Theory Evaluation: Application to your current nursing practice and your anticipated practice as a  masters-prepared nurse.


In Roy’s Adaptation Model, health is defined as a “state and a process of being and becoming integrated and whole” (Parker, 2001).  I feel this embodies the concept of hospice, in which the mind and body are connected and are treated holistically. This applies to my current nursing practice, as I am an oncology nurse who sees death and dying on a daily basis. Spirituality or the metaphysical, certainly come into play when one is dying. I often have patients, who are actively dying, request a chaplain even if he or she wasn’t previously religious. They look for a purposeful and dignified death, which relates to the self-concept mode, focusing on a “sense of unity, meaning, purposefulness in the universe (McEwen & Willis, 2011). Nurses must safeguard our patients’ quality of life and ensure they have a dignified and peaceful passing. “As illness progresses, individual’s shift cognitive focus from the physical aspects of disease, to social, psychological, and spiritual expressions…these responses are outward manifestations of dying persons’ consciousness and meaning…and once assessed and measured, point to their adaptation level” (Dobratz, 2005). Again, Roy’s goal of nursing is promoting adaptation to contribute to a person’s health, quality of life and dying with dignity (McEwen & Ellis, 2011). “Nurses are in a key place to ensure if the adaptive goals have been met…nursing goals promote individual and group adaptations in each mode; contributing …to quality of life and dying with dignity” (Kalaldeh & Shosha, 2012).  The RAM is both a holistic and humanistic model; as it to ties in both scientific and humanistic values. This truly speaks to me as an oncology nurse.  I hope that I can better serve my patients, having a deeper knowledge of the adaptation processes and thus a greater understanding of the interventions I provide.


I am currently in the CNL tract of the MSN program. I hope that as I progress in my studies, I will become more enlightened as a healthcare provider and integrate the RAM, to truly assist those in the dying process “find meaning in the life transition of death and dying, which serves as an indicator of psychological adaptation” (Dobratz, 2005). Currently working in an acute care setting, I along with my colleagues tend to focus on patient’s pain control; therefore their spirituality unfortunately, becomes a secondary concern. I hope that after my advanced degree, I will have the knowledge and support to initiate a plan to meet the metaphysical needs of the
dying.  According to a study conducted by Dobratz (2005), hospice nurses were intently focused on the physical aspect of pain relief and not observing the nonphysical signs of pain. “Assessment must include listening for those affective words that describe dying persons’tensions and fears as they might indicate distress in nonphysical realms at end of life” (Dobratz, 2005). 


 A CNL possesses the “skills and knowledge to integrate patient evaluation and risk assessment…they offer the best possible care across all types of health care settings” (“MSN…, n.d.). Therefore, I feel confident that after I receive my degree, I can facilitate improved nursing interventions while helping my colleagues to have a heightened awareness of patients’ coping and adaptive processes.

References

Alligood, M.R, & Marriner-Tomey, A., Editors. (2010). Nursing theorists and their work. 7th ed. St. Maryland Heights, MO: Mosby.

Dobratz, M. (2005). A comparative study of life-closing spirituality in home hospice patients. Research and Theory of Nursing Practice: An International Journal, 19(3). 

Kalaldeh, M. & Shosha, G.A. (2012). A critical analysis of using Roy’s adaptation model in nursing research. International Journal of Academic Research, 4(4). Retrieved from       
http://www.academia.edu/1775409/A_CRITICAL_ANALYSIS_OFUSING_ROYS_ADAPTATION_M
ODEL_IN_NURSING_RESEARCH

McEwen, M.& Wills, E.M. (2011). Theoretical Basis for Nursing (3rd edition) Philadelphia: Lippincott Williams& Wilkin.

MSN clinical nurse leader specialization. (n.d.). Sacred Heart University. Retrieved from
http://onlineprograms.sacredheart.edu/msn-clinical-nurse-leader.asp

Parker, M.E. (2001). Nursing theories and nursing practice. Philadelphia, PA: F.A. Davis Company.

Roy’s adaptation theory [online image]. Retrieved from
http://nursingtheories.blogspot.com/2008/07/sister-callista-roy-adaptation-theory.html

Senesac, P. (2010). The Roy adaptation model in
practice. Retrieved from
http://www.bc.edu/content/bc/schools/son/faculty/featured/theorist/Roy_Adaptation_Mod
el/Practice.html

Sister Callista Roy [Online image]. Retrieved from
http://nursing.alumni.ucla.edu/distinguished/bio/roy.aspx
 


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