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The hospice nurse sat with Ann's husband, Ben. Ann was resting quietly as the increased dosage of IV pain medication gradually reached its therapeutic level. Ben turned his head and slowly turned, looking out the room's only window. As he glanced up, a small flicker of light caught his breath. It was a shooting star. A tear fell from the corner of his eye and he turned to Ann. The nurse sensed that something significant to Ann and Ben was unfolding. Shuffling to Ann's bedside, he took her small fragile hand in his. These hands had rocked cradles, burped babies, and groomed the horses she loved to ride. Gently holding her hand, he turned to the nurse. "She would ride like the wind was chasing her." Looking back to Ann his voice broke; choking back tears "Ann, Ann I saw Jessie…Jessie is calling." Ben turned "Jessie was our daughter. She died having a baby that was too big. When she died it was a pitch-black night. Cold, so cold, the baby died too, a little boy, named him Abe, Jr. after Jessie's husband. I took Ann outside so she could cry to God above and there in this dark sky we saw two falling stars…together…just falling. We knew it had to be Jessie and Abe…two angels to light up the night." Ben turned back as a deep sigh escaped from Ann's lips. A soft smile remained as she joined Jessie and Abe. 


1. Based on this case study how would the nurse actualize Parse's theory of Human Becoming? 
2. What are characteristics of a human becoming nurse? What are strengths and weaknesses to this theory of nursing? 
3. What challenges exist for healthcare institutions to switch to this nursing approach? 
4. How might Parse's understanding of transcendence guide the nurse, as Ann's death became a reality to Ben? 
5. From the nursing theories we have discussed, what additional theory would you apply to this case study? Develop a plan of care to include both nursing theories (be specific and provide reasons) 

Overview of the Case Study

1. Rosemarie Rizzo Parse can be recognized as the most recent and famous nursing theoretician in the world. The Human Becoming theory was earlier known as Man-Living-Health theory. According to the parse, the environment, human being and health are co-related. This theory is very helpful for the nurses as it provides proper guidance to check the condition of the patients. the theory of human becoming has nine concepts such as communicating through languages, evaluation, development of images, dissimulation or revelation, authorization, restriction, separation or connection, reviving, originating, and transforming (Collins, 2012). In this case study, all the concepts of human becoming theory should be very helpful for the nurse in the case of Ben. According to this case study, the nurse has to play a significant role by listening to the words of Ben. Also, the nurse has to understand the feelings of Mr. Ben.

Perse's human becoming theory should be followed by the nurse. By using this theory, the nurse can improve the mental condition of Ben. The nurse can be able to understand the meanings and thoughts of Ben said for. In this case study, the purse theory of human becoming can be applied for the well being of Ben. This theory is not all about the treatment of the patient. The nurse should be getting very close to Ben as he can share his experience without any hesitation (Gardenier, 2015). The nurse has to show interest that what Ben wants to say to her. Without suggesting a solution, the nurse has to give mental support to Mr. Ben.

2. According to Parse’s theory of Human Becoming, the philosopher categorized the main two perspectives of nursing as the simultaneity and totality paradigms. The simultaneity paradigm will be entrenched through the viewpoint of a human-universe relationship like a mutual procedure. Each paradigm has influenced the viewpoint of numerous nursing theorists with other various theories that are incorporated into these categories. The paradigm of totally analyze the relationship of human-universe as cause-effect characteristics (Grover, 2007). The theories that fall under the totality paradigm consider mind, and body as a separate entity. It focuses upon the practice modalities emphasizing the psychological, physiological, social well-being and spirituality of individuals. The three prevailing paradigms are classified as the interactive integrative, the particulate deterministic as well as the unitary transformative. The first paired paradigm describes the perspective of the entity, which was studied and the next one explains the notion by which changes occur. The deterministic paradigm outlooks nursing phenomenon like reducible, measurable and separable entities (Lafferty, 2011). Thus, these entities have structured its connectedness towards each other that is casual as well as linear in nature.

The strength and weaknesses of nursing theories were stated in the following:

  • Ti tries to distinguish nursing from various other disciplines.
  • It is helpful for the purpose of education.
  • It helps in providing research analysis methodologies.
  • It helps in providing structure for directing inquiry of various other theories.
  • It also provides principles of care as well as user administration.
  • The research must be carried out within a closed circle.
  • It is very hard to make comparison towards the various other research studies, standardized questions, and exclusion of control group.
  • It does not use the nursing diagnoses.
  • It goes against the ideology that every single individual should engage in an exclusive lived experience (Lawrence, 2007).
  • It is not applicable towards emergent and acute care.
  • It is also not accessible towards the trainee nurses.

