Nursing Philosophy And Conceptual Framework Essay Example For College

Introduction

A visual representation of the concepts that guide a nurse’s practice is important to understand a person’s conceptual framework. The purpose of this paper is to present a conceptual model developed with reference to the personal philosophy of nursing. The synopsis that explains the components of the model is provided in the second part of the paper.

Conceptual Model

Figure 1 provides a conceptual model that represents how specific concepts of nursing can be interrelated and connected according to personal philosophy. The presented concepts can be viewed as the most important ones to guide personal practice. The model is based on Jean Watson’s Theory of Human Caring.

Conceptual model.
Figure 1. Conceptual model.

Synopsis

The conceptual model presented in Figure 1 demonstrates how the personal philosophy of nursing is based on understanding the key elements of the metaparadigm of nursing while interpreting them through the lenses of Watson’s Theory of Human Caring. From this point, the nursing paradigm, which includes person, health, nursing, and environment, is the base or foundation for this personal conceptual framework (Alligood, 2014). However, these key concepts are reconsidered from the perspective of Watson’s theory. Therefore, in this model, person, health, nursing, and environment are explained with reference to Watson’s theoretical assumptions and principles.

Specific factors that influence the conceptual model are patients’ needs for care and support from nurses. As a result, the focus is on building trusting relationships between nurses and patients, and this idea is supported by Watson’s theory (Ozan, 2015). Another important factor is a practice specialty because those patients who are observed in a trauma and emergency unit require much attention, care, and assistance from nurses (Alligood, 2014).

This model also demonstrates how the metaparadigm of nursing can influence a personal approach to caring and work with patients. Such concepts as a person, health, nursing, and environment remain to be the core of the nursing practice. Still, these ideas are reinterpreted with reference to the concepts promoted by Watson: caring, caritas, and ten caritas processes, which allow for building effective and trusting relationships with patients, and they are based on respecting patients’ needs and values (Pajnkihar, McKenna, Štiglic, & Vrbnjak, 2017). Therefore, the components of the metaparadigm are related to both the grounds of the nursing practice and Watson’s specific theory.

The conceptual model can be applied to practice at different levels of knowledge. For a novice nurse, it is possible to expect focusing on the paradigm of nursing and its components. When these basic elements are studied, and effective approaches to cooperating with patients are practiced, it is possible to refer to following the concepts of Watson’s theory and demonstrate caritas and caring with reference to the redefined elements of the paradigm.

Expert nurses are expected to work while following the principles of caring and building trusting and cooperative relationships with patients (Ozan, 2015). In addition, expert nurses should be able to apply ten caritas processes that are based on the idea of demonstrating support and care for patients while accepting and respecting their differences, needs, visions, values, and beliefs to achieve positive outcomes and contribute to developing a patient’s physical, emotional, and spiritual health.

Conclusion

The conceptual model created with the focus on the personal philosophy of nursing is presented as a visual and discussed in detail. The factors that could influence the development of the model are described. The relationship between the concepts, the metaparadigm of nursing, and different levels of practice are explained.

References

Alligood, M. R. (Ed.). (2014). Nursing theorists and their work (8th ed.). St. Louis, MO: Elsevier Health Sciences.

Ozan, Y. (2015). Implementation of Watson’s Theory of Human Caring: A case study. International Journal of Caring Sciences, 8(1), 25-32.

Pajnkihar, M., McKenna, H. P., Štiglic, G., & Vrbnjak, D. (2017). Fit for practice: Analysis and evaluation of Watson’s Theory of Human Caring. Nursing Science Quarterly, 30(3), 243-252.

American National Government And Its Features

Introduction

The features of any government are the pillars on which it is founded and identified. The United States of America is one of the governments in the world that is identified by its features. The essay will look into various elements that make the US administration. First, the American Constitution, which contains the rights and freedoms of the American people, will be analyzed. In turn, the processes, structures, and systems involved and affected by the Constitution will be discussed. Also, Federalism, which allows devolved functions for more efficiency, arms of the government that are given a mandate by the people to guard the nation and political parties of America will be discussed. It is through political parties that the voices of citizens are heard as they provide grounds for collective bargaining. The political parties also help to group constituents in standard categories. They also simplify choices for voters by formulating policies (American Government, 2009).

