‘Use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet — all at the least expense of vital power to the patient.’

Florence Nightingale--Notes on Nursing (1860)

The Lady with the Lamp and the Nursing Profession

The Nursing profession—a science and an art practiced by both man and women—Tiring, arduous, demanding, tough, eye-bag forming, yet fulfilling, a vocation of honor and dignity entwined with humility.

When??...

It was in mid 1800’s with the leadership of Florence Nightingale that organized nursing started. Before her era, nursing care was done by paupers and drunkards: persons unfit for any type of work. Hospitals were placed where the poor frequently suffered more from the environment than from the disease that brought them there.

‘No man, not even a doctor, ever gives any other definition of what a nurse should be than this — 'devoted and obedient'. This definition would do just as well for a porter. It might even do for a horse. It would not do for a policeman.’

Nightingale’s efforts to uplift the nursing profession were indeed admirable. At that time, nursing was viewed as a kind of work that requires menial tasks or routinely actions but Nightingale saw it as a vocation aided by proper use of assessment and empowered by skills, knowledge and attitude acquired from proper schooling. In her book, she takes limelight away from the Physicians, and places it on the nurses.

Notes on Nursing—What It is and What It is not

Her most frequently cited work, Notes on Nursing, was written not as a nursing text but to “give hints for thoughts of women who have personal charge of the health of others.”

Nightingale’s notes on nursing covers all the basic necessities of human lives. It explains how to deal with sick people which can be applied not just to simple cough, colds and flues but to all types of human illnesses. And yes if one can read between the lines (as we always do), the book offers tips on how to survive a hospital experience.

Nightingale’s environmental model has always been applied in the hospital setting. One setting would include the care of our patients in the Intensive Care Unit wherein all chapters of the book can be applied—ventilation and warming, noise management, observation of the sick etc. And even if we are not in the hospital setting whether we are just in our office or at home, Nightingale’s vision of nursing is always present. We can even relate it to a song by Chris Brown and Jordin Sparks entitled No Air… and the lyric goes like this

“Tell me how I’m supposed to breathe with no air? Can’t live, can’t breath with no air That’s how I feel whenever ain’t there There’s no air, no air”

See? Nightingales contribution is so wide that the realization of her vision is not only limited to us nurses. And with that, her vision should inspire, motivate and direct every interaction we make and every intervention we do to be able to provide a wholistic nursing care to our patients and help them in their need for identifying their health concerns without them telling us what we can do for them but doing it automatically.

………………

Although Nightingale’s book was more of a lecture, a sermon, or even a plea put into writing, she backed up her concepts with well researched studies to prove her points.

She is also a skilled statistician- used statistics to present her case for hospital reform. According to Cohen, “the idea of using statistics for such a purpose- to analyze social conditions and the effectiveness of public policy- is common place today, but at that time it was not” (Marie L. Lobo: NURSING THEORIES; The Base for Professional Nursing Practice; Fourth Edition; 1995)

The notes on nursing by Nightingale repeatedly emphasize on its aim to empower women to take control of the care not only the sick but also the healthy members of the family especially the children. We understand that this highlight is because the children are ought to be the foundation of the future. She used statistics to support her claims. These lines are lifted from the first pages of Notes on Nursing to show how extensive Nightingale’s research is for her to come up with such data; “--- do you know that in every seven infants in this civilized land of England perishes before it is one year old? That in London, two in every five die before they are five years old? And, in the other great cities of England, nearly one out of two?----More than 25,000 children die every year in London under 10 years of age” These are just some but they prove that Nightingale’s craft is based on thorough research and statistics.

Basing on today’s world, though advance techniques are being used in the nursing profession, still Nightingales thoughts are being applied. In a hospital in Dubai where one of our groupmates work (Ms. Elvie Abanico), still-life paintings are displayed in the patient’s room and nurses look at how long tentatively patients will stay in the hospital, the longer they stay the nurses will plan to give a room with a view—where flowers and tress can be seen from the patients window since basing on research variety of colors and pictures can help to make a patient feel well. As supported by Nightingales Notes on Nursing variety section page 44: "Variety of form and brilliancy of colors in objects presented to patients are actual means of recovery and that "Variety is just like food for a starving stomach, just like a sick patient who wants to see a variety, just like a starving eye”.