3. The challenges, which exist within the healthcare institutes, are:

  • Lack of interest emerges as the barrier for nurse involvement within the development procedure of health policy. Lack of participation includes a deficit of forum, a deficit of opportunities, a deficit of experience, need for active involvement, lack of proper planning for the problem identification process and top-down approach for policy-making process.
  • Lack of proper skill, knowledge, and support appears as a challenge to nurses’ involvement in policy activity. It comprises the reduced amount of tertiary education, negligible level of confidence and support and a negligible amount of knowledge related to the development process of health policy (Lovie, 2012).
  • Negative representation of nursing appears as the challenge, which is faced by the nurses. This comprises of the contribution of nurses towards policy procedure that is not being acknowledged as well as the negligible amount of opportunities that is to be engaged in the development of health policy.
  • The deficit of facilitating structures is determined as a challenge for nurses’ involvement within the health policy. It comprises of the institutional structures, lack of representation of the nurse leaders, policy-making responsibility is given only to doctors, doctor signifies nurses and issues related to nursing at the development forum of health policy (Murphy, 2015).
  • A negligible amount of attainable resources appears as the challenge to the nurses’ involvement in the development of health policy. Thus, it includes non-possessing resources as well as capable to organize these for the activities of policymaking. The development of influencing policy along with the health policy course is regarding the securing resources intended for healthcare activities.

4. Most of the nursing residence patients have only some relationships left for providing self-reflection, dialogue as well as meaningful communications. The relationship between nurse and patients is considered as a most crucial resource for promoting self-transcendence as well as multidimensional welfare. The relational self-transcendence aspect encompasses the interwork for self-acceptance, improve the individual's life circumstances, allowing other's help, physical disabilities and obtaining the meaning of life's experience (Rizzo Parse, 2007). The effort to enlarge the knowledge regarding the analysis of self-transcendence along with the relationship among multidimensional welfare and self-transcendence were required to help nurses in promoting welfare. The Ann’s husband has to accept the reality that his wife is not going to live any further and Ben tries to describe the situation as various examples like Ann’s hands had rocked cradles, Ann used to groom the horses with these hands and had burped the babies with her hands. Ben turned his back from his wife as she exhales her last breath and kept a soft smile upon her lips while she joined her dead daughter in heaven (Thompson, 2007).

5. Philosophy and caring model of Jean Watson can be applied for this case study. The concepts of philosophy and caring model and human becoming theory are very much similar. The philosophy and the care model are depicted to be reflecting the appropriate development of the culture in the nursing profession. The improvement in the processes, as well as the changes in the implementation of the care plan, is depicted to be dependent on the activities which are surrounding the development of the plan (Totney, Grummisch, Lowe & Price, 2011). The enhancement in the activities is reflecting the changes in the processes as well as it is helpful for analyzing the data. The implementation of this theory will enable in reflecting the nursing processes and the practices as carried out in this study.

References

Collins, T. (2012). Strategies to increase organ donation: the role of critical care practitioners. Nursing In Critical Care, 17(3), 112-114. doi: 10.1111/j.1478-5153.2012.00509.x

Gardenier, D. (2015). Are Nurse Practitioners Becoming More Like Physicians?. The Journal For Nurse Practitioners, 11(6), 608-609. doi: 10.1016/j.nurpra.2015.02.023

Grover, J. (2007). Healthcare. Detroit: Greenhaven Press.

Lafferty, B. (2011). Trauma Nurse Practitioners. Journal Of Trauma Nursing, 18(2), 115-120. doi: 10.1097/jtn.0b013e31821f647f

Lawrence, S. (2007). The role of advanced nurse practitioners in nursing homes. Independent Nurse, 2007(8). doi: 10.12968/indn.2007.1.8.75112

Lovie, S. (2012). The Student’s Guide to Becoming a Nurse – Second editionThe Student’s Guide to Becoming a Nurse – Second edition. Nursing Standard, 27(5), 30-30. doi: 10.7748/ns2012.10.27.5.30.b1418

Murphy, L. (2015). Becoming an authentic nurse leader. OR Nurse, 9(4), 12-15. doi: 10.1097/01.orn.0000466726.48646.b7

Rizzo Parse, R. (2007). A Human Becoming Perspective on Quality of Life. Nursing Science Quarterly, 20(3), 217-217. doi: 10.1177/0894318407303446

Thompson, L. (2007). Care of the Patient With Adult Congenital Heart Disease. Critical Care Nursing Quarterly, 30(1), 3-11. doi: 10.1097/00002727-200701000-00002

Totney, A., Grummisch, M., Lowe, G., & Price, M. (2011). Emergency Nurse Practitioners—A review of role perceptions and staff attitudes in the workplace. Australasian Emergency Nursing Journal, 14, S37. doi: 10.1016/j.aenj.2011.09.092

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