CHAPTER II

DISCUSSION
A. Perspective On Nursing Theory.
Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an
observable fact or event) that is explanatory & predictive in nature. Theories are composed
of concepts, definitions, models, propositions & are based on assumptions. They are derived
through two principal methods; deductive reasoning and inductive easoning. Nursing
theorists use both of these methods. Theory is “a creative and rigorous structuring of ideas
that projects a tentative, purposeful, and systematic view of phenomena”. A theory makes it
possible to “organize the relationship among the concepts to describe, explain, predict, and
control practice”
Definition
• Concepts are basically vehicles of thought that involve images.
Concepts are words that describe objects, properties, or events & are basic components of
theory.
• Types: Empirical concepts
Inferential concepts
Abstract concepts
• Models are representations of the interaction among and between the concepts showing
patterns.
• Propositions are statements that explain the relationship between the concepts.
• Process it is a series of actions, changes or functions intended to bring about a desired
result. During a process one takes systemic & continuous steps to meet a goal & uses both
assessments & feedback to direct actions to the goal.
• A particular theory or conceptual frame work directs how these actions are carried out.
The delivery of nursing care within the nursing process is directed by the way specific
conceptual frameworks & theories define the person (patient), the environment, health &
nursing.
• The terms ‘model’ and ‘theory’ are often wrongly used interchangeably, which further
confounds matters.
• In nursing, models are often designed by theory authors to depict the beliefs in their
theory (Lancaster and Lancaster 1981).
• They provide an overview of the thinking behind the theory and may demonstrate how
theory can be introduced into practice, for example, through specific methods of
assessment.
• Models are useful as they allow the concepts in nursing theory to be successfully applied
to nursing practice (Lancaster and Lancaster 1981).
• Their main limitation is that they are only as accurate or useful
as the underlying theory. Importance of nursing theories
• Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn
and Jacobs1978).
• It should provide the foundations of nursing practice, help to generate further knowledge
and indicate in which direction nursing should develop in the future (Brown 1964).
• Theory is important because it helps us to decide what we know and what we need to
know (Parsons1949).
• It helps to distinguish what should form the basis of practice by explicitly describing
nursing.
• The benefits of having a defined body of theory in nursing include better patient care,
enhanced professional status for nurses, improved communication between nurses, and
guidance for research and education (Nolan 1996). In addition, because
• The main exponent of nursing – caring – cannot be measured, it is vital to have the theory
to analyze and explain what nurses do.
• As medicine tries to make a move towards adopting a more multidisciplinary approach to
health care, nursing continues to strive to establish a unique body of knowledge.
• This can be seen as an attempt by the nursing profession to maintain its professional
boundaries.
The characteristics of theories
Theories are :

1. interrelating concepts in such a way as to create a different

way of looking at a particular phenomenon.
2. logical in nature.
3. generalizable.
4. bases for hypotheses that can be tested.
5. increasing the general body of knowledge within the discipline through the research
implemented to validate them.
6. used by the practitioners to guide and improve their practice.
7. consistent with other validated theories, laws, and principles but will leave open
unanswered questions that need to be investigated.
Basic processes in the development of nursing theories ,Nursing theories are often based on
influenced by broadly applicable processes & theories. Following theories are basic to
many nursing concepts. General System Theory It describes how to break whole things into
parts & then to learn how the parts work together in “systems”. These concepts may be
applied to different kinds of systems, e.g. Molecules in chemistry, cultures in sociology, and
organs in Anatomy & Health in Nursing.

Adaptation Theory
• It defines adaptation as the adjustment of living matter to other liiving things & to
environmental conditions.
• Adaptation is a continuously occurring process that effects change & involves interaction
& response. Human adaptation occurs on three levels :
1. The internal (self)
2. The social (others) &
3. the physical (biochemical reactions)
Developmental Theory
• It outlines the process of growth & development of humans as orderly & predictable,
beginning with conception & ending with death.
• The progress & behaviors of an individual within each stage are unique.
• The growth & development of an individual are influenced by heredity, temperament,
emotional, & physical environment, life experiences & health status.
Common concepts in nursing theories
Four concepts common in nursing theory that influence &
determine nursing practice are:
1. The person (patient).
2. The environment
3. Health
4. Nursing (goals, roles, functions)

