On the Way to Theoretical Nursing:Stages and Milestones

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辩论护理之路:阶段与里程碑

Despite the barriers against theoretical thinking and theorizing
identified in the previous chapter, nurses, in caring for human beings
in an orderly and organized way, have always been involved in some form
of theorizing. Concepts of care, comfort, communication, protection,
healing, and health, among others, were used to guide clinical practice
before they were labeled as concepts and before they were linked
together to form nursing theories. However, between 1950 and 1980, a
process of serious labeling and a more systematic communication of
concepts and theories occurred. This process continues to enrich the
discipline of nursing.

固然在上一章中关系的理论思考和理论化障碍存在阻力,医护人员在有序和有组织地招呼人类方面一向参预某种格局的说理商量。护理,舒适,交流,体贴,康复和例行等概念被用于辅导临床实践,然后才将它们标记为概念,并且在将它们总是在协同形成护理理论在此之前。但是,在1946年到一九七六年时期,产生了三个庄严的价签和更系统的定义和驳斥交换的进度。这一个进程持续拉长护军事学科。

First attempts in theoretical nursing were made by Florence Nightingale
in the late 19th and early 20th centuries to describe nursing focus and
action in the Crimean War.Nightingale was prompted to articulate her
ideas in numerous publications, with different goals. Among these goals
were gaining support for a national need for nurses, achieving
acceptance for the development of educational programs for nurses, and
exposing the unhealthy environmental conditions that were endured by
English soldiers during wars.

弗Loren斯·南丁格尔于19世纪末和20世纪初第二回尝试实行辩驳护理,描述了克里米亚战争中的护理重点和行动。南丁格尔被促使在不少出版物中阐释他的视角,并建议分化的对象。这么些指标之一是获取对国家对护师的须要的支撑,为看护的教导安插的开拓进取取得接受,并暴暴光战争时期英国士兵忍受的不健康的条件规范。

Subsequent attempts in theorizing were published by American nurse
educators in the mid- 1950s, prompted by the need to justify different
educational levels for nurses and the need to develop curricula for each
of the educational levels in nursing. To differentiate curricula, and to
enhance the quality of education in each curriculum, a few pioneer
nurses combined their clinical expertise with forward vision to answer
such questions as “What are nursing goals?” and “What ought to be the
aims of nursing?” These early theorists were aware that by developing
programs that represented a nursing perspective, they would help nursing
students—that is, future clinicians—to focus on nursing phenomena and
problems rather than on medical phenomena and problems. Groups were
formed in different parts of the United States (and subsequently or
simultaneously in other parts of the world) and committees were formed
to discuss the nature of nursing, the nature of nurses’ work, and the
unique aspects of nursing. The goals of these early efforts were also
focused on differentiating nursing from other health science
disciplines. These dialogues went further to explore the nature of
nursing knowledge.

跟着的理论化尝试由米利坚医护人员教育工笔者在20世纪50年份中期宣布,需求证实差异的看护教育水平是入情入理的,并且必要为看护中的各类教育级别制定学科。为了差别课程设置,并增强每门课程的教育质量,一些先驱护师将其医疗专业知识与前瞻性视野结合起来,回答诸如“什么是医生和护师目的?”和“护理目的应该是怎样?”等题材。这几个先前时代理论家意识到,通过付出代表护理观点的安排,他们将帮扶护法学生(即将来的看病医务卫生人士)专注于护理现象和难题,而不是看病意况和题材。在美利坚联邦合众国的两样地点(随后或同时在世界其余地点)成立了小组,并树立了委员会来研商护理的属性,护师工作的品质以及医生和医护人员的超过常规规方面。这几个前期工作的对象还集中在将护理与其余常规不利学科区分开来。那么些对话进一步钻探了护理知识的属性。

Perhaps the best way to consider the history of nursing theory and to
analyze nurses’ current interest in theory in perspective is to consider
dominant themes in the different stages of the development of nursing
knowledge (see discussion on Nursing Perspective in Chapter 6). The
implicit assumption here is that the themes discussed in the literature
are indicative and representative of what members of the discipline were
interested in at different times during the process of its development.
In addition to delineating these themes, an analysis of the
theory-literature provides us with specific milestones that may have
helped in the development of theoretical nursing. Both approaches
provide insights into how nursing evolved into its current status.

大概考虑护理理论历史和剖析护师当前对理论的志趣的最好办法是在护理知识发展的不一样阶段考虑主导宗旨(参见第⑤章的护理观点斟酌)。那里包蕴的借使是,文献中钻探的核心是提示性的,并表示了该学科在其前进进度中不一样时期对怎么成员感兴趣。除了讲述这一个核心外,对理诗歌献的辨析为大家提供了可能带动理论护理发展的现实里程碑。那三种艺术都提供了医护怎么样演化成其日前事态的见地。

In this chapter, the themes are articulated as stages that have
influenced progress in knowledge development. Stages are complemented by
milestones, which characterize the turning points for moving from one
stage to the next. These stages and milestones helped achieve the
current level of progress in the discipline.

在本章中,宗旨被演讲为影响知识发展进程的等级。阶段是由里程碑来补充的,这一个里程碑描述了从二个阶段转移到另贰个阶段的关头。这一个等级和里程碑有助于达成本学科方今的上扬程度。

冯Lily教师,U.S.A.登记医护人员、医生和医护人员师、总结机学位等身份,她一贯在上学在升高,此次是20多年来第③次回国出席我们进行的议会。

STAGES IN NURSING PROGRESS

在几年前就与冯老师在议论国内外护理的展开难点,相比国内和美利哥的性状,只怕有借鉴学习的地点,很多时候越聊越深切,由此老是沟通都到半夜,其实,她在美利坚合众国,我们在地球的两面调换,即使有微信那样的通信工具,但有个别剧情也不能够在微信说清楚。

看护进度中的阶段

Since the time of the Crimean War, nursing has gone through many stages
in its search for a professional identity and in defining its domain. It
is interesting to note that our analysis and evaluation of nursing’s
theoretical thought, the patriarchal societies we live in, and the view
and status accorded nurses and nursing may make it appear as if each of
these stages was a deviation from the goal of establishing the
discipline of nursing. However, each of these stages has indeed
sharpened and clarified the dimensions needed for the establishment of
the scientific aspects of the discipline, promoting or leading to a
scholarly evolution of the nursing discipline. Each stage has helped
nurses come closer to identifying the domain of nursing, defining its
mission, and defining its theoretical base. Progress in the development
of theoretical nursing is definable in terms of six stages: practice,
education and administration, research, theory, philosophy, and
integration.

自克里米亚战争以来,护理在追寻工作身份和概念其世界方面经验了累累等级。值得注意的是,我们对医生和护师理论思维,大家所生存的男权社会以及医护人员和护理职员的见地和地位的辨析和评估可能会使得看起来每一种阶段都距离了创建护文学科。但是,那几个等级中的每一种阶段的确曾经济建设立和澄清了建立该学科科学方面所急需的维度,促进或促成了医生和护师学科的学问演化。各个阶段都援救护师更类似鲜明护理领域,分明其义务,并规定其论理基础。

专程是谈到事情拓展的难点,很三人都只认为,学护理,一辈子便是治病上的小医护人员了。其实不是,看冯老师的身价,已经是跨专业甚至是跨界了,哪怕是作者,也都致力教师、管理网站、呆过手术室、依旧临床网络的出品高管,也终于跨了无数行业。

Stage of Practice

在设计医护人员笔记APP的护士身份分类时,当时就把医护人员可开始展览的直白总计为以下十七个

实施阶段

The Western version of nursing as an occupation dates from the late 19th
century and the early 20th century, a product of the Crimean War.
Because of the need to care for wounded soldiers, Florence Nightingale
organized a group of women to deliver care under her supervision and
that of the war surgeons. Nightingale focused on hygiene as her goal and
environmental changes as the means to achieve that goal.

作为职业的西方护理版本的野史可追溯到19世纪末和20世纪初,是克里米亚战争的产物。由于必要照顾受伤的大兵,弗Loren斯·南丁格尔公司了一群女士在他的监察下和烟尘产科医师那里提供护理。南丁格尔以净化为目的,以环境变迁为手段达成这一对象。

The Eastern version of the beginning of nursing gives credit to Rufaida
Bent Saad al-Aslamiya (also referred to as Koaiba Bent Saad), who
accompanied the prophet Mohammed in his Islamic wars. She, too,
organized a group of women and focused on hygiene and environment in
caring for the wounded. She established special moving tents to attend
to the sick, the wounded, and the disabled. She modeled first aid,
emergency care, and long-term healing and caring. She cared for patients
and trained women in the arts of first aid and nursing (Fangary, 1980;
S.H. Hussein, personal communication, 1990). Like Nightingale,
al-Aslamiya established the first school of nursing in the Muslim world.
In addition, she conceptualized a code of ethics for nurses and inspired
young women to be educated (Jan, 1996). Like Nightingale, her role in
nursing did not end with the war. al-Asalmiya continued to advocate for
health care, preventive care, and health education.

开班护理的东面版本赋予Rufaida Bent Saad al-Aslamiya(也号称Koaiba Bent
Saad),他在伊斯兰洲大学战中陪伴先知穆罕默德。她也协会了一批妇女,专注于照顾伤员的干净和条件。她建立了出格的活动帐篷来照顾病者,伤员和残疾人。她仿效了急诊,殷切护理和长久治疗和医生和医护人员。她关怀病人并磨炼妇女开始展览急救和看护(Fangary,一九七九;
SH
Hussein,个人通信,1988)。像南丁格尔一样,al-Aslamiya在穆斯林世界建立了第①所护理高校。其它,她还为护师和启发性年轻女性举办了伦理规范概念教育(一九九七年2月)。像南丁格尔一样,她在护理中的剧中人物并没有乘势战事而终止。al-Asalmiya继续发起保健,预防保健和例行教育。

Hussein (1981) described al-Aslamiya’s devotion to nursing and her
success in establishing new rules and traditions for quality nursing
care as precursors to modern nursing in the Middle East. In both Eastern
and Western versions of the beginnings of nursing, a woman saw the need
for organizing other women to care for the wounded in wars; in both,
they provided emergency care as well as long-term care. They both
focused on caring, healing, promoting healthy environments, and on
training other nurses. They both were driven by moral commitments to
alleviate suffering and enhance healing.

Hussein(1983)描述了al-Aslamiya对医生和医护人员的忠爱和她在确立新的条条框框和优质护理守旧地点的中标,那些规则和历史观是中东现代护理的前人。在护理伊始的东西方版本中,一名女孩子认为有要求组织别的女性照顾战争中的伤员;
在那两上边,他们都提供火急护理和漫长护理。他们都留意于关切,康复,促进健康环境,并培育其余医护人员。他们都蒙受道德承诺的驱使,以减轻伤心和压实医疗。

Therefore, during this stage, the mission of nursing was defined as
providing care and comfort to enhance healing and a sense of well-being,
and to create a healthy environment that helps decrease suffering and
deterioration. Nurses defined their domain to include the patient and
the environment in which the care is offered. Both Nightingale and
al-Aslamiya created and monitored the environment in which the care was
being given. The stage of practice gave nursing its raison d’être, its
focus, and its mission. Theoretical writings by Nightingale (1946)
describing the care goals and processes are testimony to the potential
for nurses to articulate practice activities theoretically. These
writings also point to the potential for nursing as a field of practice
to be articulated theoretically.

故此,在那一个等级,护理的义务被定义为提供护理和舒心,以升高康复和幸福感,并创设3个有助于收缩痛楚和恶化的健康条件。护师将其领域定义为包含病者和提供护理的条件。Nightingale和al-Aslamiya都创设并监测了医生和医护人员的条件。实践阶段赋予护理其存在的理由,其症结和沉重。Nightingale(1947)的叙说护理指标和进程的辩白着作注明了护师从理论上演说实践活动的潜力。那个着作也提出护理作为一个履行领域的或许在答辩上赢得解说。

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Stage of Education and Administration

本来,上边的专科医护人员很多还没发展宏观,甚至是才起来在境内实施。

有教无类和行政阶段

From that early focus on practice and the concomitant traditions of
apprenticeship and service, there was a shift to questions related to
training programs and nursing curricula. The “how to” of practice
eventually was translated into what curriculum to develop to support
different levels of nursing education and how to teach it. Almost three
decades were spent experimenting with different curricula, ways of
preparing teachers, modes of educating administrators for schools of
nursing and for service, and ways of preparing nurse practitioners.
During this stage, the focus was on the development of functional roles
for nurses. The dominant themes of this stage evolved from the
educational and administrative roles of nurses.

从初期对履行的珍爱以及陪同的学徒和服务守旧出发,转向了与创设陈设和医生和医护人员课程有关的题材。实践的“怎样”最后被转正为升高的学科,以援助分化层次的看护教育以及哪些教师它。将近三十年的日子花在品尝分化的课程,准备教授的主意,为看护和服务高校教育管理职员的法门,以及准备执业医护人员的章程。在这么些阶段,重点是医护人员职能角色的上扬。那么些等级的主要宗旨是从护师的启蒙和行政剧中人物衍生和变化而来的。

The significance of this stage in the theoretical development of the
discipline lies in the impetus it provided nurses to ask questions
related to the domain of nursing. In developing curricula geared toward
preparing nurses for different educational levels, nurses asked: What is
nursing? How different is nursing care as provided by a diploma
graduate, an associate-degree graduate, a bachelor of science graduate,
or a master’s-degree graduate? These questions prompted nurses to
articulate the core of nursing practice in more theoretical terms
(Henderson, 1966). In a curious way, it is during this stage that the
theoretical ideas of the pioneering American nurse theorists were born.
A focus on teaching and education, therefore, may have paved the way for
the further development of theoretical nursing.

这一阶段在该学科理论发展中的首要意义在于它提供了医护人员向医生和护师领域提议难点的重力。在制定面向分歧教育水平医护人员的学科时,医护人员问:什么是守护?由文凭结业生,副大学生结业生,历史学硕士学位或博士学位结业生提供的守护服务有多分裂?那个题材促使医护人员用愈多的答辩术语来表明护理实践的主导(Henderson,一九六七)。奇怪的是,正是在那一个阶段,美利坚协作国看护先驱理论家的论战观念诞生了。由此,器重教学和教诲大概为辩驳护理的更为升高铺平道路。

今天看了冯老师的PPT,美利坚联邦合众国竟然有100种护师工作,而且,各样都有相应的中式格局。

Stage of Research

有100项护理分支,不肯定都适合国内,但能够毫无疑问的是,那是看护行业提升的可行性,高学历,高等专科高校业的课程。

研讨等级

The stage of research evolved through a series of events overlapping
with the stages of practice and education. As Gortner (2000) indicated,
during the 1920s, case studies were formulated as teaching tools, but
they also were used as an impetus for standardization. Systematic
evaluation of these cases triggered the need for graduate education
during the post-Depression years in the United States. The war years
required data collection and analysis, necessitating the establishment
of the Division of Nursing Resources as part of the U.S. Public Health
Services in 1948. The beginnings of a research enterprise were born. In
the 1970s, commissions and councils of nurse researchers were
established. Nurses increasingly were receiving graduate degrees in
other disciplines, funds for National Research Service awards were
established, and nursing research journals were initiated.

探讨等级是通过一三种与履行和引导阶段重叠的事件演变而来的。Gortner(三千)提出,在20世纪20年间,案例钻探被制定为教学工具,但它们也被看作标准化的引力。对那些案例的体系评估引发了美国民代表大会萧条后的博士教育须要。战争时代需求多少收集和剖析,由此必要在一九五〇年确立U.S.A.共用卫生服务机关,创设护理能源机构。2个研商公司的降生就此诞生。在20世纪70时代,护师商讨员委员会和理事委员会制造。医护人员更加多地在任何课程获得硕士学位,国家研讨服务奖的工本已经确立。

The momentum in nursing in education, curriculum development, teaching
and learning strategies, and in administration also led educators to
pursue research. Experts in nursing curricula recognized that without
research and a systematic inquiry into, for example, the different
teaching/learning modalities and the teaching/learning milieu on
outcomes, the education of nurses could not be improved. Therefore, the
research interest emerged from and focused on questions related to
educational and evaluative processes. The scholarship in teaching
dominated the early research enterprise.

护理在教育,课程开发,教学和学习策略以及管理方面包车型地铁自由化也导致教育工作者实行研讨。护理课程专家认识到,借使没有色金属钻探所究和系统钻探不一样的教学/学习方法和教学/学习条件对成果的熏陶,医护人员教育就不大概获取改良。因而,研商兴趣从事教育工作育和评估进度中出现并集中于难点。教学奖学金主导着早期的切磋型公司。

How to teach, how to administer, how to lead, and which strategies would
be more effective in teaching and administering were questions that led
to the development and expansion of nursing research (Gortner and Nahm,
1977). The first nursing research journal—entitled Nursing Research— in
the world was established in 1952, in the United States, and the
Southern Regional Educational Board (SREB) and the Western Council for
Higher Education in Nursing (WCHEN) were founded in the mid-1950s and
mid-1960s, respectively. Their objectives called for improving nursing
education, enhancing nursing research productivity, and raising the
quality of research. The journal and the meetings of the SREB and WCHEN
helped nursing develop its scientific norms—that “set of cultural values
and mores governing the activities termed scientific” (Merton, 1973, p.
270).

怎样教,如何保管,怎样领导以及怎么样政策在教学和管理方面更实用是致使护理切磋升高和扩张的题材(Gortner
and
Nahm,1976)。1951年,美利坚独资国创立了第1份名为“护理研商”的守护钻探杂志,南美地区教委(SREB)和西方护理高教育委员会员会(WCHEN)创造于1953年中。
20世纪50时期和60时期中叶。他们的目标须要千锤百炼护理教育,提升级护师理切磋的生产率,进步钻探品质。该杂志和SREB和WCHEN的集会帮衬护理人士发展其科学规范,即“一套文化古板和管理科学活动的文化”(默顿,一九七一年,第一70页)。

Criteria for reviewing scientific papers were established, on the basis
of the assumption that scientific inquiry must be judged by peers.
Therefore, nurse researchers began to abide by Merton’s norm of
universalism, the impersonal evaluation of a research product by some
objective criteria (Merton, 1973, p. 270). Universities also held the
same expectations for nursing faculty that they held for other faculty;
specifically, members of faculty in schools of nursing were required to
develop their ideas and communicate them in the scientific arena through
publications in refereed journals and scholarly presentations in
meetings. Therefore, when seen in the context of science, the “publish
or perish” dogma was not unrealistic but was rather another norm
governing nursing science. Nurses were now involved in that
communality—the sharing of ideas—and their research was subjected to the
scrutiny of their peers and anonymous critics (Gortner, 1980; Merton,
1973).

