Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

Nursing Theory and Model for Occupational Health Nursing: Man's Adaptation to Stress, Study notes of Nursing

The theory and model of nursing for occupational health nursing developed by Shirley L. Baughn. The theory is based on the concept of man's adaptation to stress and the unique function of nursing to assist individuals in performing activities contributing to health or its recovery. The document also introduces the nursing process as a systematic approach to implementing the theory.

What you will learn

  • How does man's adaptation to stress factor into this nursing theory?
  • What is the nursing theory and model for occupational health nursing presented in this document?
  • What role does the nursing process play in implementing the nursing theory for occupational health nursing?

Typology: Study notes

2021/2022

Uploaded on 03/31/2022

palumi
palumi 🇺🇸

4.2

(14)

245 documents

1 / 6

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
ANursing Theory and
Model
for Occupational
Health Nursing
Shirley
L.
Baughn,
R.N., M.S., C.O.H.N.
Mrs. Baughn is astaff nurse at Whirlpool
Corporation, Evansville, Indiana.
Duri ng recent years nursing has been struggling to
establish itself as a
scientific
discipline, with its
own
scientific
body of knowledge. An important,
essential factor in the growth of any
discipline
is the
development of theory. A theory is a scientifically
acceptable general principle
which
governs practice.
Atheory may also be proposed to explain observed
facts.
In the interval of the past few years, much has been
written in the nursing literature pertaining to nursing
theory, and , more basic,about nursing concepts.
Concepts are necessary both to serve as a broad
foundation for nursing practice and to provide a
theoretical basis for research into nursing practice.
All
theories of nursing have underlying basic
assumptions
which
are arrived at after considering
different aspects of a specific
concept
The theory of
nursing pursued in this study has been formu lated
after
seriously
considering
the
concepts
and
assumptions in regard to man, stress, adaptation,
nursing, and healttVweliness.
Man is a biopsychosocial
cuitural
being who can be
located at any given time somewhere along the
continuum
of health-illness-wellness.
High-level
weIIness involves adirection in progress toward a
higher potential of functioning. Any concept of
nursing must begin with the recipient of nursing care,
which is man. The basic needs of man are the
ingredients of high-level wellness for the individual.
Man cannot live without experiencing some degree
of stress all the time. Stress plays a major role
in intensifying patients' actions and reactions to
Occupational Health Nursing, January 1977
environmental stimuli. Stress can be a beneficial
experience whereby apatient learns ways of coping
with future stressful situations. Some individuals are
better equipped to cope with stress than others.
According
to adaptation theory, man is an organism
in
constant
interaction
with
his
changing
environment To respond positively to environmental
changes, man must
adapt
Man's adaptation may
either decrease or increase his successful functioning
as an individual.
Nursing is an open system reacting with the patient
and his environment The unique function of the nurse
is to assist the individual,
sick
or well, in the
performance of those activities contributing to health
or its recovery. The practice of
clinical
nursing is
goa~directed,
deliberatively carried out. and patient-
centered. One of the functions of nursing is to support
and promote patient adaptation. This
will
involve the
two factors of assessment and intervention. In her
assessment of the patient. the nurse
will
recognize his
position on the health-iIIness-wellness continuum and
will
determine the effectiveness of the coping
mechanisms which he is using to adapt to his
situation. Next. the nurse
will
intervene appropriately
to promote the patient's adaptation.
Exploration
of
the
foregoing
concepts
and
assumptions led to the formulation of the following
theory of nursing which,although developed within
the framework of an industrial setting
with
the primary
goal being to retain ahealthy worker at the optimum
level of health, is both general and specific enough to
apply to
all
areas of nursing practice. Nursing is an
7
pf3
pf4
pf5

Partial preview of the text

Download Nursing Theory and Model for Occupational Health Nursing: Man's Adaptation to Stress and more Study notes Nursing in PDF only on Docsity!

A Nursing Theory and

Model for Occupational

Health Nursing

Shirley L. Baughn, R.N., M.S., C.O.H.N.

Mrs. Baughn is a staff nurse at Whirlpool Corporation, Evansville, Indiana.

