course materials

1. Assignment: Effectively create a nursing care plan
Assignment: Effectively create a nursing care planAssignment: Effectively create a nursing
care planStudent’s Name Institution Relational Statements ? The theory allows nurses to
effectively create a nursing care plan that is easily adapted in the event complications arise
with a patient (Peplau et al. 2015). ? It integrates the mental health concepts into a basic
nursing curriculum. ? It also suggests that nurses validate their inferences with their
patients before drawing any conclusions (Gaudet & Howett, 2018). ? It further describes the
professional function of nursing as been to find and meet the patient’s immediate need for
help (Sampoornam, 2015). Concept Map References ? Peplau, H., Travelbee, J., & Orlando, I.
J. (2015). Nurse– Patient Relationship Theories. Nursing Theories and Nursing Practice, 67.
? Gaudet, C. A., & Howett, M. (2018). Applying the Theory of the Dynamic Nurse-Patient
Relationship to Develop Communication Skills for Nurses. ? Gaudet, C., & Howett, M. (2018).
Communication and Technology: Ida Orlando’s Theory Applied. Nursing science quarterly,
31(4), 369-373. ? Sampoornam, W. (2015). Nursing process and Orlando process discipline-
A case scenario. Asian Journal of Nursing Education and Research, 5(2), 212. J O U R N A L F
O R N U R S E S I N S T A F F D E V E L O P M E N T Volume 26, Number 1, 17–22 Copyright
A 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Advocates of a return to
theory-based practice .. believe that this will improve clinical outcomes and .. nurse
satisfaction. The research question of .. Concept Mapping for .. whether concept mapping is
an effective method .. of teaching nurses how to apply theory to their .. Applying Theory to
daily practice was tested during an action research .. project conducted at a community
hospital. .. Nursing Practice Registered nurses serving on a practice council .. .. were
presented a review of nursing theory and .. Parrie Veo, MEd, RN, NEA-BC given instruction
on concept mapping. Symbols .. representing theoretical application were added .. to the
usual concept map components of idea .. nodes and interconnecting relationship lines. .. ..
Participants developed concept maps of familiar .. nursing tasks and were able to apply the ..
theoretical symbols to those maps. Although the .. limitations of action research are evident
in this .. study, observations of the members of the small .. .. participant group and their
interview responses .. show a positive effect from the instructional .. intervention. The
researcher suggests that review .. of nursing theory and the use of concept mapping .. to
analyze its application should be considered .. .. …………………………………………. for staff nurse
development. N ursing theory is described as housing the base of knowledge that guides
nursing actions (Mitchell, 2002) and functions as a paradigm for the nurse (Parker, 2001a).
Advocates of a return to theory-based practice believe that this will improve nurse

2. satisfaction and clinical outcomes as the values that form the basis of nursing theory give
meaning to practice and influence care (Fawcett, 2003). However, staff nurses may believe
that theory is ‘‘for nursing educators to teach, not real nurses to use’’ (p. 215) rather than
applied in client-focused activity (Woodward, 2003). In 2005, a research project that
considered this dissonance was conducted at a community hospital in the rural Midwest.