科学诗歌的评审标准建立在不利探索必须由同行业评比议的功底上。因而,护师研究职员初阶服从默顿的普遍主义规范,即经过客观标准对研商产品举办合理评价(默顿,壹玖柒伍年,第壹70页)。大学也对她们为其余老师担任的护理教授抱有一致的盼望;
具体而言,护理高校的导师成员须求宣布本身的想法,并透过在学术期刊上刊载的篇章和在学术会议上的学术演讲在不利领域进行沟通。由此,从天经地义的角度来看,“出版或消灭”教条并非不现实,而是管理护理科学的另三个正规。

Nursing’s initial attempts at introducing ideas and sharing research
results were met with severe and, at times, devastating criticisms from
other nursing colleagues. (Those who participated in early research
conferences may remember the lengthy and severe research critiques that
traumatized researchers and audience alike. These authors of these
critiques may not have considered the stage of nursing research
development.) As a result, and in addition to universality and
communality, two other norms evolved: objectivity and detached scrutiny.
Objective criteria for research evaluation, which were identified and
shared, provided a turning point—a scholarly medium for research
refinement and further development (Leininger, 1968).

护理在介绍想法和享受商讨成果方面包车型地铁伊始尝试遭到了其它医生和医护人员同事严重的,有时甚至是毁灭性的批评。(那么些参与过早期斟酌会议的人唯恐会记得长日子和无情的钻研批评,那几个斟酌批评让研讨人士和客官都境遇了创伤。这么些批评的撰稿人恐怕没有设想过护理商讨的进化阶段。)由此,除了普遍性和共同性,其余五个正规演化:客观性和单身审查。研讨评估的合理性标准通过了认可和共享,为商讨细化和特别进步提供了2个关口(Leininger,1969)。

The stage of research development made major contributions to
contemporary scholarly nursing. It was also the stage in which tools of
science left a major mark on curricula through the new offerings of
research classes and statistics courses and through the several
publications in which major research tools and instruments were compiled
and combined.

商讨进步阶段对现代的学问护理做出了重庆大学贡献。科学工具通过商量学科和总结课程的新产品以及通过编写制定和组合要紧切磋工具和工具的几何出版物在课程中留给首要标志的阶段。

These stages have a global parallel. Progress in knowledge development
is also influenced by international levels of education. Some countries,
such as Australia and Germany, moved nursing education from hospital
training to university training in the 1980s and 1990s, respectively.
Subsequently, there has been a steady increase in philosophies and
theoretical dialogues, as well as a cumulative trajectory of research
productivity.

那个等级是天底下平行的。国际教育水平也潜移默化着知识发展的拓展。一些国家,如澳洲和德意志,分别在20世纪80年份和90时代将护理教育从医院培养转向大学培养和陶冶。随后,教育学和申辩对话以及硕士产力的积聚轨迹不断充实。

These, then, were the beginnings of nursing inquiry and science. During
this stage, as in other sciences, researchers emphasized scientific
syntax—the process rather than the content of research (Kuhn, 1970). The
binding frameworks or depositories of collected facts were still
lacking. Nevertheless, the syntax of the discipline had been formulated.

由此,那里的一百项咱们并不适用,小编会在接下去的日子用一篇小说介绍,国内护理人员应该向哪些领域前进或专科方向升高。

那么,这么些就是医生和医护人员调查和正确的开始。在那么些阶段,与别的科学一样,钻探者强调科学语法

经过而不是商量内容(Kuhn,一九六八)。收集到的实况的牢笼框架或存款和储蓄依然缺少。即使如此,该科指标语法已经制订。

笔者英文水准一般,大家能够用翻译器翻译那100项内容吗,在此多谢冯先生的授权宣布的总括

Stage of Theory

Below is a list of 100 things you can do with a any number of different
types of nursing degree. Some of these positions do require
specializations and many will need you to hold a master’s degree (MSN)
at least.

反驳阶段

Eventually, the fundamental questions about the essence of nursing—its
mission and its goals—began to surface in a more organized way. An
incisive group of leaders, nurses who believed that theory should guide
the practice of nursing, wrote about the need for theory, the nature of
nursing theory, philosophers’ views of theory, and how nursing theory
ought to be shaped. Although the conceptual schemata of nurse theorists
for the discipline of nursing appeared during the education and
administration stages of the discipline, it was not until the emergence
of the stage of theory that they were taken seriously (Nursing Theory
Think Tank, 1979).

最终,关于护理本质的大旨难题 – 其职责和指标 –
早先以更有系统的方法展现。一群尖锐的老总,医护人员认为理论应当引导医生和医护人员实践,他写到理论的急需,护理理论的面目,国学家的驳斥观点以及哪些塑造护理理论。固然护工学理论家在护教育学科的定义图式出今后科指标指引和管理阶段,但甘休理论阶段出现后才被注重(Nursing
西奥ry Think Tank,1979)。

During this stage, arguments arose about whether nursing was merely a
chapter of medicine or whether it was part of the biologic, natural, or
physical sciences (analogous to the earlier Cartesian concept that
biology is simply a chapter of physics). The Cartesian concept was
rejected (biology is indeed a distinct and autonomous science), and
nursing continued to resist the implication that it was a part of
medicine. It became clear to a new breed of nurse leaders—the
philosophers and the theorists (or conceptualists, as some referred to
them)—that nursing could not be reduced to a single science that
inquires into just one aspect of man, just as biology is not reducible
to physics. Nursing is complex, necessitating its intrinsic autonomy in
content and methods.

在那个阶段,关于护理是或不是唯有是法学的二个章节,或许它是生物学,自然科学照旧物理科学的一片段(类似于中期的笛卡儿的定义,生物学仅仅是物医学的三个章节)的争议就涌出了。笛卡儿的定义被推翻了(生物学确实是一个万分的自治科学),护法学继续对抗它是医术一部分的意思。对新一代医护人员领导者

  • 国学家和理论家(大概概念主义者,仿佛她们提到的那一个人)而言 –
    变得很掌握 –
    护理不能够不难地总结为一种只关乎人的1个上边的纯净科学,就像生物学一样不能够简化为大体。护理是繁体的,必要其剧情和措施的内在自主性。

The search for conceptual coherence evolved from a preoccupation with
syntax to the disciplined and imaginative study of the realities of
nursing and the meaning and truths that guide its actions (Table 5-1).
Its development from preoccupation with scientific method to speculation
and conceptualization is reminiscent of the development of philosophical
thought in the 18th and 19th centuries. The 18th century was greatly
influenced by Newton and by Bacon, who was in turn influenced by
Descartes. The 19th century was dominated by Kant, whose hypothetical,
deductive, and metaphysical approach encouraged the speculative nature
of science. The speculators in nursing began to construct realities as
they saw them, and their imaginative constructs evolved from their
philosophical backgrounds and from their educational inclinations.

对定义一致性的追求从对语法的注意发展到对医生和医护人员现实的严俊和装有想象力的钻研,以及辅导其作为的含义和真理(表5-1)。从对科学方式的注目到估算和架空的前行,让人回想18世纪和19世纪管理学思想的上扬。18世纪受Newton和Bacon的影响十分大,而Bacon又遭受笛卡尔的熏陶。19世纪由康德主宰,其只要的,演绎的和教条主义的主意鼓励科学的投机本质。护理中的投机者开端构建他们见到的现实,他们有所想象力的协会从他们的艺术学背景和她俩的启蒙倾向进步而来。

56net亚洲必赢手机 3

CHARACTERISTICS OF THE BEGINNING STAGE OF THEORY DEVELOPMENT

(麦:下边列出了医生和医护人员100种不一致档次的工作。其中有的义务供给专业化,很几人起码要求你拥有博士学位(MSN)。)

表5-1 理论发展起来阶段的表征
•  利用外部范式来指导理论
•  关于学科现象的不确定性
•  离散和独立的理论
•  研究,实践和理论之间的分离
•  寻求概念上的一致性
•  用于课程的理论
•  单一范例的目标占上风

It was natural for theory development to be influenced by the paradigms
of other disciplines, by the educational background of nurse theorists,
and by the philosophical underpinnings of the time. Therefore, we find
premises stemming from existentialism, analytical philosophy, and
pragmatism guiding the development of those theories, sometimes
explicitly and often implicitly. Nurses also adopted concepts and
propositions from other paradigms, such as psychoanalysis, development,
adaptation, and interaction, as well as from humanism, to guide its
assessment and its action. Theories were developed in response to
dissatisfaction with isolated findings in research. The emerging
theories addressed the nature of the human being in interactions and
transactions with the health care system, as well as the processes of
problem solving and decision making for assessment and intervention.

辩驳发展遭逢任何科指标范式,医护人员理论家的启蒙背景以及当时的法学基础的震慑是很自然的。因而,大家发现源于存在主义,分析军事学和实用主义的前提是指引那个理论的向上,有时是总而言之而且平常隐含的。医护人员还使用了别的范式的概念和命题,如精神分析,发展,适应,互动以及人文主义,以指引其评估和行进。理论是为了应对对商讨中独立的钻探结果的遗憾。新出现的反驳阐释了人类在与医疗保健系统的互相和交易中的本质。

Although certain theoretical concepts were synthesized from diverse
paradigms, most nursing theories, such as subsystems of behavior, role
supplementation, therapeutic touch, and selfhelp, were definable and
analyzable only from the nursing perspective. Theories offered a
beginning agreement on the broad intellectual endeavors and the
fundamental explanatory tasks of nursing. This stage offered knowledge
of relevant phenomena, but uncertainty continued about the discipline of
nursing and its intellectual goals. Just as in nuclear physics—when the
first achievement was not one of observation or mathematical calculation
but one of intellectual imagination— conceptual schemata evolved before
there was any clear recognition of nursing’s empirical scope. In
nursing, theories helped the discipline to focus on its concepts and
problems.

固然有个别理论概念是从不一致的范式综合而来,但唯有从护理的角度来看,当先50%医护理论(如行为子系统,剧中人物补充,治疗触觉和自助)都是能够限制和分析的。理论为大面积的文人墨客努力和医生和医护人员的中央解释性职分提供了初阶球协会议。这一个阶段提供了有关意况的文化,但医生和医护人员学科及其智力指标仍存在不分明性。就像在原子核物医学学中

  • 当首个到位不是观测或数学计算之一,而是智力想象 –
    概念图式之一在对护理的经验范围有别的鲜明认识在此以前就演化了。在护管理学方面,理论协理该学科专注于其定义和难题。

Rogers (1970) offered a conception of nursing that focused on the
constant human interaction with the environment. Johnson (1980)
developed the notion that a human being—a biologic system—is also an
abstract system of behavior centered on innate needs. Levine (1967) and
Orem (1971) proposed guidelines for nursing therapeutics that preserve
the integrity of the human being, the psychology, the community
affiliation—in short—the entire person. Orem (1985) reminded us that the
human being is perfectly capable of self-care and should progress toward
that goal.

罗吉尔斯(一九六九)提议了医生和护师概念,重点关心人与环境的无休止交换。Johnson(一九八〇)发展了一种价值观,即人类

  • 海洋生物系统 –

    也是以原始要求为大旨的虚幻系统。Levine(1968)和Orem(一九七二)提议了护理疗法的指点方针,以维护人类的完整性,心绪学和社区挂钩

    简单的说,正是一切人。Orem(一九八四)提示我们人类完全有能力自小编照顾,并理应朝着那么些目的前进。

Because of the earlier focus on education and professional identity,
because the National League for Nursing stipulated a conceptual
framework for curricula, and because the truth of a theory had not yet
been established using the empirical positivists’ criteria of
corroboration, emergent theories were not used to guide practice or
research but were instead used to guide teaching. Consequently,
scientific energies were dissipated in developing curricula that
corresponded to these theories.

由于较早关心教育和职业认可,因为全国护理缔盟规定了课程的定义框架,并且由于尚未利用经验实证主义者确证的正统分明理论的真正,所以没有运用新兴理论指导实践或切磋,而是用来指点教学。由此,在制定与这么些理论相呼应的课程时,科学能量消失了。

Although theories may have influenced practice through students, such
influence was not documented in the literature, which focused more on
theory in educational programs. As an educator who was a member of a
school that used nursing theory (also called a model) as a framework for
the curriculum, I experienced first-hand, in the mid-1960s, the
conflicts that graduates of the program encountered when they wanted to
use a nursing framework, one that they studied and experienced in their
educational program, in practice and were unable to do so because of its
novelty and its esoteric concepts. Whether the use of nursing models in
education rendered nursing care more effective and efficient is a matter
left to speculation and was evidenced only in isolated incidents and
through experiential narrative analyses that were discounted for their
lack of universality and generalization. The graduates of programs based
on nursing theories in the early and mid-1960s should be encouraged to
write the stories of their experiences with these theoretically based
programs and the ways by which their practice was informed or not
informed by these programs.

虽说理论恐怕影响了学生的进行,但那种影响在文献中从不记载,那么些文献更加多地集中在教育连串辩解上。作为一名教育工作者,他曾是一所运用护理理论(也称之为方式)作为课程框架的学院和学校的积极分子,在1957年份中叶,笔者亲自体验了安排结束学业生在他们想要的时候蒙受的争辩使用护理框架,他们在实践中学习和感受过他们的教育陈设,并且由于其新颖性和奥秘的概念而一筹莫展那样做。护理格局在教育中的使用是不是使护理特别实惠和有功用是二个留下来举行估算的标题,并且仅在孤立事件中以及由此经验性叙述分析说明,因为它们不够普遍性和泛化。应该鼓励60时期先前时代和60年间中叶护理理论课程的结束学业生用那一个依据理论的学科写出他们经历的轶事,并经过那么些科目告知或不告知他们的实行。

  The nagging questions continued:

  • What frameworks enhance safety in nursing practice?
  • What are the goals of nursing care?
  • What are the desired outcomes related to nursing care?
  • How do nursing interventions relate to desired outcomes?
  • What are the quality care criteria by which to judge nursing practice?

  唠叨问题仍在继续:

  • 哪些框架可以提高护理实践的安全性?
  • 护理的目标是什么?
  • 与护理有关的理想结果是什么?
  • 护理干预如何与预期结果相关联?
  • 什么是评判护理实践的质量护理标准?

These questions continued to lead to one type of answer: Let us find a
guiding paradigm or search for a universal theory with explanatory power
for all dimensions of nursing and, once we find this all-encompassing
theory, we will be able to answer questions related to the discipline.
This approach reminds us that Galileo and Descartes talked of the
scientist’s task as that of being able to decipher once and for all the
secrets of nature and to arrive at the “one true structure” of the
nature of the world. However, that was a Platonic ideal rather than a
plain description of the task of scientific research. Later, scientists
began to discard this line of pursuit. Physicists and physiologists “now
believe that . . . we shall do better in these fields by working our way
toward more general concepts progressively, as we go along, rather than
insisting on complete generality from the outset” (Toulmin, 1977, p.
387). Toulmin proposed that “human behavior in general represents too
broad a domain to be encompassed within a single body of theory” (p.
387). When scientists accept the need for multiple theories, and when
they accept the process nature of science, it will be a “sign of
maturity rather than defeatism” (p. 387) within the discipline.

这个难点继续导致一种档次的答案:让我们找到3个引导范式,或探寻1个对富有医生和护师维度具有解释力的宽广理论,一旦大家发现那几个包括万象的辩论,大家将能够回答相关的标题到纪律。那种方法提示我们,伽利略和笛Carl谈到地法学家的任务是能够破译大自然的心腹并完毕世界真相的“真正结构”。但是,那是Plato式的优良,而不是对科研职责的显眼描述。后来,物艺术学家开始放弃那种追求。物工学家和生经济学家“今后相信那或多或少。。。我们应当在这一个领域做得更好,在日益走向更相像的概念的还要,而不是从一发端就持之以恒完全的经常“(Toulmin,一九七八,p。387)。图尔明建议,“人类的一举一动总体而言代表了八个太宽广的领域,被含有在1个理论体内”(第贰87页)。当地文学家接受各类反驳的内需,并且当他俩承受科学的长河本质时,它将改为该科目中“成熟而不是失败主义的标志”(第①87页)。

Because nurse scientists searched for one theory for the entire
discipline, the task was either overwhelming and too highly abstract
(Rogers, 1970), or too simplistic and reductionist (Orem, 1971). The
sentiment of practitioners was to question the possibility and
usefulness of an allencompassing theory, as evidenced by the meager
literature throughout the 1960s and 1970s on nursing practice using
nursing theory. The desire for a single conceptual framework to guide
the nursing curriculum was carried to nursing practice. Nurse
practitioners came to believe that they were being asked to make a
choice between theories, and then adhere to that one particular theory.
Because none of the theories addressed all aspects of nursing, nurse
practitioners avoided nursing theory, ignored it, or refused to use it.
A myth was being formed. However, many nurses abandoned the notion of a
universal theory to describe and explain nursing phenomena and units of
analysis and to guide nursing practice, just as physicists did when they
abandoned the 17th-century hope that a universal science of nature could
be developed within the framework of fundamental ideas of classical
mechanics.

因为护师地教育学家在全体课程中搜索一种理论,所以那个职责依然是压倒性的,要么太肤浅(罗吉尔s,1967),可能过于简单化和简化(Orem,1971)。从业职员的心理是对整个理论的恐怕性和有用性建议质询,正如20世纪60年份和70时代在护理实践中动用护理理论的轻微文献所证实的那么。护理实践供给一个纯粹的定义框架来引导医生和护师课程。医护人员从业者开首相信她们被须要在争鸣之间作出采取,然后坚韧不拔这一一定的申辩。因为那些理论都未曾关联护理的各类方面,所以医护人员从业者制止了医生和护师理论,忽视了医生和护师理论,只怕拒绝使用护理理论。神话正在形成,可是。

Three themes in nursing that evolved during this stage were acceptance
of the complexity of nursing and the inevitability of multiple theories;
acceptance of the need to test and corroborate major propositions of
differing theories before dismissing any of them; and the idea that
concepts or theories remaining in the field, through a cumulative
effect, become the basis for the development of a specific perspective.
Dualism and pluralism were the norms during the stage of theory. It was
also during this stage that nursing developed the boundaries necessary
to focus its inquiry and the flexibility necessary to allow expansion
through creative endeavor.

医生和护师的多少个主旨是在这么些等级发展的,接受护理的繁杂和各个答辩的必然性;
接受在解散任何辩护此前测试和认证差别理论的重点命题的急需;
以及经过积累效应留在现场的定义或辩论成为发展现实意见的根基。二元论和多元论是辩论阶段的正儿八经。在这一品级,护理职员开发了供给的疆界,以便将重点放在查询和须要的油滑上,以便通过成立性努力贯彻扩充。

  1. Psychiatric Mental Health Nurse

Stage of Philosophy

Work with people with psychiatric problems in hospitals or psychiatric
wards and prisons.

