Compare and Contrast Two Nursing Theories

Nursing requires daily, hourly and even up to the minute tasks and details. The nurse is reactive and supportive, caring and efficient. It may be overwhelming to keep up with the many activities of daily nursing. But being professional nurse is all that and more. It means that you have an internal roadmap to patient care, a guide that helps you achieve good outcomes. This is where nursing theory comes in. Nursing theory can help you with overt and covert problems, as well as inform your nursing decisions. In the two studies that I read, each used a very different theory to guide their nursing care. That is because nursing is so diverse, and we are fortunate to have had many beacons of light come before us in the form of Grand Theorists. I chose to contrast the Nicely article (2011), using Virginia Henderson’s theory, with the Merrit article(2010), using Hildegard Peplau’s theory.

Virginia Henderson’s theory centers around immediate care of the physical needs of the patient and family, emphasizing deep caring. Nicely’s article organizes patient care for the brain-dead patient according to Henderson’s 14 nursing support activities that were intended to create independence for the ill patient. Nicely argues that these activities are also appropriate for the brain-dead patient for important reasons. The brain-dead patient should be treated with the same care as if the patient were to live, because the patient’s organs will indeed live on and be harvested if the patient is treated correctly. Correctly, according to Henderson’s theory is to support 14 activities, some of which are “eating and drinking”, “elimination of body waste”, “select suitable dress and undress” and “desirable posture, sleep and rest”, to name a few.

It seems implausible to imagine that Henderson had anything in mind other than the “live” patient when she penned her theory, and the interesting twist here is the use of this theory for the patient who has expired. The theory is practical and immediately applicable, making it a good choice for the acute situation of recent brain-death. Brain death and subsequent organ harvesting benefit from a clear road map that has very little deviations and is universally applicable. But the care of the patient who presents with mental health needs requires a theory that encompasses long-term care. We have come to learn that mental health does not have a one-size-fits-all quick solution. Hildegard Peplau argues that the patient will benefit most when the nurse takes on specific roles to model for the patient.

Peplau emphasizes “the person rather than the problem”, and focuses on the “shared humanity” between patient and nurse. In Merrit’s case study, the nurse adopts the seven roles proposed by Peplau, some of which are “The stranger role”, “The resource role”, “The teaching role”, and others. These roles are carefully delineated, so as to provide an education for all nurses on the “interpersonal relations” between patient and nurse. In Merrit’s case study, these interpersonal relations form the basis for healing, which takes place over an extended period of time.

Peplau’s theory guides the authors of the study to gain patient trust, provide counsel, educate, refer and heal. The theory allows for this to happen over time. The nature of mental health requires self -inquiry for both patient and nurse, and time for self-reflection. Henderson’s model would not be adequate for this type of nursing. The science of nursing is fortunate to have various theories to draw from for diverse nursing situations.

References:

Nicely, B., & DeLario, G. T. (2011). Virginia Henderson’s principles and practiceof nursing applied to organ donation after brain death. Progress in Transplantation, 21(1), 72-77. (Links to an external site.)

Merritt, M. K., & Procter, N. (2010). Conceptualising the functional role of mental health consultation–liaison nurse in multi-morbidity,using Peplau’s nursing theory. Contemporary Nurse 34(2), 158–166. (Links to an external site.)