D

uring recent years nursing has been struggling to establish itself as a scientific discipline, with its own scientific body of knowledge. An important, essential factor in the growth of any discipline is the development of theory. A theory is a scientifically acceptable general principle which governs practice. A theory may also be proposed to explain observed facts. In the interval of the past few years, much has been written in the nursing literature pertaining to nursing theory, and, more basic, about nursing concepts. Concepts are necessary both to serve as a broad foundation for nursing practice and to provide a theoretical basis for research into nursing practice. All theories of nursing have underlying basic assumptions which are arrived at after considering different aspects of a specific concept The theory of nursing pursued in this study has been formu lated after seriously considering the concepts and assumptions in regard to man, stress , adaptation, nursing, and healttVweliness. Man is a biopsychosocial cuitural being who can be located at any given time somewhere along the continuum of health-illness-wellness. High-level weIIness involves a direction in progress toward a higher potential of functioning. Any concept of nursing must begin with the recipient of nursing ca re, which is man. The basic needs of man are the ingredients of high-level wellness for the individual. Man cannot live without experiencing some degree of stress all the time. Stress plays a major role in intensifying patients' actions and reactions to

Occupational Health Nursing, January 1977

environmental stimuli. Stress can be a beneficial experience whereby a patient learns ways of coping with future stressful situations. Some individuals are better equipped to cope with stress than others. According to adaptation theory, man is an organism in constant interaction with his changing environment To respond positively to environmental changes, man must adapt Man's adaptation may either decrease or increase his successful functioning as an individual. Nursing is an open system reacting with the patient and his environment The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery. The practice of clinical nursing is goa~directed, deliberatively carried out. and pat ient- centered. One of the functions of nursing is to support and promote patient adaptation. This will involve the two factors of assessment and intervention. In her assessment of the patient. the nurse will recognize his position on the health-i IIness-wellness continuum and will determine the effectiveness of the coping mechanisms which he is using to adapt to his situation. Next. the nurse will intervene appropriately to promote the patient's adaptation. Exploration of the foregoing concepts and assumptions led to the formulation of the following theory of nursing which, although developed within the framework of an industrial setting with the primary goal being to retain a healthy worker at the optimum level of health, is both general and specific enough to apply to all areas of nursing practice. Nursing is an

7

A NURSING THEORY AND MODEL FOR OCCUPATIONAL HEALTH NURSING (continued)

open system whose purpose is to assist man in adapting to stress so that he can attain, maintain, and retain a high level of weIIness. With this theory as a basis. the next step was to deve lop a mode I of nursi ng which would facilitate implementing the theory into nursing practice by means of the nursing process. The model is demonstrated in Figure 1. Basically the model is an open system of stress and reaction. Some form of stress bri ngs the worker (patient) into the health care delivery system and into contact with the nurse. The nurse then initiates nursing action of assessment and appropriate intervention to support and promote the patient's adaptive mechanisms. Hopefully, by the nurse's intervention the patient will be able to successfully adapt to his stress and return to a pre-stress state of hig~level weIIness. In the event that the nursing action is not successfu I, the patient wou Id leave the health care delivery system and return to his previous stress state. The nursing model was implemented by means of the nursing process. The nursing process is a rational, ongoing, systematic manner of assessing, planning, implementing. and evaluating nursing care. These four steps are accomplished by and through communication and interaction. It is based on relevant theories and concepts from the physical and social

sciences. Nursing process is a term to describe what nurses do with emphasis on a systematic, methodical approach rather than any randomness of efforts. It accents a planned, deliberative method of nursing care. The nursing process is a set of actions leading to a result There are many advantages to using the nursing process in occupational health nursing. It can be a means of communication shared with the worker and his family. It provides needed legal records in the form of assessments and care plans. There is continuity of care of patients and education of workers to vital health problems. It faci litates verification of epidemics of occupational illness. Finally, it is a valuable evaluation technique. An assessment tool (Figure 2) was developed to gather pertinent information about the patient during the initial interview which followed some stressful event which caused him to enter the health-care area. In addition to the patient's major concern, this assessment tool enabled the nurse to gather data concerning past work-related medical history, present and past pertinent medical history, restrictions, stress factors which may have precipitated present concern, and coping or adaptive mechanisms which the patient might be using. The information gathered by way of the assessment