The Constitution

The American Constitution opens by a preamble that assures that the document was created for the people. In the preamble, the intentions and the objectives of the American people are well articulated. It is then followed by Article 1 in which sections 1 through to 7 talk majorly of the House of Representatives (Leduc, 2016). The House of Representatives, as the name suggests, is the representation of the citizens, while the Senate is a representation of the states. Sections 8 through to 10 talk about the mandate of the Congress. The sections identify the level of authority of the Congress, what it is meant to do, and what it cannot do, among other things. The Constitution also provides guidelines for the formation of the National government and its three arms.

The Constitution protects the rights and freedoms of its individual citizens. Also, the American Constitution separates the power of the national government from that of the federal government, hence, avoiding friction and misunderstanding regarding jurisdiction (Lee, 2013). The foundation laid by the Constitution to help the national government to mediate and to solve interstate issues, and the ability to offer checks and balances to all the three arms of the government concurrently, are two major strengths of the American Constitution.

It has been claimed that America has been able to stand for more than 200 years due to her Constitution. However, the Constitution has some flaws that hinder its affectivity. For example, the amendment process of the Constitution is slow such that it cannot be relied on during emergencies. The stated factor is slowly leading the country into a bipartisan. The Constitution is also vague in some of its sections. Such parts need to be amended to cover each and every aspect affecting the people in the most articulate way. The suggested can only happen if citizens take it upon themselves to study the Constitution to avoid any manipulation by the legislators (Kelly, Harbison & Belz, 2008).

Federalism

Federalism is defined as a government system in which power is shared between the central government and the states. The concept and definition were arrived at by delegates from different US states after the trial of both Confederation, and the unitary government failed. Federalism began as a compromise to resolve the many disadvantages of the previously tried forms of government. Therefore, it is necessary to highlight one advantage of Federalism that made it more favorable compared to both unitary and Confederation states.

One advantage of Federalism is that it distributes power between the national government and the states (Lahav, 2016). The distribution ensures that there is no tyranny on either side. The concept also provides that no one entity has full and absolute power. Absolute power would lead to dictatorship and irreconcilable governance. Through Federalism, it is impossible for anyone entity to claim autonomy regarding power. The balance brought about by Federalism ensures that both the national government and the federal states are accountable for their actions (Zimmerman, 2009).

The Social Security Administration (SSA) is one of the policies that the federal bureaucracy must implement. SSA is a system where Americans are put under a pay-as-you-go system, also referred to as “forced saving.” The method is advantageous as it helps a majority of the American population that consumes all their income without thinking about the need to save. The SSA policy has been able to reduce the American retirees’ poverty rates from 78% in the early 20th century, to 12% in the 21st century. The policy, albeit forced, has immensely worked for the benefit of the people. Its biggest selling point is that it applies to a wide range of the population as SSA is easily deducted on every payslip (Social Security Bulletin, 2017).

A disadvantage, however, of the forced system is that it was wrongly marketed as a fully fledge insurance. Hence, the American people have stopped caring about their insurance and thrown themselves under the SSA banner, which has limited benefits. Indeed, citizens believe that they are fully covered under SSA, a belief that is not only alarming but also dangerous. The forced saving system has led to the development of ignorance among many people. Interestingly, Americans have also started ignoring pension schemes, which would grant them better security at old age, in a belief that SSA will pay them better benefits. Both the federal and the national governments should take it upon themselves to educate citizens on how the SSA works, its coverage and limitations, as well as its inclusiveness.

The suggested civic education would also demystify the idea that SSA can wholly be used as personal insurance. Through the said public education, citizens will be able to understand the importance of personal insurance and be motivated to register with different insurance companies. By so doing, both the federal and central government will help reduce poverty levels in old age and sufferings among the young due to ignorance of how SSA operates.

Branches of the American Government

There are three arms of the American government. The executive, the first branch, includes the president, the vice-president, and the cabinet. The legislature, which is the second arm of government, consists of the Congress, the Senate and the House of Representatives. The third branch of government is the judiciary, which consists of the Supreme Court and the federal courts.

While the executive arm is well suited for the implementation of the laws and giving of executive orders, it cannot work without the legislature and the judiciary. The president, who is also the head of the judiciary, is responsible for the appointing of the Chief Justice and other members of the executive, such as members of the cabinet. The judiciary, as mentioned, consists of federal and national supreme courts and is responsible for some functions. The primary purpose being the interpretation of the clauses made by the legislative arm of the government. In cases where the Constitution is unclear about some matters, the judiciary is mandated to act by forming ‘judiciary-made laws.’

