Dr. Faye Abdellahs typology of the 21 nursing problems is a theoretical approach primarily concerned with problem recognition using a problem analysis strategy. Fayes theory is categorized under the nursing philosophy classification in the perception that the theory is grounded in analysis, rationalization, research and coherent argument instead of the application of experiential strategies (Alligood, 2014). Therefore, Fayes model is an inductive approach since she obtained the observations from earlier studies which became the foundation for her conceptualization. The statements are not experimental since they are based on objectives, traditions, and values that cannot be verified for its precision or imprecision hence her work is philosophical.
Application of the 21 nursing problems approach enables the clinician to evaluate the patient, propose nursing diagnosis and strategize intervention. Fayes chief aim is the enhancement of the nursing education, that is, both nursing education and the practice. The model transforms the professional objective from disease-focus to patient-focus. The patient-focused approach was made useful in nursing practice since it aided in bringing the structure and organization to what was an initially unsystematic assortment of nursing care experiences.
Extensive research acted as a foundation for the selection of the 21 problems categorizations hence making her work very applicable and useful. Currently, Fayes framework has stimulated research on the responsibilities and role of the nurse (Raingruber, 2014). The diversified concept in her structure gives the opportunity to pinpoint directional relationships in nursing interventions. Presently, Fayes amazing research, publications, and global reputation have been influential in disseminating the patient-focused approach to educational platforms worldwide. Instructors realized that revisions are mainly crucial if the nurses were to be self-governing. They identified the primary failure in the occupation was the lack or incompleteness of the scientific form of knowledge exclusive to nursing.
After the development of disease in a patient whose diagnosis necessitate treatment through hospitalization for a surgical intervention the patient and the family members or the primary caregivers are involved in a manner that may comprise experience of numerous emotional variations. For instance, when the patient is in the ICU, the emotional variations most frequently observed are anxiety, stress, and depression (originating from family, technical or financial issues) or intensive care syndrome(Kenner, 2017). In this period excessive noise might make rest and sleep hard, pain approaches for ventilation purposes that alter the effective communication of the patient.
Additionally, the patient develops a sense of self-discipline loss as results of the sensation of safety and knowledge of what happening. The patients in most cases become aggressive and rude to handle and in some scenarios may utter insults especially if they are VIP patients. As a nurse (human) its difficult to manage such a patient, and many of the nurses defensively raise the voice to the patient in harassment without critically and logical igniting a friendly conversation despite the unconducive environment. In some scenarios, if the patient is not handled well might develop Posttraumatic Stress Disorder after hospital discharge (Kenner, 2017). Therefore, its appropriate for the treatment of the patient to be multidisciplinary, meeting both the physical requirements of the condition/disease and the psychological requirements too. Psychological aspects are determinants of the therapeutic advancement; the requirement becomes clearer for hospitals and medical practitioners to consider psychosocial and cultural requirements of the patient to treat the individual wholly not just the condition entity.
Solving Health Issue using Dr. Fayes Model
Fayes approach towards the psychological needs is based on the problem-solving technique which acts as outlining nursing problems as the patient shifts to a healthy prognosis. The psychological care includes the acceptance of the finest likely objectives in the presence of limitations both physical and emotional, application of the community resources to help in resolving the health issues that originate from the diseases and comprehending the significance of the social problems as critical aspects in the case of illness (Alejandro, 2017).The model identifies ten steps in the identification of the patients problem and nursing skills about the psychosocial requirements.
Firstly, the clinician should in advance learn to know the patient; this entails the religious background, community norms, and values, their occupation that is entirely knowing them personally. Secondly, the nurse should select relevant and significant regarding the health issues and community standards of the patient. Thirdly, the clinician should make generalizations on the available data in connection to similar nursing issues presented by other patients. This step entails the anticipation from the patient and how one should handle the patient if they show the same reactions. Fourthly, the clinician should identify the therapeutic plan for the patient on the grounds of the norms, cultural values, and psychological reactions or issues. Then, the clinician should test the generalizations with the patient and make more generalizations based on the observation of the patient being handled. Next, authenticate the patients conclusions about his nursing problems for instance rough complaint when disinfecting the wound. Then, the clinician should progress to observe and assess the patient for a while to identify any attitudes and clues that are impacting his/her behavior (Oyira & Ella, 2016). Then, integrate the patient and their family to the therapeutic plan since the patient behavior can arise from ignorance of what happening to them and their future. Next, identify how you (nurse/clinician) by patients complaint and if you can handle them. Lastly, discuss and develop a comprehensive nursing care plan which includes catering for psychological needs.
The nursing skill required in the implementation of the decision to handle the patient is effective patient-nurse communication and shared resolution since they are principal components of the patient-focused care. The skills require informed, motivated and participatory patient and family collaboration with a patient-focused care team that has effective communication tactics and is anchored by an available, well-organized and responsive healthcare system (Alejandro, 2017). The patient-focused communication will be aimed at foster mending relationships, exchange knowledge, react to emotions, controlling uncertainty, making resolutions and facilitating patient self-management. The six objective will facilitates implementation of an ideal plan for enabling meeting of psychological needs.
Dr. Fayes model is inconsistent with the concept of holism which states that holistic nursing is based on the philosophy of living and being that is founded on caring, relationship, and interconnectedness; the nature of the 21 nursing problems confirms this (Bluhm, 2014). Consequently, the patient may be identified as having plentiful that would lead to fractionalized attention efforts and the possible problems ultimately might be ignored since the client is thought to be at a certain stage of illness. Dr. Fayes model should be researched practically to demonstrate if the steps that she has stated and the expected nursing skills are logical and rational in the caring of the patient, especially with multiple conditions.
Alejandro, J. I. (2017). Lessons learned through nursing theory. Nursing2017, 47(2), 41-42.
Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.
Bluhm, R. L. (2014). The (dis) unity of nursing science. Nursing Philosophy, 15(4), 250-260.
Kenner, C. A. (2017). Trends in US Nursing Research: Links to Global Healthcare Issues. Journal of Korean Academy of Nursing Administration, 23(1), 1-7.
Oyira, E. J., & Ella, R. E. (2016). Knowledge Practice and Outcome of Quality Nursing Care Among Nurses in University of Calabar Teaching Hospital (UCTH). Journal of Education and Training Studies, 4(11), 179-193.
Raingruber, B. (2014). Health promotion theories. Contemporary health promotion in nursing practice, 53, 53-94.
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