[Dr Loretta Crawley]
[Perspectives on Nursing
Perspectives on Nursing
[12th April 2018]
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In recent years nursing has developed from a task-orientated to a systematic, more complex approach to care. Pearson et al (1996) suggests that this has been achieved through the use of theories and models to guide practice. By using nursing models or philosophical frameworks it helps to protect and preserve the focus and clarity of nursing's distinct contribution to health care. These models are not limited to nurses; they are applicable to any healthcare profession from health care assistants to the catering staff of the hospital, they are the core of any hospital’s philosophy.
One of the most widely used nursing models is the Roper Logan Tierney (originally published in 1980, and afterwards revised in 1985, 1990, 1998 and 2001). This theory emphasises the importance of the patient’s ability to carry out everyday activities. It is often used to assess how a patient’s life has changed due to illness or admission to hospital, rather than as a way of planning for increased independence and quality of life. This model is made up of five components: activities of daily living (ADL’s), dependence/independence continuum, factors influencing ADL’s, and individuality in living. This helps the nurse determine what interventions will lead to increased independence as well as what ongoing support is needed to offset any dependency that still exists.
The model is based on the twelve prioritised activities of living. Such activities include the following: maintaining a safe environment, communication, breathing, eating and drinking, elimination, washing and dressing, thermoregulation, mobilisation, working and playing, expressing sexuality, sleeping, and death and dying (Roper, Logan and Tierney, 2001). There are certain times in our lives where we might be more vulnerable so we become dependent on others to meet our needs. The role of all nurses while working in the hospital is to help patients to move towards independence in all activities of daily living, we aim to help get patients back to as close of 100% independent where at all possible.
On my first clinical placement, it was evident that the Roper Logan Tierney model was in use. Within my five weeks of placement we were able to guide a number of very vulnerable, dependant patients to independence once again whilst using this framework. Each day we worked closely with the patients alongside a team of health care workers, such as physiotherapists and occupational therapists to work towards the long term goal, of getting the patient independent again, i.e. the physiotherapist helped ensure the patient could mobilise by themselves with minimum assistance. Many of the patients came onto the ward weak and unable to mobilise without at le...