Borrowed (non-nursing) Theories Applied to the Nursing Profession

While the focus of this course is nursing theory, frequently the use of non-nursing or borrowed theories occurs. Select a nursing practice area (i.e. education, executive, advance clinical practice, informatics, and health care policy); then identify a non-nursing (borrowed) theory; and apply it to the area you have selected. Be sure to provide an example of how the non-nursing theory can be used to enhance the selected practice area. Don’t forget to include scholarly reference(s) to support your information.

Borrowed (non-nursing) Theories Applied to the Nursing Profession

While caring for patient nurses often learning and using nursing theory as a great resource, there are many theories that not specific for nurses but still provides valuable and useable information. My selected nursing practice is Nurse Practitioner (NP). NP is advanced practice registered nurses that work auto-mostly and collaborate with other healthcare professionals to provide patient focused care (Woten & Karakashian, 2017). NP help patient and their family in managing illnesses, provide education on prevention care, conduct checkup, making sure that patient is safe. NP using nursing theories in their practice to promote patient care, increase knowledge and skills and may also use theories that not consider nursing theory such as Maslow’s hierarchy of needs. Maslow’s theory focuses on the idea that human act toward goals which mean that any behavior could satisfy many functions at the same time, for example, going to the gym might help patient with social interaction, self-esteem and improve health (Mennella & Holle, 2017). Maslow’s hierarchy of needs have five levels that includes self-actualization, self-esteem, belonginess, safety and physiological needs. Nurses applying Maslow’s theory in their practice even when it is not a nursing theory.

Borrowed (non-nursing) Theories Applied to the Nursing Profession

Self-actualization needs focus on personal potential and growth, in this case NP teaching and motivating patient to care for themselves and take control on their own illness.

Self-esteem focus on self-esteem for oneself such as dignity and independence, self-esteem for gaining respect from other. NP treat patient with respect at all time and impowering them to take control on their own illness so they will be able to care for themselves when they are at home. NP respect patient’s values and beliefs, working with patient on future goals as a team.

Borrowed (non-nursing) Theories Applied to the Nursing Profession

Belonginess focus on trust, friendship, affection and love. NP should always consider belonginess when caring for patient. NP should establish nurse patient relationship based on trust and include patient’s family in the care.

Safety focus on security and protection. NP protect patient from actual and potential harm and encouraging spiritual practice and making sure that patient understand everything regarding care and any procedure. NP should educate patient on their illness how to control and maintain their diseases as well as medications with side effects.

Physiological needs include basic needs such as food, drink, shelter, sleep etc. On assessment NP focus on patient basic needs, for example, NP assess patient oxygen level, oxygen consider as the most essential basic survival needs, without oxygen in bloodstream patient will die. Nutrition as well play important role in patient health and must be address by NP when patient not eating or not getting enough nutrient.

Borrowed (non-nursing) Theories Applied to the Nursing Profession

In the healthcare setting focus of theory typically leads to those that are nursing related theory. Non-nursing theory can also provide a variety of concepts that will align with that of clinical practice as well. Executive leadership utilizes many theories as they lead an organization and look for ways to be strategic in that endeavor. From a leadership perspective if you continue to do business the way it was done yesterday it will be done that way tomorrow and continue to get you the same results. You must want to be the best and change is part of that progress. One model that I have used is Kurt Lewin’s theory of planned change. I have always looked at change as progress and healthcare is an evolution of change. Lewin’s view was that if one could identify the potency of forces, then it would be possible not only to understand why individuals, groups and organizations act as they do, but also what forces would need to be reduce or reinforced to bring about the change so desired (Shirey, 2013). He developed a model with three stages through which the identified champions of change must proceed before change can become engrained in culture; unfreezing, moving, and refreezing (Mitchell, 2013). Unfreezing is where the status quo is examined and helps you identify what needs to be changed (Mitchell, 2013). Moving is the step where you will identify your change champions, implement and test the change, and make the desired changes (Mitchell, 2013). The final step of Lewin’s model is refreezing in which the changes you made after trial and error become permanent with the implementation for the new way of doing business and you reward the team for achieving the desired outcomes (Mitchell, 2013). With much emphasis on outcomes and processes I utilize this model for change often. If we don’t continue to stress the importance of nursing theory or models then we are not providing our nurses with the number of tools at our disposal. Theory will aide in success by providing a much wider band width of knowledge that could ultimately transpire into better patient care and outcomes. If the focus is moving more towards things that are measurable then we must remember that patient satisfaction or HCAHPS and outcomes are all things that are measured with value based purchasing and the utilization of theory can have an indirect impact on that.