Indeed, one could simply say that Florence Nightingale is Nursing and Nursing is Florence Nightingale. So would it not be sensible if we also try to looked at her well-known work—‘Notes in Nursing’, in a whole new perspective that goes beyond the scope of Nursing?

No Place for a Woman: The Femme Fatal

During Nightingales time, women are considered second class in short they have no right to assert something—near helpless with lethargic lifestyle—a life of thoughtless comfort for the world of social service. During her time, she encountered a lot of problem just because she is a woman. Though she took part on influencing the decisions of the War Department by providing information to Sir Sidney Herbert by giving any of the position papers and reports, because of the position of women in Victorian England, she was not permitted to submit her findings under her own name.

(-Marie L. Lobo: NURSING THEORIES; The Base for Professional Nursing Practice; Fourth Edition; 1995)

In her book entitled Cassandra, she wrote:

“Women are never supposed to have any occupation of sufficient importance not to be interrupted, except ‘suckling their fools’; and women themselves have accepted this”

The above quote shows the displeasure of Nightingale on how women of her times accepted their roles at the society without even exerting an effort to show what they are capable of. In fact, she stated that there were even books written on the acceptance of role that women play in the society then. But Nightingale never conformed to the society nor did she accept. In fact, her writings as well as actions showed her firm disagreement with how society regarded women. So Nightingale was also one of great women in history who did her part to lobby for the rights of women.

Nightingale had a strong conviction that woman have the mental capacities to achieve whatever they wish to achieve. Out of this conviction came her resolve and action to establish nursing as a profession wherein women could develop the intellectual abilities to contribute meaningful service to society.

With her book—Notes on Nursing, a glimpse of feminism can be seen since the book empowers women to have personal charge of the health of others though it does not teach them how, but it asks women to teach herself. Thanks to Florence Nightingale, women now realize that they must gain control over their own time in order to change the social and political structures over their lives—it can be observed that majority of the nurses of today are women living what Florence Nightingale had stated in her book though it is a fact that men also share her vision of what nursing is.

Voluminous texts were written on Florence Nightingale and her contribution to the Nursing profession. What many nurses fail to realize is that she did more than just that. We hope our little blog could help them see and appreciate another aspect of her life and her contributions not just to nursing, but to the world.

“Nurses we are love serves—this is the essence of nursing. For what ever reason we pursue this course, regardless of where we practice it, the essence of nursing should be internalized…”

Jordin Sparks duet with Chris Brown - No Air

READ MORE - DULCIUS EX ASPERIS--(sweetness after difficulties)

“When push comes to a shove, we will seldom disappoint ourselves. We all harbour greater stores of strength than we think. Adversity brings the opportunity to test our mettle and discover for ourselves the stuff of which we are made.”

Do not underestimate the power of a person to cope. He may be dependent now but deep within him lies the energy to adapt.

I remember a particular a particular patient when I was still an ICU nurse. He was a pastor afflicted with a serious liver problem. Specialists come and go at his ICU bed but they cannot seem to diagnose the problem. Time is running out and the pastor is slipping fast. He’s bleeding and God knows how many units of blood have been transfused to him. He went into coma. Doctors were giving up, and so were we. We’ve primed the family but they just won’t give up…yet. The wife is always there at his side during visiting hours, always cheerful and full of hope. So is the daughter who even lets her dad listen to praise songs as if he is not comatose. Many days passed and to our amazement, the pastor woke up from coma. It’s been uphill from there. Everything just fell into the right place. He was transferred to a regular room and eventually discharged with a clean bill of health.

Amazing? What could it be? A miracle? Or could it be the medications working, or the transfusion? Or the family’s fervent prayers? We couldn’t tell but one thing is certain: human beings are made to persist. And that is what Sister Callista Roy believed, too.

Sister Callista Roy is a member of the Sisters of Saint Joseph of Carondelet. She received a bachelor of science in nursing from Mount Saint Mary’s College in Los Angeles California, a master of science in nursing from UCLA, and a master’s degree and doctorate in sociology from UCLA (Philips, 2002). Roy first proposed the RAM while studying for her master’s degree at UCLA, where Dorothy Johnson challenged students to develop conceptual models of nursing (Philips, 2002; Roy & Andrew, 1999). She received many honors and awards for her scholarly and professional work and is currently the Graduate Faculty Nurse Theorist at Boston College, School of Nursing (Roy, 2000).