STRESS

ENTRANCE INTO HEALTH CARE DELIVERY SYSTEM

ADAPTIVE MECHANISMS

~I PAT~NT 1/

RETURN TO HIGH LEVEL WELLNESS

FIGURE 1

NURSING MODEL

NURSING ACTION

A NURSING THEORY AND MODEL FOR OCCUPATIONAL HEALTH NURSING (continued)

form was analyzed and interpreted and a nursing care- plan (Figure 3) was formulated for each patient The nursing care-plan was also a tool developed specifically for use in the industrial setting. The problem was simply stated. Planning included setting priorities, deciding on a plan of action, and appropriate intervention. I nterventi on inc luded actual treatment given, environmental manipulation, referral, supporting present coping mechanisms being used by the patient, or whatever nursing action was deemed necessary to help the patient adapt to his situation, and meet his specific need. In helping the worker adjust to his situation, or to arrange for implementation of the nursing care plan, the industrial nurse often found it necessary to enlist the skills and help of other members of the industrial complex. She/he frequently consu Ited with the plant physician and safety director. She/he also used the services of the union, members of management, and other outside referral agencies when she/he considered it necessary to implement appropriate intervention on behalf of a patient Nursing process intervention is demonstrated in Figure 4.

Criteria for evaluation were developed to measure success or fai lure of the nursi ng action:

  1. Was nursing care of patient sufficient? Was need met?
  2. Was nursing action based on scientific principles of assessment, planning, and intervention?
  3. Was maximum safety and security insured?
  4. Were long-term outcomes reflected?
  5. Did it meet psychosocial needs of workers?
  6. Did it provide for worker-fami Iy participation? Assessment, planned intervention, and evaluation of those workers who are experienci ng stress as a resu It of some work-related injury usually present no problem for the industrial nurse. Nursing action is obviously medical intervention and the expected outcome or goal is equally obvious. These patients present no difficulty in implementing the nursing theory and model. Nursing action and establishment of goals become a little more difficult in dealing with patients with injuries complicated by one or more secondary stresses. I n these situations the nurse has many opportunities to use his/her observational and interviewing skills before deciding on a course of

FIGURE 3

NURSING CARE-PLAN

NAME:

HEALTH SUMMARY:

PROBLEM

AGE:

INTERVENTION

SEX: DATE:

EVALUATION

BAUGHN

Other

<, Specific Skills

Nurse

Nursing Skills Physician

-: Diagnostic Skills

Administrative /SkilIS

Management

HEALTHY WORKER

Communication

<. Union Monitoring Skills

Safety

FIGURE 4 MODEL OF NURSING PROCESS INTERVENTION

planned nursing action. Looking for physical signs of increased anxiety or tension, and assessing the verbal and non-verbal clues given by the patient are necessary nursing actions in dealing with the patient who is experiencing some life stress. Reducing tension and setting a reality focus become important in interacting with these patients. This nursing model was developed specifically to be used as a framework to improve nursing practice in the industrial area. Its main strength lies in the fact that it is structured to be implemented by means of the nursing process, a not-too-tarnl liar term to most industrial nurses. The nursing process, if used as a framework in the occupational setting, can assist the nurse in sharpening his/her total assessment of employee needs, and it can lead to thoughtful plan- ning and well-executed implementation of nursing action. Further, it emphasizes evaluation, which is many ti mes neg lected. The assessment of patients in industrial nursing is

Occupational Health Nursing, January 1977

quite important, for this is where present health needs can be detected as well as the presenting problem. The assessment tool used in conjunction with implementing the nursing model is short enough to be done in allotted time but also comprehensive enough to be of real value to the nurse in determining patient needs and in developing effective nursing care plans. The model discussed has not been previously used in clinical practice and so has no proven validity or reliability. Perhaps one argument against the model is that it is not complex enough. However, it was thought that it wouId be more advantageous to start with a simple nursing model that would work in the clinical industrial health area, and then adapt and modify it as expertise and need are demonstrated. There has been no attempt to present the nursing model herein discussed as a complete entity. Instead, it is hoped that the model wi II serve as a basis for further development and application of nursing models to the clinical area of industrial nursing, thereby improving the practice.