The Orems And Roys Model Nursing Essay

The Orems And Roys Model Nursing Essay The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orems Self-Care Deficit Theory and Sister Callista Roys Adaptation Model are considered as grand nursing theories. The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives. This easy furnishes a comparison and contrast of Orems Self Care Deficit Nursing Theory with Sisters Callista Roys Adaptation Model in their importance to clinical practice. Roy put forward her theory of nursing in response to motivation of her mentor Dorothy E. Johnson. After doing B.A. in nursing, she did her masters and PhD in sociology which has an impact of her theory of nursing. In her concepts, Persons are viewed as living adaptive systems whose behaviors may be classified as adaptive responses or ineffective responses. These behaviors are due to internal and external stimuli and derived from regulator and cognitive mechanism. Her Model provides the framework for nurses by viewing the adaptability of patients to internal and external stimuli in their environments (Alligood Tomey, 2006.). Nurses work towards achievement of adaptive response by four adaptive modes; Physical, Group Identity, Role Function, and interdependence. Nurses incorporate four modes by utilizing informati on about the person, adaptive level and various stimuli. By doing so, nurses manipulate these stimuli to promote adaptive responses and process of health by meeting the goal of survival, growth, reproduction and mastery. Dorothy Orems suggests that each person has a need for self care in order to maintain optimal health and wellness. Each person possesses the ability and responsibility for care for themselves. According to Orem, nursing becomes necessary when an individual can no longer care for him or herself. Nursing provides care through acting, guiding, supporting, teaching, and environmental manipulation promoting personal development. Orem developed this theory from her experience and personal connection with the Vincentian-Louisiana nursing tradition of the Daughters of Charity (Libster, 2008.) Metaparadigm for analysis The metaparadigm for nursing is the concepts that define the nursing practice. Since 1970s, person, nursing, health, and environment are considered as the core concepts of nursing theories by many nursing theorists. Person According to Orem, a person is made of a physical, psychological, and social character with variable degrees of self-care ability (Dorothea Orems Self, 2011.).Orem described the person as able to appraise situations, reflect upon them, and reason and understand them. Based on this description, the person deliberately chooses to perform specific action, something he or she can do even in the face of internal and external pressure to the contrary. She further explains that actions are goal directed; that is, undertaken to achieve valued outcomes (Orem, 1980). This view of the person as self-determined, action oriented, and goal directed is captured in Orems portrayal of the person as agent or as having agency. In view of Whall and Fitzpatrick (2005) Orem challenged, to some extent, the more prevalent view of nursing that the person is an adaptive system and can be understood as adapting to his or her environment. Roy views a person as an adaptive system that responds to internal and external stimuli in their environments (Alligood Tomey, 2010). Within the adaptive model, person is described as an adaptive system, a whole made of parts that adapts to changes in the environment and also affects the environment. The mechanistic view of person is inconsistent with the holistic view espoused by Roy. However, Roy has stated that the focus on parts is only for descriptive purpose and that the model is based on a holistic view espoused by Roy. However, Roy has mentioned that the focus on parts is only for descriptive purpose. Nursing Orem and Roy have the different attitude toward the concept of nursing. Orem sees nursing as an intervention to meet the daily needs for self-care and medical-care patients need (Dorothea Orems Self, 2011). Nursing when defined in terms of focus (for knowledge and practice), is a specialized health care service necessitated by an individuals inability to maintain the amount and quality of self -care that is therapeutic in sustaining life and health, in recognizing disease from injury or in coping with their effects. Nurses create a Nursing-System as helping system in which the method of helping is determined by the degree to which the patient is able to accomplish his or her self-care requirements as explained by Whall and Fitzpatrick (2005, p 113). Roy believes nursing as a key player to help patients to develop coping mechanism and positive outcome from the constant stimuli exposure. Roys goal is for the patient to achieve adaptation leading to optimum health, well-being, quality of life, and death with dignity, and finding in life by participating in their own care (Andrews Roy, 1999.).Two aspects of nursing are unique to the model: the two-level assessment in the nursing process and intervention as management of stimuli. The two-level assessment provides for the evaluation of the patients behavior (response) and the stimuli to which the person is responding. This notion is appropriate to the model that it focuses on person responding to stimuli. Nursing enhances adaptation through the use of nursing process, thereby promoting health through the management of stimuli or the strengthening of coping process (Andrews Roy). Health Orem defines health as physical, mental and social well being (Dorothea Orems Self, 2011.). It adds to the complexity of Orems