PHILOSOPHICAL UNDERPINNINGS OF THE THEORY

Johnson’s nursing model was the impetus for the development of Roy’s Adaptation Model. Roy also incorporated concepts from Helson’s adaptation theory, von Bertalanffy’s system model, Rapoport’s system definition, the stress and adaptation theories of Dohrenrend and Selye, and the coping model of Lazarus (Philips, 2002).

MAJOR ASSUMPTIONS, CONCEPTS AND RELATIONSHIPS ASSUMPTIONS

In the Adaptation Model, assumptions are specified as scientific assumptions or philosophical assumptions.

Scientific Assumptions

• Systems of matter and energy progress to higher levels of complex self- organization.
• Consciousness and meaning are constitutive of person and environment integration
• Awareness of self and environment is rooted in thinking and feeling
• Humans by their decisions are accountable for the integration of creative processes.
• Thinking and feeling mediate human action
• System relationships include acceptance, protection, and fostering of interdependence
• Persons and the earth have common patterns and integral relationships
• Persons and environment transformations are created in human consciousness
• Integration of human and environment meanings results in adaptation (Roy&Andrew, 1999, p.35).

Philosophical Assumptions

• Persons have mutual relationships with the world and God
• Human meaning is rooted in the omega point convergence of the universe.
• God is intimately revealed in the diversity of creation and is the common destiny of creation.
• Persons use human creative abilities of awareness, enlightenment, and faith.
• Persons are accountable for the processes of deriving, sustaining and transforming the universe (Roy & Andrew, 1999, p. 35).

Reading through Roy’s adaptation theory, I now understand man’s immense capacity to adapt. I believe in a higher power, I believe in miracles, but I believe, too, that the greater miracle is the perfect interplay of all the factors that push a person to adapt at various modes.

The Four Modes of Adaptation

1. Physiologic-Physical Mode

Physical and chemical processes involved in the function and activities of living organisms; the underlying need is physiologic integrity as seen in the degree of wholeness achieved through adaptation to change in needs.

2. Self-concept- Group Identity Mode

Focuses on psychological and spiritual integrity and sense of unity, meaning, and purposefulness in the universe.

3. Role Function Mode

Roles that individuals occupy in society, fulfilling the need for social integrity. It is knowing who one is in relation to others.

4. Interdependence Mode

The close relationships of people and their purpose, structure and development
individually and in groups and the adaptation potential of these groups.

So how did the pastor recover? At the physiologic level, it was good that he was brought to the ICU immediately since the basic physiologic needs are met at once. He was intubated (for oxygenation), an NGT was put in place (for nutrition), a foley catheter was inserted (for elimination), and enema was also done to facilitate elimination of wastes.

Visitors were restricted early on to provide optimum rest and to minimize cross contamination. Isolation measures were also instituted. Routine ICU care, so to speak. Every time the patient is assigned to me, I try to talk to him as if he listens and can answer. His churchmates were also there every time they are allowed to see him telling him that they are waiting for him at their church. The wife and the daughter never gave up on him. They are always there to tell him how much they love and need him. The adaptation process was a long one, but he did adapt and went on to recover. The ICU environment is not a very ideal place for adaptation, but given the situation and condition of the patient at that time, it was the best place to support the body’s power to adapt.

ROY’S THEORY AS APPLIED TO:

NURSING PRACTICE

Using Roy’s six –step nursing process, the nurse assesses first the behaviors and second the stimuli affecting those behaviors. In a third step the nurse makes a statement or nursing diagnosis of the person’s adaptive state and fourth, sets goals to promote adaptation. Fifth, nursing interventions are aimed at managing the stimuli to promote adaptation. The last step in the nursing process is evaluation. By manipulating the stimuli and not the patient, the nurse enhances the interaction of the person with their environment, thereby promoting health.

Hamner in 1989 discussed the Roy model and how it could be applied to nursing care in a cardiac unit (CCU). Hamner describes the model as enhancing care in the CCU and being consistent with the nursing process. Hamner found that the model assessed all patients’ behavior, so that none was excluded. The author discovered that the Roy model provides a structure in which manipulation of stimuli are not overlooked. The model puts emphasis on identifying and reinforcing positive behavior which speeds recovery.

