Paradigms And Theories In Nursing Practice

Paradigms and Theories in Nursing Practice
Over the course of the past century, the nursing profession has undergone multiple periods of transformation brought by the evolution of paradigms in nursing theory. The three major paradigms of empiricism, interpretive, and critical social theory now each provide a distinct set of principles to the discipline, while a pragmatic perspective serves to guide their application in practice. The intent of this paper is to discuss the contributions of each paradigm and demonstrate how pragmatism has furthered the practical discussion of nursing theory in the 21st century by using real examples in clinical practice. This paper will examine the case of John Doe, a 72-year-old male admitted to a palliative
The empirical paradigm is based on empirical knowledge, or empirics. Empirics is a way of knowing that is publicly verifiable, factual descriptions, explanations, and predictions based on subjective or objective group data (Fawcett, Watson, Neuman, Walker & Fitzpatrick, 2001). Empiricism is also based on the assumption that what is known can be verified through the senses (Monti & Tingen, 1999). The empirical approach allows researchers to ‘quantify’ information through observation, as this is the preferred method of data collection for empiricists (Monti & Tingen, 1999). Nursing first adopted empiricism as it allowed early nursing scholars to develop the scientific foundation for nursing and seek professional status (Weaver & Olsen,
When John Doe was first admitted on to the palliative care floor, he was assessed by the health care team (including social nurses, physicians, social work, spiritual care, physical and occupational health). A care plan was put into place based on the hierarchy of concerns. In Mr. Doe’s case, this was managing a pain crisis. The doctor’s began treating his pain with hydromorphone. The empirical paradigm has allowed researchers to determine through controlled studies that hydromorphone administered at regular intervals has proven to be effective in controlling severe pain (Pereira, 2008). Once John’s pain was managed, the nurses were able to assess Mr. Doe’s performance. The tool used was the Palliative Performance Score (PPS) tool. The PPS, developed by Victoria Hospice, is designed to measure a patients' performance status in 10% decrements from 100% (healthy) to 0% (death) based on five observable parameters: ambulation, ability to do activities, self-care, food/fluid intake, and consciousness level (Victoria Hospice, 2001). The data collected through observation allows staff to evaluate Mr. Doe’s current and future needs. The result is that when used properly, Mr. Doe’s performance on the scale should be the same regardless of what nurse or doctor is doing the assessment. The results can be replicated and interventions carried out based on the data. As evidenced by Mr. Doe’s experience, the empirical