conceptualization that health is presented as an outcome of self-care and as one of the numerous factors that influence self-car agency and self-care demand. To clarify a person in a poor state of health is likely to have diminished self- care agency that add to persons self-care demand. Roy views health as a method used by patients to obtain their utmost possible health, regardless of the presence or absence of disease. Health is a state and a process of being and becoming an integrated and whole person. It can be viewed as a reflection of the interaction or adaptation of human adaptive systems within a changing environment as elaborated by Whall and Fitzpatrick (2005, p 148). Environment Orem and Roy both state the individual exists in an environment. Orem sees the environment in two dimensions, the physical, chemical, biologic features and socioeconomic features, which influence the self-care requirements of the individual (Dorothea Orems Self, 2011.) According to Roy, the environment consists of stimuli including conditions, circumstances, and influences surrounding an individual, whether focal, contextual, or residual. Analysis for Use in Practice Orems Self-Care Deficit Theory and Roys Adaptation Model can be applied to groups or individuals, and used at any nursing settings. However, Orems Self-Care Deficit Theory is more recommended for the acute-care setting, where a patient receives active but short-term treatment for a severe injury or episode of illness. Orem focuses on finding the self-care deficit of the patient and providing the necessary care to promote his or her well-being. Whereas, Roy is concerned with the different stimuli that forces adaptation in order to achieve optimal health. A nursing model provides the structure to guide practice by providing direction for the nursing process. The adaptation model provides this direction based on its well developed guidelines for the use of nursing process. Simultaneous assessment of the behavior and stimuli leads to the identification of nursing diagnosis and the establishment of goal. The model provides the framework for intervention, which is focused on the management of the stimuli and management of the adaptive processes. Evaluation assesses the effectiveness of the intervention by examining the behavior. Roys Adaptation Model views the person as an adaptive system which includes the four adaptive modes. These adaptive modes are: physiological-physical mode, self-concept-group identity mode, role function mode, and interdependence mode. Although first two modes can be identified immediately, the assessment of role function mode and interdependence mode is time consuming. It depicts that Roys adaptation model is more suitable for chronic care settings. However, usefulness of the adaptation model in practice has been demonstrated in a variety of settings with diverse population (Alligood Martha, 2010). Furthermore, the expansion of the model offers a framework for systematic healthcare delivery to aggregate, making it more amenable to community health nursing (2010). The holistic approach of the model helps prevent putting too much emphasis on aspects of illness and allows for the inclusion of health promotion. It all adds in to the efficiency of the model in effectiveness of working on the nursing process and better patient outcome. Along with its usefulness the holistic assessment based on the model can be a lengthy and time consuming process. This concern has been found to be most problematic in intensive care units where there are rapid changes in patient condition and least problematic in long term care settings of the hospitals or health care organizations (Weiss et al., 1994). The adaptation model goes with the classification furnished by the American Nursing Association (ANA); that is, North America Nursing Diagnosis Association (NANDA), that focus on the component of nursing process. The adaptation model incorporates the specific interventions and outcomes for the specific diagnoses (Wilkinson, 2000.). This adaptation model is more suitable to clinical practice by provision of the framework for the nurses to rehearse the art of nursing process explained in the model. It is clear from the above discussion that nursing theories promotes better patient care, bring positive impact on nursing practice and improves the overall nursing standard. Along with the directing the nurses to utilize evidenced based and well thought process of care, nursing theories guide in developing nursing educational programs, nursing administration and research pertaining to nursing profession. Many organizations now exist to support the advancement of nursing profession. Sigma Theta Tau International, the Honor Society of Nursing, is created to support the learning, knowledge and professional development of nurses committed to making a difference in health worldwide (STTI Organizational, 2011.). It also worth mentioning that the two described models have professional organizations that have as their purpose to support and develop further in the models. International Orem Society promote the advancement of nursing science and provide scholarship in the area of Orems Theory of Self-Care Deficit Nursing to lead to further advancement of knowledge for the discipline of nursing (International Orem, 2011.) The Roy Adaptation Association (RAA) is a society of nursing scholars who want to advance nursing practice by developing basic and clinical nursing knowledge based on the Roy Adaptation Model (Roy Adaptation, 2011.) These organizations along with progression of the nursing the ories will promote the advancement of nursing science and enhance the nursing profession.

