NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

Sample Answer for NURS 8114 Exploring Middle Range Theories and Framing Practice Issues Included After Question

You will begin this Discussion by identifying a practice issue that will be your frame of reference as you analyze the theoretical basis of nursing practice. Be aware that your choice can potentially carry through the course, as you will continue to address this issue in the context of other types of theories in Week 3. This practice issue can also be one focus of your Module 3 exploration of evidence-based practice and quality improvement, and your Module 4 investigation of a critical practice question. Consequently, as you prepare for this Discussion, think carefully about your example for connecting middle range nursing theories to patient care.

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To prepare:

NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
NURS 8114 Exploring Middle Range Theories and Framing Practice Issues
  • Analyze your nursing practice for issues of particular interest or concern to you. Identify one issue as the focusof your application of theory to practice.
  • Review the Week 2 Learning Resources to identify specific middle range theories that may apply to your practice issue.
  • Choose at least two middle range theories that might be most relevant and valuable in addressing your practice issue.
  • Search the Walden Library for scholarly articles that address application of middle range theories to practice issues.
  • Consider how to frame your focus practice issue in terms of the middle range theories that you have selected.

With these thoughts in mind …

By Day 3 of Week 2

Post an explanation of your practice issue. Then, describe two middle range theories that are most valuable in addressing this issue and explain why. Be specific and provide examples.

Read a selection of your colleagues’ posts.

By Day 6 of Week 2

Respond to at least two colleagues on 2 different days by suggesting other middle-range theories for them to consider. Support your recommendations with at least one scholarly article to share with each colleague.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

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A Sample Answer For the Assignment: NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

Title:  NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

Practice Concern

A practice concern with my organization is access to quality specialty care. Resources in my community could be more extensive, especially with specialty care. We have one cardiology office, which makes quick consults impossible. Neurology, nephrology, gastroenterology, and urology are all an hour away. We have a standing ER, but the quality of care has diminished because of the lack of specialty care. If a patient needs hospital admission, they are transferred to another hospital an hour away. My community is like many other communities in the US that are designated as rural. Rural dwellers are less likely to have completed higher education, are older, and are usually veterans or uninsured (Cyr et al., 2019).

 

Middle-Range Nursing Theories

A middle-range nursing theory that incorporates the setting of my community is the Rural Nursing Theory. This framework notes that health is the ability to work and be productive ( Lee & Winters, 2004). Secondly, rural dwellers are self-reliant and resist accepting help from services or agencies (Lee & Winters, 2004). Lastly, the providers in the rural center lack anonymity (Lee & Winters, 2004), limiting their ability to have private lives. The rural nursing theory is valuable in addressing my community’s need for specialty services. Specifically, the rural nursing theory concept that most rural residents define health as the ability to work is a battle that I encounter daily. Health expectations differ; as long as patients can work and contribute to their household, they consider themselves healthy. Using this framework, I can propose healthiness with the ability to work. For example, I can approach controlling blood sugars in people with diabetes as imperative by expressing consequences that will prevent the patient from being able to work. Many of my patients are local truck drivers; the only way these patients make money is by driving a truck. However, this right to drive can be revoked if they do not have control of their blood pressure, blood sugars, or sleep apnea. Unfortunately, because of the idea of health as being able to work, patients do not present at the beginning of this diagnosis, and they do not come in for preventive care. Warranting specialty care consults.

Furthermore, Florence Nightingale’s Environmental nursing theory can evaluate the rural environment and assess its effects on specialty care. The basic concept of environmental nursing theory is that the patient’s physical environment can affect the well-being and healing of the patient (Gonzalo, 2019). With this theory, I would assess my local community to identify the barriers to specialty care. Is transportation the primary barrier, or could traveling to specialty care take too much time out of the work day? Once the identity of the barrier is exposed, interventions can start. For example, if traveling takes up too much of the patient’s time, I could try to access specialty care through telemedicine. If lack of transportation is a barrier, I would contact local taxi companies and see if, with the local government, a grant could help pay for transportation.

Many different nursing theories can be used in a rural setting to improve the overall health of residents. All require interdisciplinary collaboration and local government support. As a DNP-prepared nurse, I will have the knowledge to make a real change.