工学的级差

As nurses began reflecting on the conceptual aspects of nursing
practice, on defining the domain of nursing, and on the most appropriate
methods for knowledge development, they turned to philosophical
inquiries. The focus during this stage was on raising and answering
questions about the nature of nursing knowledge (Carper, 1978; Silva,
1977), the nature of inquiry (Ellis, 1983), and the congruency between
the essence of nursing knowledge and research methodologies (Allen,
Benner, and Diekelman, 1986). During this stage, philosophy was
considered an attempt to understand the philosophical premises
underlying nursing theory and research (Sarter, 1987) and an attempt to
develop philosophical inquiry as a legitimate approach to knowledge
development in nursing (Fry, 1989).

乘势护师伊始反省护理实践的定义方面,界定护理领域以及最符合知识发展的办法,他们初阶思考历史学问题。这一阶段的主要性是提议和回复关于护理知识本质的题材(Carper,一九七九;
Silva,一九八〇),商讨的属性(艾利斯,1984)以及护理知识的真相与研讨方法之间的一致性(
阿伦,Benner和Diekelman,一九九零)。在那么些等级,经济学被认为是准备领会护理理论和商讨的农学前提(Sarter,一九八六),并打算升高工学研讨作为医护知识发展的法定格局(Fry,一九九〇)。

This stage influenced profoundly the intellectual discourse in nursing
literature. During this stage, epistemological diversity was accepted
and the need for ethical, logical, and epistemological inquiries was
legitimized, as evidenced in the numerous philosophically based
manuscripts accepted for publication (Ellis, 1983).

这一阶段长远影响了医生和医护人员文献中的知识分子话语。在那些等级,认识论的八种性被接受,对道德,逻辑和认识论的探赜索隐的内需被合法化,正如接受公布的浩大依据管理学的手稿所证实的(Ellis,一九八三)。

This stage was also marked by a scholarly maturity in the discipline, as
its members acknowledged the limitation of appropriate tools to
investigate fundamental and practical issues. Assumptions about
wholeness of human beings, contextual variables, and holism of care
called for congruent investigative tools, and nurse scholars
acknowledged the complexity of capturing nursing phenomenon using
existing tools (Newman, 1995; Stevenson and Woods, 1986). Accepting
limitations while maintaining the reality of the contextuality and
complexity of the phenomenon represents a marked scholarly maturity and
the potential to focus on the development of appropriate tools.

以此等级的表征还在于该学科的学术成熟,因为它的分子认同限制适用的工具来调查商讨基本和实际难点。关于人类全部性,情境变量和完整护理的比方必要一律的检察工具,而医护人员学者认可使用现有工具捕捉护理现象的纷纷(Newman,一九九三;
史蒂文斯on和伍德s,1988)。在维持现象的背景性和错综复杂的同时接受局限性代表了显着的学术成熟度,并且有大概将重视播在开发适合的工具上。

Earlier during this stage, discussions encompassed the different “ways
of knowing” in nursing and espoused a call for going beyond the
empirical (Carper, 1978). These epistemological discussions focusing on
the structure of knowledge, nature of theory, criteria for analysis, and
justification of particular methodologies for knowledge development
significantly contributed to the discovery and construction of an
identity for the discipline of nursing. As theorists and metatheorists
discussed the philosophical bases that shaped nursing knowledge (Allen
et al., 1986; Roy, 1995), a new set of questions emerged. These
questions reflected more the values and meaning of the knowledge being
developed and the consequences of this knowledge on nursing practice,
and focused less on the structure and justification of knowledge
(Bradshaw, 1995; Silva, Sorrell, and Sorrell, 1995).

在这一个等级早些时候,钻探带有了护理中不一致的“认知艺术”,并建议超越经验的请求(Carper,一九七七)。这一个有关文化结构,理论性质,分析标准以及文化发展一定措施的理由的认识论钻探不小地力促了医生和护师学科身份的意识和建构。当理论家和变体论者研究创设护理知识的理学基础时(Allen等,1988;
罗伊,1992),出现了一组新的难题。这几个题材更加多地反映了正在开发的学识的价值和意义以及那一个文化对医生和医护人员实践的震慑,而更少关切知识的结构和合理性(Bradshaw,一九九三;
Silva,Sorrell)

The emphasis on knowing was complemented by another emphasis on “being.”
The being was not limited to the nurse, or to the patient, but to each
separately and to both joined in caring interactions (Benner, 1994;
Newman, 1995). This philosophical stage, encompassing both components of
epistemology and ontology, provided nurses with the legitimacy to ask
and answer questions related to values, meanings, and realities using
multiple philosophical and theoretical bases.

对学识的强调与对“存在”的另一强调相辅相成。存在并不仅仅限于护师,也不制止病者,而是分别与各样人以及双边都出席关注互动(Benner,一九九一;
Newman,1991)。这几个包含认识论和本体论三个组成都部队分的管理学阶段为看护提供了动用多重农学和辩驳功底来打探和回应与价值,意义和实际相关的标题标合法性。

This philosophical stage persists, overlapping with the following stage
of integration. Dialogues about postcolonialism provide the
philosophical canons for understanding how domination, power, and
resistance influence health care encounters at all different levels,
from the individual to society (Kirkham and Anderson, 2002). The
postcolonial scholarship in nursing was informed by the discourse in the
discipline on race, culture, ethnicity, diversity, and power
differential. It refers to and frames the theoretical and empirical work
of people’s experiences living under the oppression of colonial control.
Using this philosophical stand, we can better understand the effects of
diversity in color, religion, sexual preference, ethnicity, and class in
shaping responses to health and illness. It allows health care
professionals to access the meaning of marginalization.

那么些医学阶段持续存在,与下三个整合阶段重叠。关于后殖民主义的对话提供了领会控制权,权力和抗拒怎么样影响从个人到社会各种层次的医疗保健遭逢的理学经验(Kirkham
and
Anderson,2002)。在种族,文化,种族,五种性和权杖差异的教程中,后殖民地护农学奖学金得到了通告。它是指和构架生活在殖民统治压迫下的芸芸众生经历的驳斥和实证工作。利用这一医学立场,大家能够更好地通晓色彩,宗教,性取向,种族和阶级性三种性对作育健康和疾病反应的影响。

Postmodernism, a reaction by philosophers to positivism, translated in
nursing into a prevailing sentiment described by Whall as “Let’s get rid
of all nursing theory” (Whall, 1993; Whall and Hicks, 2002). Although
the context is vital to postmodernism philosophy, universal totality is
not possible. Other concepts that characterize postmodernism are
relativism, deconstruction, context, atheoretical narratives, and
structural influences.

后现代主义,教育家对实证主义的反响,将护理翻译成Whall描述的“让我们摆脱全体医生和医护人员理论”(Whall,1995;
Whall和希克斯,二〇〇三)。即使背景对后现代艺术学至关心敬重要,可是大规模的完整是不容许的。表征后现代主义的其余概念是相对主义,解构主义,语境,无理论叙事和组织影响。

  1. Physician’s Office Nurse

Stage of Integration

Work directly with people and the job tends to be 9 to 5.

重组阶段

This stage has seven universal characteristics, each described in the
subsequent text. They should be used to stimulate thinking and
discussions about the state of development of our discipline, both
nationally and internationally. This stage differs from the next stage
in its internal versus external integration with other disciplines. A
first characteristic of this stage is the use of substantive dialogues
and discussions focused on identifying coherent structures of the
discipline of nursing at large and of its specific areas of
specialization (Schlotfeldt, 1988). The structures include scientific,
theoretical, philosophical, and clinical knowledge that is focused on
the nursing domain and its phenomena. These dialogues take place in
conferences, think tanks, and themed journal editions devoted to the
development of middle-range and situation-specific theories focused on
an aspect of nursing.

其一等级有五个通用特征,每种特征在随之的公文中都有描述。应该用它们来激发对本国学科发展景观的想想和议论,无论是在境内照旧在国际上。那些等级与中间和表面其余科目整合的下一阶段分裂。这一阶段的首先性情状是行使实质性的对话和议论,侧重于规定整个护历史学科及其特定专业领域的同一结构(Schlotfeldt,一九九零)。那么些协会包涵在意于护理领域及其现象的科学,理论,管理学和医疗知识。这个对话发生在议会,智囊团。

A second characteristic of this stage is the development of educational
programs that are organized around substantive areas through the
integration of theory, research, and practice— such as environment and
health, symptom management, or transitions and health. It is also
manifested in the ease by which nursing administrators, clinicians, and
educators use theoretical nursing, and in the increasing dialogue among
members of the discipline regarding matters related to knowledge,
discovery, and development that is focused on and emanates from the
domain of nursing.

这一阶段的第一个特色是透过理论,钻探和实践的整合(例如环境与平常,症状管理或转型与健康)围绕实质性领域展开教育安顿。那也突显在医生和护师管理职员,临床医务职员和教诲工小编采纳理论护理的便利性以及学科成员与文化,发现和前进相关事项之间更是多的对话,这几个知识,发现和进化都汇聚在和发泄护理。

A third characteristic of this stage is the evaluation of different
aspects of theoretical nursing by members of the discipline—nursing
clinicians, teachers, administrators, researchers, and theoreticians.
Evaluation is not limited to theory testing; it includes description,
analysis, and critiques as well. Each of these processes is important in
the development and progress of our discipline because of its diverse
philosophical bases.

这一等级的第5个特征是由课程护理治疗医务人士,教授,管理职员,研讨职员和理论家对理论护理的不比地点开始展览评估。评估不制止理论测试;
它还包涵描述,分析和批评。由于其各个经济学基础,这一个经过中的每贰个对大家学科的开拓进取和升高都很要紧。

A fourth characteristic of this stage is the attention that members of
the discipline give to the strategies of knowledge development that are
congruent with the discipline’s shared assumptions and that consider the
conditions of holism, patterning, experience, and meaning (Newman,
1995).

这一品级的第四个天性是,学科成员对学识发展战略给予的关切与该课程的联合借使一致,并考虑到全部性,情势化,经验和意义的标准化(Newman,1992)。

A fifth characteristic is the involvement of members of specialty fields
in developing theories that are pertinent to the phenomena of that
particular field. This involvement does not preclude similar attention
to theories related to phenomena of the domain of nursing at large; for
example, theories to describe and intervene in symptoms.

第四个特征是明媒正娶领域成员参预提升与特定领域现象有关的答辩。那种参加并不拔除对与护理领域现象有关的论战的好像关切;
例如,描述和干涉症状的论争。

A sixth characteristic is the critical reappraisal of philosophical and
theoretical underpinnings that have guided the definitions and
conceptualizations of the central concepts of the nursing domain, as
well as the methodologies used to generate knowledge. An example of such
discourse is the reappraisal of the definition of client in the nursing
literature and the congruency of these definitions with domain
assumptions (Allen, 1987). Another example is the dialogue about melding
different methods to generate knowledge that is more congruent to the
tenets of a human science, such as grounded theory, feminist theory, and
critical theory (Kushner and Morrow, 2003).

第陆天个性是对文学和辩驳功底的革命性重新评估,这么些基础指点了医生和医护人员领域基本概念的概念和浮泛,以及用于转移知识的方法论。那种话语的二个例子是再度评估护理文献中型大巴户的定义以及那几个概念与天地即使的一致性(Allen,一九八七)。另一个事例是有关融合差异措施以产生更合乎人类科学原理的文化的对话,如扎根理论,女权主义理论和批判理论(Kushner
and Morrow,二〇〇二)。

A seventh characteristic of this stage is the creative ways by which
academic institutions in nursing become involved with patient care,
either through academically run clinics (nursing clinics), or by
developing clinically based faculty positions.

这一等级的第几特个性是因此学术单位运行诊所(护理医院)或作育临床教员职位,使护医学术部门加入病者看护的创制性形式。

  1. Nurse Case Manager (案例管理)

Stage of Interdisciplinarity

You will need an MSN degree for this role.

跨学科阶段

The stage of integration leads and overlaps the stage of
interdisciplinarity. The road map for the National Institutes of Heath
(NIH) at the beginning of the 21st century provided a strong impetus for
a different type of integration, one that challenged members of
different disciplines to build programs of research that incorporate the
theories and evidence from different fields. Although nursing has
consistently depended upon, borrowed from, and shared the research and
theories of other disciplines, the drive for interdisciplinary education
and teaching research was now being promoted at leading research
institutions. A central tenet of this stage is the forging of
relationships between researchers and clinicians who are members of
different disciplines, to develop joint institutes, advance research
programs, or to provide more comprehensive education. Centers for sleep
research, pain management, palliative care, complementary and
alternative practices, safe practice, and gun-shot injuries are examples
of areas that require the expertise of members of different disciplines.
A similar move to reflect the nature and complexity of science was
initiated at the NIH. The question that drove these institutes was
whether they should reflect discipline or an area of science. Time will
tell whether a move away from disciplinary institutes will continue to
support the development of disciplines horizontally as well as
vertically. More discussion of disciplines and interdisciplines is
provided in Chapter 14.

整合阶段造成并跨越跨学科性阶段。United States国立卫生商讨院(NIH)在21世纪初的不二法门图为差异体系的三结合提供了强硬的推动力,那种结合向分化科目标分子提议挑衅,以创造纳入差异理论和证据的研商安排领域。即使护理平素依靠,借鉴并分享别的科指标钻研和辩解,但跨学科教育和教研的驱重力现在正值超级的探讨单位中取得放大。这一等级的着力大旨是创制不相同科目成员的钻研职员和医疗医务人士之间的涉及,发展同步研商机构,推进切磋安顿,或提供更完善的教诲。睡眠商讨为主,疼痛管理,姑息治疗,补充性和替代性实践,安全实施和枪伤是内需差异学科成员的专业知识的范例。NIH运转了一项反映不错性质和复杂性的近乎举动。驱动这么些部门的题材是它们是不是相应展现纪律或不利领域。时间将告诉大家,摆脱纪律部门是或不是会接二连三帮助横向和纵向学科的上扬。关于课程和跨学科的越来越多讨论在第壹4章中提供。枪支受伤是亟需分裂学科成员的专业知识的范例。NIH运转了一项反映不错性质和复杂的好像举动。驱动那么些单位的标题是它们是不是相应反映纪律或不易领域。时间将告诉大家,摆脱纪律部门是或不是会接二连三协助横向和纵向学科的前进。关于课程和跨学科的更加多研讨在第贰4章中提供。枪支受伤是内需区别科目成员的专业知识的范例。NIH运维了一项反映不错性质和复杂性的近乎举动。驱动那些机构的题材是它们是否合宜展示纪律或不利领域。时间将报告我们,摆脱纪律部门是或不是会继续帮忙横向和纵向学科的进步。关于课程和跨学科的越来越多切磋在第叁4章中提供。时间将告诉大家,摆脱纪律部门是还是不是会持续支持横向和纵向学科的提升。关于课程和跨学科的更多商讨在第三4章中提供。时间将报告我们,摆脱纪律部门是或不是会一而再支持横向和纵向学科的进化。关于课程和跨学科的越多研商在第③4章中提供。

  1. Nursing Informatics Specialist

Stage of Technology and Information Systems

This requires an MSN degree specialization.

技能和音讯体系阶段

Health care records, robotic medication dispensers, tele-home care,
long-distance monitoring, virtual surgeries, and voice mail reminders of
appointments and medications are characteristic of this stage in the
history of the development of the nursing discipline. Theories that
incorporate variables and conditions related to informatics and
technological breakthroughs are necessary drivers for this stage.
Self-care practices take on different meanings for individuals and
families when they incorporate the most advanced and up-to-date
information disseminated by scientists and clinicians to the public via
the internet. Self-care practices and goals also incorporate the use of
such new monitoring devices as home blood pressure apparatus, glucose
kits, self-diagnosis protocols, and self-monitoring gadgets. The ability
to sort among accurate and inaccurate information, and the alternative
“if-then” scenarios that result, will need to be guided by
situation-specific theories that incorporate guidelines for clinicians
and consumers (An, Hayman, Panniers, and Carty, 2007).

看护记录,机器人药物分配器,远程家庭护理,远程监护,虚拟手术以及约定和药物的语音邮件提醒是看护学科发展史上这一等级的表征。包括与音讯学和技能突破有关的变量和准星的答辩是此阶段的必不可少驱动机原因素。将地教育学家和看病医生通过互连网向群众传播的发轫进和新型新闻纳入个人和家中时,自笔者保健实践将全数分化的意义。自作者保健的做法和对象还包含选取家用血压仪,葡萄糖试剂盒,自小编诊断协议和作者监测小工具等新式监测设备。

56net亚洲必赢手机 4

THEORY DEVELOPMENT IN NURSING: MILESTONES

  1. School Nurse
表5-2看护中的理论发展:里程碑
1955年之前 从弗洛伦斯南丁格尔到护理研究
1955-1960 护理理论的诞生
1961-1965 理论:护理的国家目标
1966-1970 理论发展:学术界的切实目标
1971-1975 理论语法
1976-1980 反思
1981-1985 年的时间护理理论的复兴:领域概念的出现
1986-1990 从元理论到概念发展
1991-1995 中期和情境理论
1996-2000 证据意味着研究而不是理论
2001- 2005 思想多样性:将理论与实践联系起来
2006-2010 护士授权:以证据和技术为资源

Work directly with children. You will have some time off during school
holidays.

MILESTONES IN THEORY DEVELOPMENT

  1. Legal Consultation Nurse

力排众议发展的里程碑

The progress and development of theoretical nursing is marked by several
milestones, which are identified through an analysis of theoretical
literature that appeared in selected nursing journals between 1950 and

  1. These milestones substantially changed the position of theory in
    nursing and profoundly influenced the further development of theoretical
    nursing. Each milestone is defined and briefly described here (Table
    5-2). Identifying and defining these milestones challenges others to
    explore the impact each milestone may have had on the progress and
    development of nursing knowledge.

理论护理的迈入和前进抱有多少个里程碑意义,这个里程碑是透过分析1947年至二〇〇一年时期选定的医生和医护人员期刊中出现的理诗歌献而规定的。那些里程碑大大改观了辩护在医生和护士中的地位,深远地影响了护理进一步升华理论护理。每一种里程碑都在此处实行了定义和不难描述(表5-2)。识别和概念那个里程碑会挑衅旁人探索每种里程碑大概对护理知识的开始展览和升高产生的熏陶。

Relates to the handling of medical malpractice cases.

Prior to 1955—From Florence Nightingale to Nursing Research

  1. Research Nurse (研究)

壹玖伍贰年事先 – 从弗Loren斯南丁格尔到护理切磋

The significant milestone of the period before 1955, which has
influenced the subsequent development of all nursing science, was the
establishment of the journal, Nursing Research, with the goal of
reporting on scientific investigations for nursing by nurses and others
(Fig. 5-1). The journal’s most significant goal was to encourage
scientific productivity. The establishment of the journal confirmed that
nursing is indeed a scientific discipline and that its progress will
depend on whether nurses pursue truth through an avenue that respectable
disciplines take, namely, research. Although Nightingale may have
provided the beginning impetus for research and theory, initially, her
impact was most keenly felt in nursing education. Education of nurses
had predominantly occurred in diploma programs, but this period marked a
beginning interest in providing different routes for nurses’ education.

