¶ … diverse population nurses must attend to, the concept of 'transcultural' nursing is important to understand. Instead of viewing health as a universal concept, transcultural nursing attempts to understand the conceptual building blocks of the nursing profession as cultural products that are socially-constructed. It strives to understand the similarities and differences between different health attitudes and practices (Leininger 1991). First developed by Madeline Leininger, transcultural nursing is founded upon the idea that the "health care providers need to be flexible in the design of programs, policies, and services to meet the needs and concerns of the culturally diverse population, groups that are likely to be encountered" (Transcultural nursing, 2012, Current Nursing). Nurses must be culturally astute and adapt their practices to patient's cultural needs as well as to physical needs. This concept has been somewhat controversial within the nursing profession given that Western medicine's emphasis on preserving life and optimizing treatment may come in conflict with the patient's beliefs. The book The Spirit Catches You and You Fall Down by Ann Faidman chronicles the tragic miscommunication between a Hmong immigrant family that had a daughter prone to seizures and the doctors that treated her. The family understood the condition as 'spells' with a spiritual dimension, the doctors saw the girl's epilepsy as an illness. The inability of the treatment team to fully comprehend the worldview of the family led to the child's inability to be treated by the physicians in an effective manner.

References

Faidman, A (2012).The Spirit Catches You and You Fall Down. Farrar, Straus and Giroux

Leininger M. (1991). Culture care diversity and universality: A theory of nursing. New York:

National League for Nursing Press.

Transcultural nursing. (2012). Current Nursing. Retrieved:

http://currentnursing.com/nursing_theory/transcultural_nursing.html

Topic 2: Knowledge Development in Nursing

Deductive reasoning, according to the classic conventions of systematic logic, begins with a premise which is then applied to a specific scenario. Inductive reasoning involves accumulating data and deriving a general principle from that data. It moves from the specific to the general. The scientific method is a form of inductive reasoning: generating a hypothesis, accumulating data, and then proving or disproving a hypothesis based upon that data (Scientific method definitions, 2013, Savannah River Ecology Lab). However, in most aspects of regular medical practice, it is abductive reasoning that dominates. "Abductive reasoning typically begins with an incomplete set of observations and proceeds to the likeliest possible explanation for the set. Abductive reasoning yields the kind of daily decision-making that does its best with the information at hand, which often is incomplete. A medical diagnosis is an application of abductive reasoning: given this set of symptoms, what is the diagnosis that would best explain most of them?" (Deductive, inductive and abductive reasoning, 2008, Butte College). Abductive reasoning reflects the fact that it is almost impossible to gain a full portrait of a patient's health, even within the technical discipline of radiology in which I operate: there is always some guesswork involved, given that the patient cannot be put in a perfectly controlled environment as in a standard scientific experiment (Thagard & Shelley 1997).

References

Deductive, inductive and abductive reasoning. (2008). Butte College. Retrieved:

http://butte.edu/departments/cas/tipsheets/thinking/reasoning.html

Scientific method definitions. (2013). Savannah River Ecology Lab. Retrieved:

http://srel.uga.edu/kidsdoscience/sci-method-planes/Sci-method-definitions.pdf

Thagard, P. & Shelley, C. (1997). Abductive reasoning: Logic, visual thinking, and coherence.

Waterloo, Ontario: Philosophy Department, University of Waterloo. Retrieved: http://cogsci.uwaterloo.ca/Articles/Pages/%7FAbductive.html

Unit 3: Topic 1: Clarifying Concept of Interest

"Abstract terms refer to ideas or concepts; they have no physical referents…. Concrete terms refer to objects or events that are available to the senses" (Friedlander 2012). An abstract concept is something along the lines of 'cultural sensitivity' or 'wellness.' In contrast, concrete concepts like 'pain' and 'fatigue' may be somewhat subjective, but can at least be measured and defined within specific parameters.

An operational definition is a definition that is useful to practitioners in the field. "For example, the operational definition of temperate is how much a column or mercury or red colored alcohol expands in a thin tube put in the thing whose temperature you want to measure…In contrast, a theoretical definition is based on a theory" (Operational definition, 2013, University of Indiana). For example, a theoretical application of the concept of temperature is "the Kelvin scale's 0 degrees is the temperature at which all atomic motion (theoretically) stops" (Operational definition, 2013, University of Indiana). An operational definition of transcultural nursing might be 'integrating patient's beliefs about health and wellness into treatment' versus a theoretical definition of transcultural nursing which might include 'respecting all cultural worldviews regarding health practices' (Transcultural nursing, 2012, Current Nursing).

References

Friedlander, J. (2012). Abstract, concrete, general and specific terms. Grammar Guide.

