Understanding how a nursing theory relates to nursing practice helps to understand the models of health care. In the 1950s, a biomedical model was the primary health care model. According to this model, good health is the freedom from pain, disease, or defect. The model analyzes every malady as physical, focusing on objective data from tests, excluding psychological, environmental, and social influence. A working example is that a disability is purely a biomedical issue: to be cured and to return the patient to normal. This presented controversy regarding what is normal and the thought that a disability is negative. Many were upset at the tenets of the biomedical model (Gruman et al., 2021).
Between 1960 and 1980, George Engel authored many papers criticizing the single focus of the biomedical model, postulating that the belief that every illness results from organic dysfunction were limiting. Engel felt that behavioral, social, and environmental factors cause-and-effect diseases. He coined this theory the biopsychosocial model and included human and psychological data. The biopsychosocial model was criticized because it could not empirically deliver research data, so it did not conform to the structure of a model. This model did not overshadow the biomedical model. They still use biomedical in western medicine and exclusively in European medicine (Farre & Rapley, 2017). The biopsychosocial model is more representative of the art and science of nursing and is vital for consideration in developing nursing practice.
Change is often met with resistance. To discern the most effective way to go about a change, I looked at the research. Chauhan and colleagues (2017) completed a systematic review of effective strategies and change models. The conclusion was that behavior changes that included education, training, and collaborative team-based approaches effectively change practice. That became a priority for a change model.
After considering that the two years of survival mode has made nursing into a task-oriented job and the belief that all care and interventions should be patient-centered. I investigated the model our system uses: The Theory of Human Caring. Watson’s theory is mentioned in readings with change theories such as Lewin, Stage Model of Change Unfreezing Changing Refreezing: piquing my curiosity.
Lewin’s model is three steps: unfreezing, change, and refreezing. The unfreezing step is to get rid of “that is the way we have always done it” so that change can occur. Changing or moving phase is three-fold; Convincing others that the change is beneficial and the status quo is not, working with others to find added information and connecting with leaders to garner support (Udod & Wagner, 2018). The phase of refreezing is to implement the change and ensure its sustainability. In my opinion, this model does not address interpersonal relationships, the role of the change agent that is important in nursing and that I would like to be a cornerstone of a nursing practice change. The intrinsic inspiration of who we are and why we do what we do.
Watson’s Human Caring Theory uses the nursing process to guide practice change using the nursing process: assessment, plan, intervention, and evaluation. The tenets of the theory are that the person is not an object but the summation of all their experiences, deserving respect and dignity. The change agent, the nurse, has a crucial role in addressing the personhood complexities of each unique person. Using Watson’s theory allows all components to return to the patient and the nurse’s role to care (Pajnkihar et al., 2017). Incontinence brings with it stigma and decreased QOL for the patient. Caregivers can find disgust in caring for the patient after incontinence and nonverbally express that to the patient. It is important to consider the patient’s perspective to embrace the importance of timely and kind incontinence care.
Our organization bases its operation and interventions on Watson’s theory. My preceptor explained how it is used in infection control interventions and is the core of practice. She reports that when patients are at the center of our care it is quality and effective care.
Farre, A., & Rapley, T. (2017). The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness. Healthcare (Basel, Switzerland), 5 (4), 88. https://doi.org/10.3390/healthcare5040088
Gruman, J., Schneider, F., & Coutts, L. (2021, February 16). Biomedical model | Applied social psychology (ASP). Sites at Penn State | powered by CampusPress. https://sites.psu.edu
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