Table of Contents
- A Brief Summary of the Problem
- The Middle Range Theory
- A Brief Discussion of the Middle-Range Theory's Origins
- How the Middle-Range Theory Has Been Previously Applied
- Application of the Middle-Range Theory to the Identified Problem
- How the Practice Would Change by Incorporating This Theory
- Related Nursing essays
A Brief Summary of the Problem
When a patient walks in a health care organization, they have to be attended to by different units and departments before they can be discharged. These units may include the lab and radiology, respiratory therapy, pharmacy, clinical therapies and discharge planning as well as dietetics units among others. Consequently, the holistic health care requires the health professionals to interact across unit boundaries as they work to treat a given patient. The problem in this case is that these units are created to work independently in most cases, with the lab people barely interacting with the pharmacy people cordially. The interactions between units are rather mechanical thus limiting a seamless operation in the health care organization. There is a need for connections between all the staff members attending to a patient so that they can share all the critical information regarding the patient’s condition without having to rely on the written contents of the patient file. Some of the critical information could be observed and ignored and may only come up in conversation. It is thus important for these professionals to have a conversation. Effective communication in this case is the only way to guarantee effective collaboration.
The Middle Range Theory
Hildegard Peplau’s Interpersonal relations theory is a middle range theory that could be applied to this problem. This theory is mainly about nurses having to interact with their patients in a way that promotes growth and understanding, thus enabling holistic nursing care. In the theory, it is expected that the nurse could help the patient to understand whatever difficulties they are experiencing, thus making it easy for the patient to deal with their situation psychologically, spiritually and even physically (Gralton & Brett, 2012). In a real situation, a nurse needs to interact with the patient at a personal and comfortable level for better nursing care outcomes. This theory is not directly applicable to the problem at hand but its major concepts can be borrowed heavily and applied to the human resources situation within the health care organization. Rather than focusing on how the nurse should interact with their patients, this case will focus on how the nurse should interact with their colleagues for the sake of the patients. The end goal is relatively the same. The reason for choosing this theory is that it focuses on a human resource management perspective for the nurse when dealing with a patient. The identified problem in this case is also heavily based in the human resources department within the health care organization.
A Brief Discussion of the Middle-Range Theory's Origins
Hildegard Peplau was mainly a psychiatric nurse and her experiences in the field inspired the interpersonal relations theory of nursing. She advocated for therapeutic care in the place of custodial care, requiring the nurse to be more involved with the patient in order to promote knowledge and wellbeing (Meleis, Sawyer, Im, Hilfinger Messias & Schumacher, 2000). Getting the nurse to consider the patient as an individual especially within a psychiatric setting was seen to help both the patient and the nurse in terms of growth and fulfillment. Thus, the need to achieve this all through the health care system is what drove Hildegard Peplau to create Interpersonal Relations Theory of nursing.
How the Middle-Range Theory Has Been Previously Applied
In 2011, Penckofer, Byrn, Mumby and Ferrans wrote an article about how this theory can be applied to recruit and retain participants in a given study. According to these authors, the incentives provided by the researchers may improve the participation but the most effective determinant is the relationship between the researcher and the participants. In this case, it was established that the participants were more interested in research studies where they had an actual relationship with the researchers. Incentives are rather general and thus they do not work effectively on the intended participants (Penckofer, Byrn, Mumby, Ferrans, 2011). Using the Interpersonal Relations Theory, these authors established that the nurse-patient relationship described in the theory could be converted to a nurse-participant relationship and, thus, aid significantly in encouraging the participant to remain with the researcher. Like in the nurse-patient situation, the researcher-participant context also emphasizes on trust as a major building block for the recruitment and retention of participants.
Application of the Middle-Range Theory to the Identified Problem
Interpersonal Relations Theory of nursing defines the human being as an organism with a need to reduce tension and generally be comfortable. It means that each client is driven by a certain need, usually being to get well. In this context, the other members of the staff are driven by the need to perform well on their jobs. This means that they are likely to be interested in concepts that improve their performance. Another applicable definition in this case is that of the society or the community in question. The theory does not specifically define the society but greatly focuses on the definitions based on the patient’s contexts. Here, the nurse should be able to interact with other members of the staff based on their social or cultural contexts (Penckofer et al., 2011). This implies a need for cultural competence and some level of self-awareness and understanding. The theory also defines nursing as a human relationship that is between the nurse and their patient. To this problem, nursing would be considered as the human relationship between the nurse and their colleagues in other units within the organization. Rather than looking at other health care professionals as simple pieces in a puzzle, there is a need for the nurse to consider them as human resources that play a significant role in the nursing care of the patient at hand. This implies having to develop an actual human relationship with them in a bid to enable shared governance at all times. Each of the members of the staff has a role to play and sharing this information is the only way to maximize the potential of the nursing care processes. Each of the nurses within the organization has to be trained to perceive their colleagues as humans and develop a working relationship with them. This may be difficult considering how busy an average health care organization can get; however, with the right motivations, it is highly possible.
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How the Practice Would Change by Incorporating This Theory
First, the nurses would stop looking at other members of the staff as numbers or units and start seeing them as individuals. This means that they will no longer consider the lab team as the paper on which the results are written. Rather than simply going to collect the results form, these nurses will be actually talking to the lab people and finding out any other discrepancies that may have been noted in the patient even if it was not being tested for. Communicating with other people in the organization will not only make work easier but also more effective (Meleis, Sawyer, Im, Hilfinger Messias & Schumacher, 2000). For example, if the patient was being tested for a particular problem and the results came back negative, the lab people may have noted something else that was however not being tested for. If the nurse relies on the lab form, they may not know of the findings but if they actually have a relationship with the lab technicians this may come up in a conversation. In the end, they save time and resources, while shortening the amount of time that the patient has to wait to get treated. Thus, when the theory is incorporated into practice, there will be seamless operations all through the organization thus faster and more efficient health care services for the patients and easier work for the nurses.
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