NURSING FUNDAMENTALS Foundations & Nursing Theory

These study notes cover the core concepts of Foundations and Nursing Theory, a critical area for any nursing student. Mastering these concepts provides the framework for all clinical practice. 1. History and Evolution of Nursing Early Nursing History • Nursing roots traced to religious and military caregiving in ancient civilizations. • Florence Nightingale (1820–1910): founder of modern nursing; emphasized environment in healing. • Nightingale's Notes on Nursing (1859) outlined the importance of sanitation, ventilation, and nutrition. • First Canadian nursing schools established in the 1870s–1890s. Development in Canada • The Victorian Order of Nurses (VON) founded in 1897 to provide home care. • Canadian Nurses Association (CNA) established in 1908. • Legislation regulating nursing practice differs by province/territory. • Introduction of baccalaureate nursing education as entry to practice standard. 2. Nursing Metaparadigm The nursing metaparadigm consists of four central concepts that define the discipline: PERSON The recipient of nursing care — an individual, family, group, or community. Viewed as a holistic being with biopsychosocial, cultural, and spiritual dimensions. ENVIRONMENT All internal and external conditions, circumstances, and influences surrounding and affecting the person (physical, social, political, cultural). HEALTH A dynamic state of well-being. The WHO defines health as 'a state of complete physical, mental, and social well-being, not merely the absence of disease.' NURSING The actions and attributes of nurses providing care — including caring, therapeutic relationships, health promotion, and advocacy. 3. Major Nursing Theories Florence Nightingale — Environmental Theory • Health is maintained by controlling the patient's environment. • Key environmental factors: fresh air, warmth, light, cleanliness, and quiet. • Considered the first nursing theorist. Virginia Henderson — Need Theory • Nursing assists individuals to perform 14 basic human needs they cannot perform independently. • Goal: help the patient achieve independence as quickly as possible. • Influenced the WHO definition of nursing. Dorothea Orem — Self-Care Deficit Theory • People are self-care agents who can care for themselves under normal circumstances. • Nursing is needed when a self-care deficit exists. • Three nursing systems: wholly compensatory, partly compensatory, supportive-educative. Sister Callista Roy — Adaptation Model • Humans are adaptive systems responding to environmental stimuli. • Four adaptive modes: physiologic, self-concept, role function, interdependence. • Goal of nursing: promote adaptation in all four modes. Jean Watson — Theory of Human Caring • Nursing is centered on caring as a moral ideal. • Emphasizes the therapeutic nurse-patient relationship. • Ten carative factors guide caring practice. Martha Rogers — Science of Unitary Human Beings • Humans are energy fields in constant interaction with the environment. • Emphasizes wholeness — humans cannot be reduced to their parts. • Abstract and philosophical in nature. 4. The Nursing Process (ADPIE) A — Assessment Systematic collection of subjective and objective data about the patient. D — Diagnosis Clinical judgment about the patient's response to actual or potential health problems. P — Planning Setting goals and developing nursing interventions to address diagnoses. I — Implementation Carrying out the nursing care plan; performing interventions. E — Evaluation Determining whether patient goals have been met and revising the care plan as needed. 5. Critical Thinking in Nursing • Critical thinking is essential for safe, competent, and ethical nursing practice. • Components: interpretation, analysis, evaluation, inference, explanation, self-regulation. • Clinical judgment: applying critical thinking to patient situations. • Reflective practice: examining one's own actions and reasoning to improve future care. 6. Professional Nursing in Canada Regulatory Bodies • Each province/territory has its own regulatory college (e.g., CNO in Ontario, BCCNM in BC). • Regulation protects the public by setting entry-to-practice competencies and standards. • Nurses must maintain continuing competence throughout their careers. Ethical Principles in Nursing • Autonomy: respect patient's right to make decisions. • Beneficence: act in the patient's best interest. • Non-maleficence: do no harm. • Justice: fair and equitable treatment of all patients. • Fidelity: keep promises and commitments to patients. • Veracity: be truthful with patients.