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Main concepts of theory

Discuss about the Fay Glenn Abdellah a Nursing Theorist and her Nursing Contributions?

Faye Glenn Abdellah was the first woman nurse who became Deputy Surgeon General. She formulated ‘21 Nursing Problems Theory’. Her theories helped nursing profession to change form disease centered to patient centered. As a result, there is incorporation of care of families as well elderly patients in the nursing service. The patient assessment protocol of nursing care developed by Abdellah is used as standard protocol in the United States. Abdellah’s theory states that , ‘Nursing is an art and science which moulds approaches, intellectual capabilities, and technical skills of the individual nurse into wish and aptitude to assist people, either sick or normal and cope up with their requirements. Patient centered approach developed by Abdellah is considered as human needs theory’. This theory was developed as a tool for nursing education, hence most applicable in the nursing filed. This theory is applicable both in hospital institutions and community health nursing. This nursing theory deals with different aspects like social enterprises, social problems, poverty, racism, pollution and education. This theory is applicable and useful in the health and healthcare delivery, changing nursing education, development of nursing leaders and continuing education for professional nurses. This theory established relationship between nursing problems and problem solving. Focus of her theory is patient and families as individuals, however she doesn’t described assumptions of the individual nature of the patient (Sabra, 2014; Shiver and Eitel, 2009).


Main aim of this theory is to achieve complete health by providing nursing service. In her theory, she described requirements of total health as well healthy condition of mind and body. According to this theory, health is a dynamic model of functioning which comprises of continuous interaction of external and internal factors. This interaction results in the best possible utilization of available resources to minimize vulnerabilities. Although, there should be incorporation of society to provide health at local, state and international level, this theory focused more on the provision of nursing service at individual level. Patient’s health requirements should be considered as problems in nursing care. These problems may be overt like noticeable and covert like hidden. Covert problems might be of different types like emotional, sociological, and interpersonal. In most of the nursing interventions, covert problems are missed and overlooked. In most of the cases, correction of the exact problems can correct overt problem also (Anonyms, 2011). Quality of professional nursing practice depends upon capability of nurse to identity and solve overt and covert nursing problem. Problem solving capability in the nursing can be improved by implementation of the problem-solving approach. This problem-solving approach comprises of different steps like identification of the problem, selection of the relevant data, formulation of hypothesis, collection of data for hypothesis testing and revision of hypothesis if required (Abdellah, 2004).

Basic needs and nursing steps

Abdellah used Henderson’s 14 basic human requirements and nursing research to ascertain the problems in nursing. According to her theory, basic problems of nursing research comprises maintenance of good hygiene and physical comfort, promotion of optimum health through healthy activities like exercise, rest and sleep, promotion of safety by preventing health hazards like accidents, injury, trauma and infection and maintenance of proper body mechanics and avert deformity. Sustenal care needs of good health comprises of optimum supplementation of oxygen to all cells in the body, supply of nutrition to all body cells, safeguarding of fluid and electrolyte balance, identification of the physiological response to disease conditions, safeguarding regulatory mechanisms and functions and upholding sensory function (Alligood, 2014). Remedial care needs are useful in identification and acceptance of positive and negative expressions, feelings and emotions. It is also helpful in maintaining effective verbal and non -verbal communication, promotion of fruitful interpersonal relationships, facilitation of improvement in achieving personal spiritual goals, creation and maintenance of therapeutic environment and increasing awareness of individual with different physical, emotional, and developmental needs. Restorative care needs comprises of accepting probable goals in face of limitations, utilization of community resources to solve problems related to illness and understanding role of social problems in illness (Abdellah, 2004).   


Abdellah’s work is mainly focused on the solving problems and it described nursing problems in achieving complete health for the patient. Abdellah suggested different steps like learning to understand patient, sorting out important information, making generalizations of the available data from another similar type of patient, identification of therapeutic plan, making generalization with the patient, validation of patient’s conclusions related to nursing problems, observing and evaluating patient over a period of time and identifying attitudes and clues affecting patient’s behavior, exploring patient and family’s opinion of therapeutic intervention and involve them in therapeutic intervention, identification of nurses feelings about patient’s nursing problems, discussing and developing comprehensive nursing care plan (Snowden et al., 2014).