EDUCATION

The adaptation model is also useful in educational setting. Roy states that the model defines for students the distinct purpose of nursing which is to promote man’s adaptation in each of the adaptive modes in situations of health and illness.

In the early 1980’s the School of Nursing at the University of Ottawa experienced a major curriculum change. This change included incorporating a nursing model by which to base their new curriculum. The change included incorporating a nursing model by which to base their new curriculum. The Roy adaptation model was one of the models to be included in the first year of the baccalaureate program. The professors had to meet four challenges during this change:

1. Adapting the course to be congruent with the Roy model,

2. Developing teaching tools suitable for student learning.

3. Sequencing of content for student learning

4. Obtaining competent role models.

RESEARCH

If research is to affect practitioners’ behavior, it must be directed at testing and retesting conceptual models for nursing practice. Roy has stated that theory development and the testing of developed theories are nursing’s highest priorities. The model must be able to regenerate testable hypotheses for it to be researchable.

Fawcett and Tulman used the model for the design of studies measuring functional status after childbirth. They also used the model for retrospective and longitudinal studies of variables associated with functional status during the postpartum period. The model was also used for ongoing studies of functional status during pregnancy and after the diagnosis of breast cancer. The model facilitated the selection of study variables and clarified thinking about the classification of study variables. The model was a useful guide for the design and conduct of studies of functional status.

GROUP D

Cortez, Joyzen

Cutay, Rose Ann

Cristobal, Maureen

De Jesus, David

Daniel, Jane

Dayao, Genevieve

Thank you for your contributions.

READ MORE - SISTER CALLISTA ROY: ADAPTATION THEORY

Transcultural Nursing...... A bridge to reach clients globally

Madeleine M. Leininger
PhD, LHD, DS, CTN, RN, FAAN, FRCNA

Madeline Leininger was a pioneer nurse anthropologist. Appointed dean of the University of Washington, School of Nursing in 1969, she remained in that position until 1974. Her appointment followed a trip to New Guinea in the 1960’s that opened her eyes to the need for nurses to understand their patients’ culture and background in order to provide care. She is considered by some to be the "Margaret Mead of nursing" and is recognized worldwide as the founder of transcultural nursing, a program that she created at the School in 1974. She has written or edited 27 books and founded the Journal of Transcultural Nursing to support the research of the Transcultural Nursing Society, which she started in 1974.
Every human race has his/her different beliefs and culture may it be taught and passed on from one generation to the other. Even if we have the same language or dialect spoken we all have different culture and beliefs being followed as one of the norms in our society. And a part of our culture was our health beliefs and practices. In our group we categorize some of the health beliefs and practices into different age group based on experiences and research. This will give us awareness on how we could be able to render effective care to our clients, with certain age and background.
PRESCHOOL AND SCHOOL AGE
An ethnographic study of Latino pre-school children’s oral health in rural California revealed that, Latino children experienced a higher prevalence of caries than do children in any other racial groups in the U.S. The study conducted in 2005 focus on both recent immigrants and longer term residents of a small agricultural town in the central valley of California. Around 95% of the population of approximately 9,000 is of Latino largely Mexican origin.
Rural immigrant parents tend not to recognize dental caries in their children as a disease, but rather classified as visible discoloration on teeth and tend not to seek help unless this were accompanied with swelling and pain. Because tooth decay is viewed as a stain, when treatment is sought, parents often requested and expected cleaning. The high cost of restorative work therefore, is a surprise.
The mothers were educated by health care workers about baby bottle decay but claimed that the problem is the bottle nipple and not the sweet fluid content of the bottle. Many mothers claimed that as adults they never had a dental treatment nor dental caries when young and now their children have dental caries and they are unsure how to prevent it.
Migrant parent also reported major changes in diet since moving to the U.S., and also commented on how different their children’s diet is from their own when growing up. Major differences between their diets were the high consumption of sugar, sodas, and less access to fresh fruits and vegetable. Parents did not specifically associate these broad dietary changes with their children’s problems although they did connect the consumption of sweet substances with the subsequent advent of dental caries. Collectively all these understanding and actions on the part of care givers sets up Latino children for high rates of unrecognized and untreated oral disease.
ADOLESCENT
As depicted in Leininger’s Sunrise model culture, worldview, and social structure influences the individual’s care behaviors and beliefs which in turn affects their health and illness status. The nurse needs to clearly understand universal and specific cultural views of adolescents and clarify values in order to promote wellness in a culturally acceptable manner.
One of the most pressing problems of adolescence in many societies is engaging in risky sexual behaviors at an early age. In some societies, adolescent participation in risky sexual behaviours are treated as a measure of ‘manhood’, a sense of ‘belongingness’, a sign of ‘friendship’. The nurse through applying transcultural care concepts of Leininger should bear in mind these problems and study the deeply rooted societal and cultural origins of these.
Cultural beliefs and practices leading to risky sexual behavior do not only lead to this specific problem but to a myriad of problems related to such health practice including teenage pregnancy, sexually transmitted diseases, poor maternal and child health, etc. The nurse in these situations should devise a strategy in teaching adolescents about the effects of risky sexual behavior and actions to curb such incidents in ways that are meaningful to them.
There are a lot of universal and culture-specific issues concerning adolescents today. It is very important for a nurse applying transcultural care concepts to be sensitive not just to cultural and social background but also to the adolescent’s developmental issues and concerns.
Being an adolescent is indeed a big transition in our lives from an adventurous kid to a growing up girl/boy. We experience a lot of challenges like peer pressure and a lot of changes in our body. One of the things as an adolescent is when I have my menarche my mother asked me to jump in the stairs 3 times ,a part of our family’s culture I guess which I find very amusing.
As adolescents, we are expected to mingle with other person with the same age but some of us have a different upbringing so some tend not to "go with the flow" wherein others tend to be depressed and commit irrational behavior like suicide. Some committed suicide because of family problems, school, and failed relationships. Aside from personal and social challenges an adolescent faces, he/she also learn a lot of new things like drinking alcohol and smoking but it depends on how he/she will handle this, the parent's guidance will be of important issue here. Because not only this will affect personal relationships but also their health is at risk. I have this patient, 17 year old male who seek treatment in the emergency room who attempted to commit suicide by drinking sleeping pills because of a failed relationship with his girlfriend. As nurses we should understand them what they are experiencing now. We should treat them with empathy. Our responsibility is teaching them the importance of life and health. We should understand them because they behave differently depends on their family values, personal experiences and beliefs.