The legislature, which is the law-making branch, has been chosen as per the instructions of the assignment. The legislative is tasked with powers to make laws. Hence, it is a critical part of the government. Though the American president has the power to veto some of the decisions made by Congress, which is part of the legislature, the final decision will still be made by Congress after it considers the opinion of the president. Additionally, Congress can go ahead and advance the cause of the law without the president’s consent. Being the only body that makes laws, the legislative arm is very powerful (Barber, 2016).

The fact that Congress has to seek approval of amendments from both the Senate and the House of Representatives ensures that decisions are made inclusively without any house feeling side-lined. In the Senate, for example, the opinion of the minority is cherished. If a bill is not passed by the full House, deliberations will take place to understand the reasons why some members do not agree with the proposed bill. However, the process of continued consultation has acted as one of the major weaknesses of the legislature.

Much time is wasted when passing a bill such that it becomes irrelevant. The irrelevance is fully realized during urgent situations. It has been argued that the fact that a minority can be able to stall a bill has dragged the country, especially in bills that are believed to be able to lead the country into further prosperity. Unlike in the Senate, in the House of Representatives, there is limited democracy since the party with the most representation makes decisions without considering the minority party. Thus, canceling the efforts that are being enhanced by the Senate, where all parties are included in the decision-making process (Patterson, 2013). There is a need to clearly articulate the boundaries of the judiciary and the executive towards the legislative arm in an attempt to keep the legislation stronger. It is also important to come up with amendments that would ensure limited consultation in the Senate, but at the same time, also encourage inclusiveness of the legislation process. There would be a need for the Senate to consider the majority rule and the House of Representatives to consider the minority voice to resolve the mentioned weaknesses.

Political Parties

US political parties are organized at different levels. The categories range from local levels to state levels and finally to national levels. At the local levels, citizens vie for the positions of mayors freely and do not have to be affiliated with any party. Such elections are, thus, referred to as non-partisan elections. At the state levels, the elections are not non-partisan since those elected are either representing the state in the legislative body or taking an active role in the running of the state’s affairs.

Each of the two largest American political parties has national committees that help in their organization. The representatives also help with coming up with contingency approaches during elections. Political parties also offer support in managing and pushing supporters towards one goal as they come up with policies that define the group’s stand. The parties also act as channels that are used to convince and persuade citizens to vote a given candidate into office.

There are several benefits associated with political parties. First, the parties have been able to act as watchdogs to the government. They ensure that government operations are on in check by putting up checks and balances to the systems of the country. In turn, the parties encourage accountability. Being that some parts of the American Constitution were vaguely written, as mentioned, the political parties have been instrumental in offering an interpretation to certain clauses of the Constitution. The interpretation has led to the continual positive development of the country in the most desired direction.

One negative impact of political parties, however, is the creation of ideological differences that have led to hatred and sparked variances between sects in the country. Such diverse differences have polarized America and increased chances of interstate and intra-state conflicts. The American Civil War was one of the conflicts brought on by differences in political parties. To strengthen the positive impact of political parties, the Constitution and other laws of the country, firmly guide their involvement, mandate, and participation. To lessen the negative consequences of sowing discord, national committees to the political parties are supposed to intensify the sensitization of their candidates and supporters to other parties. Also, the does and don’ts of political campaigns and penalties stipulated in the Constitution on actions on those found guilty of causing conflicts on political, ideological differences have kept conflict at bay (Gold, 2015).

Conclusion

America, as a democratic country, pays attention to its system of ruling. The country has survived many years of unity with a constitution that is more than 200 years old. The American Constitution protects the rights and freedoms of its citizens and has been able to control power ratios between the federal and the national government. The Constitution allows for the creation of the three arms of the government hence being referred to as the law of the land. The American Constitution is founded on six solid principles ranging from popular sovereignty, separation of powers, limited government, checks and balances, judicial review, and lastly, the federal states.

Federalism has been able to strike an almost perfect balance between unitary government and a confederation, thereby, holds the US together. The branches of the government have sustained one another over an extended period due to the clear stipulation of their different duties and mandates by the Constitution. The legislature is the law-making arm and the key determiner of the direction that both the federal states and the national government take.

