4th, February 2013
All nurses in the field of nursing must have a framework that reflects their practice in nursing. These must first, be familiar with the conceptual structure of the nursing. Therefore, knowing the different theories in nursing is crucial for all nurses, as this theoretical knowledge will be applied in their practice, and guide their nursing process. Nursing informatics is applied to all areas of nursing practice, including research, education, clinical practice, and administration. Nursing informatics is a science, which also exhibits the characteristics of a system. By referring to nursing informatics as a system, it means that just like a system, it functions to bring order and involves a coordination of different processes and working elements. On the other hand, by referring to nursing informatics as a science, it means that, like a science, it involves knowledge acquisition, especially the quantitative knowledge. For instance, the body functions well when all the other body organs are in good shape. This is the same way nursing informatics functions. Additionally, systems do use the knowledge of science to measure things such as flow of blood, among others in order to determine the wellness of the body. This is the same case in nursing informatics, as it makes use of both data of scientific nature, as well as systems. For nursing informatics to be effective, the individuals involved must make use of both practical knowledge and the theoretical knowledge in this discipline (Baker, 2012).
In nursing informatics, there are different theories, which help to frame and inform this discipline. These include the general systems theory, change theory, cybernetics theory, and the cognitive theory (Baker, 2012). All these theories support nursing informatics in different ways, and the nursing practitioners can combine the knowledge they acquire from these theories, with that they obtain from their nursing practice, to enhance their performance. This essay will address the general systems theory, and explain how this is relevant and applicable in the discipline of nursing.
The general systems theory is characterized by different parts that continuously interact with each other, and these are confined within some form of a boundary. In this theory, the human body is considered the system. This houses the different body organs of humans. These body organs in the body form the elements of the system. Overall, the general systems theory is based on the description of how different parts function together as part of one system. Therefore, apart from nursing, this theory can as well be applied in other disciplines such as sociology, and chemistry, among others. In nursing, this theory is used to explain the concepts of the human body and human health. There is a relationship between theory and practice in nursing, therefore, the general systems theory is used to influence the nursing practice (Baker, 2012).
The general systems theory was initially proposed and developed by a biologist, Ludwig von Bertalanffy (1901-1972) in the 1950’s. This theory has been applied in different disciplines, since it is a multidisciplinary theory. In nursing, the general systems theory has been used to develop more nursing theories; therefore, it has acted as a foundation upon which more nursing theories are developed. In addition, this theory has been instrumental in the conducting of nursing research. In order to understand and apply the general systems theory, one must have knowledge of systems, their characteristics, and how they function. In a system, its various components have their specific functions, and they interact with the other components within the system. Additionally, it is assumed that systems function in a similar manner.
Dorothea Orem (1914-2007) is one of the past nursing theorists, who advanced on Ludwig von Bertalanffy’s general systems theory, to develop a general systems theory that is specific to nursing. Orem was involved in the nursing career and served as a practicing nurse, a nurse educator, a nurse consultant, and an administrator. She built her philosophy on the fact that human beings desire for self-care for continued sustenance of their health and life. She also thought that the goal of nursing is overcoming human limitations. Additionally, her worldview held that human beings comprise the psychological, physical, and social nature, which are not stable, but change over time. Dorothea also argued that human beings and their environment are in a constant interaction in the context of a self-care system. Therefore, a change in the system of a human being and a subsequent change in the environment will result in changes in the self-care system. Therefore, according to Orem, human beings and the environment are one integrated system (Hartweg, 1991).
In her theory, Orem identified some important aspects in the self-care system, which influences it differently. These are the environment, person, and health. Health is considered not only in the context of bodily wellness, but also in the progress, a person makes each day in their functioning. People are seen as existing in their environment, and are always part of it. In addition, different environmental features, including social, physical, biological, and chemical environmental elements, affect the health and well-being of an individual. In this theory, a person is the recipient of nursing care, and functions socially, biologically, and symbolically. This being is also capable of learning and development. Most importantly, they can be taught and learn how to meet their self-care needs. This theory treats people as special from other living organisms, because of their special capabilities, which other living organisms lack (Basavanthappa, 2007).