A Vast Improvement in Oneself

Many students today ask why they are so tired all the time. It also seems that people in college become more stressed out either because of grades or because of work. All people need to do is get the right amount of sleep, eating well, and exercise in order to feel better about themselves and feel good in general. This is not a short process. Most experts say that it takes about twelve weeks in order to see results. But, it is guaranteed that after that duration of time one will see a vast improvement in oneself. Sleep is something that most people take for granted. It is the one thing that people are willing to compromise even more then food or money. It is estimated that between 40 to 60 million Americans are sleep deprived. Different people can get by with different amounts of sleep. There are some that can survive the next day with only a few hours. Then there are always others who cannot be called after 9:00 because they need those good solid 10 hours. The average person actually needs anywhere from between 7-9 hours a night. Why does one need sleep? When human bodies do not get enough sleep they tend to lose strength, the immune system decreases, and there is an increase in blood pressure. As students, it can effect concentration, memory, logical reasoning, and ability to do math. Now that the problem is known here is how to fix it. Dr. Stanley Coren, a professor of psychology at the University of British Columbia, focuses on consistency. The body needs consistency. This can be fulfilled by simply going to bed at the same time every night and waking up at the same time every day. But, it is important to note that making up for lost sleep on the weekends is a big negative. It is preferable that if one likes to sleep on the weekends wake up at the same time Saturday and Sunday. When going to bed it should take about 15 to 20 minutes to fall asleep. If a half-hour has gone by and one still is not asleep one should get up and do something relaxing (i. e. take a warm bath, read, watch TV, etc. ). Rita Mattson, a Certified Personal Trainer and Stress Management Counselor, makes the suggestion of drinking warm milk before retiring to bed because milk contains a high dosage of L-tryptophan which is a natural sedative. Sleep is just as important as any other part of taking good care of ones self. Another key aspect is nutrition. Nutrition is the main thing that keeps the body working. So, if one wants to keep the body working at a certain pace it needs to be fed. But, one needs to know the right foods. Think of the body as a car. People drive cars every day and some people are fast drivers who like to go above the speed limit and others are slower. Nevertheless, all cars need gas sooner or later. So, the owner of the car takes the car to the gas station and now he needs to make a decision on which type of gas to put into the car. He knows that he cannot use diesel because his car cannot run on diesel gas. The choices are now unleaded, super unleaded, or supreme unleaded. Every car driver knows that the better quality of the gas the better the car drives and performs. Bodies are the same way. Know not to use â€Å"diesel. † But, when it comes to the other â€Å"gases† one has to think what does the â€Å"car† need to perform its best. For that reason, there is the nutrition pyramid to tell us what our bodies need the most and the least of. It is important to incorporate refined carbohydrates, proteins, vegetables, and fruit to ones diet everyday to ensure that the body works. The body also needs some sugar and fat. Today, people focus on â€Å"non-fat† foods. Sometimes these are not good for the body because in order to make something natural fat-free you have to put in chemicals to alter the original make up of the food. Chemicals are difficult for you body to digest therefore in a case like this it is best to go natural. Another reason that one needs to eat some fat and sugar is because this is what the body burns when you exercise. Exercise is what â€Å"separates the boys from the men. † In other words this is the number one thing that must be done to maintain a healthy body. First, one needs to know their body and what their body can endure. That depends on age, weight, and current level of fitness. The last factor determines how fast ones body burns fat. Second, figure the basal metabolism rate (BMR). The formula for that, according to Margaret Deutsch, is for adult males: weight in pounds times 12; for females: weight in pounds times 11. Also, for every 10 years older than 20 one should lower the result by 2%. Next, understand that different programs work for different people. People tend to go by the fad when it comes to picking an exercise program. Do some shopping around to see which exercise is not only fit for you but also is something that you will enjoy. Aerobic exercise is an example. Aerobic exercise is exercise, which essentially uses aerobic pathways to provide energy to the muscles involved. It is sometimes called a â€Å"endurance exercise† which means that the heart rate is raised to 70 to 85% of your age predicted Maximum Heart Rate (MHR), and held at that point for a uninterrupted 20 to 30 minutes. Another example is weight-bearing exercises. This includes picking up weights that are a portion of your body weight. To remain in shape one does not have to do a lot of it but one should do some. It is important in any type of exercising to avoid injury to the body from stretching before exercising to wearing the correct clothing. Civilization tends to be aware of the former but ignore the latter. Sports bras are a common example of women hypocritingly exercising and at the same time injuring the body. Skin and ligaments (elastic connective tissue) provide a delicate support frame for the breasts that can be damaged by too much bouncing and stretching. There are two types of sports bras: compression bras and encapsulation, harness-type bras. The first works better for smaller breasted women because of the fit and the second tends to work better for larger women. When choosing the correct one for you take into account: the fit, how much support it is giving for the exercise that is going to be done, fabric (does it absorb moisture well), seams and stitching to avoid chaffing, and mobility. After taking all these into account one can be assured that he is well prepared for the exercise routine. In conclusion, all the factors mentioned above can lead to a less stressful life. Sleep can help the body relax to deal with everyday pressure. People who eat a diet low in refined carbohydrates, sugar and caffeine, and high in whole grains, have shown a greater ability to cope with stress as in contrast to those who consume the opposite. Exercise, as well, is a way to release stress and tension (i. e. running, kickboxing, stair stepping, etc. ). If one keeps all the factors in mind a healthier happier life can be achieved.