1953年此前影响全体医生和护师科学后续发展的1个主要里程碑是树立了医生和医护人员研究期刊,指标是报告医护人员和别的人对护理的科考(图5-1
)。该杂志最重大的靶子是鞭策科学生产力。该杂志的建立证实了护理的确是一门科学学科,其进展将取决于护师是不是因而可敬的课程所运用的不二法门追求真理,即研究。即便南丁格尔或许为切磋和辩解提供了初阶的重力,但早期,她的震慑在医生和护师教育中极其敏感。医护人员教育重点产生在文凭课程中。

This period was otherwise uneventful for nursing theory, except that the
establishment of nursing research publications provided the framework
for a questioning attitude that may have set the stage for inquiries
that led to more theoretical discourses in later years.

除外,护理切磋出版物的创造提供了一种质疑态度的框架,可能为查询制造了舞台,在有生之年导致越多的辩论话语,那段时间对于护理理论来说是平凡的。

56net亚洲必赢手机 5

Chronology of the development of theoretical nursing

Gives you the opportunity to pave the way for the future.

1955–1960—The Birth of Nursing Theory: The Columbia University Teachers College Approach

  1. Diabetes Management Nurse

壹玖伍伍-一九六〇年 – 护理理论的出生:哥大师范高校方法

Although Florence Nightingale’s ideas about nursing, focusing on the
relationship between health and environment, were developed in the early
1900s, it was not until the mid-1950s that nurses began to articulate a
theoretical view of nursing. Questions about the nature of nursing, its
mission and goals, and about nurses’ roles drove nurse educators to
capture the answers to these questions and present them in a more
coherent whole. These questions grew out of an interest in changes in
the educational preparation of nurses from diploma to baccalaureate
programs, out of concerns about what to include or exclude in curricula,
and about what nurses needed to learn to function as nurses.

尽管弗Loren斯·南丁格尔关于护理的见地着眼黄浩然规与环境之间的关联,但是在20世纪初发展兴起的,直到20世纪50年间中叶,护师才起来表明护理的答辩观点。关于护理本质,其任务和目的以及护师剧中人物的题材促使护师教育工小编捕捉这么些标题标答案,并将其变未来尤其贯通的总体中。那几个题材根源对护师从文凭课程到博士学位课程的指导准备的扭转的兴味,出于对课程内容或解除内容的忧患,以及医护人员必要上学怎么样担任医护人员。

Columbia University’s Teachers College, where the first professor of
nursing, M. Adelaide Nutting, was appointed, offered graduate programs
that focused on education and administration, to prepare graduates as
expert educators and administrators. Although the focus of that
visionary program was not on nursing science or nursing theory,
participants in this program must have felt that they were in an
environment that promoted dialogue and debate of philosophical and
theoretical questions. Of note, in 1999, the nursing education program
celebrated 100 years of influence, a well-placed celebration given that
most theorists who offered a conception of nursing during that decade
were educated at Teachers College; these included Peplau, Henderson,
Hall, Abdellah, King, Wiedenbach, and Rogers (Table 5-3).

哥大师范高校的首任护工学教师M. AdelaideNutting被任命为大学生课程,首要负责教育和治本,为结业生做好我们教育和保管的预备。固然这一个深谋远虑的布置的要害不在于护理科学或护理理论,但该陈设的加入者一定已经觉获得他们处于促进法学和申辩难点的对话和驳斥的环境中。值得注意的是,在一九九六年,护理教育布置庆祝了100年的影响力,那是叁个很好的庆祝活动,因为在那十年中提供护理概念的大部理论家都在中医药大学接受教育;
蕴涵Peplau,亨德森,哈尔l,Abdellah,King,Wiedenbach和罗吉尔s(表5-3)。

56net亚洲必赢手机 6

TABLE 5-3 NURSING THEORISTS: 1950–1980

Work directly with people with diabetes, helping them manage their
condition.

表5-3守护理论:一九四九-一九七八
1952年 Hildegarde Peplau。护理人际关系。也于1962年,1963年,1969年出版。
1955年 弗吉尼亚亨德森。护理原理和实践教科书(与B.哈默)。也是1966年,1972年,1978年。
1959年 多萝西约翰逊。“护理哲学”。也是1961年,1966年,1974年。
1959年 丽迪雅大厅。护理哲学。也是1963年(和其他人,1975年)。
1960年 Faye Abdellah。“以病人为中心的护理方法”也是1965年,1973年。
1961年 艾达让·奥兰多。动态的护患关系。
1963年 D. Howland和E. McDowell。“医院系统模型”。
1964年 D. Howland和E. McDowell。“病人护理的测量:概念框架。”
1964年 Joyce Travelbee。人际关系方面的护理。也是1969年,1971年,1979年。
1964年 E. Wiedenbach。临床护理:帮助艺术。也是1967年,1969年,1970年,1977年。
1966年 Myra Levine。“适应和评估。”
1966年 M. Harms和F. McDonald。“一个新的课程设计。”
1967年 Myra Levine。临床护理简介。也是1969年,1971年,1973年。
1968年 Imogene国王。“护理参考的概念框架”。也是1971年,1975年。
1969年 Joyce Travelbee。干预精神病护理。也是1971年(1979年)。
1970年 玛莎罗杰斯。护理理论基础介绍。1980年。
1970年 Callista Roy姐妹。“适应:护理概念框架”。也是1974年,1976年,1980年,1984年。
1971年 Imogene国王。走向护理理论:人类行为的一般概念。
1971年 Dorothea Orem。护理:实践的概念。也是1981年,1982年,1985年,1991年。
1972年 贝蒂纽曼。“贝蒂纽曼医疗保健系统模型。”也是1989年。
1976年 约瑟芬帕特森和L. Zderad。“人文护理”,也是1988年。

Being prepared for functional roles and experiencing a sense of
competency in preparing syllabi, setting staffing patterns, and so on
may have freed the creative abilities of these scholars for other
aspects of the scholarly process, such as theory or conceptual model
development. And, although other experiences and programs may have
directly influenced these scholars in their theoretical pursuits (e.g.,
Rogers’ doctoral preparation at Johns Hopkins), it appears that the
philosophy of Teachers College indirectly left an impact, not only on
psychiatric theory and research, but also on theoretical thinking in all
of nursing (Sills, 1977). Asking and answering questions about the
influence of scholarly environments on preparing productive scholars may
have stimulated the search for the nature of scholarship, which may have
led to questions related to the nature of the nursing identity.

为准备成效角色和感受准备教学大纲的能力,设置人士配置方式等大概早就刑释了那些学者对学术历程的任什么地点方(如理论或概念模型开发)的创立能力。就算别的经验和安排也许一贯影响到那几个学者的争鸣追求(例如,罗吉尔斯在John霍普金斯高校的硕士随想准备),但就像师范高校的农学间接地不仅影响了精神病学理论和研商,而且还关乎全部医生和医护人员的理论思考(Sills,一九七六)。询问和应对有关学术环境对准备有收获的专家的影响的标题大概会促使人们寻求奖学金的习性。

Peplau (1952), using Harry Stack Sullivan’s theory title and concepts to
develop her own, produced the first articulated concept of nursing as an
interpersonal relationship, with components of interpersonal processes
central to nursing needing to be elucidated and analyzed. The field of
psychiatric nursing subsequently was substantially developed using
Peplau’s ideas. Other theories that evolved in the 1960s were based on
those early conceptions of nursing. For example, Virginia Henderson,
with Bershan Harmer, developed the early seeds of a nursing theory that
was published in the mid-1950s in a textbook on the principles and
practice of nursing.

Peplau(1953)利用哈利 Stack
Sullivan的申辩标题和定义来支付协调的答辩,发生了医生和护师作为人际关系的率先个人所共知的定义,当中人际进程的组成都部队分须要被发明和剖析。精神病护理领域随后利用Peplau的想法大幅提升。别的在20世纪60年份发展起来的反驳是依照那个早期的守护概念。例如,弗吉尼亚亨德森与贝尔森哈默一起研究开发了医生和护师理论的最初种子,该辩驳于20世纪50年份前期发布在医生和医护人员原理和施行教科书上。

The request from the International Council of Nursing (ICN) to define
nursing and its mission led to the subsequent ICN statement in 1958 that
appeared in a publication with wide distribution and that was adapted
internationally (Henderson, 1966, p. 15). The message given by both
Peplau and Henderson was that nursing has a specific and unique mission
and that this mission has some order and organization that can be
communicated. These articulated wholes represented the beginnings of
theories in nursing.

国际护理理事委员会(ICN)建议的范围护理及其职务的必要致使一九六零年的ICN评释现身在大面积分发的出版物中,并在国际上进展了调整(Henderson,一九六八年,第③5页)。Peplau和Henderson给出的新闻是,护理有三个一定的和分外规的职分,而且这几个义务有一些方可传达的秩序和团伙。那些鲜明的欧洲经济共同体代表护理理论的先导。

Abdellah’s nursing theory, evolving from her work at Columbia
University, is another example of the influence of that school on
theoretical nursing (Abdellah, Beland, Martin, and Matheney, 1961).
Abdellah’s doctoral dissertation in 1953 at Teachers College, under the
leadership of Hildegard Peplau, focused on determining covert aspects of
nursing problems. The results of her research were subsequently
published in Nursing Research, marking the beginning of her attempts at
theorizing the nursing care process. Her conceptualization of nursing
care evolved from her dissertation research and from another study
completed in 1955, on the needs of patients for nursing care. The latter
was based on data collected from patients, nurses, and doctors. Abdellah
developed her conception of what nursing is by focusing attention on
patients rather than on techniques.

从他在哥大的办事中提升而来的Abdellah的守护理论是该高核对理论护理影响的另二个例证(Abdellah,Beland,马丁和Matheney,1962)。1954年Abdellah博士诗歌在希尔德gard
Peplau领导下的交通大学专注于规定隐性方面包车型地铁看护难点。她的商讨成果随后发布在护理斟酌中,标志着他尝试理论化护理进程的上马。她的看护概念化是从她的大学生杂谈切磋和从壹玖伍壹年完毕的另一项研究中,遵照病者对医生和护师的急需而上扬而来的。后者是依照从伤者,护师和先生收集的多少。

Ideas of other theorists were formulated around the need for a binding
framework to guide curricula, but their writing and publications did not
have the instant impact as that of Peplau, Henderson, and Abdellah on
theoretical nursing. Their conceptions were slow to have an impact on
nursing. Orem’s ideas were first published in a guide for developing a
curriculum for practical nursing in 1959. Patient needs were also the
focus. Hall developed, in 1959, and implemented, in 1963, a concept of
nursing based on needs and interpersonal relations at the Loeb Center
for Nursing and Rehabilitation. One can see the influence of both Peplau
and Henderson in her writing (Hall, 1963).

其他理论家的想法是环绕必要贰个有约束力的框架来教导课程设计的,但他俩的编慕与著述和出版物并从未像Peplau,Henderson和Abdellah那样对理论护理爆发即时影响。他们的观念对护理发生潜移默化缓慢。Orem的想法第一遍发布于1958年制定实用护理课程的指南开中学。病者须要也是最主要。霍尔于一九六〇年开支并于壹玖陆叁年在勒布护理和大好中央进行了一种基于必要和人际关系的看护概念。人们得以看来Peplau和Henderson在她的作品(哈尔l,壹玖陆贰)中的影响。

Independent of the Teachers College group of theorists, Johnson was
beginning to play a central role in conceptualizing nursing. Johnson’s
(1959) analysis of the nature of science in nursing was undoubtedly a
milestone in drawing attention to the potential of nursing as a
scientific discipline and in advocating the development of its unique
knowledge base. At that time, Johnson tentatively suggested that nursing
knowledge is based on a theory of nursing diagnosis that is distinct and
different from medical diagnosis. The substantive matter for such
diagnosis, the beginning of Johnson’s theory, was starting to be
formulated at this time. (See Chapter 20 for appropriate citations for
each theorist.)

单身于地质大学的理论家小组,Johnson开始在虚幻护理中公布核心成效。约翰逊(1956)对医生和护师学科学性质的剖析无疑是在注意看护作为一门科学学科的潜力以及提倡发展其特殊的知识底子方面包车型地铁贰个里程碑。当时,约翰逊权且建议护理知识是依照与历史学诊断截然分歧的医生和护士诊断理论。那种诊断的实质性难题是Johnson理论的开头,以后初步制定。(请参阅第①0章,精晓每位理论家的适合引文。)

Another milestone in nursing progress was the establishment of the
special nursing research fellowship program to facilitate, support, and
encourage nurses’ education for research careers. This program provided
financial incentive and support for nurses to pursue their doctoral
education in related fields such as biology, physiology, sociology, and
anthropology, among others.

护理进展的另2个里程碑是确立专门的看护商讨奖学金安顿,以推进,辅助和鼓励医护人员的切磋生涯教育。该安插为看护在生物学,生经济学,社会学和人类学等相关领域继续开展硕士教育提供了财政激励和支撑。

  1. Cruise Ship Nurse

1961–1965—Theory: A National Goal for Nursing

This is a fantastic opportunity for those who want to travel the world.
You will generally have a reasonably low workload, but you do have to be
on call around the clock.

1962-一九六二-理论:全国护理目的

From a reduced conception of a human being as “an illness” or “a
surgery,” with signs and symptoms, nursing theory in the late 1950s
refocused nursing attention on the individual as a set of needs and
nursing as a set of unique functions. Still, a reductionist approach to
nursing existed. The 1960s, with its turbulent society, the Camelot
goals of harmony and coexistence, and the influence of Peplau may have
prompted the refocusing of nursing from its stated mission of meeting
patients’ needs to the goal of establishing a relationship between the
nurse and client. If relationships are effectively established through
interpersonal interactions (as previously articulated by Peplau, 1952,
and as advocated by a new group of theorists), then nursing care can
meet the needs of the patient—not as defined by nurses, but as perceived
by the patient.

从压缩人的概念为“疾病”或“手术”出现体征和症状,20世纪50时代前期的医生和护师理论将护理注意力重新集中在私有作为一组要求和作为一组卓绝成效的守护上。即使如此,还存在一种还原手段。20世纪60年间,在波动的社会中,Camelot的和谐与存活的靶子以及Peplau的影响大概驱使护理从其满足患儿要求的义务转向医护人员与伤者之间确立关系的靶子。如果因而人际交往有效建立关联(如一九五一年Peplau以及一组新的理论家所倡导的那么),那么护理护理能够满意患儿的须要

  • 不像护士所定义的那么,而是由伤者。

During this period, the Yale School of Nursing’s position, influenced by
the Columbia Teachers College graduates who became faculty members at
Yale, was beginning to be formulated. To these scholars, nursing was
considered a process rather than an end, an interaction rather than
content, and a relationship between two human beings rather than an
interaction between unrelated nurse and patient. Multiple social forces
helped the Yale group to develop its ideas into concepts of nursing.
Federal grant money was available for preparation ranging from
psychiatric nursing to teaching positions, for identifying psychiatric
concepts in nursing, and for developing an integrated curriculum. The
availability of time and resources, therefore, was significant in
providing the necessary push, as well as the appropriate environment in
which to reflect on nursing’s mission and goals.

在此时期,斯坦福大学护理高校的身份受到了哥伦比亚共和国农业学院完成学业生的熏陶,该高校结业生成为巴黎综合理文高校的教师,正在起初制定。对于那个专家的话,护理被认为是1个历程而不是甘休,二个相互而不是内容,以及四个人中间的涉及,而不是风马不接的看护和伤者之间的互相。各个社会能力增派麻省理理大学将其观点发展为守护概念。联邦拨款用于准备从精神病护理到教学岗位,用于鲜明护理中的精神病学概念以及支出综合科目。因而,时间和财富的可用性在提供须求的促进。

Although the work of the faculty of the Yale School of Nursing may have
profoundly influenced nursing research in the United States in the
1960s, its influence on theory was not as marked at the time. A revival
of that impact came in the 1980s, as nurses acknowledged Yale’s
strategies for theory development; this is evidenced by the
reconsideration of Orlando’s work (Schmieding, 1983, 1987, 1988) and by
the paradigmatic shift in nursing research to phenomenology (Oiler,
1982; Omery, 1983; Silva and Rothbart, 1984). These writers’
conceptualization of nursing, therefore, was not the milestone that
prompted the evolution of the next stage of theory. Rather, it was the
position paper of the American Nurses Association (ANA)—in which nursing
was defined as care, cure, and coordination, and in which theory
development was identified as a most significant goal for the profession
of nursing—that may have been influential in the further development of
theoretical nursing (ANA, 1965).

尽管斯坦福大学护理大学的工作恐怕在20世纪60年间对美利坚合众国的看护研讨产生了源源不绝的震慑,但其对理论的震慑在即时并没有那么显着。那种影响的复苏发生在20世纪80年间,因为医护人员认同新加坡国立的反驳发展战略性;
这显示了奥兰多工作(Schmieding,一九八三,一九八八,1987)以及医生和医护人员切磋向现象学的范式转变(Oiler,壹玖捌叁;
Omery,一九八五; Silva and
Rothbart,壹玖捌贰)的重新考虑。因此,这几个小编的看护概念化并不是推进下一阶段理论发展的里程碑。相反,它是美利哥护协(ANA)的立场文件

  • 护理被定义为看护,治疗和和谐。

Two other significant developments occurred during this period. First,
federal support was provided to nurses wishing to pursue doctoral
education in one of the basic sciences. The graduates of these programs
are those who, in the mid-1970s, further developed metatheoretical
ideas. The second development was the inauguration of the journal,
Nursing Science. Although shortlived, it was a medium for the exchange
of ideas on theory and science in nursing and a confirmation that
nursing is an evolving science with theoretical principles and
underpinnings.

在此期间发生了此外两项关键气象发展。首先,向希望在在那之中一门基础科学领域接受硕士教育的看护提供联邦帮忙。那个课程的结束学业生是那个在20世纪70时期中叶进一步上扬了复合理论的人。第二个提高是守护科学杂志的揭幕。固然时间不久,但它是医生和护师理论和科学观点调换的媒婆,也作证护理是一门具有理论功底和底蕴的频频前进的不错。

  1. Camp Nurse

1966–1970—Theory Development: A Tangible Goal for Academics

Work in summer camps involving children. However, there are also
increasing numbers of health-related camps, such as those for people who
are overweight.

1968-一九七零年 – 理论发展:学术界的实际目的

With the ANA’s recommendation that theory development was of highest
priority in the profession, and with the availability of federal
support, a symposium sponsored by Case Western Reserve University was
held as part of the nursing science program. This symposium was divided
into three parts. The part focusing on theory was held on October 7,
1967, and was considered a milestone during this period (Table 5-4). The
papers were published in Nursing Research a year later. These
publications supported what were previously considered simply
perceptions and conceptions of theoretical nursing from an isolated
number of theorists. Not only did a group of significant people in
nursing get together to discuss theory in nursing, but the official
scientific journal of the field recognized the significance of these
proceedings by publishing them.