The nursing systems theory by Orem is part of her general theory of nursing, which also consists of self-care theory and self-care deficit theory, which are all applied in nursing. Self-care comprises various activities, which an independent person performs to maintain their personal well-being. On the other hand, self-care deficit theory explains the circumstances under which nursing is needed, and the various ways through which patients can be given assistance through nursing. This is normally the case when the self-care agency fails to meet their self-care needs. This compels nurses to come in and help the patient meet their self-care needs through different ways (Basavanthappa, 2007).
In the theory of nursing systems, Orem suggested that this referred to the variety of steps or procedures, which nurses often take in the process of meeting the self-care needs of their patients. These procedures vary from patient to patient, depending on their individual self-care needs. This theory therefore, dwells on the roles of both the patient and the nurse, as well as the general responsibilities of the nursing process. Additionally, this theory describes the nature of relationship between the nurse and the patient, as well as the different actions needed in order for the needs of the patient to be met. She divided this into three main nursing systems, including wholly compensatory, partly compensatory, and supportive-educative (Hartweg, 1991).
In the wholly compensatory system, the patient’s self-care is limited and sometimes impossible. Therefore, the patient has to rely on other parties for his or her survival and well-being. In the partly compensatory system, a patient has the capability to meet some of their self-care needs, but not all of them. The patients in this system will therefore, require a considerable assistance from the nurses. In the supportive-educative system, a patient is capable of meeting their self-care needs, but only requires support from the nurse in the form of knowledge acquisition, decision-making, and behavior control. The nurse in this case plays the role of a consultant (Hartweg, 1991).
Orem’s theory has been widely applied in nursing because of its relevance in the discipline. Today, health care has become a complex system. There are multiple providers of health care, there is a wide range of new technology in health care today, competition has become high, and the growing search for information keeps increasing. Since nursing is considered a complex system, it therefore, comprises different entities, as observed. These include people, physical objects, as well as processes. This theory is therefore, applicable in the field of nursing today, since the nursing system today keeps becoming more complex, just like the case in Orem’s theory. Therefore, nurses can borrow from the knowledge in Orem’s theory of how to practice nursing in a complex nursing system (Clancy, Effken, & Pesut, 2008).
Orem’s theory is the foundation of the nursing practice in different settings. This theory can be applied in the process of assessment of the nursing process. In addition, this theory emphasizes nursing care as the responsibility of the nurse, which must not be forfeited. Therefore, this encourages nurses in the profession to be patient-oriented, and not task oriented. In nursing informatics where technology is highly utilized, Orem’s theory emphasizes the importance of patient-nurse interactions, and therefore, the technology must not take the place of the nurse, as the physical presence and support of patients by the nurse is a factor that contributes to their recovery. However, Orem recommends the use of technology to help nurses have their patients recover quickly. Since in this theory, Orem defines nursing process as a system, this means it is a complex process. Therefore, nurses might need some aid from technology in order to make the process easier. This is what nursing informatics is all about. Nurses may use social technologies, which focus on human needs, communication, and limitations. They may also use regulatory technologies, which aim at sustaining and enhancing life of the patients. However, these should not take the place of the nurse, and the special role they play in the nursing process (Basavanthappa, 2007).
In conclusion, nursing theories are important to nurses and to the entire nursing discipline. Individuals in the nursing profession need to develop theoretical knowledge, which is based on research findings in order to develop the foundation of nursing practice. These also provide guidance to the process of nursing education, research, and practice. Nursing theories also make nursing practice stand out from the other disciplines. For instance, the general systems theory, which was multidisciplinary, has been adopted by professionals in the nursing discipline, and enhanced to be more specific to nursing only. Orem’s theory provides a framework through which the nursing process can be practiced. Apart from defining the nursing care needs of patients, this theory also describes various interactions that should occur between the patient and the nurse. Therefore, nurses must ensure they interact with their patients and build good relations with them, and not let computers and technology take their place in the nursing process.
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Retrieved 4 February 2013 http://dspace.uta.edu/bitstream/handle/10106/9689/Baker_2012_Informatics_PNC.pdf?sequence=1
Basavanthappa, B.T. (2007). Nursing Theories. New Delhi: Jaypee Brothers Publishers.
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Hartweg, D. (1991). Dorothea Orem: Self-Care Deficit Theory. London: SAGE.