Retrieved: http://grammar.ccc.comment.edu/grammar/composition/abstract.htm

(2013). Indiana University. Retrieved:
http://www.indiana.edu/~p1013447/dictionary/operat.htm

Transcultural nursing. (2012). Current Nursing. Retrieved:

http://currentnursing.com/nursing_theory/transcultural_nursing.html

Topic 2: Application to Research and Practice

According to Bonis (2009), the concept of 'knowing' has been critical to the development of the discipline of nursing. "Various patterns of knowing, as well as research focused on reflection on experience, have been the foundation for activities and research designed to improve practice as well as patient care in clinical, community, education, cultural and administrative settings" (Bonis 2009: 1329). The realms of knowledge of nursing practice are differentiated based upon the skills of the nurse and the needs of the patient (Roussell 2013: 33).

Although what can be known may seem self-evident given the emphasis on empirical, practical observation in medicine, nursing has long stressed the 'different ways of knowing' open to nursing practitioners, including "empirical knowing, aesthetic knowing, ethical knowing and personal knowing" (Bonis 2009: 1329). Knowing is a constructed, intensely personal practice in which nurses creatively try to 'make meaning' out of their lived, personal experiences: the pursuit of knowledge can never be purely objective. Understanding knowledge as a concept rather than as a narrow series of data sets forces nurses to better understand so-called 'borderline' cases which may not actually constitute knowledge but merely heresy and opinion (Cronin et al. 2010: 65).

References

Bonis, S.A. (2009). Knowing in nursing: A concept analysis. Nursing, 65(6), 1328-1341.

Cronin, P., Ryan, F., & Coughlan, M. (2010). Concept analysis in healthcare research.

International Journal of Therapy and Rehabilitation, 17(2), 62-68.

Roussell, L. (2013). Concepts and theories guiding professional practice. Jones & Bartlett.

Retrieved: http://www.jblearning.com/samples/0763757144/57144_ch02_018_049.pdf

Topic 2: Nursing Theorists of Historical Significance

Dorothea Orem's self-care deficit theory postulates that all human beings have an inherent desire to engage in acts of positive self-care. One of its core concepts is that "people should be self-reliant and responsible for their own care and others in their family needing care" (Dorothea Orem's self-care deficit theory, 2012, Nursing Theories). The nursing process involves addressing the self-care deficit of the patient when he or she cannot care for him or herself but also facilitating self-care to the maximum extent that it is possible for the patient.

Primary care, patient education and health literacy promotion, and preventative care are all very important to Orem, given the critical role this can play in enabling patients to take charge over their own health maintenance. "Motivation, intention, and choice are essential for engagement in self-care actions" (Pickens 2012). The nurse has a role in stimulating motivation, guiding intention and facilitating choice but the nurses' actions work in conjunction with the will of the patient. Nursing may involve a "wholly compensatory system," a "partially compensatory system," and a "supportive educative system" (Rosenbaum 1986). For example, for a severely disabled child or adult, the nurse may need to subsume most of the self-care function. For an elderly patient with physical limitations, the nurse may facilitate self-care, such as providing health monitoring while the patient is living at home under the care of a family members. For an active teen, this might include providing advice about appropriate diet and exercise to facilitate athletic performance and growth.

References

Dorothea Orem's self-care deficit theory. (2012). Nursing Theories. Retrieved:

http://currentnursing.com/nursing_theory/self_care_deficit_theory.html

Pickens, J. (2012). Development of self-care agency through enhancement of motivation in people with schizophrenia. Self-Care, Dependent-Care & Nursing, 19(1), 47-52.

Rosenbaum, J. (1986). Comparison of two theorists on care: Orem and Leininger. Journal Of

Advanced Nursing, 11(4), 409-419. doi:10.1111/j.1365-2648.1986.tb01268.x

Unit 5: Topic 1: Nursing Philosophy and Models

Imogen King's theory of goal attainment postulated "nurse and client communicate information, set goal mutually and then act to attain those goals" and "each human being perceives the world as a total person in making transactions with individuals and things in environment" (Imogen King's theory of goal attainment, 2012, Current Nursing). King was one of the first nursing theorists to suggest that human beings should be conceptualized as 'open' systems, subjected to the influences of the environment and assessment of that environment is a critical component of nursing (Uys 1987). Her theory is described as a 'grand' theory because of its sweeping, all-encompassing nature which contains prescriptive aspirations for all aspects of nursing care (Theory, 2012, Current Nursing). King defines the core components of nursing in terms of 'systems:' personal, interpersonal and social systems. Human beings are seen as social beings that can make decisions about goals and have a need for health information. Similarly, just as human beings are dynamic changing entities so is health: "which implies continuous adjustment to stressors in the internal and external environment through optimum use of one's resources to achieve maximum potential for…