Lewin’s theory of planned change is applicable to one of the most important aspects of patient care, the patient experience aspect. Kurt Lewin developed a model with three stages through which the identified champions of change must proceed before change can become engrained in culture; unfreezing, moving, and refreezing (Mitchell, 2013). This example is just one in which executive leadership can lead a positive change in patient satisfaction. Unfreezing is where the status quo is examined and helps you identify what needs to be changed (Mitchell, 2013). Unfreezing occurs each time the satisfaction benchmarks for their facility are reviewed by the Executive Leadership Team. The second phase of the review but still in stage one of the change model is when leadership does walking rounds throughout the facility and watches the interactions taking place between care provider and patient. This is where the status quo can be witnessed and validation if scores are low that there is a need to change processes or behaviors. Moving is the step where you will identify your change champions, implement and test the change, and make the desired changes (Mitchell, 2013). This second phase of moving is where leadership will identify change agents that will champion the initiative to make positive changes and will put the whole team through customer service training if identified as a need. The final step of Lewin’s model is refreezing in which the changes you made after trial and error become permanent with the implementation for the new way of doing business and you reward the team for achieving the desired outcomes (Mitchell, 2013). This will occur only after the staff is educated, competency validated, and behavior change is palpable. This final stage will also include leadership rounding on the patients in the hospital and rounding on the staff. It will also include reviewing the patient satisfaction scores more real time and monitoring movement. Part of the rounding on the patients will be a great opportunity to real time correct behaviors or reward those that are doing excellent work. Providing feedback to the team is essential in creating a productive, inclusive, transparent patient care environment which in turn increases results.

Kurt Lewin developed the Change Theory. People grow and change throughout their lives. This growth and change are evident in the dynamic nature of basic human needs and how they are met. Change is a constant and continuous. It is manifested in both everyday occurrences and more disruptive life events. This theory has three stages (Schein, 1999):

Unfreeze Stage- In this stage preparation for the impeding change is important. Understanding that the change is necessary and getting the steps in place for the change to occur.

Transition Stage- This stage is the inner movement that we make in reaction to change. This stage is the most challenging. There is no set time limit for this stage.

Freezing Stage- In this stage, stability is established with the new changes. The changes become the new norm and are accepted.

My example is going to be in advanced clinical practice.

Jim is a 58-year-old patient that came into the hospital with a diabetic foot ulcer and elevate A1c. When the nurse practitioner (NP) came into the room to discuss the plan with Jim and his wife he stated, “I know my diet is not the best. I am just not sure what I can eat and what can’t” (unfreeze stage). The NP sent in a nutritionist to provide education. When she came back, the patient was telling her what healthy dinners he was going to cook and how excited he was to go grocery shopping for healthy foods (transition stage). At Jim’s 2 month follow up appointment he had lost 12 pounds. He told the NP that he does not miss his fried food and the few times that he had eaten them he felt miserable for the rest of the day and does not have the craving for them anymore (freezing stage).

It was important for the NP to know that Jim has to realize that he needs to change and that he has to visualize the change for himself before he can take action.

Thanks,

References

Mitchell, G. (2013). Selecting the best theory to implementing planned change. Nurisng Management, 20(1), 32-37.