The Humanistic Theory in nursing was formulated by Drs. Josephine and Loretta in the mid-20th century as they worked at the Catholic University. They had been working on a task meant to cover community health and psychiatric components in a study program. They came up with the Humanistic Theory whose aim was to develop the nursing theory through studying the nursing aspects of reality and existence. This concept is based on the notion that nursing is an inter-personal operation between a patient and a nurse who exist as human beings in the world. It draws from the theory of existentialism and it offers a phenomenological method of inquiry which is used in the industry to assess and apprehend their daily practice. Existentialism is defined as a philosophy that stresses on the existence of the individual being. This person is viewed as a free being liable and answerable to their personal development process through the act of free will. It is used as a vehicle to define the principles of everyday nursing proficiencies through and inductive approach of exploration and description. Most scholars view this theory as a living dialogue that offers a structural orientation that sets a nurse's center of the universe as the interpersonal operation between the nurse and the client. The nurse, therefore, acts as the point around which the profession's functions revolve. In layman language, the defining moment of nursing is the interaction and relation between the patient and the nurse. Dr. Josephine and Loretta eventually handed over their work to Dr. Susan Kleiman, who is the chief holder and mentor of the theory.
The theory can also be described as a multidimensional and interactive one is centered on the definition of the nurse, client, and interactions between the two. The person receiving help is the patient whereas the one offering it is the nurse. Dialogue is the bridge between the theory and putting it into practice. The events occurring during dialogue and the call and response between the patient and nurse is the end product of nursing. Nurses use their professional identities and qualifications, in addition to their life experiences and project them through their trade. In this theory, nursing is also conceptualized as a live human act, and as a reaction to human acts and situations. Nursing is, therefore, not only concerned about an individuals wellbeing but with their humanity after the situation.
Rationale for Theory Selection
Nursing is a reflection of the culture in which the profession thrives and survives. The profession has been plagued with economic and technological shortages, scene variations, and lack of enough staff among other reasons. These situations in turn create a level of disorder, tension, discomfort, and insecurity among nurses. The shortcomings eventually aggravate the spirit or humanity of a nurse, which in turn, is manifested in the quality of service. The aggravation ultimately leads to self-questioning of the professional identity and purpose. The nurse is faced with a dilemma of the disappointment failing to live up to the standards of what the profession requires, or making due with the shortcomings aware of the compromised situation.
In such a case, the humanistic approach can be used to alleviate the situation because it focuses more on the interaction between the patient and client as opposed to other mechanisms involved in the treatment process. This interaction is vital in prompting confidence in the process among the patients, encouraging the nurse to find all possible means of making the relations comfortable and meaningful, and using their experience and expertise to add to the treatment process. They can also use their skills to improve the patients environment without necessarily requiring technical support. This theory is also effective in providing a holistic experience because it offers on the patients innate self. The nurse is required to understand the patient on a deeper humanity level, connecting with their human nature to meet their needs. It provides a more wholesome experience to the patients.
Theory Implementation Plan
The main factors to consider in creating an implementation plan for this theory are the four paradigms on which the humanistic theory is based. These include the person, health, environment, and the nursing experience.
Parker and Smith (2010) present the founders view of health as being beyond the simple view of the absence of disease. The theory stresses on the value of human potential beyond the absence of disease. In this paradigm, the nurse is required to explore health from a living person's perspective and compares it to the concept of undignified death in terminally ill patients. The description of undignified death from the professional's perspective is being hooked up to machines. For terminally ill patients, health is not perceived as an end goal but a resource for them to realize their potential.The main plan in this model is to ensure that the patient understands the meaning of health in this theory, and aids the patient in achieving health beyond the absence of disease.
According to Paterson and Zderad, all persons are categorized in line with their unique self (Parker and Smith, 2010). People are more than biological orgasms who grow in their situations. The two doctors imply that the humanistic approach to a persons being is concerned with increasing an individuals chances of choosing responsible paths that aids them towards a more-being. An implementation plan in this model should consist of a holistic, compassionate and nurturing effort in directing individuals towards their true self. The plan should also center on the personal relationship between the nurse and patient through a nursing dialogue. It advocates for valuing a patient's presence and understanding their autonomy. The person should be viewed as one who is special, with unique experiences, multidimensional, responsible, and capable of empathy, creativity, and communication.
