Reflective Journal Week 8
Topic: Science-Based Theory
1. Evaluate science-based theories utilized in the nursing discipline.
2. Assess potential applications of science based theories in nursing practice, research, and theory development.
Discussion Question: 8 DQ 1
Which science-based theories do you think are the most useful to advanced practice nurses, and why?
Trajectory Model of Nursing
Anselm L. Straus nominated the trajectory model of nursing as an applicable tool for managing patients that are suffering from illnesses. Patient care integration in health centers is a core priority for advanced practice nurses whose chief role is the provision of quality care to patients. It is conjoint with the reinforcement of continuity of care, coordination of accessibility to health, and strengthening the link between primary and secondary care. All these facets of health are organized via a trajectory from the time a patient exhibits signs and symptoms of ailment until the patient dies or recovers. The trajectory model of nursing is a practical middle-range explanatory theory that nurses and physicians can trust in arresting patients’ conditions with specific regard to the stage of disease advancement when patients are admitted into care.
Straus postulates that most illnesses take an eight-phase trajectory. The pre-trajectory phase occurs as a disease develops in a patient without any symptom. The trajectory onset stage is the second one, and it occurs after symptoms begin emerging. Nurses and physicians have the best opportunity to suppress diseases and treat patients at this stage. Jones and Close (2015) claim that better understanding, management, and alleviation of diseases would be harnessed if patients accessed care immediately following the first symptoms of health deterioration. However, it is rarely the case since most patients try to self-medicate and only seek professional care when they are well into the later stages and prognosis infers unlikely paths to easy recovery.
The subsequent phases are the crisis, acute, and unstable stages. Most patients seek nursing and physician intervention after they have progressed to these stages. For health workers to effectively control diseases, they first need to identify the scenario and take appropriate action. The trajectory theory is practical since it has a measured and approved schedule that determines the procedures and medication that should be taken at any one of these stages with the hope of alleviating suffering, arresting the disease, and nursing patients back to health. Longpré and Dubois (2017) postulate that patients may attribute differing paths once patients are taken into professional care. Subsequent to drug and procedure administration, patients may stabilize, relapse, or worsen. In the best-case scenarios, patients stabilize and nurses can treat other patients. Alternatively, patients can fall into the unstable condition and plummet to the terminal phases. The fatal phases are the downward phase and, ultimately, the dying phase.
Although the trajectory theory does not provide specificity in describing diseases, it provides a normal curve that is followed by almost all diseases. Pursuant to its accurateness in highlighting probable trajectories, it provides guidance on the likelihood of patient outcomes once admitted in hospitals. Nurses will find the trajectory theory useful in determining subsequent courses of action while executing their duties.
Discussion Question: 8 DQ 2
Explore various science-based theories. Select two theories to describe to your peers. How is each of these theories relevant to application for a DNP-prepared nurse.
Medical theories drive professional development and allow healthcare providers to offer personalized treatment to the patients. The medical field depends on evidence-based practice and patient-oriented treatment that allow medical practitioners to improve the quality of healthcare. To prove this point, it would be important to offer some specific examples of scientific concepts and theories that are actively used within the educational and practice spheres of medicine. Even though the interactions between science and medicine are not absolute, the two concepts are in alignment most of the time.
There is a litany of science-based theories that easily be related to DNP-prepared nurses. All nurses should be aware of these theories, but doctorate-level nurses should know how to properly apply them in a healthcare setting. One of such theories is the Gate Control Theory of Pain. Pain management may be daunting to some nurses, which is why DNP-prepared nurses should know how to synthesize the concept in ways that allows learners to take advantage of the theory (“The Gate Control,” 1978). A DNP-prepared nurse should also know the basics of the Germ Theory of Disease. The theory focuses on managing preventable infections and other related diseases (Millican, 1882). Therefore, the nurse need to pass this knowledge to other professionals to make sure that they follow infection control procedure.
A scientific mindset is not always the best answer when it comes to nursing. However, it is the correct way of proceeding and thinking in most instances. Even though a human element should always be present in nursing care, medical professionals should use proper medical theories to provide a reliable diagnosis.
The general theory of nursing developed by Orem and cultural care diversity and universality theory developed by Leininger are examples of science-based theories and can be applied to a DNP-prepared nurse. The general theory of nursing comprises three interconnected theories including self-care, self-care deficit, and nursing systems. This theory emphasizes diagnosis, nursing system design, and nursing systems production and management in the nursing process (Sitzman & Eichelberger, 2010). Thus, since the role of the DNP-prepared nurse revolves around the elements of emphasis in general theory of nursing, it makes this theory applicable. The cultural care diversity and universality theory recognized the importance of cultural understanding in nursing practice (Smith & Parker, 2015). Every culture consists of various beliefs, traditions, values, and perceptions and thus as a DNP-prepared nurse, it is critical to understand the cultural differences since it affects their role. It’s essential for the DNP to evaluate their own beliefs, tradition, values, and perceptions and become aware that others’ differences. Thus, this theory encourages the DNPs to know the different cultural backgrounds and diverse influences that affect their role (Smith & Parker, 2015).