ADULTHOOD



A common theory is that adulthood is the real test of life, to experience the world from a first-person standpoint instead of through the parents. Then the adult can pass those experiences down to younger people and they can experience them when they become adults. In this stage, there are noticeable changes in how adults view on their careers / finances and Marriage/ family. Most of these adult live their life in a fast pace. As a nurse I encounter clients who are an American businessman who is an occasionally smoker and drinker for annual physical check up. Despite admitted in the hospital he’s still focusing his attention on his work rather than his health. He’s the breadwinner of the family. He has 4 kids studying in a private school and his wife works as a cashier in a grocery store I didn’t stopped him in doing his work but when laboratory test and physical assessment will be given to him I just told him to stop for a while and cooperate. I oriented him the importance of annual check-up and having a healthy lifestyle.
Another situation experienced among expectant mothers in Filipino-Chinese women they consult a Chinese conception calendar because some would like to have their first born to be a boy. An experience of one of our groupmates also told us when she was caring for a Filipino-Chinese woman who had been admitted to their floor. She asked her to contact her obstetrician because she have to give birth before lunch even if she’s not in active labor, as one of the many beliefs that Chinese have about labor and delivery. She was quite surprised by her request but she found out that it was just one of the many beliefs that the Chinese have about labor and delivery. She was brought to the delivery room before 10 am.
Some would like their first born to be a boy, others say that they consult a Chinese conception calendar for this. The calendar is supposed to predict whether you will have a girl or boy. Personally she was able to consult this when she was pregnant with my first born, the sex of my baby was accurately predicted.
OLDER ADULTHOOD/ GERIATRIC
The theory of Leininger paved its way in the study of human culture. Culture of an individual shapes ones view of aging. Which explains that older adult is also a heterogeneous group of people. With the increasing population of baby boomers, nurses should expand their roles in the care of individual or group of older adults not only in the hospital but in the community as well. As you read the succeeding text of my blog, I hope this will make you understand why older adults behave the way they do and how nurses should deliver personalized care.
Among older adults, one of us had been able to care for a 70 y/o white American client who was due for a cataract extraction. She oriented the client with the physical set-up and hospital policy. Her wife visited her and left after 2 hours. The client told me that in the United States visitors do not stay for a long time on the patient’s room in which he is fine with it. Looking at this patient we will notice that as long as they can do things by themselves they won’t bother in asking for assistance. In this situation older people experience a feeling of fulfillment if they can have a sense of control even with alteration in health condition.
Another adult patient she had was a 69 y/o who is due for CABG, three days prior to operation he was already admitted in the hospital to undergo clearance before he undergo surgery. She oriented him with the physical setup and rules. She discussed to the client visiting hours and number of visitors and companionallowed. He asked if he could have some considerations because he is expecting a lot of relatives. The request was granted. In this scenario as nurses we act as advocate of our clients, though there are rules to follow sometimes we will have to bend some as long as we are not bypassing any authority. We should know how to assert ourselves in behalf of our patients. Her Filipino client was used to that culture wherein there is strong family ties especially in times of health illness the presence provides comfort and security being the head of the family.
REFERENCES:
Isaacs B. An introduction to geriatrics. London: Balliere, Tindall and Cassell, 1965
Geiger, J.N. & Davidhizar, R.E. (1991). Transcultural nursing: assessment in intervention. St. Louis: Mosby-Year Book.
Leininger, M. (1991). Transcultural nursing: the study and practice field. Imprint, 38(2), 55-66.
Merck $ Co. The Merck Manual of Geriatrics.1995-2007 Merck & Co., Inc., Whitehouse Station, NJ, USA
www.baby-talk.co.uk/chinese_calendar.htm
http://www.tcns.org/
Andrews,M. and Boyle,J. "Competence in Transcultural Nursing Care" The American Journal of Nursing vol 97 no.8 august 1997.pp16AAA,16BBB,16DDD,Lippincott Williams and Wilkins
Silvestri,L. (2006). Saunders Comprehensive Review for the NCLEX-RN Examination. 3rd Edition. Singapore :Elsevier.
Añonuevo,C.et al(2000).Theoretical Foundations of Nursing.Philippines:UP Open University.

