Nursing models and theories are organizing frameworks that provide critical thinking structures to guide nursing practice.

Nursing models and theories are organizing frameworks that provide critical thinking structures to guide nursing practice (Alligood, 2006). They assist nurses to organize their nursing knowledge and consider all aspects of a clinical situation to facilitate their clinical reasoning abilities (Thorne, 2014). Person, nursing, health and environment are concepts central to nursing.

Purpose:

This assignment facilitates the student’s understanding of nursing theory as it relates to their own understanding of the four nursing meta-paradigms with the practical application to a care scenario. Students continue to rehearse their scholarly writing with further development of critical thinking and clinical reasoning through the application of a nursing theory to a selected care scenario.

Engaging in an activity such as this promotes critical thinking, helps students to construct a beginning understanding of theoretical concepts, and promotes confidence in learning about nursing and other theories.

Due: Week 9

Weight: 30%

Format: Scholarly paper using 7th edition APA

Length: 6 pages (excluding title page and reference pages), double-spaced, 12 pt font (Arial, Calibri or Times New Roman)

Scholarly Paper Assignment Aims

1. Familiarize students with nursing models/theories and the central concepts of the nursing metaparadigm (person, nursing, health and environment) by applying them to a care scenario.

2. Analyze how nursing theory and the nursing metaparadigm can influence the student’s philosophical approach to caring as an RN.

3. Further develop students’ scholarly writing skills.

Scholarly Paper Overview

1. Choose one nursing theory/model that aligns with your personal beliefs and values of the nursing metaparadigm (person, nursing, health, and environment) and your personal philosophy of nursing care.

2. For the chosen theory/model:

a. Provide an overview including basic assumptions of the theory/model I.e., what the theorist is trying to convey

b. Briefly describe the concepts of the theory/model

i. Describe the theorist’s interpretation of the meta paradigms (person, nursing, health, and environment)

ii. Discuss how the application of the theory/model has influenced, affirmed, or built upon your nursing practice.

3. A patient scenario will be assigned by the instructor. “A bit Out of Sorts”

 Apply the chosen theory/model to the scenario:

a. Describe the care scenario within the theorist’s metaparadigm (person, health, nursing, environment)

b. Organize the client information within the context of the model/theory

c. Describe how you would approach the nursing care of the client in the chosen scenario based on the theory/model. A variety of quality nursing literature should be used throughout your descriptions and application. Examples of appropriate literature for a nursing theory scholarly paper include:

• _Theorist’s original writings (primary sources)

• _Nursing theory textbooks (secondary sources)

• _Professional literature related to your future nursing practice (e.g., RNAO Best Practice Guidelines, CNO Practice Standards)

• _Nursing journals (e.g., search CINAHL)

When choosing literature, consider: “What did the theorist say? What has been said since? How has it influenced practice? How would it influence this particular client situation? Do best practice and theory align?

Recommended Resources

Alligood, M. R. (2016). Nursing theorists and their work (9th ed). Elsevier.

Saginaw Valley State University (2022) Nursing theories: Middle-range theories A-Z.

