PROFESSIONAL ROLES AND VALUES Professional Roles and Values Nicole Gardner Western Governor University 1
PROFESSIONAL ROLES AND VALUES 2 Professional Roles and Values Nursing Theory One theorist that has influenced my own values and goals is Merle Mishel. Her uncertainty of illness theory proposes that patients and nursing staff are incapable of effective interventions when one is confused of any part of a plan of care. According to Cherry & Jacobs, “ This uncertainty renders the client either incapable of assigning a concrete value to the illness itself or to a predictable outcome.” When a patient is listened to for signs of uncertainty or concern, a nurse is respecting that patient’s dignity. Properly addressing those concerns and educating the patient fully allows the patient autonomy in his or her own plan of care. Mostly, this theory addresses the issue that there is no one intervention that ends a plan of care. Mishel suggests that the four stages of her theory, (1) stimuli frame (2) appraisal stage (3) initiation of coping mechanisms and (4) adaptation, are continuous within a plan of care. Monitoring for signs of uncertainty and empowering the client to cope effectively with illness allows for excellent care and effective education. Excellent Nursing Practices Mishel’s uncertainty of illness theory mirrors the nursing process. The first stage of the theory is the stimuli frame. This stage is about assessing the client. This assessment should include what information and procedures are unclear to the client. Communication skills and observation of nonverbal signs of agitation may need to be used by the nurse at this time. The second stage is the appraisal stage. In this stage, the nurse should be determining whether the uncertainties expressed by the client are hindering the plan of care or enhancing it. In other words, if one uncertainty is not delaying the plan of care or causing a determination by the client to work harder at an intervention, then this uncertainty may not need to be addressed by the nurse now. The third stage, or initiation of coping mechanisms, allows for further assessment of present coping skills and determining if those coping skills are effective. If not, the nurse may need to plan on interventions involving new coping skills. The final stage of Mishel’s nursing theory is adaptation. This stage evaluates the met goals of the patient. Allowing a patient to be well educated
PROFESSIONAL ROLES AND VALUES 3 about a plan of care and relieving uncertainties, gives patient’s the chance to be autonomous within the plan of care. Professional Practice Nursing Theory Mishel’s theory of uncertainty is significant in my present nursing practice as a hospice nurse.
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- Nursing Theorists