Full Answer Section

• Main Concepts:
  • Environment: Nightingale emphasized 13 canons or components of a healthy environment: ventilation, light, warmth, effluvia (odors), noise, cleanliness of rooms, cleanliness of walls, proper bedding, proper dressing, personal cleanliness, variety, taking food, and what food. She believed these external factors significantly impacted a patient’s ability to recover.
  • Person: A passive recipient of care, influenced by the environment, possessing inherent reparative processes.
  • Health: Not just the absence of disease, but the ability to use one’s well-being to its fullest extent. It is maintained by controlling the environment.
  • Nursing: The act of utilizing the patient’s environment to assist him in his recovery. It is a spiritual calling and requires specific knowledge.
• Significance of their Work in Nursing: Nightingale revolutionized nursing from a domestic task to a respected profession. Her emphasis on sanitation, hygiene, and empirical observation laid the foundation for evidence-based practice. Her work highlighted the crucial role of the external environment in promoting healing, influencing hospital design, public health policy, and nurse training. She professionalized nursing education and elevated the status of nurses.

Theorist 2: Hildegard Peplau (Interpersonal Relations Theory)

• Historical Context: Hildegard Peplau (1909-1999) developed her Interpersonal Relations Theory in the mid-20th century, publishing her seminal work in 1952. Her theory emerged during a period when psychiatry was shifting from a somatic (biological) focus to an interpersonal one, and nursing was seeking to establish its unique theoretical contributions beyond simply following medical orders. Peplau’s background in psychiatric nursing heavily influenced her emphasis on the therapeutic relationship.
• Main Concepts:
  • Person: An individual with a unique set of needs who continuously strives to reduce tension produced by needs. The person is seen as developing through interpersonal relationships.
  • Environment: Consists of cultural, social, and physical factors influencing the individual. Peplau primarily focused on the interpersonal environment created during the nurse-patient interaction.
  • Health: A forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living. It is a continuous process.
  • Nursing: A significant, therapeutic, interpersonal process. It involves a partnership between the nurse and patient, where both grow as a result of the interaction. Peplau identified sequential phases in the nurse-patient relationship: Orientation, Identification, Exploitation (Working), and Resolution.
• Significance of their Work in Nursing: Peplau’s theory fundamentally shifted the focus of nursing from solely tasks and physical care to the dynamic, purposeful interaction between nurse and patient. It provided a conceptual framework for psychiatric nursing, highlighting the nurse’s role in psychological healing. Her work emphasized communication skills, counseling, and the importance of the nurse’s self-awareness in facilitating patient growth, making the nurse’s interpersonal skills a critical therapeutic tool. She is often considered the “mother of psychiatric nursing.”

Theorist 3: Dorothea Orem (Self-Care Deficit Nursing Theory)

• Historical Context: Dorothea Orem (1914-2007) began developing her theory in the 1950s and published it most comprehensively in 1971. Her work emerged as nursing was striving for a distinct body of knowledge and as healthcare began to emphasize patient participation and autonomy. Orem’s background in nursing education and administration influenced her systematic approach to defining nursing practice.
• Main Concepts: Orem’s theory is composed of three interrelated theories:
  • Theory of Self-Care: Describes why and how individuals care for themselves. It includes universal self-care requisites (e.g., air, water, food, activity, rest, social interaction, prevention of hazards, promotion of normalcy), developmental self-care requisites (related to life stages), and health deviation self-care requisites (arising from illness/injury).
  • Theory of Self-Care Deficit: Explains when nursing is needed. It occurs when a person’s therapeutic self-care demand (what they need to do for their health) is greater than their self-care agency (their ability to meet those demands).
  • Theory of Nursing Systems: Describes how the nurse helps the patient. It identifies three types of nursing systems:
    • Wholly Compensatory: Nurse does everything for the patient.
    • Partially Compensatory: Nurse and patient share care activities.
    • Supportive-Educative: Nurse helps patient to develop self-care agency.
  • Person: A human being in continuous self-organization, a “self-care agent” with the ability to perform self-care.
  • Environment: The external surroundings in which the person lives.
  • Health: A state of structural and functional soundness and developmental wholeness.
  • Nursing: The act of assisting individuals with their self-care deficits to meet their self-care requisites.
• Significance of their Work in Nursing: Orem’s theory provided a comprehensive framework for nursing practice that emphasizes patient autonomy and self-care. It shifted the focus from nurses doing to patients to nurses helping patients do for themselves. This theory is widely used in nursing education, practice, and administration, particularly in chronic illness management, rehabilitation, and patient education. It empowers patients and provides a clear guide for nurses in assessing self-care abilities and designing appropriate interventions.