Assignment: Effectively create a nursing care planORDER NOW FOR CUSTOMIZED,
PLAGIARISM-FREE PAPERSAn employee satisfaction survey at the facility showed nurses
with the lowest job satisfaction of all employee categories. In a serious effort to improve
nurse morale, the hospital’s senior nursing leadership initiated structural and outreach
activities to positively change the nursing culture. These activities included improving
nursing’s image in the hospital and …………………………………… Parrie Veo, MEd, RN, NEA-BC,
is Clinical Supervisor, PCRMC Medical Group, Rolla, Missouri. the community, increasing
education opportunities for nurses, and expanding councils that allow nurse participation in
administrative decision making. In the spirit of this cultural evaluation and change,
discussions took place regarding the use of nursing theory to inform and give meaning to
practice. Nurse preceptors said that staff nurses were often task driven and found it difficult
to explain how theory learned in school guided their daily work. The researcher, one of the
facility’s administrative directors, was interested in how nurses could be taught to apply
theory to their daily practice and chose to test the effectiveness of using concept mapping
for this purpose as a graduate project. The study falls under the category of action as a type
of qualitative research. Qualitative research is not experimental but descriptive in nature,
with little quantifiable data on which to base practice decisions. Action research is
undertaken to solve an identified problem in the workplace, usually by parties who have a
stake in such problem solving, and its limitation is the researcher as active participant (Gay
& Airasian, 2003). This active participation can have obvious and subtle influences both on
the process of the study (in interacting with the participants) and on the researcher’s
JOURNAL FOR NURSES IN STAFF DEVELOPMENT Copyright @ 2010 Lippincott Williams &
Wilkins. Unauthorized reproduction of this article is prohibited. 17 evaluation of the results
(in critiquing his or her own performance). CONCEPT MAPPING Concept maps represent
knowledge organized semantically in memory. They may be hand drawn or computer
designed and are composed of concept or idea nodes (points or boxes) connected by
relationship links (directional lines; Jonassen, 2000). Concept mapping is used as a logic
tool that engages learners in critical thinking (Ellermann, Kataoka-Yahiro, & Wong, 2006).
Instead of rote memorization of the subject’s content, the learner identifies important
concepts presented and develops the map as a way of understanding those concepts by
understanding their interrelationships ( Jonassen, 2000). Assignment: Effectively create a
nursing care planAs a method to connect new ideas to previous knowledge for meaningful
learning (Novak & Gowin, 1984), concept mapping is appropriate for the adult as a
competencybased learner who wants to apply newly acquired skills or knowledge to real
life situations (Knowles, Holton, & Swanson, 2005). In business settings, concept maps may
be used to clarify and refine existing processes or serve as job aids for performance-based
instruction (Brethower & Smalley, 1998). Nursing school instructors assign concept maps to
develop understanding of the interaction of multiple diseases (All & Havens, 1997;

3. Ellermann et al., 2006) and as nonlinear care plans that teach the student the nursing
process (Ellermann et al., 2006; Taylor & Wros, 2007). (The nursing process is the term for
circular problem solving, with standard components being assessment, planning,
implementing, and evaluating.) Concept maps developed by nursing students and scored by
faculty can be compared over time to determine the novice learner’s transition to expert
critical thinker (Abel & Freeze, 2006; Hinck et al., 2006) who uses the cognitive skills of
interpretation, analysis, evaluation, inference, explanation, and self-regulation (Ignatavicius,
2001). Concept maps designed by experienced nurses of familiar nursing tasks require
critical analysis of the nursing process and actions associated with those tasks (Johns,
2003). The researcher proposed that the application of nursing theory can be represented
on task maps. NURSING THEORIES In the planned course, key ideas of five nursing theories
were presented. The theories, arbitrarily chosen by the researcher as representative, were
the caring actualized theory of Nightingale—the patient has capacity for self-healing
facilitated by the nurse’s ability to create an environment conducive to health (Dunphy, 18
2001); the self-care deficit theory of Orem (2001)—the nurse provides compensatory care
while assisting clients to achieve competence in self-care for a goal of self-empowerment;
the adaptation theory of Roy—the nurse promotes patient adaptation in the physiological/
physical, self-concept/group identity, role function, and interdependence modes (Roy &
Zhan, 2001); the modeling and role-modeling theory of Erickson, Tomlin, and Swain
(1983)—the nurse develops an image and understanding of the client’s world (modeling)
and facilitates and nurtures the individual in attaining, maintaining, and/or promoting
health through purposeful interventions (role modeling); and the nursing as caring theory
of Boykin and Schoenhofer (2001)—all humans are caring persons, with the nurse coming
to know, acknowledge, affirm, support, and celebrate the other as a caring person. Choosing
a theory is not a simple task but a dynamic process requiring commitment by the nurse or
institution for ongoing analysis and evaluation of the effectiveness of theory (Parker,
2001b). However, for this study, the selection of a nursing theory was made by the
participants after brief review. Assignment: Effectively create a nursing care planThe group
chose the modeling and rolemodeling theory for the application to practice exercise.
