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NRS 433 Discussion: Studying a Problem in Nursing

NRS 433 Discussion Studying a Problem in Nursing

Topic 1 DQ 2

Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Provide an overview of the problem and discuss how addressing the problem through nursing research can improve patient outcomes. Provide rationale and support for your answer.


Dilemma is often an issue that appears in nursing. Nurses are place in a sometime difficult and uncompromising position. From giving advice to a patient about their health or decision regarding care. (Dilemmas in nursing, 2022) Example: a patient refused having an x-ray done at bedside due to chronic pain. Patient has several decubitus and because the film will need to be placed underneath the patient back it will cause more pain and pressure to the patient. As a nurse we must explain the reason and benefit of having the x-ray done. Patients have a right to refuse treatment or any procedures. Although the patient refuses the x-ray the patient knew that continuing treatment was important regardless of having the diagnostic test. Patient did understand the importance of the test but is also aware that for the providers to further treat the disease or disorder a diagnostic test need to be done.

To address the issues or dilemmas that the patients maybe experiencing is not to have any judgement but to understand their concern. This can be done be letting the patient know that they are being heard. As nurses we need to help figure out an alternative method of helping the patient with their fear and pain to eventually move forward with getting an x-ray done. The patient has lack of control of most treatments done in the hospitals, the question to ask is what can be done to gain more control in the hospital. It will help the patient achieve a better outcome if you negotiate and express what you and the patient both cares about. (Robert A., 2015)


20 common examples of ethical dilemmas in nursing + how to deal with them. 20 Most-Common Examples of Ethical Dilemmas in Nursing. (n.d.). Retrieved July 29, 2022, from https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html


What to Do When a Patient Refuses Treatment Robert Arnold MD Download PDF. (2015). What to do when a patient refuses treatment. Palliative Care Network of Wisconsin. Retrieved July 30, 2022, from https://www.mypcnow.org/fast-fact/what-to-do-when-a-patient-refuses-treatment/

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Nursing scholars identified the core of nursing and then established theoretical formulations that would reflect the above.

NRS 433 Discussion Studying a Problem in Nursing

NRS 433 Discussion Studying a Problem in Nursing

Consequently, DeNisco and Baker (2016) argue that several theories promote theory-based practice of nursing since it bases its operation on the paradigm of care. In particular, Nightingale’ environmental theory and Watson’s Theory of Human Care can play an important role in patient care. Nightingale’s nursing theory operates under the assumption that the environment plays an important role in disease progression (McDonald, 2017). Therefore, in nursing practice, nurses should manipulate the surrounding environment during patient care so as to enhance the recovery process. Watson’s Theory of Human Caring affects the existential phase of nursing and emphasizes on holistic patient care (Sitzman & Watson, 2014). To this end, using this theory in nursing care behooves nurses to care about the patient’s body, mind, and spirit in order to maintain the healing process at an optimal level. Thus, applying the concepts of spirituality, trust, hope, caring, faith and love to nursing practice as dictated by Watson’s Theory of Human Caring helps satisfy the notion of human caring.

DeNisco and Baker (2016) observe that nurse practitioners establish an expertise in electing models and theories that are relevant and appropriate to their practice. Hence, the above-mentioned theories have capacities to incite behavioral change within a health care setting. Given that Watson’s theory focuses on issues related to patient care and even spiritual connection between a patient and a nurse, its application may influence the adoption of a model of care that transcends the patient-centered care (Sitzman & Watson, 2014). Thus, the application of Watson’s Theory of Human Caring may shift nurses’ behaviors from patient-centered care to human-to-human connection so as to improve the quality of patient care. In the same breadth, Florence Nightingale’s theory may influence nurses to focus on the environmental needs of a patient as part of care.

Nightingale’s environmental theory and Watson’s Theory of Human Caring have characteristic strengths and weaknesses. Regarding the former theory, its strengths include the improvement of the quality of care as has been demonstrated by reduced mortality rates when utilized. The wholesome values and principals of the theory continue to receive application in the education of modern nursing (McDonald, 2017). Lastly, the theorist’s five essential components concerning optimal healing that is light, cleanliness, efficient drainage, pure water and pure air continue to form a significant part of healing. However, certain cons such as the absence of proper procedures in handling extremely needy or dependent patients in the theory exist. Also, Nightingale’s assumption that diseases occur primarily due to miasma was disapproved by Pasteur in his famous work.

Watson’s Theory of Caring also has its pros and cons as evidenced by various scholarships on the matter. One of the theory’s benefits encompasses its positive influence on the nurse-patient interaction as well as practice for patients. Additionally, Sitzman and Watson (2014) postulate that the theory places a suffering patient within the context of the culture, the community, and the family and these are important mediators in the recovery process of a patient. Nevertheless, the theory neglects the patient’s biophysical needs and mainly focuses on their psychosocial needs. Such confinement limits health as it has a physiological need that requires to be addressed.

Studies have also revealed that nurse educators can integrate the two theories in their practice. Regarding Nightingale’s environmental theory, nurse educators can integrate the procedures of ensuring a clean setting environment in the curriculum.  Thus, through various educational programs, nurse educators can teach their students about hygiene at the workplace and their role in disease acquisition and progression (McDonald, 2017). Watson’s Theory of Human Caring can also play a useful role in educational settings and academic programs. Nurse educators have the capacity to empower their students and enhance their psychosocial wellness via the caring theory. Therefore, advanced practice nurses such as nurse educators can utilize the two theories in various ways.

Porter-O’Grady and Malloch (2016) aver that the concepts of autonomy, beneficence and betrayal among others form the basis for making ethical decisions in medicine. However, an intricate relationship exists between nursing and ethics and as such, examination of the ethical dimension becomes important. The ethical consideration of the two theories with regards to caring may be rooted in the lifeworld-led care. Accordingly, even as nurses provide care to their patients, they need to acknowledge the lifeworld of the patient as well as have openness to the description of the patient’s experiences (Galvin & Todres, 2013). This implies that nurses need to have the willingness to listen to the meanings and connections from the patients as the lived lives. Therefore, the ethical aspects of caring from the two theories rest on the phenomenological understanding by nurses. However, even as that is the case, nurses also need to appreciate the value of human dignity in the provision of care (Parandeh, Khaghanizade, Mohammadi, & Mokhtari-Nouri, 2016). The issue of human dignity forms an important ethical foundation in Watson’s theory of caring because of its emphasis on human-to-human connection between the patient and the nurse. Thus, even as they strive to make a connection with the patient using the theory, nurses need to be aware of the need to maintain respect and exercise professionalism.



DeNisco, S. M., & Baker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3 ed.). Burlington, MA: Jones & Bartlett Learning.

Galvin, K., & Todres, L. (2013). Caring and well-being: A Lifeworld approach. , : Routledge.

McDonald, L. (2017). Florence nightingale, nursing, and health care today. New York, NY: Springer Publishing Company.

Parandeh, A., Khaghanizade, M., Mohammadi, E., & Mokhtari-Nouri, J. (2016). Nurses’ human dignity in education and practice: An integrated literature review. Iranian journal of nursing and midwifery research, 21(1), 1-8.

Porter-O’Grady, T. & Malloch, K. (2016). Becoming a professional nurse. ( 2nd ed.), Leadership in nursing practice: Changing the landscape of healthcare Burlington, MA: Jones and Bartlett Learning.

Sitzman, K., & Watson, J. (2014). Caring science, mindful practice: Implementing Watson’s human caring theory. New York, NY: Springer Publishing Company.

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