By Z. Zapotek. Massachusetts Maritime Academy.

As this is not a book about philosophy discount atorlip-20 20mg fast delivery, descriptions of these movements are brief and simplified purchase 20 mg atorlip-20 visa, and readers are encouraged to pursue their ideas through further reading. The label ‘humanism’ has been variously used throughout human history, probably because its connotations of human welfare and dignity sound attractive. The Renaissance ‘humanistic’ movement included such influential philosophers as Erasmus and Sir Thomas More. In this text, however, ‘humanism’ is a specifically twentieth-century movement in philosophy led primarily by Abraham Maslow and Carl Rogers. The humanist movement, sometimes called the ‘third force’ (the first being psychoanalysis, the second behaviourism), was a reaction to behaviourism. Playle (1995) suggests that the art-versus-science debate within nursing is an extension of the humanistic-versus- mechanistic (i. Behaviourism The behaviourist theory was largely developed by John Broadus Watson (1878–1958) who, drawing on Pavlov’s famous animal experiments, stated that if each stimulus eliciting a specific response could be replaced by another (associated) stimulus, the desired response (behaviour) could still be achieved (‘conditioning’) (1998 [1924]). The behaviourist theory enabled social control and so became influential when society valued a single socially desirable behaviour. Thus behaviourism focuses on outward, Humanism 9 observable behaviours and for behaviourists, learning is a change in behaviour (Reilly 1980). Holloway and Penson (1987) have suggested that nurse education contains a ‘hidden curriculum’ controlling the behaviour of students and their socialisation into nursing culture. Through Gagne’s (1975, 1985) influence, many nurses have accepted and been acclimatised into a behaviouristic culture without always being made aware of its philosophical framework. Hendricks-Thomas and Patterson (1995) suggest that this behaviouristic philosophy has often been covert, masked under the guise of humanism. Thus using aspects from humanism, such as Maslow’s hierarchy of needs in Roper et al. Behaviourist theory draws largely on animal experiments; but humans do not always function like animals, especially where cognitive skills are concerned. Thus if internal values remain unaltered, desired behaviour exists only as long as external motivators remain (see Chapter 48). Options: explanation (cognitive) accepting extubation analgesia and sedation (control) restraint (e. Nevertheless, description remains deliberately behaviouristic, seeing the problem as behaviour (extubation). While extubation causes justifiable concern, behaviour is a symptom of more complex psychology. Until underlying problems are resolved, they remain problems; restraint only delays resolution. Intensive care nursing 10 No philosophy is ideal for all circumstances, and few are without some merit. In this scenario, behaviourism may justifiably ‘buy time’ until underlying pathophysiology is resolved or reduced, when extubation will no longer be a problem, and may be medically desirable. Behaviourial approaches can be useful, but they can also be harmful by dehumanising others to a list of task-orientated responses. Smith (1991) found that preregistration courses still emphasised task-orientated, rather than holistic, nursing. Nurses should analyse their values and beliefs, understanding the implications they have for practice, and selecting appropriate approaches to each context; this is, after all, an extension of individualising care. Humanism The humanist movement was concerned that behaviourism overemphasised animal instincts (and relied too heavily on animal experiments) in an attempt to control outward behaviour. Hence humanism emphasises inner values that distinguish people from animals and is a ‘person-centred’ philosophy; rather than emphasising society’s needs, humanism emphasises the needs of the individual self. Maslow’s Motivation and Personality (1987 [1954]) popularised the concept of ‘holism’ (the whole person). Humanists believe that people have a psychological need to (attempt to) achieve and to realise their maximum potential. Maslow (1987[1954]) described a hierarchy of needs, self-actualization being the highest of these; Roper et al. However, adopting primacy of the individual, inherent in humanism, conflicts with the objective decontextualisation of traditional scientific methodologies (Playle 1995), raising difficulties when undertaking humanist research, as exemplified by debate surrounding qualitative and quantitive nursing research. Emphasis on inner values led humanist educationalists to concentrate on developing and/or attempting to change inner values: values that are internalised will continue to influence actions after external motivators are removed. Thus, changes in nursing practice made in order to conform with the desires of another may not continue after that person has left, or even when absent (e. Concern for inner values and holistic approaches to care makes humanism compatible with many aspects of healthcare and nursing, although over-familiarity with terms can reduce them to clichés. Humanism has much to offer nurses in the process of analysing their philosophies of care and practice, but ideas should not be accepted uncritically. Lifelong learning Where the aim of behaviourist education was to achieve conformity, humanist education sought to promote individuality, and these differences are reflected in the training-versus- education debate.