 

References 

Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to specialty healthcare in urban versus rural US populations: a systematic  literature review. BMC health services research19(1), 1-17.

Gonzalo, A. (2019). Florence Nightingale: Environmental Theory. Nursing Theory Guide.Lee, H. J., & Winters, C. A. (2004). Testing rural nursing theory: Perceptions and needs of service providers. Online Journal of Rural Nursing and Health Care4(1), 51-63.

A Sample Answer 2 For the Assignment: NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

Title:  NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

I did a clinical rotation at a rural hospital, it was my first time seeing a hospital that small. There were only two floors in the hospital, the ER and then Med-Surg. At the time I was working at a big city hospital as a CNA so I was very shocked to see the limited resources. It was educational because I learned to draw my labs and do my IVs. The sad part about this was anytime a critical patient came through the ER, there weren’t any resources that would be able to help them efficiently. They would end up transferring to a bigger hospital once stable. The nurses who precepted me said that they’ve been fighting for more specialists to come to see the patients at their hospital but so far, nothing. Your post reminded me of my experience there as a student. The patients there often lack access to quality specialty care that they desperately need. The two theories you identified align with this issue very well.

Chapter 11, “Overview of Selected Middle Range Nursing Theories. ” (pp. 223–252) [PDF]  Theoretical Basis for Nursing, 5th Edition by McEwen, M.; Wills, E. Copyright 2019 by Wolters Kluwer. Reprinted by permission of Wolters Kluwer via the Copyright Clearance Center. Licensed in 2020.

Chapter 19, “Application of Theory in Nursing Practice. ” (pp. 434–451) [PDF] Theoretical Basis for Nursing, 5th Edition by McEwen, M.; Wills, E. Copyright 2019 by Wolters Kluwer. Reprinted by permission of Wolters Kluwer via the Copyright Clearance Center. Licensed in 2020.

A Sample Answer 3 For the Assignment: NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

Title:  NURS 8114 Exploring Middle Range Theories and Framing Practice Issues

The theory of rural nursing became eye-catching for me because of my other job, which is home health. As a home health nurse, I am responsible for visiting patients at their homes and providing nursing services and evaluations. It has been astonishing that many locations I visit are still far from being a standard reflection of the minimum health coverage goal. Distance to a health facility is a metric used to measure the proximity of any community to a healthcare facility. Some towns still do not have a clinic or health center within a 5km radius. The government target for 70% of the population to be within 5km of a health facility has remained incompletely actualized (Bennett et al., 2019).  This often poses a question to me about how such people handle periods of health emergencies.

Usually, for people in rural area, being healthy meant the ability to function, whether at work or play. The distance was a significant part of their lives, particularly in accessing prescription medications, health care specialists, and emergency care. The symptom-action-time-line process was evident in seeking care for illness and injury(Hulland et al., 2019). Some of the major themes that emerged from the qualitative analysis of accessibility of health definition of health, distance and access to resources, the symptom-action-timeline process, and choice. For these participants, being healthy meant functioning, whether at work or play (Cromartie et al., 2020).

As DNP-prepared nurses , we can help close this wellness gap for people in remote areas. We can help save lives and achieve the well-being of our patients by opening clinics within the expected radius of 5km or less.

References

Bennett, K. J., Borders, T. F., Holmes, G. M., Kozhimannil, K. B., & Ziller, E. (2019). What is rural? Challenges and implications of definitions that inadequately encompass rural people and places. Health Affairs38(12), 1985-1992.

Cromartie, J., Dobis, E., Krumel, T., McGranahan, D., & Pender, J. (2020). Rural America at a glance: 2020 edition. Amber Waves: The Economics of Food, Farming, Natural Resources, and Rural America2020(1490-2020-1865).

Hulland, E. N., Wiens, K. E., Shirude, S., Morgan, J. D., Bertozzi-Villa, A., Farag, T. H., … & Pigott, D. M. (2019). Travel time to health facilities in areas of outbreak potential: maps for guiding local preparedness and response. BMC medicine17, 1-16.

 

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Important information on Writing a Discussion Question

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  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
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  • Follow APA-7th edition
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Participation –replies to your classmates or instructor

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