Each of these concepts is usually defined & described by a nursing

theorist, often uniquely; although these concepts are common to all
nursing theories. Of the four concepts, the most important is that of
the person. The focus of nursing, regardless of definition or theory,
is the person
B. EVOLUTION OF NURSING THEORY
The following nursing timeline shows how world events and famous nurses influenced
nursing history and paved the way for modern nursing practice.
• 1751 – The first hospital was founded in Philadelphia, Pennsylvania.
• 1775 to 1783 – Nurses were recruited to care for the wounded under the command of
George Washington.
• 1783 – James Derham used his earnings from nursing to buy his freedom from slavery.
• 1841 – Dorothea Dix advocated for the mentally ill and established mental institutions.
• 1853 to 1856 – Florence Nightingale served in the Crimean War and set up a holistic
system of nursing.
• 1859 – Notes On Nursing by Florence Nightingale was published. It was one of the first
nursing manuals ever written.
• 1860 – The Florence Nightingale School of Nursing was opened in London.
1861 – Nurses began to wear uniforms.
• 1861 to 1865 – During the Civil War, over 2,000 nurses cared for injured and ill soldiers.
• 1865 – Sojourner Truth cared for injured African-American soldiers in Washington, D.C. Her
sanitation practices reduced infections, and she taught other nurses her principles.
• 1873 – Linda Richards, the first American trained nurse, graduated from the New England Hospital
for Women and Children School of Nursing.
• 1879 – Mary Eliza Mahoney, the first African-American trained nurse, graduated from the New
England Hospital School of Nursing.
• 1881 – Clara Barton established the American Red Cross.
• 1893 – Lillian Wald founded the Visiting Nurse Service of New York.
• 1900 – The first issue of the American Journal of Nursing was published.
• 1901 – New Zealand began requiring registration for nurses.
• 1902 – Ellen Dougherty from New Zealand became the first registered nurse in the world.
• 1902 – Lina Rogers Struthers was hired as the first public school nurse.
• 1908 – Congress established the United States Naval Nursing Corps.
• 1908 – The National Association of Colored Graduate Nurses was established. It merged with the
American Nurses Association in 1951.
• 1914 to 1918 – Nurses from the U.S. Navy Nursing Corps and the American Red Cross served in
World War I.
• 1917 – Margaret Sanger established the National Birth Control League that later became Planned
Parenthood.
• 1925 – The Frontier Nursing Service was started by Mary Breckinridge.
• 1939 to 1945 – Over 59,000 American nurses served in World War II.
• 1950 – The first intensive care units were established and created the specialty of critical care
nursing.
1956 – Columbia University School of Nursing offered the first master’s program for nurses.
• 1959 to 1975 – Over 5,000 nurses served during the war.
• 1965 – The University of Coloradoestablished the first nurse practitioner program.
• 1967 – Dame Cicely Saunders started the first hospice in London and provided the foundation for
care of the terminally ill.
• 1972 – Eddie Bernice Johnson was the first registered nurse elected to the U.S. House of
Representatives.
• 1979 – Case Western Reserve Universitystarted the first doctoral program for nurses.
• 1990 – Nursing uniforms become more casual. Nurses in hospital settings began to wear “scrubs”.
• 2009 – The Carnegie Foundation released the results of Educating Nurses: A Call for Radical
Transformation , a study of nursing education.
• 2010 – The Institute for the Future of Nursing released recommendations for improved health
care.
Nursing in the past laid the framework for the common purpose of health and well-being of
individuals and communities. Nursing theories and processes have changed over the years, but the
goal of nursing today remains the same.Throughout the years, wars have increased the need for
nurses and have had a great influence on the evolution of nursing. Florence Nightingale, who is
widely regarded as the mother of modern nursing, made her greatest impact when she served in the
Crimean War from 1853 to 1856. Her sanitation efforts dropped the mortality rate dramatically. She
went on to establish the Florence Nightingale School for Nurses in London. Between 1861 and 1865,
over 2000 nurses served in the Civil War, some on the front lines. Many of these nurses wrote of
their war experiences.As the United States continued to see the need for nursing education, the first
training school was opened 1872 at the New England Hospital for Women and Children in Boston. Its
first graduate was Linda Richards, the first American trained nurse. After that, more and more
hospitals opened nursing schools. Unfortunately, in many of the schools, the training consisted of
very little book learning, and many times the students were exploited as free labor. Contrary to the
autonomous Nightingale schools, nursing was under the control of medicine.
By the 1970s, the three-year, hospital-based diploma schools were starting to be replaced by two-
year associate degree programs at technical schools or by four-year Bachelor of Science degree
programs at universities. These schools provide the academic curricula and are affiliated with