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Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care purchase 20 mg atorlip-20 amex, 7th Edition generic 20 mg atorlip-20. Morita has the right to a urinary assessment to speaks, even when directly approached. He has determine if there are any underlying causes either refused to participate in any of the floor social physical or psychological for the incontinence. Nursing strategies Health Problem: Toileting self-care deficit could be implemented to promote urinary Etiology: Depression on entering nursing home and continence prior to inserting a urinary catheter. If decreased will to live these measures fail, the nurse might suggest using a Signs and Symptoms: Incontinent of both urine and condom catheter for Mr. Morita as a possible alter- stool during the day and night (need to determine native, rather than an indwelling catheter, which the frequency); alert and capable of recognizing and would increase his risk for infection. The nurse signaling the need to void/defecate; able to walk to could also look into home healthcare personnel for bathroom with assistance the couple to assist with toileting and/or light Expected Outcome: Within 2 weeks (6/17/11), patient housekeeping. What would be a successful outcome for this priately, as evidenced by reduction in incontinent patient? Morita expresses satisfaction patient in which he is assisted to the bathroom; with urinary strategies to promote continence and use these interactions to reinforce the importance receives outside help in the home. Refrain from using adult incontinent pads or in ethical/legal competencies are most likely to bring any way communicating that incontinence is about the desired outcome? Call an interdisciplinary conference to develop ology of the urinary systems and developmental a strategy to ease his transition to the home. What resources might be helpful for the Morita to the home and importance of independence. Patient strengths: Patient is alert and capable of urinary incontinence and care of urinary catheters expressing his needs for assistance. Objective data are underlined; subjective data are in Personal strengths: Good knowledge of boldface. Eisenberg, age 84, was admitted to a nursing the elderly; experienced counselor and teacher of home when his wife of 62 years died. He has two appropriate self-care measures adult children, neither of whom feels prepared to 4. When asked why he did not “After he retired from his law practice, he was ask for assistance to get to the bathroom, the terribly demanding, and it just seemed nothing patient refused to answer. His Parkinson’s dis- with the toileting regimen, and when taken to the ease does make it a bit difficult for him to get bathroom voids/defecates as needed. Will continue around, but he’s able to do a whole lot more to counsel regarding the importance of his than he is letting on. Eisenberg is reevaluate his ability to recognize the need to frequently incontinent of both urine and stool dur- void/defecate and ask for assistance. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Direct manipulation of the bowel during surgery inhibits peristalsis, causing a condition termed paralytic ileus. Developmental considerations: The stool char- b h f e g c a d acteristics of an infant depend on whether the infant is being fed breast milk or formula. Transverse (single B) colostomy—soft appearance of the stool—for instance, iron d. Ascending colostomy—soft to liquid salts result in a black stool from the oxidation e. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. The patient will explain the relation between constipating effects of the medication on Mr. The patient will relate the importance of that he should eat to stimulate peristalsis. Nursing timing, positioning, and privacy to healthy interventions to remove the fecal impaction in a bowel elimination. Diarrhea: Prepare and store food properly, avoid in his diet to prevent constipation highly spiced foods or laxative-type foods, By next visit, Mr. Cobbs verbalizes having regular, increase intake of low-fiber foods, and replace pain-free bowel movements lost fluids. Flatulence: Avoid gas-producing foods such as ethical/legal competencies are most likely to bring beans, cabbage, onions, cauliflower, and beer. Ostomies: A low-fiber diet is usually Intellectual: knowledge of the anatomy and physi- recommended, although patients may ology of bowel elimination and variables, such as experiment with their diet to determine how medications, that influence bowel elimination much fiber they can tolerate. Abdominal settings: Lying in a supine position, fecal matter in a safe and competent manner tighten and hold the abdominal muscles for 6 Interpersonal: ability to interact in a nonjudgmen- seconds and then relax them. Repeat several tal and professional manner when interacting in sit- times every waking hour. Thigh strengthening: Flex and contract the private matter thigh muscles by slowly bringing the knees up Ethical/Legal: adherence to safety and quality when to the chest—one at a time—and then lowering performing nursing interventions to promote bowel them to the bed.