Concept map symbols were developed for this theory’s aims of intervention, which include
building trust by understanding, promoting a positive orientation by nurturing self-esteem
and hope, promoting client control while affirming and promoting client strengths, and
setting mutual health-directed goals (Hertz, 1997). (The original project plan envisioned
each participant choosing his or her own theory for this exercise, but this was later modified
to make group review of each other’s maps more understandable. The researcher was
prepared to develop concept map symbols to represent any of the five theories presented
for selection.) PARTICIPANTS The hospital’s nurse practice council was approached to
participate in the project. The purpose of the council is to improve nursing practice by
review and evaluation of policies and procedures and to introduce new evidence-based
standards to the facility. Members of the council are staff nurse volunteers approved by
their directors. They must be registered nurses with acceptable job performance. At the
time of the project, all the members were associate degree prepared, but no other
demographic information, such as age or length of service, was obtained. A nurse preceptor

4. with a bachelor’s degree in nursing is the chairperson for all day meetings held monthly
with various agenda. The chairperson was very supportive of the project and encouraged
participation. The council members were given a very brief description of the project and
told January/February 2010 Copyright @ 2010 Lippincott Williams & Wilkins.
Unauthorized reproduction of this article is prohibited. that it would consist of 1 to 2 hours
of engagement each month for 4 months at the regularly scheduled council meetings. They
appeared hesitant, although the chairperson later reported that they were agreeable but
unsure of what the experience would be. Reassurance was given that participation was
optional, and informed consent was offered by the researcher. Assignment: Effectively
create a nursing care planThe consent form included acknowledgment that the participants
‘‘are expected and encouraged to give feedback regarding the applicability of the topic and
the method to their daily work experiences; such feedback will be respected and have no
influence on any participant’s employment and/or performance appraisal.’’ As the
chairperson was not a staff nurse, she was not considered a participant in the study,
although she was present for most of the encounters. Attendance at the council meetings is
valued and considered mandatory, but patient care takes precedence and may require
members to be absent on meeting day. There also is attrition, with replacements for
membership resignation and medical leave. During the project period, 4 to 8 members were
present at any given meeting. A total of 10 participants attended one or more of the four
sessions. Six of those received the core lessons on using concept mapping to apply theory to
practice. COURSE OF INSTRUCTION The researcher presented a course of instruction that
consisted of four monthly lessons each lasting 1 to 2 hours and with the following content
(see Table 1). Lesson 1 consisted of an overview of nursing theory, key ideas from five
nursing theories, and discussion on choosing a theory. An important component of the
project introduction was to establish theory as a philosophy or paradigm for practice.
Lesson 2 provided a review of the first lesson, group selection of a nursing theory for the
application to practice exercise, an overview of concept mapping with samples shown, and
the computer-aided development of a concept map for the common task of making dinner.
In that map, the person performing the task of making dinner represents the nurse in this
lesson, with the family members receiving the dinner representing the client. Optional
homework was assigned to develop a handor computer-drawn concept map of a familiar
nursing task. It was acknowledged that no two maps, even of the same task, would be alike.
Map-making rules were established that included colored shapes for the steps of the
nursing process and function labels for the interconnecting relationship lines (see Table 2).
Lesson 3 consisted of a review of the first two lessons, demonstration of theory application
by adding theoretical symbols to the dinner map and development of individual concept
maps of familiar nursing tasks. TABLE 1 Concept Mapping for Applying Assignment:
Effectively create a nursing care planTheory to Practice Course of Instruction for Four
Monthly Lessons ……………………………………… Lesson 1: review of nursing theory Overview of
nursing theory Key ideas of five nursing theories Discussion on choosing a theory Lesson 2:
concept mapping Group selection of a theory for the application to practice exercise
Overview of concept mapping with samples Development of sample concept map Lesson 3:
applying theory to practice Demonstration of theory application by adding theoretical

5. symbols to the sample concept map Concept map development of familiar nursing tasks,
with theoretical symbols added Lesson 4: course review Inserted onto the relationship lines
on the dinner map were symbols (U, S, C, and M) for key ideas in locations where those
ideas would influence the concepts of the task. The symbols represented the modeling and
rolemodeling theory’s aims of intervention: understanding/ trust, self-esteem/hope, client
control/strengths, and mutual goals (see Figure 1). Two concept maps done as homework
were reviewed. The other participants were instructed to make individual hand-drawn
concept maps of familiar nursing tasks. All were to insert the theoretical symbols where
appropriate and then present their maps to the group. Lesson 4 was a review of the course
content. EVALUATION This action project resulted in limited measurable data, which
consists of preintervention and postintervention opinion surveys. However, because of the
disparate sample sizes, those results are provided only to show the study content, not as
valid evidence. The researcher’s observations and the postintervention interviews are used
for evaluation and to support the conclusions from the study. Opinion Survey A five-item
survey was designed to measure participants’ opinion and understanding of nursing theory,
the nursing process, applying theory to practice, and theory giving meaning to practice.