乘机全东瀛航空集团建议理论发展成为该行业的万丈优先事项,并且在获取联邦援助的情景下,凯斯西储高校帮助的研究研讨会作为医生和护师科学陈设的一片段进行。此次研究探讨会分为三部分。理论部分于一九六六年八月二十二日进行,在此时期被视为三个里程碑(表5-4)。那个杂文一年后揭橥在护理商量中。这一个出版物帮助在此以前被认为是发源孤立数量的理论家对理论护理的粗略明了和概念。不仅有一群首要的护理人士聚在联合谈论护理理论,而且该领域的法定科学杂志通过公布那么些杂谈来认识那个程序的要害。

Nurses also received confirmation from two philosophers and a nurse
theorist (who had been involved in teaching nurses at Yale for 5 years)
that theories are significant for the practice of nursing, that the
practice of nursing is amenable to theoretical development, and that
nurses are capable of developing theories (Dickoff, James, and
Wiedenbach, 1968). The presentations and the subsequent series of
publications by Dickoff and James (1968) and Dickoff, et al. (1968a,
1968b) influenced the discipline of nursing profoundly, as evidenced by
the classic nature of those publications and by the subsequent
acceleration in publications related to theory. Nursing theory was
defined, goals for theory development were set, and the confirmation of
outsiders (people outside the field of nursing, nonnursing philosophers)
was productive.

医护人员还取得了两位翻译家和一位守护理论家的承认(他曾在华盛顿圣路易斯分校高学校护士理教学工作5年),理论对于守护实践有关键意义,护理实践符合理论发展,而护师是力所能及发展理论(狄克off,詹姆斯和Wiedenbach,一九七零)。狄克off和詹姆斯(壹玖陆陆)和狄克off等人的发表以及随后的一多重出版物。(1970a,1969b)深切地影响了医生和医护人员学科,这么些出版物的经典性质以及与辩论相关的出版物的继承加快表明了那或多或少。定义了医生和护师理论,制定了辩白发展对象,外界职员(护理领域以外的人,非理性翻译家)的确认是有功效的。

  1. Parish Nurse
TABLE 5-4 THEORY DEVELOPMENT IN NURSING:A HISTORICAL PERSPECTIVE
1860 Florence Nightingale addresses the need for research and the educational preparation of nurses.
1900–1950 Diploma schools served as major source of nurses—the Flexner Report for Medicine.
1952 Nursing Research first published.
1955 Establishment of the Special Nurse Research Fellowship Program in the National Institutes of Health, Division of Nursing.
1959 D.E. Johnson. The nature of a science of nursing. Nursing Outlook, 7, 292–294.
1960 R.N. Schlotfeldt. Reflections on nursing research. American Journal of Nursing. 60(4), 492–494.(The primary task of nursing research is to develop theories that serve as a guide to practice.)
1961 Surgeon General’s Consultant Group on Nursing appointed to advise the Surgeon General on nursing needs and to identify the appropriate role of the federal government in assuring adequate nursing services in the nation. This group strongly supported nursing research and recommended a substantial increase in funds.
1961 D.E. Johnson. Patterns in professional nursing education. Nursing Outlook, 9, 608. (Nursing science may evolve more easily through the identification of common but major problems of patients that are of direct concern to nursing.)
1962 Nurse Scientist Graduate Training Grants Program
1963 Nursing Science first published
1963 M.E. Rogers. Some comments on the theoretical basis of nursing practice. Nursing Science, 1,11–13. (The theoretical base of nursing practice is nursing science . . . a body of scientific knowledge characterized by descriptive, explanatory, and predictive principles . . . developed through synthesis and resynthesis of selected knowledges from the humanities and the biological, physical, and social sciences. . . . It assumes its own “unique scientific” mix through selection and patterning of these knowledges.)
1963 M.E. Rogers. Building a strong educational foundation. American Journal of Nursing, 63(6), 941.(The explanatory and predictive principles of nursing make possible nursing diagnosis and knowledgeable intervention toward predictable goals . . . nursing science is not additive, but creative.)
1964 D.E. Johnson. Nursing and health education. International Journal of Nursing Studies, 1, 219.(Nurses must be socialized as scholars and must develop commitment to inquiry and skill in the use of scientific knowledge.) J.S. Berthold. Theoretical and empirical clarification of concepts. Nursing Science, 406–422. M.I. Brown. (Spring). Research in the development of nursing theory. Nursing Research, 13, 109–112. (Assess progress of theory development in nursing and emphasize need for explicit relationship of research to theory.)F.S. Wald and R. C. Leonard. (1964). Toward development of nursing practice theory. Nursing Research, 13(4), 309–313.
1965 American Nurses’ Association. Educational preparation for nurse practitioners and assistants to nurses: A position paper.P. Putnam. A conceptual approach to nursing theory. Nursing Science, 430–442.
1967 V.S. Cleland. The use of existing theories. Nursing Research, 16(2), 118–121.
1967 L.H. Conant. (Spring). A search for resolution of existing problems in nursing. Nursing Research, 16, 115.Symposium on Theory Development in Nursing. (Reported in Nursing Research, 1968, 17(3).)
1967–1970 National Commission for the Study of Nursing and Nursing Education, Jerome F. Lysaught, director.
1968 First Nurse Scientist Conference on The Nature of Science in Nursing. Sponsored by University of Colorado School of Nursing, Dr. Madeleine Leininger, chair. (Reported in Nursing Research,1969, 18[5].)First Annual WCHEN Communicating Research Conference
1968 J. Dickoff and P. James. A theory of theories: A position paper. Nursing Research, 17(3), 197–206.(Professional disciplines are obligated to go a step further than explanation and prediction in theory construction, to the development of prescriptive theory.)J. Dickoff, P. James, and E. Wiedenbach. Theory in a practice discipline: Part I. Practice oriented theory. Nursing Research, 17(5), 415–435. Idem. theory in a practice discipline: Part II. Practice oriented theory. Nursing Research, 17(6), 545–554.R. Ellis. (1968). Characteristics of significant theories. Nursing Research, 17(3), 217–222.D.E. Johnson. Theory in nursing: Borrowed and unique. Nursing Research, 17(3), 206–209.M. Moore. Nursing: A scientific discipline. Forum, 7(4), 340–347.J.L. Sasmor. Toward developing theory in nursing. Nursing Forum, 7(2), 191–200.
1969 G. Mathwig. Nursing science: The theoretical core of nursing knowledge. Image, 3, 9–14, 20–23.R. McKay. Theories, models, and systems for nursing. Nursing Research, 18(5), 393–399.C.M. Norris (Ed.). Proceedings: First, second, and third nursing theory conference. University ofKansas, 1969 and 1970.
1971 F. Cleary. A theoretical model: Its potential for adaptation to nursing. Image, 4(1), 14–20.I.M. Harris. Theory building in nursing: A review of the literature. Image, 4(1), 6–10.M. Jacobson. Qualitative data as a potential source of theory in nursing. Image, 4(1), 10–14.J.F. Murphy (Ed.). Theoretical issues in professional nursing. New York: Appleton-Century-Crofts.I. Walker. Toward a clearer understanding of the concept of nursing theory. Nursing Research, 20(5),428–435.
1972 M. Newman. Nursing’s theoretical evolution. Nursing Outlook, 20(7), 449–453.NLN Council of Baccalaureate and Higher Degree Programs approved its “Criteria for the Appraisal of Baccalaureate and Higher Degree Programs in Nursing,” including criterion stating that curricula should be based on a conceptual framework.
1973 M.E. Hardy. The nature of theories. In M. Hardy (Ed.), Theoretical foundations for nursing. New York:MSS Information Corporation.The Nursing Development Conference Group. (1973). Concept formulation in nursing: Process andproduct. Boston: Little, Brown & Co.
1974 M.E. Hardy. Theories: Components, development, evaluation. Nursing Research, 18, 100–107.A. Jacox. Theory construction in nursing: An overview. Nursing Research, 23, 4–13.D.E. Johnson. Development of theory: Requisite for nursing as a primary health profession. Nursing Research, 18, 372–377.
1975 Nursing Theories Conference Group. (Formed out of a concern for the need for materials to help students of nursing understand and use nursing theories in nursing practice.)
1978 Advances in Nursing Science. S.K. Donaldson and D. Crowley. The Discipline of Nursing. Nursing Outlook, 26(2), 113–120.
1979 M.A. Newman. Theory development in nursing. Philadelphia: F. A. Davis.
1982 M.J. Kim and D.A. Moritz. Classifications of nursing diagnosis. New York: McGraw-Hill.
1983 L.O. Walker and K.C. Avant. Strategies for theory construction in nursing. New York: AppletonCentury-Crofts.J. Fitzpatrick and A. Whall. Conceptual models of nursing: Analysis and application. Bowie, MD: R.J.Brady Co.P.L. Chinn and M.K. Jacobs. Theory and nursing: A systematic approach. St. Louis: C.V. Mosby.H.S. Kim. The nature of theoretical thinking in nursing. New York: Appleton-Century-Crofts.I.W. Clements and F.B. Roberts. Family health: A theoretical approach to nursing care. New York:John Wiley & Sons.P.L. Chinn. Advances in nursing theory development. Rockville, MD: Aspen Systems.
1984 J. Fawcett. Analysis and evaluation of conceptual models. Philadelphia: F.A. Davis.

If you have a religious affiliation, this will allow you to integrate
health and spirituality.

表5-4护理中的理论发展:历史透视
1860 弗洛伦斯·南丁格尔满足了对研究和护士教育准备的需求。
1900-1950 文凭学校担任护士的主要来源 – Flexner医学报告。
1952年 护理研究首次出版。
1955年 在国立卫生研究院护理部建立特别护士研究奖学金计划。
1959年 德约翰逊。护理科学的本质。护理展望,7,292-294。
1960年 RN Schlotfeldt。对护理研究的几点思考。美国护理学杂志。60(4),492-494。(护理研究的主要任务是开发理论,作为实践的指导。)
1961年 外科医生总顾问护理顾问组任命向外科医生咨询护理需求并确定联邦政府在确保国内适当护理服务方面的适当角色。该团队大力支持护理研究,并建议大幅增加资金。
1961年 德约翰逊。专业护理教育模式。护理展望,9,608(护理科学可能通过识别与护理直接相关的患者的常见但主要问题更容易地发展。)
1962年 护士科学家研究生培训资助计划
1963年 护理科学首次出版
1963年 ME罗杰斯。关于护理实习理论基础的几点意见。护理科学,1,11-13。(护理实践的理论基础是护理科学……以描述性,解释性和预测性原则为特征的科学知识体……通过合成和重新合成来自人文学科以及生物学,物理学和社会科学的选定知识……它通过选择和模式化这些知识来承担自己的“独特的科学”组合)。
1963年 ME罗杰斯。建立强大的教育基础。美国护理学杂志,63(6),941.(护理的解释和预测原理使可能的护理诊断和对可预测目标的知识性干预……护理科学不是可叠加的,而是具有创造性的。)
1964年 德约翰逊。护理和健康教育。国际护理研究期刊,1,299。(护士必须作为学者社会化,必须发展对科学知识使用的探究和技能的承诺。)JS Berthold。概念的理论和经验澄清。护理科学,406-422。MI布朗。(弹簧)。护理理论发展研究。护理研究,13,109-112。(评估护理理论发展的进展,强调需要明确的理论研究关系。)FS Wald和RC Leonard。(1964年)。走向护理实践理论的发展。护理研究,13(4),309-313。
1965年 美国护士协会。护士从业人员和助理护士的教育准备:立场文件.P。普特南。护理理论的概念方法。护理科学,430-442。
1967年 VS克莱兰。现有理论的运用。护理研究,16(2),118-121。
1967年 LH Conant。(弹簧)。寻求解决护理中存在的问题。护理研究,16,115。护理学理论发展研讨会。(护理研究报告,1968,17(3))。)
1967- 1970年 国家护理和护理教育研究委员会主任Jerome F. Lysaught。
1968年 第一届护理科学性质护士科学家会议。由科罗拉多大学护理学院主持,Madeleine Leininger博士主持。(报告在护理研究,1969年,18 [5]。)第一届年度WCHEN通信研究会议
1968年 J. Dickoff和P. James。理论理论:立场文件。护理研究,17(3),197-206。(专业学科有义务比理论构造的解释和预测更进一步,对规定性理论的发展)。迪科夫,P.詹姆斯和E.维登巴赫。实践学科理论:第一部分。实践导向理论。护理研究,17(5),415-435。同上。理论在实践学科:第二部分。实践导向的理论。护理研究,17(6),545-554.R。埃利斯。(1968年)。重要理论的特点。护理研究,17(3),217-222.DE约翰逊。护理理论:借鉴与独特。护理研究,17(3),206-209.M。穆尔。护理:一门科学学科。论坛,7(4),340-347.JL Sasmor。走向理论发展的护理。护理论坛,7(2),191-200。
1969年 G. Mathwig。护理科学:护理知识的理论核心。Image,3,9-14,20-23.R。麦凯。护理理论,模型和系统。护理研究,18(5),393-399.CM Norris(编辑)。会议记录:第一,第二和第三届护理理论会议。堪萨斯大学,1969年和1970年。
1971年 F. Cleary。理论模型:其适应护理的潜力。图片,4(1),14-20.IM哈里斯。护理学理论建构:文献综述。图片,4(1),6-10.M。雅各布森。定性数据作为护理理论的潜在来源。图像,4(1),10-14.JF墨菲(编辑)。专业护理的理论问题。纽约:Appleton-Century-Crofts.I。沃克。更清晰地理解护理理论的概念。护理研究,20(5),428-435。
1972年 M.纽曼。护理的理论演变。护理展望,20(7),449-453.NLN学士学位和高等学位课程理事会批准了“评估护理学士学位和高等学位课程的标准”,其中包括标准,指出课程应基于概念框架。
1973年 我哈代。理论的本质。在M.哈代(编辑),护理理论基础。纽约:MSS信息公司。护理发展会议组。(1973年)。护理概念的制定:过程和产品。波士顿:Little,Brown&Co.
1974年 我哈代。理论:组件,开发,评估。护理研究,18,100-107.A。Jacox。护理理论建设:概述。护理研究,23,4-13.DE Johnson。理论的发展:作为一个初级卫生专业的护理的必要条件。护理研究,18,372-377。
1975年 护理理论会议组。(由于需要材料来帮助护理学生理解和使用护理理论在护理实践中形成。)
1978年 护理科学进展。SK唐纳森和D.克劳利。护理学科。护理展望,26(2),113-120。
1979年 马纽曼。护理理论的发展。费城:FA戴维斯。
1982年 MJ Kim和DA Moritz。护理诊断的分类。纽约:麦格劳 – 希尔。
1983年 LO Walker和KC Avant。护理学理论构建策略。纽约:AppletonCentury-Crofts.J。菲茨帕特里克和A.沃尔。护理概念模型:分析与应用。Bowie博士:RJBrady Co.PL Chinn和MK Jacobs。理论与护理:一种系统的方法。圣路易斯:CV Mosby.HS Kim。护理理论思维的本质。纽约:Appleton-Century-Crofts.IW Clements和FB Roberts。家庭健康:护理的理论方法。纽约:John Wiley&Sons.PL Chinn。护理理论发展进展。Rockville,MD:Aspen Systems。
1984年 J. Fawcett。概念模型的分析和评估。费城:FA戴维斯。

Although the insiders (the nurse theorists) may have charted the course
of action for theory development, the doubts and skepticism about theory
(from the critics who viewed theory as scientific and as evolving from
an empirical, positivistic model) that dominated nursing until then were
somewhat squelched by the presentations and discussions that went on
during that significant meeting in which Dickoff and James (1968, 1971)
and Dickoff, James, and Weidenbach (1968a, 1968b) presented their
metatheory of nursing. The evidence for skepticism is derived from
omission rather than commission. When theories were used during this
period, they were used in conjunction with education and not in practice
(except by New York and Yale Universities faculty and students) or
research. (Refer to the theory literature in Chapter 19 for
documentation of the omission.)

尽管当中职员(医护人员理论家)只怕制定了驳斥发展的行路路线,但直至那时截止主导护理的论战(从批评者认为理论是未可厚非的和从经验的,实证主义格局衍变而来的)的质疑和疑虑是在狄克off和James(1970,一九七三)和Dickoff,James和Weidenbach(1970a,一九六九b)浮现他们的守护成分的严重性会议时期开展的发言和议论中某个压抑。思疑主义的凭证来源于遗漏而非佣金。在那一个时期选择理论时,它们与教育结合使用,而不是在实践中(除了London和耶路撒冷希伯来高校的师生)或钻研。

The metatheorists in nursing started their questioning during this
period. Questions of this era were related to what types of theories
nurses should develop rather than to the nature of the substantive
content of those theories. The first metatheorists were Ellis (1968) and
Wiedenbach (Dickoff et al., 1968a, 1968b). Dickoff and James (1968),
philosophers by training, addressed metatheoretical concerns that
focused on types of theories and content of theories. Debates occurred
about whether the theories should be basic or borrowed, pure or applied,
descriptive or prescriptive.

在那段时光内,护理中的变体者初阶发问。这几个时代的标题与护士应该发展如何品种的争鸣有关,而不是那么些理论的面目内容的习性。第②个元变理论家是艾利斯(1969)和Wiedenbach(Dickoff等人,一九六六a,壹玖陆捌b)。狄克off和James(一九七〇)通过作育学习史学家,化解了关爱理论类型和辩白内容的答辩难点。关于那一个理论是基础性的要么借用性的,纯粹的要么应用性的,描述性的或规定性的,都爆发过争议。

Accomplishments at this stage can be summarized as:

• Nursing is a field amenable to theorizing.
• Nurses can develop theories.
• Practice is a rich area for theory.
• Practice theory should be the goal for theory development in
nursing.
• Nurses’ highest theory goal should be prescriptive theory, but it is
acceptable to develop descriptive and explanatory theories.

此时此刻的做到能够蕴涵为:

• 护理是契合理论化的天地。
• 医护人员能够支付理论。
• 实践是论战的丰硕领域。
• 实践理论应当改成护理理论发展的靶子。

医护人员的参天理论目的应该是规定性理论,可是制定描述性和平解决释性理论是还可以的。

  1. Staff Nurse

1971–1975—Theory Syntax

Work regular hours with reasonable pay in a hospital or any healthcare
setting.

