This week, I have completed an interactive case study involving the implementation and practice of human needs nursing theories. The case study was about Juan Duran, a Mexican-American who was prescribed to take insulin injections but was not instructed how to perform them. He arrived at the hospital to ask for additional instructions. In this scenario, I play the nurse’s role to approach the patient and perform all the necessary procedures to ensure the patient’s understanding, psychological integrity, and liberty of autonomy. In my practice, I had to apply several concepts from the existing nursing theories.
The practical application of theories learned in class, as I discovered, was not as easy as it initially seemed. All four theories presented in the scenario, which included Orem’s, Neumann’s, Nightingale’s, and Henderson’s theory, seemed applicable to Mr. Duran’s case. As I discovered soon after, only two out of four theories were best suited to address the patient’s needs for autonomy and psychological integrity. Orem’s theory was applicable to deal with Mr. Duran’s lack of knowledge and capability to administer insulin shots on his own (Alligood, 2017). It also respected the patient and his wife’s cultural and linguistic background, whose ability to speak and understand the language was limited. Under Orem’s theory, she was to be instructed in Spanish to be able to take care of her husband.
On the other hand, Neumann’s theory has to deal with the stress and psychological health of the patient (Alligood, 2017). It was applicable in this case scenario because the family had suffered the loss of their daughter just two weeks ago. Addressing the need for psychological support, although not directly connected with insulin administration, is paramount.
This case study is very close to what happens in actual nursing practice. Although all nursing theories have merit, depending on the situation, most nurses usually implement only one or two to a particular situation. Different theories are applicable to different tasks. For example, a nurse charged with taking care of long-term hospitalized patients is likely to use Henderson’s and Nightingale’s theories to guide her practice. Nightingale’s theory emphasizes the environment surrounding the patient and the discipline in performing nursing duties to ensure that the patient is warm, the room is ventilated, and all the necessary hygienic precautions have been utilized (Alligood, 2017).
On the other hand, Henderson’s theory enables a nurse to facilitate relationships with the patient and serve as an enabler to achieve their basic needs (Alligood, 2017). On the other hand, Watson’s theory of care is best suited for psychiatric wards and patients who have experienced severe stress due to injuries or illnesses (Ozan, Okumus, & Lash, 2015). Neumann’s theory is also applicable in such a scenario. Using one or two theories provides the necessary focus in nursing practice, while trying to use four or more theories at the same time would distract the nurse from providing care for the patient and lead to contradictory results. The case scenario presented was relatively straightforward in terms of nursing theory application – the patient had two well-defined characteristics upon which Neumann’s and Orem’s theories were chosen. In actual nursing practice, patients possess many qualities that make the choice of a proper theory difficult.
References
Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). New York, NY: Elsevier.
Ozan, Y. D., Okumus, H., & Lash, A. A. (2015). Implementation of Watson’s theory of human caring: A case study. International Journal of Caring Sciences, 8(1), 25-35.