Nursing Theoretical Foundations of Practice
Sleep deprivation among patients in ICU is a prominent problem inhealth care today. This could lead to further physiological andpsychological problems such as delirium, in extreme cases. The cause ofthis is the stress associated with the critical conditions necessitatingadmission to the intensive care unit (Roberts, 2000). A further problemassociated with this is that health care workers at times misdiagnose andmisperceive the condition as less dangerous than is in fact the case. Itis therefore clear that the problem of sleep deprivation needs to beanalyzed for its nature and its causes. There is a lack of such analysis,mainly as a result of advanced technology taking priority over thefunctionality of the patients themselves (Johnson 2000). The human elementis thus neglected in favor of treating the illness as an isolated problem(Roberts, 2000). Nursing models such as those created by Neuman, Roy andJohnson can be useful in bringing back the concept of the whole person to ICU patients experience sleep disruptions on average about every 20minutes during a 24-hour day (Johnson, 2000). These disruptions come in
Hence Johnson uses the behavioral modelupon which to base her philosophy of nursing care. Betty Neuman's Health Care Systems ModelIn this system, the person is seen as an open system composed ofphysiologic, psychological, sociocultural and developmental variables thatneed to be in balance and harmony. Furthermore Johnson's system places emphasis on the equilibriumcreated by consistent behavior. The person is then seen as abiopsychosocial being, seeking equilibrium for its unified system. Furthermore seeingthe patient as a whole person instead of treating the problem onlyphysiologically will reduce the stress levels suffered by the patient. Pain andimmobilization for example are factors that cannot be controlled to a greatextent. When a patient is thus stimulated by factors other than the existingnegative environmental stimuli, Roy's model suggests that health will beeasier to attain, and that patients will be less likely to develop sleepingdisorders and other related problems. The nursing profession is traditionally one of caring for humanbeings. The organized wholecreated by repetitive, purposeful behavior results in a state ofequilibrium ("Johnson Behavioral System Model", 2002). The benefits of using these modelsare numerous. Theuse of models is beneficial in determining the root causes of illness andthe role of stress in such illness. According to Neuman then, a state ofequilibrium could be reintroduced by firstly reducing stressful stimuli andsecondly by encouraging naturally adaptive processes. The illnessas a disrupting force is merely one factor of the problem. As in the Neuman model, the purpose of nursing is to manipulatestimuli for the optimal benefit of the patient.
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