壹玖柒壹-一九七五-理论句法

There was a period, just before the research enterprise in nursing
focused on answering significant questions in the field, when nurse
researchers focused on discussing and writing about research
methodology. A parallel exists in the area of theory. The period from
1966 to 1970 resulted in a beginning focus on theory development, which
was followed by attempts at identifying the structural components of
theory (see Table 5-4). Metatheorists dominated this period. The
emphasis was on articulating, defining, and explicating theory
components and on the processes inherent in theory analysis and
critique. Nurse theorists were no longer questioning whether nursing
needed a theory or whether or not theory could be developed in nursing;
questions of this period focused on what is meant by theory (Ellis,
1968, 1971; Walker, 1971), on what are the major components of theory
(Hardy, 1974; Jacox, 1974), and on ways to analyze and critique theories
(Duffey and Muhlenkamp, 1974). Education of nurses in basic, natural,
and social sciences through the federally supported nurse–scientist
programs produced a cadre of nurses who shared a common goal: the
establishment of the unique knowledge base of nursing. Discussions of
what constituted theory and the identification of theory syntax seemed
to be the means to achieve that goal.

有一段时间,就在护理研讨公司注意于回复该领域的严重性难题从前,护师钻探人口留意于斟酌和创作钻探方法论。理论领域存在并行。一九六九年至1966年中间开端关心理论发展,随后尝试明显理论的结构组成都部队分(见表5-4)。Metatheorists统治了这么些时代。重点在于表达,定义和阐释理论部分以及理论剖析和批判中原始的历程。护理理论家们不再困惑护理是还是不是供给一种理论,大概理论是或不是足以在护理中进步;
这一个时代的题材集中在理论的意义上(艾利斯,一九六六,一九七五;
沃克,壹玖柒壹),关于理论的重庆大学组成都部队分(哈迪,1975;

  1. Nurse Midwife

Jacox,一九七一)以及分析和批判理论的法子(Duffey和Muhlenkamp,一九七四)。通过联邦帮衬的护师

地军事学家布置对基础,自然和社科护师举办教育,发生了二个负有一块指标的看护阵容:建立分外的守护知识库。研讨哪些构成理论和申辩语法的明确就像是落到实处这一对象的手法。

Just before the close of this period, a milestone was achieved. Just as
the ANA acknowledged the significance of theory development during the
previous period, the National League for Nursing (NLN) not only
acknowledged theory but also made theory-based curriculum a requirement
for accreditation. Schools of nursing were expected to select, develop,
and implement a conceptual framework for their curricula. This
requirement for accreditation was both a moving force and a major
barrier to theory development. To use theory for curriculum development
further heightened awareness of academic nursing to the significance of
theory and to the available nursing theories. However, this requirement
diverted the goal of developing theories for practice (those theories
that would answer significant questions related to practice) to the goal
of using theory for education. Nevertheless, this milestone increased
the use of theory and discussions about theory and prompted more writing
about the syntax of theory to help academicians and students understand
and use theories in curriculum and teaching. The limited number of
journals that acknowledge and promote theoretical nursing, the focus on
promoting the publication of empirical research findings, and the
growing financial difficulties of some journals were barriers to written
exchanges on theory and theorizing.

在那段日子截止在此之前,这是二个里程碑。正如全东瀛航空集团在前一里边肯定理论发展的根本意义一样,全国护理联盟(NLN)不仅肯定理论,而且还将理论课程作为评释供给。猜度护军事学校将为她们的教程选用,开发和进行2个定义框架。这种认证须求既是重力,也是辩论发展的重中之重障碍。利用理论进行学科开发,进一步进步了学术护理对理论意义和现有护理理论的认识。可是,这一须求将推行理论(那么些将回应与执行有关的首要难题的理论)的靶子转向了将理论用于教育的对象。可是,那一个里程碑扩大了对理论的申辩和探讨的使用,并驱使更多关于理论语法的文字,以帮扶大家和学生驾驭和利用理论课程和教学。承认和推进理论护理的刊物数量有限,拉动实证研商成果公布的根本以及一些杂志财困的扩张是辩论和辩驳方面的书皮调换的阻碍。这一里程碑扩充了对理论的辩护和议论的使用,并促使愈多的关于理论语法的文章援助我们和学员知晓和利用理论课程和教学。承认和拉动理论护理的杂志数量少于,拉动实证研讨成果宣布的主要以及部分期刊财政困难的扩大是理论和理论方面包车型大巴封皮调换的绊脚石。这一里程碑扩张了对理论的说理和商讨的采纳,并驱使愈多的关于理论语法的写作帮忙大家和学生精晓和应用理论课程和教学。认可和推进理论护理的期刊数量少于,推动实证研商成果宣布的机要以及部分杂志财困的增多是辩论和辩论方面的封皮沟通的阻碍。

Help deliver babies. You will also be involved in providing ante- and
post-natal care.

1976–1980—A Time to Reflect

  1. Insurance Firm Nurse

一九八〇-壹玖柒玖年 – 反映时间

Nurse theorists were invited to participate in presentations,
discussions, and debates in conferences sponsored by nurse educators,
marking a significant milestone in the progress of theoretical nursing.
A national conference devoted to nursing theory and the formation of the
Nursing Theory Think Tank in 1978 further supported the direction of the
profession toward the utilization of existing theory and the development
of further theory to describe and explain nursing phenomena, to predict
relationships, and to guide nursing care (Preview, 1978). This was the
time for nurse academicians, who had used nursing theories as guiding
frameworks for curricula, to consider putting theory to other uses,
particularly in practice.

医护人员理论家被特邀在场由护师教育工小编主办的集会上的演说,商讨和辩解,那表明着医生和护师理论进行中的二个最重要里程碑。1979年进行的全国护理理论会议和护理理论智囊团的演进更为协理了行业内部方向,即选用现有理论和越发理论的发展来叙述和演讲护理现象,预测关系,以及引导医生和医护人员(预览,一九八零)。那是卫生员院士们将护理理论作为课程的辅导框架,考虑将答辩应用于其余用途的时候,尤其是在实践中。

The inauguration of the journal, Advances in Nursing Science, with its
focus on “the full range of activities involved in the development of
science,” including “theory construction, concept, and analysis” and the
application of theory, was another significant milestone during this
period (Chinn, 1978) (see Table 5-4). The focus of the journal on theory
and theory development added more support to the significance of
theoretical nursing and simultaneously gave nurses who were interested
in theory the necessary medium in which to present and discuss their
ideas. It allowed for the questioning and debate that is necessary for
the development of theoretical bases in any discipline.

该杂志“护理科学进行”的开幕式侧重于“涉及科学提升的满贯活动”,包罗“理论营造,概念和剖析”以及理论应用,是中间另三个首要的里程碑这几个时期(Chinn,一九七九)(见表5-4)。该杂志在争鸣和驳斥发展地点的最重要为理论护理的意义扩张了越多的帮衬,同时让理论上感兴趣的看护有必不可少介绍并探讨他们的想法。它同意在其他学科中升高理论功底所需的可疑和申辩。

This period was characterized by questioning whether nursing’s progress
would benefit from the adoption of a single paradigm and a single theory
of truth (Carper, 1978; Silva, 1977). More sophisticated debates about
what types of theory nursing needs (Beckstrand, 1978a, 1978b, 1980) and
about issues in theory (Crawford, Dufault, and Rudy, 1979) appeared in
nursing literature. A more solid commitment to the development of theory
emerged, combined with a specific direction to nurses’ efforts in theory
development (Donaldson and Crowley, 1978; Hardy, 1978). The links
between theory and research were considered and discussed (Batey, 1977;
Fawcett and Downs, 1986), the path was charted for bridging the
theory–research gaps between theory and practice (Barnum, 1990), theory
and philosophy were examined (Silva, 1977), and the role of each in the
development of nursing knowledge was clarified (see Fig. 5-1). Domain
concepts were beginning to be identified, and their acceptance was
demonstrated in the next period.

以此时代的性状是可疑护理的开拓进取是不是会从利用单一范式和纯粹真理理论中收益(Carper,一九八零;
Silva,一九七六)。护理文献中冒出了更多关于理论护理须求项目(Beckstrand,1979a,一九七九b,一九七八)和辩论难题(Crawford,Dufault和Rudy,一九七八)的论战。对理论发展的更坚定的承诺现身了,并且与医护人员在理论发展方面包车型客车鼎力的具体方向相结合(唐Naderson
and Crowley,1980;
哈代,1976)。理论与商量期间的维系被考虑和议论(Batey,1976;
Fawcett和唐斯,1987),该路线被用来修复理论与履行之间的理论斟酌差异(Barnum,一九九零)
,一九七八),并显著了各自在护理知识发展中的功能(见图5-1)。领域概念初始被辨认出来,并在下一个时日被接受。

Insurance companies often need nurses to assess claims.

1981–1985—Nursing Theories’ Revival: Emergence of the Domain Concepts

  1. Keep Studying Towards a Bachelor’s, Master’s or Doctorate Degree

1982年至1981年 – 护理理论的苏醒:域概念的产出

In this period, theory began to be questioned less and pluralism debated
less. This period was characterized by an acceptance of the significance
of theory for nursing and, furthermore, by the inevitability of the need
for the development of nursing theory. Doctoral programs in nursing
incorporated theory into their curricula and considered it a core
content area, ranking it at the top of all other core content (Beare,
Gray, and Ptak, 1981). This period was also characterized by enlightened
international interest in theoretical nursing as manifested in
conferences in Sweden and demand for consultations on theory teaching in
Thailand, Korea, and Egypt, among other countries.

在这几个时代,理论开始被困惑得越来越少,多元论辩论也越来越少。这一时半刻期的表征是承受护理理论的关键,并且还有须要开销护理理论。护医学学士课程将答辩纳入其课程并将其身为宗旨内容领域,将其列为全体任何大旨内容(Beare,格雷和Ptak,1981)的顶部。那权且期的特色还反映在国际上对理论护理的志趣,那展现在瑞典王国的集会上,并供给在泰王国,大韩民国和阿拉伯埃及共和国(The Arab Republic of Egypt)(The Arab Republic of Egypt)等国家进行理论教学磋商。

A review of theory literature during this period reveals the lack of
debate on whether to use theory–practice versus basic theory or borrowed
versus nursing theory. Instead, there appeared to be more writing on the
examination of nursing theories in relation to different research and
practice problems and on comparisons between the different
conceptualizations (Jacobson, 1984; Spangler and Spangler, 1983).
Questions of this period included:
• What have we learned from theory?
• How can we use theory?

在此时期对理故事集献的回想揭发了对于是还是不是利用理论实践与基础理论或借用与护理理论的争执。相反,就像有更加多的有关不一致讨论和执行难题以及分歧定义之间相比的护理理论探究的文章(Jacobson,一九八一;
Spangler和Spangler,1982)。这一个时期的难题包罗:
• 大家从理论中学到了什么?
• 大家怎样利用理论?

The second question was one that clinicians began to ask and for which
there have been many useful dialogues.

其次个难点是临床医务卫生职员起始精晓的题材,并且有为数不少一蹴而就的对话。

The newly emerging syntax was used to analyze existing theories
(Fawcett, 1984; Fitzpatrick and Whall, 1983). In addition, existing
theories came to be thought of as the means to develop unique nursing
knowledge. Concepts central to nursing were identified, and existing
theory, the source of the identified concepts, was in turn re-examined
in terms of further development and refinement (Crawford, 1982; Reeder,
1984).

新面世的语法被用来分析现有的论争(Fawcett,1983;
Fitzpatrick和Whall,一九八四)。此外,现有理论被认为是支付独特级护理理知识的一手。明确了护理的着力概念,并且现有理论(已规定的概念的起点)反过来在越来越的上扬和创新地方开始展览了再次审视(Crawford,一九八五;
Reeder,一九八二)。

This period was characterized by the nursing theory advocates who
pleaded for the use of a nursing perspective in general or for the
specific utilization of nursing theory (Adam, 1983; Dickson and
Lee-Villasenor, 1982). (See Advances in Nursing Science, Journal of
Nursing Administration, and American Journal of Nursing for examples of
the American advocates and Journal of Advanced Nursing for examples of
international advocates.) Another group also emerged during this period:
the theory synthesizers. The difference between the advocates and the
synthesizers was in the level of the scope of analysis. The advocates
promoted nursing theory and demonstrated its use in research projects or
in a limited practice arena. The synthesizers went beyond that limited
use to describe and analyze how nursing theory had influenced nursing
practice, education, research, and administration. The synthesizers are
exemplified by, but not limited to, Fitzpatrick and Whall (1983, 1996)
and Fawcett (1984, 1995). The Rogerian First National Conference (1983)
and subsequent ones, in which theoreticians, practitioners, and
researchers discussed the utility of Rogers’ theory from different
perspectives, is a different example of an effective synthesis of
different uses of a theory. The planners of this conference belong to
the group of theory synthesizers.

那暂且期的特征是看护理论倡导者主张选用一般护理观点或具体运用护理理论(Adam,1985;
狄克son和Lee-比利亚senor,壹玖捌肆)。(参见护理科学开始展览,护理管理杂志和美国护经济学杂志关于美利坚联邦合众国帮忙者的例子和国际支持者例子中的高级护理杂志)。在那些时代还出现了另一组:理论合成器。提倡者与合成者之间的差别处于分析范围的品位。倡导者提倡护理理论,并将其用来钻探项目或少数的执行领域。这一个合成器超出了简单的应用范围来讲述和剖析护理理论怎样影响护理实践,教育,研讨和管制。合成器的事例包蕴但不限于Fitzpatrick和Whall(一九八四,一九九八)和Fawcett(1981,一九九一)。罗吉尔斯第1回全国会议(一九八四年)及之后的理论家,实践者和切磋人口从不一样的角度谈谈了罗吉尔斯理论的法力,那是行得通综合理论差异用法的另2个例证。此次会议的出品人属于理论合成器组。是辩论差别用途的可行综合的另叁个例子。这次会议的导演属于理论合成器组。是理论分裂用途的有效性综合的另三个事例。此次会议的编剧属于理论合成器组。

A few theory synthesizers graduated from New York University in the
mid-1970s. One thing that cannot be ignored, is the influence of New
York University nursing program on advancing theoretical nursing. This
is made evident by a review of the titles of doctoral dissertations in
nursing from New York University from 1941 to 1983, which provide a
clear example of how a school of nursing using a coherent theoretical
framework can drive a coherent research agenda. Most of the titles of
the dissertations indicate a nursing perspective, and there appears to
have been an attempt at cumulative knowledge development. How and in
what ways such a pattern may have influenced and may continue to
influence theory development is an area worth further investigation and
analysis, however, we do see a Rogerian conference every once in a while
that brings many nurse scholars together to speak the same theory
language and to show their research. The outcome of such gatherings on
discovery, integration, and innovation of nursing knowledge is yet to be
documented.

某个驳斥合成器在20世纪70时代中叶从伦敦高校毕业。有一件不容忽视的事务是London高学校护士理项目对促进理论护理的震慑。通过对一九四五年至1981年London大学护管理学硕士诗歌题指标纪念能够知晓地看到那或多或少,那清楚地注解了叁个利用连贯的申辩框架的看护大学如何拉动连贯的斟酌议程。大部分杂文标题都标明了医生和护师观点,就像是积累知识发展的品尝。可是,那种格局怎么着以及以何种措施影响和可能继承影响理论发展是一个值得进一步查证和剖析的圈子,大家每隔一段时间就会看出叁次罗杰瑞集会,会让广大看护学者一起讲同样的争鸣语言并展现他们的钻探成果。那么些关于护理知识的发现,整合和换代的大团圆的结果没有形成文件。

This period was characterized by an acceptance of theory as a tool that
emanates from significant practice problems and that can be used to
guide practice and research. This period was also characterized by a
greater clarity in the relationship between theory and research than
between theory and practice.

本条时代的性状是承受理论作为1个工具,从首要的进行难点,可用以辅导实践和商量工具。这几个时代的特性是论战和钻研时期的涉嫌比理论和执行之间的涉及愈来愈清晰。

One remaining confusion during this period was related to semantics.
Conceptual models were referred to as conceptual frameworks, theories,
metatheories, paradigms, and metaparadigms and, when differentiated,
boundaries were not totally clear and properties not entirely distinct.
(See discussion about Rogers’ theory in chapter 13.)

在那段时日里剩下的二个模糊与语义有关。概念模型被称之为概念框架,理论,元数据,范式和元类,并且当区分时,界限并不完全明白,属性也不完全差别。(见第二3章有关罗吉尔斯理论的议论。)

Nurses are committed to the furthering of the professional education.
From being a nurse assistant, you can move on to license practical
nurse,

1986–1990—From Metatheory to Concept Development

to an associate’s degree in nursing, to a bachelor’s degree, to a
master’s degree and finally a Ph.D. in nursing.

壹玖捌玖-一九八八-从理论到概念发展

Three characteristics of this milestone were epistemological debates,
ontological analyses, and an increase in concept development and
analyses. One other characteristic of this period was the acknowledgment
of the gap between theory and practice. The epistemological debates
included questions related to describing alternative approaches to
knowledge development, such as the use of phenomenology, critical
theory, and feminist or empiricist methodologies, and how to connect the
dialectal approach to theory and practice (e.g., Allen, 1985; Allen et
al., 1986; Hagell, 1989; Leonard, 1989). Although the debates were
focused on knowledge development in general rather than on theoretical
development of the discipline, these debates were related as well to the
development of theoretical nursing. Concept development emerged as a
potential link between the theoretical knowing and the practical doing.

本条里程碑的八个特征是认识论辩论,本体论分析以及概念发展和分析的增多。那临时期的另2个特色是认识到理论与实施之间的距离。认识论辩论蕴含与讲述知识发展的任何形式有关的题材,如气象学的施用,批判理论,女性主义或经验主义方法论,以及哪些将方言方法与理论和实践联系起来(如Allen,壹玖捌肆;
Allen et al。 壹玖捌柒; Hagell,一九八六;
伦Nader,壹玖捌捌)。就算辩论的重中之重集中在知识发展上而不是学科的驳斥发展上,但那几个理论与理论护理的前行也有涉嫌。

Effective analyses were those that focused on ontological beliefs
related to central nursing concepts, for example, environment
(Chopoorian, 1986; Stevens, 1989), and health (Allen, 1985, 1986;
Benner, 1984). These analyses added substantially to a more contextual
approach to understanding each concept. These analyses also raised the
awareness and the consciousness of nurses to the necessity of using
frameworks that allow for an integrative, holistic, and contextual
description of nursing phenomena, phenomena that go beyond the
individual clients. Such frameworks, these authors demonstrated,
maintained the integrity of the basic ontological beliefs that have
historically guided nursing practice, for example, holism, integrated
responses, and relationship with environment.