https://librarysubjectguides.svsu.edu/nursingtheory/middlerange

Pierre-Louis Lemoine 85 years old Resides at Maple Grove Lodge Retirement Home
Elderly man. Photograph. Britannica Image 1	When Marceline saw her father this morning, she felt he seemed “a bit out of sorts,” but she grew increasingly concerned when he became very tearful and upset while they were having lunch at his favorite Haitian restaurant. The RN at the retirement home where Pierre-Louis has lived for the past 4 months, mentioned to Marceline that she has noticed that he does not eat as much at mealtime as he used to. Marceline mentioned that this might be why he complains that his pants do not fit right anymore and wants his suspenders. Pierre-Louis was a strong voice in the home choir but has not wanted to join the group for the past month or so. Pierre-Louis also has stopped going to the weekly card games; however, he has been spending more time at happy hour and there has been concern that he is drinking more alcohol than he first did when he moved into the home. Most recently when the PSW was helping him down to the dining room, she told the nurse that Pierre-Louis said he just wants it all to end.   GEM Nurse: “How are things Pierre-Louis”? Pierre-Louis: “Fine for an old man like me.” GEM Nurse: “Do you know why Marceline brought you into the emergency room today”? Pierre-Louis: silence… (Starts to cry) GEM Nurse: “Pierre-Louis, are you ok? Do you mind if I chat with your daughter Marceline for a few minutes”? Pierre-Louis: “Please do, I don’t really feel like talking right now any way.” GEM Nurse then speaks with Marceline.  Marceline: “My Dad has changed so much in the past few months. He is not the same, he used to look at things as the ‘glass half full’, but lately everything is bothersome. He has been in good health most of his life, but now he complains of aches and pains in his back, head, and stomach. We have had these checked out and everything is fine. He is not as excited when the grandkids come to visit – they used to be his pride and joy. When he started crying at lunch, I knew I needed to get him some help; I am worried. Something is really wrong”.

N2AA3 A Bit Out of Sorts Scenario: Chart Data

Pierre-Louis is an 85-year-old male, who is living in a retirement home.

Using a Comprehensive Geriatric Assessment, the following data was obtained:

Health History:

• Depression 33 years ago following the death of his wife; treated within 4 months
• Diagnosed with osteoarthritis of the knee at the age of 72
• Hypercholesterolemia

Medications:

• Lipitor: 40mg po od
• Acetaminophen: 500mg po q 4-6 PRN
• Denies use of any drugs

Family History:

• Father died at 63 from a myocardial infarction (heart attack)
• Mother died at 91 from cancer

Substance use:

• Enjoys the occasional beer; has 1 – 2/week
• Has been drinking more over the past month

ADLs Functional Capacity:

• Pierre-Louis can do all of the following independently: bath, dress, toilet, maintaining bowel and bladder continence, feed, and transfer
• He does not require assistance with cooking, taking his medications, and handling his finances

Fall Risk:

• Pierre-Louis has started to slow down when he walks, he walks independently but will wall walk/furniture walk at times and needs to stop frequently for breaks
• Pierre-Louis does not have a history of falls
• Pierre-Louis finds he can get lightheaded at times
• He has orthostatic BP changes; the nurse is concerned this could be related to his medications

Cognition:

• When Pierre-Louis moved into the retirement home they conducted a baseline MMSE and Pierre-Louis scored 23
• Pierre-Louis has been forgetting the date and year at times

Mood:

• Over the past month, Pierre-Louis has been feeling down, and has had little interest or pleasure in doing things that he used to love
• Pierre-Louis has been waking up early every day at 0430, as a result has been suffering from excessive daytime sleepiness

Nutrition/Weight Change:

• Pierre-Louis eats all his meals at the retirement home
• He has not been eating as much lately and his pants are starting to get loose

Sensory:

• Wears a hearing aid
• Wears glasses for reading and playing cards

Social:

• Widower: wife passed away at age 58 from breast cancer
• Two children – Marceline 60, and Emmanuel 62; both children are married
• Five grandchildren
• Immigrated to Canada from Haiti at the age of 24
• Retired at age 62
• Pierre-Louis was a certified electrician and owned his own electrical company
• Pierre-Louis loves to have a social drink during happy hour on Fridays at the retirement home
• When Pierre-Louis first moved into the home he was active in the recreational activities – enjoyed playing cards and singing in the choir

Spiritual:

• He is a Catholic, and usually attends the home church service on a weekly basis

Financial:

• Pierre-Louis managed his own money well and does not have any financial concerns
• His daughter is his financial power of attorney and helps Pierre-Louis manage his finances now

Critical Thinking Pause:  Consider your critical thinking and 3 D activities from the last case.  Is the clinical presentation in this case the same or different or a combination?  What do you suspect is going on?  What priority nursing assessments should be completed?  Be specific and explain your rationale. 

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