Results could show JOURNAL FOR NURSES IN STAFF DEVELOPMENT Copyright @ 2010
Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 19
FIGURE 1 Sample concept map of the common task of making dinner. Theoretical
application is indicated by symbols (U, S, C, and M) representing the modeling and role-
modeling theory’s aims of intervention. whether or not gains were made because of the
instructional intervention. The survey tool used a Likert scale (strongly disagree, disagree,
undecided, agree, and strongly agree) and to support anonymity did not have an identifier
such as name. Nine of the 10 participants completed the preintervention opinion survey as
they entered the project at the first or second sessions. Five of the 6 participants who
received the core lessons on using concept mapping to apply theory to practice completed
the postintervention survey. The postintervention survey form had a comment section
added. Only one survey had comments: ‘Assignment: Effectively create a nursing care plan‘I
enjoyed the presentations. I did gain some knowledge and it will be helpful in my daily
tasks.’’ The unmatched sample sizes reflect the inconsistent participation, and so no
conclusions will be made from the survey point compar20 isons (see Table 3). Although
associate degree programs may have limited focus on nursing theory in their curricula, the
respondents to the survey answered that they were familiar with one or more nursing
theories. However, none of the participants claimed a particular theoretical paradigm.
Observation The researcher initially sensed participants’ wariness, as evidenced by cool
demeanor and few comments. This perception changed as council members later expressed
interest in the topic. As homework and during the third meeting, six participants developed
concept maps for the tasks of administering medication, transfusing blood, administering an
intravenous infusion, performing a quality January/February 2010 Copyright @ 2010
Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
TABLE 2 Concept Map-Making Rules ……………………………………… Node colors and shapes
Assess = pink circle Plan = blue square Implement = orange rectangle Evaluate = green
diamond Special influence = white rounded square Knowledge base = white rectangle

6. Theory application U = understanding/trust S = self-esteem/hope C = client
control/strengths M = mutual goals Connecting lines Unidirectional or bidirectional arrows
Line labels Addressed by Assists Determines Evidenced by Influences Orders Relates to
Results in assurance review of a medical record, preparing time records for payroll, and
inserting a urinary catheter. One of the maps done at home had been drawn with computer-
aided design software. Those who did not work in direct patient care realized that they used
the TABLE 3 nursing process in their daily tasks. The participants took turns presenting
their maps, some of which included the theoretical symbols, to the group. Prompted by the
researcher and with suggestions from the other participants, all were able to indicate where
theory could be applied within the concept relationships of their maps. Interview The
interview questions were designed to be congruent with the course content. The six
participants who received the core lessons of using concept mapping to apply theory to
practice completed the interview. On being asked what was the most interesting part of the
course, responses were ‘‘choosing a theory,’’ ‘‘applying theory to practice’’ (the most
frequent response), ‘‘putting on paper what you are thinking,’’ and ‘‘the realization that
(the) nursing (process) applies to many fields of nursing, not just direct nursing care.’’ All
agreed that concept mapping is a good way of showing the nursing process, but comments
were made that this method is lengthy and very involved with detail. All also agreed that
inserting theory into a concept map makes applying theory to practice more
understandable, with the comment that this would be especially helpful for a new nurse.
There was unanimous agreement that this conscious application of theory to practice was
meaningful, with one ‘‘somewhat’’ response and one statement that what was meaningful
was the realization of how much goes into performing a task. There was near-unanimous
agreement that staff nurses would benefit Assignment: Effectively create a nursing care
plan