THEORETICAL FOUNDATIONS OF NURSING; A. ENVIRONMENTAL THEORY I think ones feelings waste themselves in words; they ought all to be distilled into actions which bring results. Florence Nightingale (1860) Florence Nightingale defined Nursing as the act of utilizing the environment of the patient to assist him in his recovery (1860/1969), that it involves the nurse’s initiative to configure environmental settings appropriate for the gradual restoration of the patient’s health, and that external factors associated with the patient’s surroundings affect life or biologic and physiologic processes, and his development. Environmental Factors Affecting Health Defined in her environmental theory are the following factors present in the patients environment: pure or fresh air pure water sufficient food supplies efficient drainage cleanliness light (especially direct sunlight) Adequate ventilation has also been regarded as a factor contributing to changes of the patients process of illness recovery.

Any deficiency in one or more of these factors could lead to impaired functioning of life processes or diminished health status. She also emphasized in her environmental theory is the provision of a quiet or noise-free and warm environment, attending to patients dietary needs by assessment, documentation of time of food intake, and evaluating its effects on the patient. Nightingale believed that the environment was the major component creating illness in a patient; she regarded disease as the reactions of kindly nature against the conditions in which we have placed ourselves. Her theory Contains three major relationships: environment to patient nurse to environment nurse to patient

B. INTERACTIVE THEORIES INTERPERSONAL RELATIONS THEORY The kind of person that the nurse becomes makes a substantial difference in what each patient will learn as he or she receives nursing care. Hildegard Peplau (1952) She defined Nursing as an interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help. Dr. Peplau emphasized the nurse-client relationship as the foundation of nursing practice. At the time, her research and emphasis on the give-and-take of nurse-client relationships was seen by many as revolutionary. She described the nurse-patient relationship as a four-phase phenomenon. Each phase is unique and has distinguished contributions on the outcome of the nurse-patient interaction.

Phases Of Nurse-Patient Relationship;

1. Orientation Individual/family has a felt need and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase.

2. Identification Where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate professional assistance.

3. Exploitation The nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services.

4. Resolution Where patients needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person.

Nursing Roles In the course of the nurse-patient relationship, the nurse assumes several roles which empower and equip her in meeting the needs of the patient.

1. Stranger Role: Receives the client the same way one meets a stranger in other life situations; provides an accepting climate that builds trust.

2. Resource Role: Answers questions. Interprets clinical treatment data, gives information.

3. Teaching Role: Gives instructions and provides training; involves analysis and…


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