theory-

-Davis and Aroskar- a decision is right because the doer desires it and is comfortable with it.

Act Deontology-

- agents own moral values are involved.

Rule Deontology-

rules for judging morally are involved, usually a command of God.

Theory of obligation-

- Frankena- justice as fairness with the greatest benefit given to the least advantaged. "Veil of Ignorance"

Ideal observer theory-

- Firth- disinterested, dispassionate and consistent viewpoint of all information considered of the future consequence.

Veracity-

-to tell the truth and not mislead or deceive intentionally.

Fidelity-

- an obligation to be faithful to the agreement/ committment made ( concept of accountability)

Beneficence-

- olbligation to do good and not harm to others.

Nonmaleficence-

- prohibition of intentional harm.

Justice-

Fairness, treat like cases similarly.

Deception-

- lying.

Confidentiality

- respecting pt.'s personal information and not sharing it with others (diagnosis, medications, treatments...)

Paternalism-

-acting on behalf of a pt. without their consent to secure good or prevent harm.

Ethical dilemma-

- occurs when one must choose between two unfavorable alternatives.

Process of ethical decision making-

-Identify and Clarify problems, Gather data, Identify options, Make decisions, Evaluate outcomes.

Beginning of Life Ethical Issues-

-abortion( should be legal/illegal?) surrogacy(what if gestational mother is unwilling to give up child?), in vitro fertilization(what should be done with left over fertilized eggs?)

Sustaining Quality of Life Ethical Issues-

- organ donation/transplantation(who deserves it?) genetic screening(abort a genetically impaired fetus?) eugenics(unwillingly sterilize the "socially inadequate" to accomplish "human perfectibility"?) stem cell research( use the leftover fetus or cells from abortions)

End of Life ethical issues-

-euthanasia(illegal in every state) asisted suicide, DNR, withdrawal of nutrition and hydration, right to die(legally recognizes client's right to refuse treatment)

Euthanasia-

- illegal- Negative euthanasia- "no codes" "DNR" Positive euthanasia - Prescription drugs result in death.

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