The political parties, which initially had been perceived to be the cause of all American political problems, have proven to be a strong pillar in the country. One of the major advantages of political parties is the interpretation of vague parts of the Constitution. Interpretation of the Constitution by the political parties has led to sustained growth and development concerning both infrastructure and service delivery. Political parties have also swayed elections as candidates are nominated, mainly, through political parties. The dynamism in the American government is indeed fuel to its unparalleled success.

References

Barber, M. J. (2016). Ideological Donors, Contribution Limits, and the Polarization of American Legislatures. Journal of Politics, 78(1), 296-310.

Gold, H. (2015). Americans’ Attitudes toward the political parties and the party system. Public Opinion Quarterly, 79(3), 803-819.

Kelly, A., Harbison, W. & Belz, H. (2008). The American Constitution: Its origin and development. New York, NY: Ventura.

Lahav, A. D. (2016). The roles of litigation in American democracy. Emory Law Journal, 65(6), 1657-1704.

Leduc, A. (2016). Beyond babel: Achieving the promise of our American Constitution. Cleveland State Law Review, 64(2), 185-249

Lee, T. H. (2013). International Law and Institutions and the American Constitution in War and Peace. Berkeley Journal of International Law, 31(1), 291-306

Patterson, T. (2013). American democracy. New York, NY: McGraw-Hill

Social Security Bulletin (2017). Social Security: A Program and Policy History. Social Security Office of Policy, Web.

Zimmerman, J. (2009). Contemporary American Federalism. New York, NY: State University of New York Press.

Brigham And Women’s Hospital’s Nursing Change

Introduction

The present paper considers the introduction of a mechanism for reporting staffing issues, concerns, and suggestions as a planned change intervention for the Brigham and Women’s Hospital Department of Nursing [BWHDN] (2016). This change should contribute to the solution to the ever-present problem of nurse shortage (Maenhout & Vanhoucke, 2013). The paper discusses the issue and uses a blend of the change theories by Lewin and Rogers to offer a step-by-step plan for the proposed change.

Problem and Solution Identification

One of the key issues of modern healthcare organizations is the shortage of nurses, and one of the solutions is the efficient management of the nursing staff (Buchan, Duffield, & Jordan, 2015). In particular, effective staffing can be helpful (Maenhout & Vanhoucke, 2013). The American Nurses Association [ANA] (2015b) emphasizes the significance of optimal staffing that should incorporate the presence of the mechanisms for staffing evaluation.

However, BWHDN (2016) does not report the presence of a reporting mechanism for nurses’ considerations and suggestions. If this problem is resolved, the organization will gain another mechanism for staffing evaluation, which can be employed to achieve optimal staffing. Thus, the present paper proposes the development of a mechanism for nursing feedback on staffing issues and considerations.

BWHDN (2016) is interested in the quality and outcomes of its care. In particular, BWHDN’s (2016) vision consists of promoting global health, and its mission aims to improve the health of the community through nurse-led collaborative care. The proposed change is in line with these goals because improved staffing tends to promote safe and high-quality care (Maenhout & Vanhoucke, 2013). Also, the values of the organization include collaboration and professionalism, both of which will be employed with greater efficiency due to optimal staffing (ANA, 2015b).

Finally, the importance of the quality of care and patient safety is highlighted by the ethics code proposed by the American Nurses Association (2015a), and optimal staffing is promoted by the standards of practice developed by ANA (2015b). Thus, the proposed change is in line with BWHDN’s (2016) culture and supported by nursing standards.

Change Theory Choice

Change is a complicated process, and certain theories and models can be used to guide it for better outcomes (Marquis & Huston, 2015). For example, Lewin’s theory suggests that three stages of change exist: “unfreezing, moving (or transitioning), and refreezing” (Shirey, 2013, p. 69). The first stage presupposes increasing the awareness of the need for change, the second stage is the change itself, and the final one presupposes routinization. The approach is expanded by Lewin’s force field analysis, which focuses on determining the phenomena that can assist or hinder the process of change (Marquis & Huston, 2015, p. 166). These forces are assessed and manipulated throughout the change process.

Rogers’ theory of innovation includes the stages that are called “awareness, interest, evaluation, trial, and adoption” (Mitchell, 2013, pp. 32-33). The first stage presupposes building the awareness of the need for change, but before the change is acted upon, the decision to do so is made (Batras, Duff, & Smith, 2016). This element helps to avoid unnecessary changes (Marquis & Huston, 2015). After that, the change is trailed and evaluated, which may lead to redefinition, and, eventually, routinized.

