Nursinf Theories in relation to Clinical Practision in Nursing

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Nursing Theories in relation to Clinical Practicum in Nursing:

Nursing Theories in relation to Clinical Practicum in Nursing

A Model of Nursing Practice:

A Model of Nursing Practice Philosophy of Care Philosophy of Therapy Scientific Dimension Ethical Dimension Aesthetic Dimension Deliberation Enactment

Clinical Practice: As Use of Knowledge & Application of Skills:

Clinical Practice: As Use of Knowledge & Application of Skills Engagement in clinical situations as a professional nurse Engagement in nursing practice processes for patient care Involvement in the organized system of nursing service

Knowledge for Clinical Practice:

Knowledge for Clinical Practice Declarative (Theoretical) Knowledge – “ Knowing that ” Procedural (Practical) Knowledge – “ Knowing how ”

Private Knowledge for Practice:

Private Knowledge for Practice Declarative Knowledge Gained through formal and informal learning – Accessed from the Public Knowledge Abstract in nature Symbolic Models Procedural Knowledge Gained through personal experiences Situational in nature Lead to Schemata and Scripts

Relationship between Knowledge in the Public & Private Domains:

Relationship between Knowledge in the Public & Private Domains Private Knowledge Public Knowledge Knowledge Assimilation Knowledge Use In Practice Theory Development Research Consensus Development Standard Setting Maxims & Models Other Personal Experiences

Processes of Knowledge Use in Clinical Practice:

Processes of Knowledge Use in Clinical Practice Practice Situation: Multiple Phenomena Private Knowledge Private Knowledge Private Knowledge Private Knowledge Practitioner’s Framing of Situation – Problem Definition Selection of Theories & Strategies for Nursing Approach Enactment of Nursing Approaches or Interventions Public Knowledge Public Knowledge Public Knowledge Public Knowledge Step 1 Step 2 Step 3 Step 4 Practitioner’s Perception – Definition of Situation

Nursing Theories in Step 1:

Nursing Theories in Step 1 Nursing Theories for Attaining Practitioner ’ s Perceptions and Definition of the Situation Inferential – General Nursing Theories or Frameworks – Preference established Referential – Private Theories of Clinical Schemata

Nursing Theories in Step 2:

Nursing Theories in Step 2 Nursing Theories for Framing the Situation and Problem Definitions Inferential – Nursing theories of description & explanation (Causal and non-causal theories) Referential – Declarative referential theories of clinical experiences; Private theories of patterns and scripts Transformative – Declarative transformative theories for understanding & emancipation Desiderative – Theories of “ normality ”

Nursing Theories in Step 3:

Nursing Theories in Step 3 Nursing Theories of Alternative Nursing Approaches and Therapeutics Inferential – Prescriptive & nursing approach theories Referential – Public & Private descriptive theories of nursing approaches Transformative – Emancipatory theories of nursing approaches Desiderative – Normative theories for selection of nursing approaches

Nursing Theories for Step 4:

Nursing Theories for Step 4 Nursing theories for acting in clinical situations Inferential – Action theories of practice Referential – Descriptive theories of situated nursing practice; Private practice scripts Transformative – Emancipatory theories of action Desiderative – Normative theories of action

Nursing theories & Practice:

Nursing theories & Practice Nursing practice through the synthesis of knowledge (theories and other understandings) – Synthesis means: Selection of appropriate theories for the situation Putting together the selected theories at specific steps Establishing a specific practice model for a given clinical situation

Clinical Practicum in Nursing:

Clinical Practicum in Nursing Situation-specific, person-centered clinical experiences for obtaining practical knowledge – Schemata & scripts (Exemplars) Exposure to a variety of clinical situations Progression in experiences from simple to increasingly complex clinical situations Gaining clinical competency through skill development and broadening and deepening of clinical knowledge

Clinical Practicum:

Clinical Practicum Expansion of the Stock of Private Knowledge of Nursing Relevance Learning how to synthesize knowledge (theories) effectively Expansion of Clinical Skills Critical thinking & decision making Working with Data (Assessment, Analysis, & Evaluation) Technical skills (Environmental & instrumental controls, Monitoring & Supportive techniques, etc.) People skills (Interaction, Communication, Empowering, Counseling, Advocating, Teaching, etc.) Nursing therapeutics

Teaching Nursing Theories in Clinical Practicum:

Teaching Nursing Theories in Clinical Practicum What nursing theories exist as the declarative knowledge What nursing theories exist integrated into the procedural knowledge Discrimination of what theories are appropriate in specific clinical situations What nursing theories are lacking in students – How to assimilate nursing theories in the Public Domain

Approaches to Teaching in the Clinical Practicum:

Approaches to Teaching in the Clinical Practicum Reflective Practice – Donald Sch ö n Critical Reflective Inquiry Narrative Phase Narratives through recall of practice for depth-description of patient-care incidences (action, thinking, & feelings) Reflective Phase Analytic reflection on theories-in-use and knowledge (theories) use Critical Phase Critique of practice vis- à -vis a normative model of practice Engagement in Emancipatory and educative processes

Critical Reflective Inquiry:

Critical Reflective Inquiry Narrative Phase Reflective Phase Critical Phase Narrative Writing Actions Thinking Feelings Espoused theories (Scientific, Ethical, Aesthetic) Description of the Context Description of the Intension Description of the Self Self Emancipation Mutual Emancipation Improvement of practice Development of an ideal practice Discovery of Theories-in-use Identification of Nursing Theories Applied in Practice Identification of Ideal Nursing Theories for the Situation