Technology and Plagiarism

Widespread technology and communication has made both plagiarism and the detection of it easier than ever before. In the competitive field of journalism, integrity and individuality plays a massive role. The ethics of writing in a world where writing is an exponentially growing area of work are essential. In the field of journalism, writers must act according to the subject’s code of ethics. â€Å"Truthfulness, accuracy, and objectivity† (Journalism Ethics and Standards) are important characteristics that each journalist must follow. A journalistic piece must meet these indisputable standards – after all, the main idea behind journalism is to deliver the truth. There have been many cases of misconduct and disobedience of the journalistic code of ethics in the past and recent future. Zachery Kouwe, a Times business reporter, was rightly accused of plagiarizing from The Wall Street Journal. After in-depth research into his other pieces of work, plagiarism was apparent in many of his works. The New York Times article called plagiarism a â€Å"journalistic sin† to emphasize the gravity of the issue. Another excellent example of a writer compromising his journalistic integrity can be seen in Billy Ray’s Shattered Glass (2003). This movie, based on a real life story, shows the life of a journalist who’s lost his way and his integrity. Stephen Glass, a former reporter for The New Republic, was caught for a serial fraud in his articles. He fabricated quotations, sources, descriptions, and events in his stories and was eventually fired when his deception came to light. Plagiarism is a common issue for those writers who have lost their integrity. In fair play, written works must be original and accredited. We have the opportunity to use insightful ideas from countless pieces of work. There are written works available in almost every thinkable subject – anywhere from linear algebra to dance ballet. The only requirement for contributing to and taking from the gigantic world of words is integrity. Upholding this honor is the only way to avoid fraud and plagiarism.

Major Accomplishments of Cartimandua, Brigantine Queen

In the mid-first century, the Romans were in the process of conquering Britain. In the north, extending into what is now Scotland, the Romans faced the Brigantes. Tacitus wrote of a queen leading one of the tribes within the larger group of tribes called the Brigantes. He described her as flourishing in all the splendor of wealth and power.  This was Cartimandua (about 47–69 CE), whose name includes the word for pony or small horse. In the face of the Roman conquests progress, Cartimandua decided to make peace with the Romans instead of confronting them.  She was thus allowed to continue to rule, now as a client-queen.   Some in a neighboring tribe within Cartimanduas territory in 48 C.E. attacked the Roman armies as they moved forward to conquer what is now Wales.  The Romans successfully resisted the attack, and the rebels, headed by Caractacus, asked for aid from Cartimandua.  Instead, she turned Caractacus over to the Romans. Caractactus was taken to Rome where Claudius spared his life. Cartimandua was married to Venutius but wielded power as a leader in her own right. A struggle for power among the Brigantes and even between Cartimandua and her husband broke out. Cartimandua asked for help from the Romans in regaining peace, and with the Roman legion behind her, she and her husband made peace. The Brigantes did not join the rebellion of  Boudicca  in 61 C.E., probably because of Cartimanduas leadership in maintaining good relations with the Romans. In 69 C.E., Cartimandua divorced her husband Venutius and married his charioteer or arms bearer.  The new husband then would have become king. But Venutius raised support and attacked, and, even with Roman assistance, Cartimandua couldnt put down the revolt. Venutius became king of the Brigantes and ruled it briefly as an independent kingdom. The Romans took Cartimandua and her new husband under their protection and removed them from her old kingdom.  Queen Cartimandua disappears from history. Soon the Romans moved in, defeated Venutius, and ruled the Brigantes directly. Importance of Cartimandua The importance of Cartimanduas story as part of Roman Britains history is that her position makes clear that in Celtic culture at the time, women were at least occasionally accepted as leaders and rulers. The story is also important as a contrast to Boudiccas.  In Cartimanduas case, she was able to negotiate a peace with the Romans and stay in power.  Boudicca failed  to continue her rule  and was defeated in battle because she rebelled and refused to submit to Roman authority. Archaeology In 1951–1952, Sir Mortimer Wheeler headed an excavation at Stanwick, North Yorks, in northern England.  The earthwork complex there has been studied again and dated to the late Iron Age in Britain, and new excavations and research were carried out 1981–2009, as reported by Colin Haselgrove for the Council of British Archaeology in 2015. Analysis continues and may reshape the understanding of the period.  Originally, Wheeler believed that the complex was the site of Venutius and that Cartimanduas center was to the south.  Today, more are concluding the site is that of Cartimanduas rule. Recommended Resource Nicki Howarth Pollard.  Cartimandua: Queen of the Brigantes. 2008.