Abdellah suggested necessary nursing skills like observation, communication, application of knowledge, planning, organizing, using resource materials, using personal resources, problem solving, allocating work to others, therapeutic use of self and nursing procedure. Abdellah’s work is helpful in providing comprehensive nursing services to patient (Wayne, 2014). These comprehensive nursing services comprises of recognisation of patient’s problems, decision on correct nursing intervention relevant to the nursing principles, provision of uninterrupted nursing care based on individual’s total needs, provision of constant care to patients to relieve pain and discomfort, modifying individual care plan based on patient’s total needs, assisting individual to turn into more self directed to attain healthy state of body and mind, helping individuals to amend according to individual’s limitations and emotional problems, working in collaboration with allied health workers to provide holistic care to the patients and keeping update on the recent research and implement new nursing methods and techniques for the patients (Alligood and Tomey, 2013). This 21 problem theory is useful in implementation of different phases of nursing care like assessment phase, nursing diagnosis, planning phase, implementation and evaluation. In assessment phase, nursing ghidelines provide    

Nursing skills

Abdellah’s problem solving approach can be generalizable and specific. This approach is generalizable for application in all types of patients and it can be implemented for health needs and specific health problems. This model can be useful in carrying out various activities in the clinical setting in the hospital. The language used by Abdellah is simple and easy. Problem solving approach proposed by Abdellah is logical in nature (Peterson and and Bredow, 2009).

She was pioneer in directing nursing education to theory and research. She initiated her research career with qualitative research and later she moved to physiology, chemistry, and behavioral sciences. She established a frame work for care of critical care patients which is termed as progressive patient care. According to this framework, critical care patients should be treated in intensive care unit, then shifting to immediate care and finally home care. Intensive care unit and immediate care became very popular in the nursing profession. Home care was not acceptable to most of the nursing professionals in the initial period, however after 40 years, it became essential part of the nursing profession (Brousseau, 2014).


She also contributed to the establishment of first coronary care unit. She also developed Patient Assessment of Care Evaluation (PACE).  It is a standard system useful to determine quality of particular health care facility. This PACE is still being used in healthcare industry. She also established categorization system for patient care and patient oriented records. A diagnostic related group (DRGs) is the result of her classification of patient records. DRGs became the standard coding system for medicare use and it is useful in categorization of patients based on the primary and secondary diagnosis. This system proved helpful in lowering healthcare cost. Being a consultant and educator, she implemented her nursing theories to the people all over the world. She delivered seminars in most of the countries like rance, Portugal, Israel, Japan, China, New Zealand, Australia, and the former Soviet Union. She also served as a consultant to World Health Organization. For giving healthcare services to people at global level, she suggested to undertake scientific research on traditional and non-western medicines. She was associated with numerous professional nursing institutes and published around 150 publications (McKenna et al., 2014). Problem solving approach introduced and implemented by Abdellah proved useful in augmenting nurse’s critical and analytical thinking skills because problem solving approach requires sound assessment and validation of findings. Abdellah’s theory can be made more acceptable by implementation of theory to community or society because nurses cannot provide nursing care to only one person and the community healthcare is more important than curative efforts in the hospital (Shiver and Eitel, 2009).   

References:

Abdellah, F.G. (2004).  Establishing the Graduate School of Nursing at the Uniformed Services University of the Health Sciences. Military Medicine, 169(6), pp. vii-x.

Abdellah, F.G. (2004). Interview with Rear Admiral Faye Glenn Abdellah. Interview by Captain Melvin Lessing. Military Medicine, 169(11), pp. iii-xi.

Alligood, M. R. (2014). Nursing Theorists and Their Work. Elsevier Health Sciences.

Alligood, M. R., and Tomey, A. M. (2013). Nursing Theorists and Their Work - E-Book. Elsevier Health Sciences.

Anonyms. (2011). Faye Glenn Abdellah's Theory. Twenty-One Nursing Problems.  Retrieved form https://currentnursing.com/nursing_theory/abdellah.html on 24.04.2017

Brousseau, H. J. (2014).  APRNs' Confidence to Prescribe. Master of Science in Nursing. 35.

McKenna, H., Pajnkihar, M., and Murphy, F. (2014). Fundamentals of Nursing Models, Theories and Practice. Wiley.

Peterson, S. J., and Bredow, T. S. (2009). Middle Range Theories: Application to Nursing Research. Lippincott Williams & Wilkins.

Sabra, H. (2014). Theories in Nursing Administration. Lulu.com.

Shiver, J. M., and Eitel, D. (2009). Optimizing Emergency Department Throughput . CRC Press.

Snowden, A., Donnell, A., Duffy, T. (2014). Pioneering Theories in Nursing. Andrews UK Limited.

Wayne, G. (2014). Faye G. Abdellah’s 21 Nursing Problems Theory.  Retrieved from https://nurseslabs.com/faye-g-abdellahs-21-nursing-problems-theory/ on 24.04.201

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