得力的剖析首要集聚在与中心护理概念有关的本体论信念,例如环境(Chopoorian,1989;
Stevens,一九八八)和健康(Allen,一九八五,一九八八;
Benner,一九八三)。那些分析大大扩张了驾驭各个概念的更多田地点法。那个分析还增强了护师对使用框架的要求性的认识和发现,这个框架允许对医生和医护人员现象开始展览归咎,全部和田地描述,那么些处境超出了个人客户的界定。那些小编表明,那样的框架保持了历史上引导医生和护师实践的基本本体论信念的完整性,例如全部论,综合反应和与环境的涉及。

The third property of this milestone was an increase in writings related
to concept development. These developments were different from earlier
theory developments that included answers to such general questions as
“What is nursing?” These analyses were more practice oriented, were
integrative, and represented early attempts in the development of single
domain theories. This was also the period in which a plea for substance
was made (Chinn, 1987; Downs, 1988; Meleis, 1987; Woods, 1987). These
authors echoed the sentiment of other discipline members by urging
discourse that was more focused on substantive issues that were
confronting health care recipients.

其一里程碑的第几本性子是与定义开发有关的着作扩展。这么些进步与最初的反驳发展不一致,那么些发展包蕴对“什么是守护”那样的一般难点的回应。这一个分析越发以实施为导向,是整体的,并且表示了单领域理论发展的最初尝试。那也是对物质实行抗辩的一代(Chinn,一九九零;
唐斯,1986; Meleis,1988;
伍德s,1989)。这个笔者答疑了别的学科成员的见识,并驱使更关爱医疗对象面临的实质性难题的讲话。

Process debates became more a potential force for theory development
when and if they were grounded in substantive disciplinary content.
Therefore, instead of debating whether critical theory or feminist
theories were more appropriate as a philosophical base for the
discipline, one may argue whether it was more effective to view
environment or comfort from either or both perspectives. Such
substantive debates then would add to or revise parameters and
dimensions of that area of knowledge.

在实质性纪律内容的基本功上,进度辩论成为辩论发展的潜在力量。由此,与其理论批判理论或女权主义理论是还是不是更契合当作该课程的理学基础,人们也许会冲突从那三种意见或三种观点来看环境照旧舒适都越来越实用。那样的实质性辩论会扩大或改动该文化领域的参数和维度。

  1. Work Abroad

1991–1995—Middle-Range and the Beginning of Situation-Specific Theorizing

The nursing degree that you obtain in this country can be transferred to
a license to practice in most other countries.

一九九五-1994-中间范围和特定情境理论化的始发

One significant milestone that marks the considerable progress in
knowledge development in nursing is manifested in the numerous
middle-range theories that evolved during this period. Some of these
were labeled as theories (e.g., Younger’s Theory of Mastery [1991] or
Mishel’s Theory of Uncertainty [1990]). Others were considered in the
process of becoming theories. (See Funk, Tornquist, Champage, Copp, and
Wiese [1990] for discussions about key aspects of recovery and
Hagerty, Lynch-Sauer, Patusky, and Bouwsema [1993] for their emerging
theory of human relatedness.) Middle-range theories focus on specific
nursing phenomena that reflect and emerge from nursing practice and
focus on clinical process (Meleis, 1987). They provide a conceptual
focus and a mental image that reflect the discipline’s values, but they
do not provide prescriptions for practice or specific practice
guidelines (Chinn, 1994).

标志着医生和护师知识发展获得长足进步的四个至关心保养要里程碑浮未来那权且期发展兴起的许多中路范围理论中。个中一部分被标记为辩白(例如,Younger的主宰理论[1991]或Mishel的不明确性理论[1990])。其余人被认为正在变成辩论。(请参阅Funk,Tornquist,Champage,Copp和Wiese
[1990]有关恢复生机和Hagerty,林奇-Sauer,Patusky和Bouwsema
[1993]关于她们关于人类相关性的新生理论的主要方面包车型大巴座谈。)中等范围理论重点对反映并从护理实践中涌现出来并拥戴治病进程的实际护理现象(Meleis,1990)。它们提供了展示学科价值的概念主题和心境图像。

Situation-specific theories may be emerging as another milestone,
although they were better defined in later years. They are theories that
are more clinically specific, theories that reflect a particular
context, and may include blueprints for action. They are less abstract
than middle-range theories but far more abstract than individual nurses’
frameworks for practice designed for a specific situation (Meleis, 1997;
Im and Meleis, 1999; Im, 2005). These situation-specific theories may
emerge from synthesizing and integrating research findings and clinical
exemplars about a specific situation or population with the intent of
giving a framework or blueprint to understand the particular situation
of a group of clients. They are theories that are developed to answer a
set of coherent questions about situations that are limited in scope and
limited in focus. For example, a conceptualization of patterns of
responses to health–illness transitions of Middle Eastern immigrants
could be developed from the results of research studies, the clinical
exemplars, and the experience of nurses in their care of this population
(Meleis, Isenberg, Koerner, Lacey, and Stern, 1995). An example is work
that has focused on Middle Eastern immigrants (Afghans, Iranians,
Egyptians, and Arabs), supported by similar work on these populations in
their native countries, which helps illuminate patterns of behavior and
responses before immigration and helps in providing a historical and
sociocultural context for the responses of immigrants in their new
country.

具体情状的说理恐怕正在变成另1个里程碑,就算它们在晚些时候有更好的定义。它们是更具临床意义的论争,反映特定背景的反驳,并且大概包蕴行动蓝图。他们与其说中层理论抽象,但比单个医护人员针对具体境况设计的实施框架更抽象(Meleis,一九九九;
Im and Meleis,一九九六;
Im,二〇〇六)。这几个针对具体情状的争鸣恐怕现身于综合和整合有关特定情景或人群的钻研结果和医疗样本,以期提供框架或蓝图来掌握一组客户的特定情景。它们是为了酬答有关限制有限且主要有限的景观的一密密麻麻连贯难题而制定的说理。例如,能够从商量结果,临床样本以及医护人员对这一个人群的看护经验中提升出中东移民健康疾病转变反应情势的定义(Meleis,Isenberg,Koerner,莱西和斯特恩,一九九三年)。3个例子是注重于中东移民(阿富汗人,伊朗人,阿拉伯埃及共和国(The Arab Republic of Egypt)人和阿拉伯人)的办事,那么些干活儿获得那么些人在笔者国的类似工作的帮助,那促进申明移民前的一坐一起和反馈形式,并有助于提供历史以及移民在新国家的反应的社会文化背景。能够从钻探结果,临床样本以及护师在这么些人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中升华出中东移民对健康疾病转变反应格局的定义。斯特恩,一九九二年)。几个例证是着重于中东移民(阿富汗人,伊朗人,阿拉伯埃及共和国(The Arab Republic of Egypt)(The Arab Republic of Egypt)人和阿拉伯人)的工作,那一个干活儿赢得这么些人在作者国的接近工作的协助,那促进申明移民前的行事和反应格局,并推进提供历史以及移民在新国家的感应的社会文化背景。能够从研讨结果,临床样本以及医护人员在那1个人群中的经历(Meleis,Isenberg,Koerner,Lacey等人)中进步出中东移民对健康疾病转变反应格局的定义。斯特恩,1993年)。二个事例是重视于中东移民(阿富汗人,伊朗人,埃及(Egypt)人和阿拉伯人)的劳作,那些工作取得这几个人在作者国的接近工作的支撑,那有助于表明移民前的行为和反应方式,并有助于提供历史以及移民在新江山的反响的社会文化背景。以及护理职员照顾那么些人群的经历(Meleis,Isenberg,Koerner,Lacey和Stern,1991)。3个例子是珍视于中东移民(阿富汗人,伊朗人,阿拉伯埃及共和国(The Arab Republic of Egypt)人和阿拉伯人)的干活,那一个干活儿赢得那些人在本国的好像工作的帮忙,这有助于注脚移民前的作为和影响方式,并促进提供历史以及移民在新江山的反射的社会文化背景。以及护理职员照顾这一个人群的经验(Meleis,Isenberg,Koerner,Lacey和Stern,一九九一)。2个例证是注重于中东移民(阿富汗人,伊朗人,埃及人和阿拉伯人)的工作,这几个干活儿赢得这个人在笔者国的近乎工作的援助,那促进表明移民前的行事和反应情势,并推进提供历史以及移民在新国家的感应的社会文化背景。

  1. Prison Nurse

1996–2000—Evidence Means Research, Not Theory

This is incredibly hard work and not for the faint of heart.

一九九六年至3000年 – 证据意味着钻探,而不是理论

Evidence-based practice evolved after much discourse in the literature
from evidence-based practice to evidence-based nursing. During this
milestone, the focus of the literature written about the discipline was
on identifying the similarities and differences between utilizing models
of care with best evidence, translating research into practice, and
using applied research (French, 1999). To determine evidence,
methodologies were discussed for defining the quality of individual
studies, the methods for integrating study findings, and criteria for
judging integrative findings and what constitutes evidence that could be
used in the literature (Goode, 2000; McKee, Britton, Black, McPherson,
Sanderson, Bain, 1999). Several properties distinguish this milestone.
First, most of the dialogues were initially based on arguments from the
medical field, which reduced “the evidence” to biomedical, empirical,
and positivist variables and criteria (Lohr and Carey, 1999). A second
property is a critical dialogue about eclectic views of evidence that
may incorporate components that are more congruent with nursing science
and emanate from how nursing knowledge and knowing have been defined.
This critical dialogue includes discussions on widening the meaning of
evidence to make it more pluralistic, to incorporate humanistic
experiences as well as personal experiences as evidence of models of
care to be used (Clarke, 1999). However, the criteria for judging
evidence from within this framework have not been explored, and no
definitive ideas been reached. A third property of this milestone is a
focus on best strategies to implement the best evidence in health care
institutions. Different models and approaches to utilizations are
defined and explored utilizing teaching-learning theories as well as
organizational change theories (Grol and Grimshaw, 1999).

据悉证据的履行在文献中从循证实践到循证护理的累累口舌中国对外演出集团变而来。在这几个里程碑时期,关于该学科的文献重视于明确利用保健模型与极品证据,将商量转化为实施以及使用使用钻探(意大利语,一九九七年)之间的相似之处和差别之处。为了分明证据,探讨了定义个体切磋品质的办法,整合探究结果的点子,判断综合发现的正统以及能够用于文献的证据(Goode,3000;
McKee,Britton,Black,
McPherson,桑德son,Bain,壹玖玖捌)。几脾气情区分了那个里程碑。首先,超越五成对话最初都以依照军事学领域的争辩,那将“证据”降低到生物历史学,经验和实证主义的变量和行业内部(Lohr
and
凯里,壹玖玖陆)。第二个天性是关于证据的投降观点的开拓性对话,那个看法恐怕带有与医生和护师科学更平等的组成都部队分,并且来自于怎么样定义护理知识和知识。那些主要的对话包含研商扩展证据的意思以使其进一步多元化,将人文经验和民用经验作为待用格局的证据(Clarke,1996)。不过,从那几个框架内判断证据的专业还并未被追究,也尚无汲取分明的想法。这一里程碑的第①项属性是关注在卫生保健机构执行最佳证据的最佳策略。

The Cochrane Database of Systematic Review plays a major role in
providing frameworks for rigorous reviews of data-based evidence, for
integrating reviews for determining best supported evidence, and for
developing and implementing best organizational infrastructures to
implement and promote best practices (Foxcroft, Cole, Fullbrook,
Johnston, Stevens, 2001).

Cochrane系统评价数据库在为从严复核数据证据提供框架,整合评定审查以明确最佳协理证据,开发和执行最佳团队基础设备以实践和放手最佳实践方面发挥着关键职能(Foxcroft,Cole,
Fullbrook,Johnston,史蒂文斯,二〇〇〇)。

The fourth property of this milestone is its global appeal and
utilization of evidence-based concepts in different parts of the world.
Nurses, researchers, and clinicians in different regions engaged in
dialogues about integrative reviews and accessibility of research-based
knowledge for clinicians. (See Thompson, McCaughan, Cullum, Shelton,
Mullhall, and Thompson 2001.)

这一里程碑的第五项属性是其在满世界各市的吸重力和行使基于证据的定义。分歧地区的护师,研讨人口和医治医师插手了有关医疗医师依据钻探的知识的总结评估和可访问性的对话。(见汤普森,McCaughan,Cullum,Shelton,Mullhall和汤普森二零零一)

The last property of this milestone is the absence of a robust
theoretical dialogue about the place of theory or philosophy in driving
the nature of evidence, the premises supporting pluralism in methods,
the framework for interpretation, and the principles behind the
selection of outcomes. Shifting from an evidence–based discourse about
practice to an inquiry–based dialogue could bring back a critical
theoretical discourse to nursing practice. (Doane and Varcoe, 2008;
Holmes, Murray, Perron, and Rail, 2006; Holmes, Roy, and Perron, 2008.)

这一里程碑的末梢3个特点是短缺关于理论或教育学在促进证据性质方面包车型大巴强有力的论争对话,帮助格局多元化的前提,解释框架和结果选取背后的尺度。从以实践为底蕴的循证论述转变为以探索为根基的对话可能会唤起对医生和护士实践的批判性理论研商。(Doane和Varcoe,二〇一〇;
霍姆斯,Murray,Perron和Rail,二零零七; 霍姆斯,罗伊和Perron,二〇〇八)

  1. District Nurse

2001–2005—Diversity in Thought: Linking Theory and Practice

Take responsibility over health delivery and health promotion in a
specific district.

二〇〇二-二〇〇七 – 思想的种种性:联系理论与执行

A focus on diversity is a hallmark of this milestone in the ongoing
journey toward the theoretical development of the discipline. As the
agents of scholarship become diverse in identity, ethnicity, and
heritage, and as they become more comfortable with their differences,
their varices began to appear in the literature reflecting their
different values, beliefs, and goals. Among the examples of the
diversity in thought and in theories are those by nurses from different
countries. Theories were developed by nurses from Finland and Sweden and
dialogues about more authentic theoretical formulations reflecting the
realities of different countries gained more popularity (Salas, 2005).

关爱多元化是本学科理论发展历程中这一里程碑的申明。随着专家的地方,种族和价值观七种化,并且随着他们对出入特别中意,他们的静脉曲张发轫产出在文献中,反映了他们差别的历史观,信仰和目的。思想和申辩多种化的例证是发源不相同国家的医护人员的事例。理论是由芬兰共和国和瑞典王国的看护开发的,并且有关更真实的论战绩达的对话反映了不一样国度的有血有肉越来越受欢迎(Salas,二零零五)。

Similarly, during this milestone, diversity of views on developing
theories from a number of grounded theory research projects as well as
through integrating different theories emerged with more robust
dialogues than ever occurred before. Olshansky (2003), for example,
conducted six grounded theory projects and developed a theory of
“identity as infertile” and combined this theory with Miller’s (1991)
theory of “relational cultural” theory to explain potential
vulnerability to depression of women whose identity is established as
“infertile women.” Both theories were integrated and provide a stronger
explanation for identity shifts that occur post pregnancy for these
women. The theory explains that although the women identified as
“infertile women” were able to become pregnant, it is very difficult for
them to perceive themselves as pregnant. This difficulty in identity is
an obstacle to forming relationships with other pregnant women.

一样,在这一个里程碑时期,从局地扎根理论商讨项目发展理论以及因而整合差别理论出发的有余看法出现了比原先更为有力的对话。例如,Olshansky(贰零零肆)实行了四个扎根理论项目并向上了一种“身份不孕”的辩白,并将这一驳斥与Miller(一九九一)的“关系文化”理论相结合,以表达女性困扰的秘闻脆弱性,被分明为“不孕女人”。三种理论都被重组,并为这一个女性在妊娠后发生的身价转变提供了更强大的解释。该理论解释说,纵然被明确为“不孕女生”的妇女可以怀孕,但她们很难认为自身是怀孕的。

Diversity as a hallmark of this milestone was manifested in a variety of
health–illness situations requiring a careful analysis of the factors
that create diversity. Among these are age, race, ethnicity, country of
heritage, gender, and sexual orientation. This awareness led theorists
and researchers to critique prevailing approaches and assumptions and
propose alternative and more contextually situated theoretical thoughts.
Examples are Berman (2003) on the myths surrounding the power of
children, Im and Meleis (2001) in their proposal for developing
gender-sensitive theories that focus on health and illness, and Anderson
et al. (2003) who rewrote a conceptualization of cultural safety within
postcolonial and postnationalist feminist theories.

作为这一里程碑的注脚,多种性表现在种种正规疾病的动静下,要求仔细分析造成多样性的元素。个中囊括年龄,种族,民族,遗产,性别和性方向。那种认识导致理论家和钻研人口对现行反革命的不二法门和要是实行批判,并建议替代性和更具内容的论争思考。例如伯曼(Berman,二零零三)关于围绕小孩子权力的传说,Im和Meleis(2000)在她们关于开发关心健康与疾病的性别敏感理论的提出中,以及Andersonet
al。(2001)重写了后殖民主义和后民族主义女权主义理论中的文化安全概念。

Georges (2003) defined the prominent discourses that reflect this
milestone. Her thesis is that there are two discourses in nursing that
are shaping epistemic diversity in contemporary nursing. These are the
discourses on science that are more broad and enlightened and a
postmodernism discourse on marginalization. Both of these discourses
provide a critique of dominant understanding and agreements on
scholarship allowing freedom to represent the different perspectives on
knowledge development. Epistemic diversity in an era that honors
diversity in its broadest sense may free members of the discipline to be
inclusive and may transform the discipline to make it truly reflective
of the people nurses need to serve. Such diversity would also allow
critique of power inequity as well as existing networks that support
such inequities and transform social practices that tend to
institutionalize dominant approaches to theory (Gustafson, 2005). Once
again Hall (2003) reminds us in a powerful autobiographical note from
her illness experience about how medicalization of illness experiences
and about how the stronghold of the biomedical model are not in the best
interest of patients and their families. Georges (2005) uses a critical
feminist perspective to uncover her journey in rewriting her own
identity as a clinician-theorist-academician-researcher. She provides a
robust philosophical argument for the linking of theory and practice
within the political and social context of the first decade of the 21st
century. Such linking could occur through teaching theory using
strategies that help students to develop their authentic voices about
their practice. Properties of this milestone are critique of status quo,
reconceptualization that is situated and contexted, and attention to
analysis that honors diversity in cultures, ethnic backgrounds,
heritage, language proficiency, gender, and sexual orientation.

格奥尔格e(Georges,二零零二)定义了反映这一里程碑的重庆大学话语。她的诗歌是看护中有两种话语正在职培训养当代医生和医护人员中的认知三种性。这么些是有关正确的讲话更广大和开明,以及有关边缘化的后现代主义话语。那七个话语都提供了对关于允许私行代表区别文化发展理念的主流通晓和协和式飞机的评论和介绍。在叁个讲究最广泛意义上的多样性的时期中,认识的多种性大概使该科目标积极分子免于包容,并可能变动学科,使其真正面与反面映医护人员须求劳务的人。那种各类性还会容许对权力不等同的批判以及协理这种不一致等的现有网络以及变更倾向于将主流理论方法制度化的社会实践(格斯tafson,二〇〇七)。霍尔(2001)再度提示大家,在她的毛病经历中,有一段强有力的自传体记录,关于疾病经历的法学化以及生物军事学模型的壁垒如何不合乎伤者及其亲朋好友的顶级利益。乔治(二零零六)使用批判女权主义的看法来公布她改写本身当作治疗医务人士

  • 理论家 –
    院士商量员身份的旅程。她为在21世纪头十年的政治和社会背景下将舌战与执行联系起来提供了1个有力的医学论证。那种关系能够因而教学说理运用政策来落到实处,这几个策略能够扶持学员升高他们的推行真实的响动。这一个里程碑的性情是对现状的批判,所处地方和意见的重新概念化,以及对学识,种族背景,遗产,语言能力,性别和性取向的各个性予以珍视的辨析。
  1. Learning Disabilities Nurse

2006–2010––Nurses Empowered: Evidence and Technology as Resources

Work with children and adults who have various levels of learning
disabilities.