hospitals for clinical training. As the need for higher education in nursing is growing, universities also
are offering master’s and doctorate programs.
The following nursing timeline shows how world events and famous nurses influenced nursing
history and paved the way for modern nursing practice.
• 1751 – The first hospital was founded in Philadelphia, Pennsylvania.
• 1775 to 1783 – Nurses were recruited to care for the wounded under the command of George
Washington.
• 1783 – James Derham used his earnings from nursing to buy his freedom from slavery.
• 1841 – Dorothea Dix advocated for the mentally ill and established mental institutions.
• 1853 to 1856 – Florence Nightingale served in the Crimean War and set up a holistic system of
nursing.
• 1859 – Notes On Nursing by Florence Nightingale was published. It was one of the first nursing
manuals ever written.
• 1860 – The Florence Nightingale School of Nursing was opened in London.
• 1861 – Nurses began to wear uniforms.
• 1861 to 1865 – During the Civil War, over 2,000 nurses cared for injured and ill soldiers.
• 1865 – Sojourner Truth cared for injured African-American soldiers in Washington, D.C. Her
sanitation practices reduced infections, and she taught other nurses her principles.
1873 – Linda Richards, the first American trained nurse, graduated from the New England Hospital
for Women and Children School of Nursing.
• 1879 – Mary Eliza Mahoney, the first African-American
trained nurse, graduated from the New England Hospital School of Nursing.
• 1881 – Clara Barton established the American Red Cross.
• 1893 – Lillian Wald founded the Visiting Nurse Service of New York.
• 1900 – The first issue of the American Journal of Nursing was published.
• 1901 – New Zealand began requiring registration for nurses.
• 1902 – Ellen Dougherty from New Zealand became the first registered nurse in the world.
• 1902 – Lina Rogers Struthers was hired as the first public school nurse.
• 1908 – Congress established the United States Naval Nursing Corps.
• 1908 – The National Association of Colored Graduate Nurses was established. It merged with the
American Nurses Association in 1951.
• 1914 to 1918 – Nurses from the U.S. Navy Nursing Corps and the American Red Cross served in
World War I.
• 1917 – Margaret Sanger established the National Birth Control League that later became Planned
Parenthood.
• 1925 – The Frontier Nursing Service was started by Mary Breckinridge.
• 1939 to 1945 – Over 59,000 American nurses served in World
War II.
• 1950 – The first intensive care units were established and created the specialty of critical care
nursing.
• 1956 – Columbia University School of Nursing offered the first master’s program for nurses.
• 1959 to 1975 – Over 5,000 nurses served during the war.
• 1965 – The University of Coloradoestablished the first nurse practitioner program.
1967 – Dame Cicely Saunders started the first hospice in London and provided the foundation for
care of the terminally ill.
• 1972 – Eddie Bernice Johnson was the first registered nurse elected to the U.S. House of
Representatives.
• 1979 – Case Western Reserve Universitystarted the first doctoral program for nurses.
• 1990 – Nursing uniforms become more casual. Nurses in hospital settings began to wear “scrub
• 2009 – The Carnegie Foundation released the results of Educating Nurses: A Call for Radical
Transformation , a study of nursing education.
• 2010 – The Institute for the Future of Nursing released recommendations for improved health
care.
C. Explain About Patient Assesment
Nursing assessment is the gathering of information about
a patient's physiological, psychological, sociological, and spiritual status by a
licensed Registered Nurse. Nursing assessment is the first step in the nursing process. A
section of the nursing assessment may be delegated to certified nurses aides. Vitals and
EKG's may be delegated to certified nurses aides or nursing techs. (Nurse Journal, 2017) It
differs from a medical diagnosis. In some instances, the nursing assessment is very broad in
scope and in other cases it may focus on one body system or mental health. Nursing
assessment is used to identify current and future patient care needs. It incorporates the
recognition of normal versus abnormal body physiology. Prompt recognition of pertinent
changes along with the skill of critical thinking allows the nurse to identify
and prioritize appropriate interventions.] An assessment format may already be in place to
be used at specific facilities and in specific circumstances
Use expressions for assessing the head, face and neck
Inspection, palpation, percussion and auscultation are examination techniques that enable
the nurse to collect a broad range of physical data about patients :
1.Inspection
The process of observation, a visual examination of the patient's body parts to detect
normal characteristic or significant physical signs
2. Palpation
Involves the use of the sense of touch. Giving gentle pressure or deep presure using your
hand is the main activity of palpation
3.PercussionInvolves tapping the body with fingertips to evaluate the size, borden, and
consistency of body organs and discover fluids in body cavities
4. Auscultation
Learning to sounds produced bt the body