Group members: Cherry Sagge, Marlon Salazar, Michael San Juan, Jay Ar Santiguel, Laarni Sarad, Marie Jam Separa, Clarisse Elise Sintor, Ma. Cristina Setubal, Elsie Santiago

READ MORE - Group K:Transcultural Nursing...... a bridge to reach clients globally

Ourselves, our body, our health….. enhancing self usage towards prevention of illnesses & promoting well-being.

Nora J. Pender developed the Health Promotion Model that is proposed as a holistic predictive model of health-promoting behavior for use in research and practice. She is Professor Emeritus in the School of Nursing at the University of Michigan, and an advocate of health promotion.



“I committed myself to the proactive stance of health promotion and disease prevention with the conviction that it is much better to experience exuberant well-being and prevent disease than let disease happen when it is avoidable and then try and cope with it.”
Nola J. Pender, PhD, RN, FAAN



Health Promotion Model has given health care a new direction. According to her, Health Promotion and Disease Prevention should be the primary focus in health care, and when health promotion and prevention fail to prevent problems, and then care in illness becomes the next priority. She defined 2 concepts: health promotion & health protection.

Health promotion is defined as behavior motivated by the desire to increase well-being and actualize human health potential. It is an approach to wellness. On the other hand, health protection or illness prevention is described as behavior motivated desire to actively avoid illness, detect it early, or maintain functioning within the constraints of illness. (Kozier, 2004)

Figure 1 – Health Promotion Model

This model (Figure 1) is moving towards understanding multi-faceted nature of persons correlating with their interpersonal nature and interacting with their interpersonal & physical environments as they trail towards health.
Because of the model, nurses have already advanced their health approaches, addressing not only the curative side, but as well as prevention of diseases & promotion of well-being. Application of this theory is varied and substantive on its own.





Applications

Nursing Practice

“We are moving toward an era of science-based practice in nursing that incorporates the latest findings from the behavioral and biological sciences into practice to assist people of varying cultural backgrounds to adopt healthy lifestyles.” – Pender

As what they say, prevention is better than cure. Thus, health promotion is valued much. But how? Question seems hard…hard as if you don’t know how to solve the problems of the world…But how, again? If super heroes could save life using their super powers, we nurses could do more by using our caring touch, and therapeutic talks. Health teachings are always part of nurses’ experience in the workplace. Despite of various clinical & community health care settings, we nurses are always interacting with our patient/client.