二〇〇五-二零零六年 – 护师授权:证据和技能作为能源

The post positivism age, the age of interdisciplinarity, and the age of
postcolonial feminism are marked by a major milestone in nursing, the
empowerment of nurses and the nursing profession in affecting nursing
care. Call me an optimist but let me give some reasons why I believe
that such a turning point is happening. Many addressed the
decolonization of nursing from the biomedical model, from the
patriarchal hierarchy, and from nonnursing institutional regulatory
mechanisms (Holmes and Gastaldo, 2004; Holmes, Roy and Perron, 2008).
Separating nursing from these paradigms is in itself liberating;
however, more compelling indicators of this liberation is the use of
different paradigms to guide theory development and research, as is
evident in the nursing literature produced at the end of the first
decade of the 20th century (see examples in Advances in Nursing Science,
Nursing Inquiry, and Nursing Scholarship). The prominence of nurses in
prime-time television and their depiction as forceful independent
clinicians are other examples of the changing image and visibility of
nurses. The media finds that nursing stories are worth printing, which
is an indication that reporters are recognizing that the public is
interested in these valuable experiences. Improving compensation, the
availability of diverse employment options, and the selection of nurses
to staff independent mini-clinics are all indications of the shifting
power structures in health care systems.

后实证主义时代,跨学科时期和后殖民女权主义年代的特征是医生和护师的八个主要里程碑,护士和护理专业人士在潜移默化护理方面的权限。称自个儿为乐观主义者,但让小编付出一些原因,为啥本身认为那种转折点正在爆发。许多切磋从生物经济学形式,男权制等级和非体贴制度管理机制(Holmesand Gastaldo,二零零零; 霍姆斯,罗伊 and
Perron,二〇一〇)对医生和护师的非殖民化举行了研讨。将护理与那些范式分开本人正是解放的;
不过,更相信的翻身目标是采取差异的范式来辅导理论发展和钻研,这点在20世纪初期十年的护理文献中很强烈(见护理科学,护理调查和护医学奖学金的以身作则)。黄金时段电视机中护师的非凡地位以及他们作为有力的独立临床医务卫生职员的描述是医护人员变化的形象和著名度的此外例子。媒体发现,护理旧事值得印刷,这标志记者正在认识到公众对这个高雅经验感兴趣。革新补偿,各类化就业接纳的可用性,以及为职工独立的微型诊所选取医护人员都是医疗保健系统权力结构变迁的迹象。黄金时段电视机中护师的卓越地点以及她们作为有力的独自临床医务卫生人士的叙述是卫生员变化的形象和盛名度的别样例子。媒体发现,护理典故值得印刷,那标志记者正在认识到公众对那一个难得经验感兴趣。改革补偿,四种化就业选取的可用性,以及为职工独立的小型诊所采用医护人员都是医疗保健系统权力结构转变的马迹蛛丝。黄金时段TV中护师的优秀地点以及她们作为有力的单身临床医务卫生人士的叙述是看护变化的形象和闻名度的任何例子。媒体发现,护理传说值得印刷,那标志记者正在认识到公众对那一个宝贵经验感兴趣。改正补偿,各类化就业选取的可用性,以及为职工独立的袖珍诊所选拔护师都以医疗保健系统中权力结构转变的征象。

The health care reform discourse surrounding the moral obligation of the
government to provide safe, quality, and equitable health care for the
U.S. population includes an acknowledgment that the nurse’s role is
central to the health care reform. The inclusion in the discourse of the
need for increasing the number of nurses in the workforce, as well as
ensuring the utilization of their full capacity, is in itself empowering
for nurses. Therefore, the increasing dialogue about primary health
care, patient-centered care, and collaborative partnerships between
physicians and nurses, whether in conferences or in Institute of
Medicine publications, honors and acknowledges the value of nursing
knowledge and nursing care (Frenk et al., 2010; IOM, 2011). These in my
view, are indicators of a milestone: Nurses are empowered.

关于政党为西班牙人数提供安全,优质和正义医疗保健的德行职分的诊疗改进话语包罗承认护师的角色是治疗改良的主题。在演说中提到要求充实工作人士的医护人员人数,并保险丰裕利用其力量,那笔者就予以了医护人员权力。因此,关于初级卫生保健,以病者为主干的医护以及医师和看护之间的通力协作伙伴关系(无论是在议会上可能在医研院出版物中),对医生和医护人员知识和护理的股票总值予以尊重和认可(Frenk等,
二〇〇八; IOM,2013)。那几个在小编眼里,是三个里程碑的目的:护师有权力。

There are other indications of nurses’ power to make a difference.
Entering hospitals and observing nurses handling patient tracking
systems, health care records, automated medication carts, and remote
monitoring systems raises many questions. In particular, how do nurses
integrate theoretical frameworks with technological development and the
increasing reliance on communication through computers? How do nurses
maintain their focus on the goals of nursing—patient-centered goals of
health promotion, caring, comforting, decreasing suffering, and
promoting self-care and a sense of well-being—while being attentive to
the new demands imposed by the information and monitoring technology
characteristic of hospitals and home care in the 21st century?

还有其它迹象注脚护师有力量有所作为。进入医院并洞察处理病人追踪系统,医疗保健记录,自动药物车和长距离监护系统的看护提议了过多题材。特别是,医护人员怎样将舌战框架与技能进步相结合,以及愈发注重通过总结机实行交换?护师怎么着将注意力集中在医生和医护人员和病者为主旨的经常化促进,关爱,安慰,减轻优伤,促进作者照顾和幸福感的靶子上,同时注意护理职员施加的新须要21世纪医院和家园护理的消息和监测技术特点?

The juxtaposition of caring for the individual and her family within the
environment of innovation and complexity of information and technology
requires the development of new frameworks and models of care. This
stage of the discipline’s development is enriched by forging different
and new partnerships between such disciplines as engineering, pharmacy,
and the information sciences.

在消息和技巧的立异和复杂性环境中关怀个体和家庭的并置要求开发新的框架和看护形式。学科发展的那一个等级通过在工程学,药学和新闻科学等课程之间建立分歧和新的搭档关系而赢得足够。

An aging population, as well as an increase in the numbers of people
aging at home and of families living and caring for chronically ill
individuals through the lifespan, requires the development and use of
theories that are more specific to the particular needs of a more
defined population. Requirements for compensation and reimbursement by
insurance companies and the consequences of massive health care reform
frame patterns in advancing knowledge during this stage. Research
evidence is vital for credibility, safety in providing care, and
reimbursement for services. And nurses are taking full advantage of the
evidence and the technology.

人口老化,以及家庭老龄化人口和家中生活和照管短期患有个体的人数高居不下,要求支付和使用更有血有肉的理论,以满意越来越显眼的一定需要人数。保证公司的增补和报废供给以及在此阶段推进文化的广大医疗改正框架情势的结局。研商证据对于信誉,提供护理的安全性以及对劳动的补给根本。医护人员正在充足利用证据和技巧。

  1. Occupational Health Nurse

CONCLUSION 结论

This chapter presented significant historical themes that are related to
an interest in theoretical nursing. Progress and development in
theoretical nursing was defined in terms of stages and milestones. A
view of historical development offers a significant perspective on which
current and future theoretical thinking can be built. Analysis of
present development is deficient without tracing these historical
themes.

本章介绍了与辩论护理相关的要紧历史主题。理论护理的拓展和升华是依据等级和里程碑来定义的。历史发展观提供了一个有关当前和今后的理论思考能够建立的主要见解。没有追溯那些历史核心,分析当前的升高是欠缺​​的。

56net亚洲必赢手机 7

REFLECTIVE QUESTIONS

Work in large companies or in hospitals. You will ensure people can work
in a mentally and

反射难点

1.对理论护理发展史的回看在哪些方面阻碍或促进了护经济学科的前行?
2.哪些阶段和里程碑对推进护理理论至关心重视要?为啥?
3.您干吗觉得 20世纪五 六十时期哥伦比亚(República de Colombia)和瑞典王国皇家理经济高学校护士理高校的环境和知识对
理论家和申辩思维的进化起了推进意义?
4.理论知识的等同性质是还是不是会促成理论研究与实践之间的差异?假若是这样,那么
在21世纪的政治和制度中什么防止那几个出入啊?
5.你能找出越多当代的论战思维流派吗?什么样的环境只怕造成那个理论话语中的每三个?
6.打听你对理论护理发展的最早先段和里程碑所做的行事,你会怎么样预测今后的等级和里程碑?提供成立今后愿景的国策。
7.你认为推进领会理论护理历史的怎么样阶段和里程碑未蕴含在此次研究中?
8.从您自个儿的角度鲜明主要阶段和里程碑。你从读书本章中拿走了有关理论护理的如何观点?
9.您什么描述您的母校(部门)的环境?你高校的环境以怎么着办法推进你的学术发展?

physically safe manner.

Acknowledgments 致谢

The first part of this chapter is based on A.I. Meleis (1983). The
evolving nursing scholarliness. In P.L. Chinn (Ed.),Advances in nursing
theory development, pp. 19–34. Reprinted with permission of Aspen
Publishers, 1983.

本章的第1片段是基于AI Meleis(1985)。不断开拓进取的护法学学科。在PL
Chinn(责编),护理理论发展拓展,第③9-34页。转发于一九八五年的Aspen
Publishers许可。

  1. Pediatric Nurse

Work with children between the ages of 0 and 19.

  1. Pharmaceutical Nurse

This is an interesting field for nurses who no longer wish to work
directly with patients. Working for

pharmaceutical companies is a very interesting alternative.

  1. Public Health Nurse

This is reserved for those with an MSN degree.

  1. Plasma or Blood Bank Nurse

You will take plasma and blood from donors, encourage others to donate,
test blood and more.

  1. Army Nurse

The army is always looking for nurses, particularly since we are still
involved in a number of different conflicts.

  1. Home Health Nurse

You get to build a long lasting relationship with your patients, whom
you will see in their homes.

  1. Hospice Nurse

Hospice nursing is hard, as you will be dealing with people who are
dying. Your role will be to

allow them to do so comfortably and in a dignified manner,

and supported by their loved ones.

  1. Surgery Nurse

Assist surgeons during procedures, as well as look after patients during
recovery.

  1. Critical Care Nurse

Critical care nursing is one of the most fast-paced jobs.

  1. Emergency Room Nurse

You will never know what sort of cases you are going to get. Expect
long, unsociable hours

in a fast-paced environment.

  1. Managed Care Nurse

For those with chronic or terminal conditions, who require specialized
care at home and/or in health

care settings for the rest of their lives.

  1. Dermatological Nurse

This allows you to treat skin conditions.

  1. Plastic Surgery Nurse

Plastic surgery is often done for cosmetic reasons, although it is also
done for people with

disfigurements and scars.

  1. Burns Unit Nurse

Work with people who have suffered burns, including fire burns and acid
burns.

  1. Oncology Nurse

Work with cancer patients.

  1. Rehabilitation Center Nurse

Help people who have had an accident or other physical issue to regain
as much mobility as possible.

  1. Missionary Nurse

Spread the word of God throughout the world, while at the same time
deliver health care

to impoverished countries.

  1. Charity Nurse

Numerous charities employ nurses, many of which provide disaster relief.

  1. Traveling Nurse

Traveling nurses are sent from one place to the next for short durations
of time to cover in hospitals and

care settings with an acute shortage of nurses.

  1. Inspire Others

Be an inspiration to other people by showing your care and dedication to
others.

  1. Rural Nurse

Many nurses work specifically in areas with poor access to health care.

  1. Outpatient Care Nurse

Outpatient care is one of the easier sides of nursing, as it allows you
to treat patients ad hoc and then send them back home.

  1. Nurse Anesthetist

Assist surgeons and anesthetists during procedures.

  1. Health Administration Nurse

Health administration allows you to work in a range of healthcare
fields, where you can influence policy development.

  1. Clinical Nurse Specialist

A CNS has a specialization in a very targeted area of nursing practice,
such as women’s health.

  1. Clinical Nurse Leader

This is the newest nursing role, whereby your goal will be to improve
safety outcomes and care quality for patients.

  1. Family Nurse Practitioner

Work with everybody in the family, seeing them as a full unit rather
than groups of individuals.

  1. Health Visitor

Health visitors mainly focus on working with women who have had babies
in the past two years, ensuring the development of the babies and
infants is as expected.

  1. Paramedic

Paramedics provide acute emergency care. It is a stressful job with
long, unsociable hours, but it is also incredibly rewarding.

  1. Licensed Nursing Facility Administrator

Handle the administration in facilities like nursing homes. Generally,
you will have very little direct contact with patients.

  1. Health Coach

Teach others how to obtain and maintain optimum health.

  1. Nutrition and Fitness Nurse

Work directly with individuals who hire you on a personal level.

  1. Nanny

Although perhaps far removed from nursing, many nurses can become a
nanny as it allows them to work on a one-one-one basis with a young
child.

  1. Acute Care Nurse

Adult-gerontology acute care is a very popular field of work, where you
take care of adult patients with various problems as and when they
present themselves.

  1. Community Nurse

Represent an entire community of people, usually underserved ones.

  1. Obtain Further Non-nursing Related Education, Such as Counseling,
    Social Work or Law

Many nurses who hold a bachelor’s degree go on to achieve another
bachelor’s or a master’s degree in an non-nursing field.

  1. Health Programs Nurse

The development of health programs allows you to make a true difference
across the world, improving outcomes while reducing costs at the same
time.

  1. Health Representative at Conferences and Media

Whenever decisions are made in the field of healthcare, they have to be
presented to the rest of the world and questions have to be answered
about this.

  1. NGO Nurse

Non-Government Organizations (NGOs) often help to improve the world on a
very personal level and offer very rewarding career options.

  1. Procurement Nurse

You will purchase the equipment needed for nurses to do their jobs
properly, always trying to find the lowest price and highest quality.

  1. Nursing Students Mentor

New students require mentors to look up to. This is something anyone
with a nursing degree should aspire to be.

  1. Grant Writing Nurse

Grant writing means you are directly responsible for applying for
funding in the hopes of improving health care delivery.

  1. Health Facilities Survey Nurse

This will allow you to ensure health facilities are fit and will
actually improve the health of the people they serve.

  1. Commissioner for Health Products and Programs

More and more services are now outsourced and by working in
commissioning. You will ensure that the right services are used.

  1. Quality Assurance Nurse(品质担保/维护护师)

Quality improvement can be achieved in all areas of nursing.

  1. Public Health Research Nurse

See whether certain initiatives have actually improved the health
outcomes of the population and why.

  1. Disease Prevention Nurse

Help stop the spread of infectious diseases.

  1. Epidemics Research Nurse

There is a significant worry that we are on the brink of a new epidemic
or pandemic, like Ebola. Nurses are needed to research the various new
illnesses and

come up with cures and techniques to prevent spreading.

  1. Asylum Nurse

Asylum seekers often have highly complex health needs, including
psychological needs.

  1. Nurse for At Risk Populations

Certain populations are classed as “at risk,” such as veterans and the
homeless. They often require specialized health care.

  1. Nurse Lobbyist

You will speak to Congressmen and Senators in the hope of encouraging
certain health care ideas to be legislated and receive funding.

  1. Federal Health Care Nurse

Work on federal health care development programs to affect outcomes for
various populations.

  1. Continuous Professional Education Coordination

All nurses are dedicated to their continuous professional education.
Coordinating this and keeping on records on further education is an
interesting and varied role.

  1. Bioterrorism Research Nurse

Bioterrorism requires extensive knowledge on development and behavior of
pathogens.

  1. Medical Journalist

Investigate and report on healthcare issues around the globe.

  1. Disaster Management and Relief Nurse

Provide health care to affected populations after a disaster.

  1. Toxicology Nurse

Having an understanding of poisons and their effects on humans is hugely
important.

  1. Environmental Health Nurse

Environmental health, how our behavior affects the planet and how the
planet affects our health are very important issues to look at for a
nurse.

  1. Hazardous Waste Nurse

Hazardous waste could have devastating consequences on the health of
entire populations.

  1. Industrial Nurse

This is closely related to occupational health, although this type of
nurse will look more at overall risk and hazard prevention.

  1. Forensic Nurse

Forensic nursing is often required after crimes have been committed.

  1. Study Programs Development Nurse

Develop programs for the next nursing generation.

  1. Vaccine Research Nurse

Ensure that people are immunized against various illnesses, and review
their effectiveness and possible side effects.

  1. Ambulatory Care Nurse

With ambulatory care, cases that would usually require stay in hospital
are resolved on an outpatient basis.

  1. Flight or Transport Nurse

Help treat people who have to be expatriated due to illness or injury.

  1. Certified Nurse Assistant

Support the workload of other nurses and ensure they can perform their
job properly.

  1. Cardiac Catheterization Lab Nurse

Help to insert catheters into aortas to diagnose heart conditions.

  1. HIV/AIDS Nurse

HIV/AIDS continues to be a significant health issue that requires
research, development and care.

  1. Genetics Nurse

You will research genes and their effects.

  1. Holistic Nurse

Holistic nurses believe everything is interconnected and needs to be
addressed in order to provide great health care.

  1. Mind, Body and Spirit Nurse

Very similar to holistic nursing but you often use Eastern and Oriental
care techniques, including Reiki and acupuncture.

  1. Legal Nurse Consultant

Provide consultation on legal matters within the health care field.

  1. NICU Nurse

Work with very sick and premature babies in the Neonatal Intensive Care
Unit.

  1. Peri-Anesthesia Nurse

Help patients who are coming out of anesthesia.

  1. Peri-Operative Nurse

Look after patients who are recovering from surgery.

  1. Radiology Nurse

Work extensively with cancer patients.

  1. Registered Nurse

Most of those who have a nursing degree simply begin work as an RN
before choosing an area of specialization.

  1. Transplant Nurse

Work with people who require organ transplants.

  1. Wound Ostomy Continence Nursing

This is a highly specialized field of nursing where you deal with
patients who have problems with wounds, ostomy and continence. Only some
4,000 nurses worldwide have specialized in this field to date.

  1. Focus on Improved Health Care Outcomes

DATA analysis and research, must be MSN.

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