D. EXPLAIN HOW GIVING INSTRUCTIONS AND EXPRESSIONS DURING THE

IMPLEMENTATION IN NURSING
To giving instruction and expression during the implementation in nursing , We Must Use
Good And Correct Language So Patients Can Respond Well, For Example:

would you lie on the bed ?

would you like to lie down to the left?
Would you lie down on the coach ?
Would you like to eat your food ?
Would you mind , please raise your right/left leg
Would you mind, please roll your sleeve up
Would you mind, please give me you right/left hand
Would you mind , please raise your arm
Now , i want you to take medicine
Now ,i want you to take a deep breath
Now , i want you breathe in and breathe out
Now , i want roll yourself into side lying posisition
E. FIND PICTURE OF SURFACE ANATOMY : REGION (ANTERIOR VIEW OF FEMALE)
 Preface

First of all, thanks to Allah SWT because of the help of Allah, writer fisinihed writing the
paper entitled “Nusing” right in the calculated time.
The purpose in Witing this paper is to fulfill the assigment that given by Mrs. Mira as
lecturer in english major.
In arranging this paper, the writer trully get lots challenges and obstructions but eith help of
many individuals, those obstructions could passed. Writer also realized there are still many
mistakes in process of writing this paper.
Because of that, the writer says thank you to all individuals who helps in the process of
writing this paper. Hopefully Allah replies all helps and bless you all. The writer realized that
this paper still imperfect in arrangement and the content. Then the writer hope the criticsm
from the readers can help the writer in perfecting the next paper. Last but not the least
Hopefully, this paper can helps the readers to again more knowledge about samantics
major.

Ambon, November 23th 2019

Author
 REFERENCE
ENGLISH FOR HEALTH
https://id.scribd.com/doc/110035996/Concept-And-tgeory-Nursing
http://bermanto.blogspot.com/2015/08/example-word- preface-makalah-
language.html?m=1
https://netterimages.com/surface-anatomy-regions-anterior-view-of-female-labeled-
anatomy-atlas-7e-rehabilitation-carlos-a-g-machado-75361.html
 TABLE OF CONTENTS
PREFACE
TABLE OF CONTENTS
CHAPTER I INTRODUCTION
A. Issue Background
B. Problem Identification
C. Problem Formulation.
CHAPTER II DISCUSSION
A. Perspective On Nursing Theory.
B. Evolution Of Nursing Theory.
C. Patient Assessment.
D. Giving Intsruction And Expressions During The Implementation In
Nursing.
E. Picture Of Surface Anatomy : Regions Canterior View Of Famale.
CHAPTER III FINAL
A. Knot
B. Advice
REFERENCES
 CHAPTER I
INTRODUCTION
A. Issue Background

Nursing has a long history as a way to provide help to patients as they work toward health goals.
From the earliest nuns who cared for the sick and dying to the modern men and women who work in
hospitals, clinics, and homes to help people achieve and maintain health, nursing is a way to get
involved in the health care industry and work with patients on a personal level. Though different
nursing jobs require different duties and responsibilities, the definition of nursing has not gone
through as many changes as the career itself.Nursing theory is defined as "a creative and rigorous
structuring of ideas that project a tentative, purposeful, and systematic view of phenomena".
Through systematic inquiry, whether in nursing research or practice, nurses are able to develop
knowledge relevant to 8improving the care of patients. Theory refers to "a coherent group of
general propositions used as principles of explanation".

B. Problem Identification

1. Perspective On Nursing Theory.

2. Evolution Of Nursing Theory.
3. Explain About Patient Assessment.
4. Explain How Giving Intsruction And Expressions During The Implementation In Nursing.
5. Find Picture Of Surface Anatomy : Regions Canterior View Of Famale.
C. Problem Formulation.

1. How To Know And Understand About Nursing Theory.

2. How To Understand About Patient Assessment.
3. How To Describe About Giving Instruction And Expressions In Nursing.
 CHAPTER III
FINAL
A. Knot
Nursing theory is defined as "a creative and rigorous structuring of ideas that project a
tentative, purposeful, and systematic view of phenomena". Through systematic inquiry,
whether in nursing research or practice, nurses are able to develop knowledge relevant to
improving the care of patients. Theory refers to "a coherent group of general propositions
used as principles of explanation".Patient Assessment It is important to perform a history
and do a focused physical exam to be sure that there aren't any medical risks that would
predispose the patient to a medical emergency during the actual procedure. It is also
important to talk to the patient to get a feel for the patient's psychological state.

B. Advice
From the conclusions, we as prospective nurses must continue to improve their
competence, one of them is through nursing education that is supported, so that we do not
need to increase the interest of international nursing. In addition, as prospective nurses we
can discuss how the development of existing nursing, so that we can debate about the
nursing profession and through that we can learn about the profession we live.