Community health care setting is the best avenue in promoting health & preventing illnesses. Using Pender’s Health Promotion Model, community program may be focused on activities that can improve the well-being of the people. Health promotion and disease prevention can more easily be carried out in the community, as compared to programs that aim to cure disease conditions. This is because the people in the rural area tend to veer away from modern medical methods. Most of them, due to financial reasons, choose to avail of the services offered by “herbolarios” and other folk healers. In our local setting, promoting health to our fellow Filipinos is very crucial. Though, there are campaigns provided by our government’s health agency, which is the Department of Health (DOH), there’s still a big percentage in the population who live unhealthily and many are suffering from different type of diseases.

Nurses, though are scattered in different fields, have common primary concern: to promote health to every individual. The following are just examples of methods on how to promote health to our fellows.


Insight from an Academe nurse teaching CHN… A group of students taught the families the value of eating a balanced diet. They introduced the concept of including the different food groups in all their meals. They also stressed the benefits and advantages of the various vitamins and minerals found in those food. Another group encouraged the community to practice lifestyle modification. They discussed the disadvantages of vices such as smoking and drinking alcoholic beverages. For disease prevention and health protection, one group tried to inculcate the importance of early detection of illnesses. They taught the women the proper way and timing of self-breast examination. The mothers were also encouraged to avail of the vaccination services offered by the nearby health center. These programs proved to be very beneficial to the community. Because one can truly build a healthier tomorrow through good community health practice.


Insight from an ICU nurse… Although most patients admitted in the ICU are experiencing health problems, Health Promotion Model may still be applied in one way or another. This is projected towards improving health condition and prevention of further debilitating conditions. Diet modifications and performing passive & active range of motion exercises are examples of its application.




Nursing Education

“I believe that the future will be very bright and productive for nurses who direct their careers toward understanding disease prevention and health promotion processes.” – Pender

Nurses are expected to be adaptive. Indeed, changes are always constant. In health care settings, patients come & go. Meet & greet. Recover or expire. As this theory advocated, we should not allow our patients to experience severe conditions if we could only prevent them from encountering such. We are expected to know, if not in depth, the disease processes. Because of this know-how, we could apply health promotion and worsening prevention before the hands of the clock stop moving.

Percentage of nurses is geared towards continuing professional education. Attending seminars & conventions. Enrolling to masteral & doctoral classes. All are goaled towards becoming competent nurses. Nursing education is not a one-phase process. It does not end after passing the licensing exam. It is continuous. Unending. Ever changing. We must be abreast with new technologies, new approaches, and new techniques. Because of this theory, we nurses could address more the needs and problems of the client before it progresses to exacerbation. This model could be a basis for structuring nursing protocols and interventions.

Nursing Research

“I was committed to health promotion and encouraged other scholars to move in that direction long before health promotion and risk reduction became popular.” - Pender

Research help Health Care provider to develop a systematic problem-solving approach to improve and develop strategies to promote good health to individuals. Through research we will be able to clarify and verify the phenomenon.

Evidenced-based practice is fast emerging because of its factual and substantive results. These researches yield fruitful outcome that of great help in addressing arising problems and in setting nursing protocols. Much more research must be done to tailor interventions to individuals rather than to group stereotypes.

If we could remember, common research topics in our nursing college days are health promotion techniques and disease prevention. To name a few, some geared their research on effectiveness of Expanded Program on Immunization, others on health practices of mothers and families, some on efficiency of early detection of common illnesses. These are all but few of the model’s application to research.




Of all the theories presented in the module, Health Promotion Model is the easiest of them, yet substantive & useful. In our day-to-day experiences as nurses, we are always promoting health, preventing illnesses, and upholding well-being. We are seen by the public as health advocates. We have knowledge on health & illnesses, thus, we are expected to share this to laymen and contribute to their well-being. As what Pender said, “We cannot continue to let people become ill when we have the means to keep many people well--particularly when problems are environmentally and behaviorally induced”. Thus, the theory of Pender on Health Promotion is indeed a great to advocate to prolong and preserve life. This theory really manifests the noble work of a NURSE. Remember, nurses we are LOVE SERVES.

READ MORE - Health Promotion Model: Heuristic Device for Health Care Professionals