Impact Of Nursing Models In A Professional Setting Essay - 2,747 words

IMPACT OF NURSING MODELS IN A PROFESSIONAL SETTING INTRODUCTION People of all ages and life circumstances are bringing to nurses increased numbers of complaints about being depressed. Nursing practitioners in diverse settings are well aware of this increase. The growing incidence of depression is often attributed to factors in contemporary society such as depersonalization, loss of the capacity to trust, interpersonal destructiveness in transitory but intense relationships, and a loss of control over ones destiny. This paper shall look into the aspects of depression among children, especially adolescents, as well as approaches and benefits and implications of the issue using three nursing models. It would seem that candidates for depressive episodes are people who have reached their unique tolerance level for managing events that threaten their self-esteem and their need for emotional support. Some individuals are predisposed to depressive reactions because of early childhood frustrations. The childs response to frustration forms a prototype response pattern used when later frustrations and threats to dependency needs and self-esteem occur (Laughlin, 1967).


Beck (1967) reviewed evidence that suggests a genetic predisposition to depression, but concluded that available research data does not establish conclusively whether affective disorders are genetic, environmental, both or neither (p. 132). At present, there does not appear to be any evidence on which the practitioner can rely that identifies factors such as social class, nationality, race, ethnic group, and personality typologies as predispositional in the development of depression. Candidates for depression may be defined as those people who, because of past learning, character traits or psychodynamic reasons, will find it difficult to manage one of the following common precipitants of depression: perceived threat to self-worth; actual, assumed or predicted loss of a love object or person; fear or failure after achieving success. THE EXPERIENCE OF DEPRESSION Depressions seem to run a particular, but general, course from onset to termination. Most depressions seen in counseling are reactive, i.e., they are triggered by identifiable external events of loss, threat, or disappointment. Depressions may have acute onsets, although some seem to develop gradually until the person cant take it anymore. Acute onsets usually bring about dramatic behavior changes which are of concern to the client and to those in his or her environment. Depressions tend to get worse before they get better. The client is increasingly negative, pessimistic and helpless in outlook.


There is an understandable wish to escape from the discomfort of the depression. The depressed client feels worn-out and complains of vague aches and pains. As experience and research accumulate, providing a base for theoretical formulation, a coherent body of knowledge emerges. Theory at its best links explanation to method. This understanding is, of itself, a useful part of any treatment or educational program. When methods are tied to a rationale, improved understanding of either component will usually effect a corresponding improvement of the other, thus providing for continued growth and effectiveness of the procedure. Psychoanalytic theory and practice today (e.g.


Blanck and Blanck, 1974) is far different from Freuds original formulations due to the continuous work of his followers in modifying both theory and technique with the knowledge derived from additional experience. The primary task of the theory-based approach lies in a tendency to overvalue the accuracy and effectiveness of the approach. Followers act as though the theory was a fact instead of an evolving set of beliefs. Another risk is that proponents of one theory may try to fit everyone into that model, failing to acknowledge its limits of application. Client-centered counseling is of proven utility with many verbal college students, but can be harmfully misapplied to crisis intervention. A situation calling for concrete action may deteriorate further if the counselor insists on gradual exploration.


At the heart of case-based intervention is evaluation on an individual basis. Each person or situation is considered unto itself. The helping person brings to the assessment/intervention process all the theoretical and technical ability that can be mustered toward an understanding of how to assist the client. The parameters of that assessment usually include the following features: (Sayre, Joan. 2000). Severity of the anxiety Mild to moderate.


The clients functioning is impaired but not immobilized by the anxiety. Alice gets restless and nervous every morning on her way to work. The crowds on the train bother her. Coming home is not quite as bad. Phobic. The clients functioning is virtually paralyzed in a specific area of everyday life.


Every time Jack enters an elevator, he begins to sweat. He gets dizzy and nauseous and feels like he will pass out unless he gets off the elevator. Panic. The client verges on terror, often with no specific cause. No distractions or reassurance are helpful. Sue feels like shes losing her mind.


She cant think or concentrate. She keeps having this terrible feeling she can barely describe. Source of anxiety Historic. The anxiety may be of recent origin or of long standing. Jim reports, Ive had this nervous stomach for as long as I can remember. Precipitant. Anxiety attacks are triggered by an event or person(s) in the clients life.


Ive been like this ever since my marriage broke up. Kind of Anxiety Focal. Anxiety is evoked at particular times, by particular conflicts or conditions, conscious or unconscious. I dont know why, but it happens every time Hal comes by. Diffuse. Anxiety is ever present, widely experienced, unrelated to time, place or person.


That uneasy feeling is always there. I cant get rid of it. Nature of the anxiety Situational. The most common cause of anxiety is a situation which is perceived as threatening, whether or not the danger is objectively real. Alex gets sweaty palms and rapid heartbeat whenever someone asks him for a favor. Developmental. Moving from one developmental period to another requires a change and adjustment that is often stressful.


The person may be too well-rooted in the present stage and unwilling to change (e.g. the campus hero who is about to graduate). The impending life stage contains threatening elements (e.g. acknowledging that one is no longer youthful). Unresolved earlier issues conflict with developmental demands (e.g. repressed anger at mother inhibits relating to female peers). Need frustration or deprivation. The pressure to satisfy blocked or unfulfilled needs creates anxiety.


Linda gets severe headaches whenever she tries to diet. Incremental. Oftentimes a variety of smaller stresses accumulate, erode the persons coping resources, and precipitate an anxiety attack, My wife is pregnant, my father just had a heart attack, business is bad, I cant take much more of this (client begins to cry). Traumatic. A sudden or unexpected emotional shock will almost invariably elicit manifestations of anxiety and mental illness, often severe reactions, Oh, my God. (shouting, thrashing arms about) Help me! Hes dead! In the course of looking at the theories behind this issue, it is important to analyze this concern using nursing models conceptual models. This paper shall examine three nursing models. MYRA LEVINES CONSERVATION MODEL One of this is Myra Levines Conservation Model. This model stipulates that individuals are holistic beings and which happens to be the major concern for nurses in the maintenance of a persons wholeness. (Polit & Henderson p. 10).


Indeed, mental illness can assume many forms and many levels of severity, even though, in addition, anxiety can sometimes be inferred from its apparent absence. Certain situations are of sufficient threat value to justify an expectation of anxiety arousal. When the person acknowledges no awareness or overt sign of anxiety, a nursing practitioner will look for indications that a defense mechanism has been invoked to dispel the perceived threat. Since mental illness is such a potentially disruptive experience, the nursing practitioner must be sensitive to any clues which indicate that the client is unable to deal effectively with the experience. More specifically, does the anxiety cause personal fragmentation or activate rigid defense mechanisms? Or, is the person able to utilize coping mechanisms to resolve the conditions giving rise to anxiety? Intervention then can be thought of as a procedure utilized by a nurse to assist a client in more effective management of anxiety. Intervention strategy is the selective use of intervention modalities, based on an assessment of the individ ...................................................................................................................................................................................................................................................................................................................................................................

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Essay Tags: mental illness, client, anxiety, defense mechanism, human mind

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