The Lewin’s approach is simple and has an important focus on the psychology of change, but it lacks complexity or non-linearity (Shirey, 2013). Rogers’ theory, on the other hand, exhibits non-linearity and is more complex, but it can be improved through the use of force field analysis and the consideration of the processes of freezing and unfreezing. It has been proposed that it is possible to fuse several theories (Mitchell, 2013), and the present paper suggests employing the combined benefits of the two approaches to make a hybrid theory for the proposed change.

Planned Change: Steps to be Made and Stakeholders

Both discussed theories require improving the awareness of the need for the change. As a result, it is important to consider stakeholders. The change process can and should be led by nurses, especially nursing leaders. Indeed, they are familiar with the interests of the organization’s nurses, and they should employ this knowledge and their leadership skills to the benefit of the change. However, staffing is a complex process (Maenhout & Vanhoucke, 2013), which is likely to involve multiple organizational levels. As a result, the stakeholders of the change are going to include the administration.

The support of the administration is crucial for the change process due to its influence on decision-making and resources, which is why nursing leaders need to attract their attention. A way to do so would involve the assessment of the problem and the preparation of a report, which should demonstrate the need for the introduction of a reporting mechanism for nurses. ANA (2015b) guidelines may be employed to guide the development of the report since they include some recommendations on optimal staffing.

The same report can be used to increase the awareness of the need for change among the nurses; the latter should be engaged in the discussion of the problem, and their reported cases can also be employed to attract the attention of the administration.

Thus, the attraction of the attention of the stakeholders is the first step of the change process. It is going to be interlaced with the investigation of the issue, which can be viewed as the second element of the plan. Moreover, the investigation is going to be employed for the assessment of possible solutions. The specifics of the reporting mechanism (or mechanisms) should depend on the available resources and preferences of stakeholders. Both these factors can be reviewed with the help of an organizational assessment and extensive discussion between the stakeholders.

The third step would involve the decision-making that is required by the Rogers’ theory. The stakeholders would be expected to review the information gathered during the previous step and decide to employ a particular mechanism. After that, the fourth step, which is the implementation, will begin.

The implementation process is complex and should include the trial, evaluation, and adjustment of the change as suggested by Rogers’ theory. Moreover, it should involve the work with the stakeholders, including Lewin’s force field analysis and motivation of the staff (Mitchell, 2013). Also, effective communication needs to be promoted (Mitchell, 2013), which can be achieved, for example, by soliciting feedback from nurses. Finally, after the successful adjustment of the change to the needs of the stakeholders and organizational resources, its routinization (refreezing) and maintenance can take place. The maintenance process predominantly hinges on nurses and their leaders.

Conclusion

The problem of understaffing is a significant issue for modern healthcare organizations, but it can be resolved through the improvement of the staffing process. The latter can be achieved, among other things, through the introduction of efficient evaluation mechanisms.

For instance, BWHDN (2016) could introduce a nurse-centered mechanism for reporting staffing issues. A change theory can facilitate the development of the change plan; for example, the present paper uses a theory that incorporates the key notions of those by Lewin and Rogers to preserve their advantages and counter disadvantages. As a result, the proposed plan begins with awareness-building stages and ends with the routinization of the trialed, evaluated, and reformed change. It can be suggested that this theory can indeed guide the process of planning a nurse-led staffing change at the workplace.

References

American Nurses Association. (2015a). Code of ethics for nurses with interpretive statements. Web.

American Nurses Association. (2015b). Nursing: Scope and standards of practice. Web.

Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: Implications for health promotion practice. Health Promotion International, 31(1), 231-241. Web.

Brigham and Women’s Hospital Department of Nursing. (2016). 2016 annual report. Web.

Buchan, J., Duffield, C., & Jordan, A. (2015). ‘Solving’ nursing shortages: Do we need a New Agenda? Journal of nursing management, 23(5), 543-545. Web.

Maenhout, B., & Vanhoucke, M. (2013). An integrated nurse staffing and scheduling analysis for longer-term nursing staff allocation problems. Omega, 41(2), 485-499. Web.

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK, 20(1), 32–37. Web.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69–72. Web.

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