Scholars reviewing the Humanistic Theory affirm of the significance of time and space as critical aspects of a patients environment (Silva, 2013). Under time factor, the patient is reflective on past experiences by attributing his or her life's meaning to the past encounters or achievements. A time shift occurs when the patient realizes that the current condition is a barrier to experiencing his or her full potential. Space refers to the immediate surroundings of a patient, for example, the admission room, bed, or visiting area. Creating a holistic experience for the patients involves finding ways to express their individualities or including personal memorabilia to create an atmosphere of familiarity and remove the depressed state. On the aspect of time, the nurse should ensure that the patient is still mentally present on earth. Some people detach themselves because they feel left out and different from others in society (Wu and Volker, 2012). This can be corrected through engaging the patient in routine work, or creating programs of interaction with others.
This model is at the center of a patient-nurse relationship defined by the complex call and response nature of engagement. The nurse is required to be there whenever the patient calls. This patient, in turn, recognizes the reliability in the nurses presence. In the case of a terminally-ill patient, the client is reliant on the nurse for full care and emotional support. They develop a genuine relationship of care and compassion. The nurse in this model should focus on creating full emotional, spiritual, physical, and educational for their patients regardless of their conditions.
Barriers and Challenges to Implementation
There are some barriers that may get in the way of providing a holistic experience in the Humanist Nursing Theory. Some of the environmental challenges include lack of a conducive environment to promote a good client-nurse relationship. For instance, lack of machines, medicine, and a shortage of staff. They affect the provision of health services thus denying nurses the opportunity to provide experiences beyond ensuring the physical well-being of patients. They are more focused on finding ways to work within the limited resources, often forgetting the main concept of the humanist theory is to go beyond the physical wellness.
Secondly, the patient situation matters in the execution of implementing this humanist theory. A normal patient may view the constraints of time and space differently from a terminally-ill one. The nurse is, therefore, tasked with the responsibility of understanding different personalities at the same time. The process may be grueling, and weigh them down emotionally especially when it comes to death after forming attachments (Wu and Volker, 2012). There may also be a personality clash between a patient and client that may affect the nature of the relationship created. Finally, nurses are evaluated on their mastery of theory concepts of nursing. Achieving the execution of being a humanistic nurse requires a certain type of personality, and; unfortunately, most training institutions do not assess nurses on their ability to connect with other people or show compassion.
Evaluation of the Effectiveness of the Humanist Theory
The most effective way of evaluation this theory is by assessing the nurses presence and performance with patients (Silva, 2013). The first aspect to evaluate is openness. Here, the nurse is assessed on their ability to open up to the patient, share memories, and give the patient full information regarding the status of their health. Secondly, a nurse's receptivity should also be measured. This evaluates the health profession's ability to listen and respond to the patient's concerns regarding life and death, and other personal issues. The third aspect covered in assessment is readiness. This characteristic entails measuring the proactive reactions of nurses. They should be able to train patients in the evaluation of their code status. Finally, the other aspect of assessment is availability. The nurse should be able to show his or her availability towards the patient at all times. He or she should also be able to provide comfort and reliability through their presence and interaction with the patients.
The Humanist Theory of Nursing was developed to add a human touch to the practice. It stresses on the quality of the relationship and interaction between a client and the nurse. Factors to consider in application of the theory include understanding the definition of nursing, the person entity, the environment and how it affects the patient, and the meaning of health. Nurses are at the core of this relationship and are tasked with the responsibility of being caring, comforting, reliable, and using their knowledge and experience in creating a holistic approach to wellbeing in their patients.
Wu, H., & Volker, D. L. (2012). Humanistic nursing theory: Application to hospice and
palliative care. Journal of Advanced Nursing, 68(2), 471.
Silva, T. N. (2013).Paterson and Zderad's Humanistic Theory: Entering the between Through
Being When Called Upon.Nursing Science Quarterly,26(2) 132-135.
Parker, M. & Smith, M. (2010) Nursing theories and nursing practices (3rd ed). SAGE Pub.
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