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Health Care for Women International discount atorlip-20 20mg, for developing nursing science cheap atorlip-20 20 mg otc, and then de- 13(1), 67–76. Assessing patient self-care for side effects of mented in the literature today supports the cancer chemotherapy—part 1. Patterns of self-care in cancer patients re- ity of the theory for the profession in guiding ceiving radiation therapy. Oncology Nursing the research and scholarship of nurses world- Forum, 24(6), 983–990. Meten van zelfzorg: Verpleegkundige instru- Proceedings of the International Research Congress. Unpublished doctoral dissertation, of patient-environmental factors among nursing home resi- Wayne State University, Detroit. Issues in and validity testing of Finnish version of the appraisal of self- Comprehensive Pediatric Nursing, 13, 253–264. Unpublished doctoral dissertation, Wayne State model for the identification of nursing requirements in a selected University, Detroit. Self-care actions of healthy, middle-aged tic self-care demand and self-care agency in individuals with women to promote well-being. Measuring the self-care practice of children quacy of a health promotion self-care interview guide with and adolescents: Instrument development. Maternal Child healthy, middle-aged, Mexican-American women: A pilot Nursing Journal, 23(3), 101–108. The contribution of personality to adult concept and self-care in children with cancer. International research project to test Nephrology Nurses Association Journal, 18, 45–47, 53. Concept for- of scientific session of the 29th Biennial Convention of Sigma malization in nursing: Process and product (2nd ed. Structuring nursing practice based on Orem’s ated by chemotherapy patients in response to fatigue. Family culture, family resources, depend- Nursing Administration Quarterly, 15(3), 72–78. A case study: Perspectives on a self-care nary artery bypass surgery, a prospective study. Primiparas’ prenatal concern for learn- effects: A programme of inquiry within Orem’s self-care ing infant care. Nursing assessment for risk of homicide Dutch version of the appraisal of self-care agency scale: with battered women. Self-care actions taken by older adults for in- care agency in people beginning a weight loss program. Response to “Predictors of children’s self- of elderly client and nurse perceptions of the clients’ self-care care performance: Testing the theory of self-care deficit. Perceptions of chemotherapy: An assessment of nursing interventions— self-care in Sweden: A cross-cultural replication. Measuring informational intervention for chemotherapy knowledge and self-care behavior. Using self-care the- dational capabilities, and urinary incontinence self-care in ory to guide nursing management of the older adult after hos- women. Appraisal of self-care agency scale: Validity and strument to measure exercise of self-care agency. The nursing preparation of stoma patients for home visits to elderly people by community nurses in the self-care. Assessing and teaching self-care cancer-related fatigue: Refinement and evaluation of Orem’s to youths with diabetes mellitus. Validation of an instrument to measure ex- Conceptualizations and operationalizations. Journal of Adolescent acting variable with self-care agency: Testing a theoretical Health Care, 9, 55–60. Journal of ment to measure mothers’ performance of self-care activities Gerontological Nursing, 17(6), 39–43. A nursing practice theory in three parts, independent elderly: Self-concept affects well-being. Archives of Psychiatric Nursing, 6, ated by chemotherapy patients in response to fatigue. Dependent care, caregiver burden, and tor analysis of Bickel and Hanson’s questionnaire. The health-promoting self-care system concept of women’s self-care developed within Orem’s self-care model: Directions for nursing research and practice. Journal deficit theory: Instrumentation, psychometric evaluation and of Advanced Nursing, 15(10), 1162–1166. Malinski Introducing the Theorist Introducing the Theory Separate Theories Implicit in Science of Unitary Human Beings Summary Bibliography Introducing the Theorist guides practice to promote health and well-being for humankind.

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