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Copy of Paterson and Zderad

Florence Nightingale

Mary John Renong

on 7 August 2013

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Transcript of Copy of Paterson and Zderad

Nursing Theory

Josephine Paterson
& Loretta Zderad.
Josephine G. Paterson
Dr. Paterson majored in public health, completed doctorat of nursing science degree at Boston University – dissertation in comfort.
Loretta T. Zderad.
Dr. Zderad majored in psychiatric nursing, completed doctorate at George town University in philosophy with dissertation on empathy.
Paterson and Zderad met in the 1950’s while working at Catholic University, where their task was to create a new program that would include psychiatric and community health.

Friendship that has lasted over 35 years.
What is it all about?
Humanistic theory is based on idea that nursing is a relationship between a nurse and a patient who are human beings existing in the world.
Is a philosophical approach that can be used by nurses to examine and understand every day practice. By understanding existentialism, health is a process of finding meaning in life.
Man is an individual being necessarily related to other men in time and space.
Interdependence is inherent in the human situation, and human existence is coexistence.
Health is seen as a matter of personal survival, as quality of living and dying.
Nursing is a nurturing response of one person to another in time of need that aims toward the development of well-being and more being.
5 phases in Paterson and Zderad's study of nursing:
1. Preparation of the nurse knower for coming to know.
2. Nurse knowing the other intuitively.
3. Nurse knowing the other scientifically.
4. Nurse complimentarily synthesizing known others.
5. Succession with the nurse from the many to the paradoxical one.
1. Preparation of the nurse knower for coming to know.
• Self knowledge
Understanding own viewpoint helps to make sense and aid in acquiring meaning of experience.

No judgment, no personal opinion.
Just patient’s point of view and care.

• By identifying own views they can be withheld, so that they do not interfere with one’s attempts to describe the experiences of another.

• Openness
Being open to new and different ideas/ understandings is a necessary position in being able to get to know the other intuitively.
2. Nurse knowing the other intuitively.
3. Nurse knowing the other scientifically.
“This is the time when the nurse mulls over, analysis, sorts out, compares, contrasts, relates, interprets, gives names to and categories (Paterson & Zderad, 1976)”.
Combining knowledge, technology and desire to help.
Figure 2: Nurse knowing the other intuitively. Adapted by Kleiman from illustration in Briggs, J., & Peat, D. (1989). Nurse knowing the other intuitively. In Turbulent Times (p. 176). New York: Harper & Row
• Paterson and Zderad describe this as “moving back and forth between the impressions the nurse becomes aware of herself and the recollected real experience of the other” (Paterson & Zderad, 1976).
• Dialogue back and forth between patient and nurse allows for clearer understanding further generalisation in developing process.
Creating a new understanding of the patient avoiding expectations, labelling, and judgments.
Figure 2: Nurse knowing the other scientifically. Adapted by Kleiman From illustration in Briggs, J., & Peat, D. (1989). Nurse knowing the other intuitively. In Turbulent Times (p. 176). New York: Harper.
4. Nurse complimentarily synthesizing known others.
The "Call" snd "Response" in "coming know"
The ability of the nurse to develop or see themselves as a source of knowledge, to continually develop the nursing community through education, and increased understanding of their owned learned experiences.
Nurses use both personal experience and a rich theoretical foundation of education and practice.
Call and response relationship is one where the client (family or community) call for assistance and the nurses hear the call and respond with their knowledge, life experience, and skills to help care for patient.
5. Succession with the nurse from the many to the
paradoxical one.
• “Nurse comes up with a conception or abstraction that is inclusive of and beyond the multiplicities and contradictions (Paterson & Zderad, 1976)”

.• Process that allows for reflection, correction and expansion of own angular interpretation.

• Implies universal understanding from the simplest to most complex dialogue and interactions between the nurse and assimilates patient experiences.

• No member of this interaction or experience is the same as before.

• Coming together of patient and nurse.
Let us tell you a story of a good nurse.
One day she was assigned to care for Mrs. A,
an older patient who was 87,
Recipe of humanistic nurse.
You are intelligent!
The nurse thought she has nothing in common with old people, they hard to please.
They are slow and most of the time they can not understand you.
Got technical skills.
but there was a problem.
Have a nursing degree.
1. What are the contents of becoming a humanistic nurse?
2. If you will get older people as your clients , what do you think is important to “care” for them?
3. Do you think a client need to send a call through words or perhaps carry a S.O.S sign with them ?

I wanted a younger patient,
I have never been comfortable around
old fellows, how am I going to see them
undressed and help them with personal
care . No way!
Nurse cut patients food in to pieces
Nurse checked Patients vital signs
Fgure 1: Illustrate Call and Response, by Domino B. Puson, 2010, A Humanistic Nursing Approach. Retrived April 5, 2013 from http://dc218.4shared.com/doc/9vH9pECD/preview.html.
Help her in bath and in changing clothes
Nurse took the patient for a walk
They nurse came to know that the patient has had a stroke ,
now needs help with transfers and walks with a walker with supervision.
The nurse introduced her self and started her daily routine
Later on nurse said to herself that she will start to work out, so she won’t get old and has to move slowly, and will never have a stroke.
In the mean time patient asked
to see the nurse.
Figure 3: Nurse complementarity synthesising known others (Kleiman)
And said “You treated me like a child.
You do not know me, what I can do and
what my goals are. I live alone, drive a
car, volunteer at the Hospital for Sick
Children, and was a high school principal.
I sensed your disgust at my appearance.
Getting old is in your future. I am a Veteran
of World War II and I served this country.”
Nurse felt sad and overwhelmed. She
had meant to do your best. Seeing her
sad her nurse manager felt a call coming
from her and responded right away.
The nurse had a sudden insight, she realised how she
had biased views and personal thoughts on the client,
how she forgot her role as a care giver. But she said
she will start tomorrow with a client centered relationship.
she also realised that she has to start her day tomorrow
with lived dialogues. She also realised that she was in
a rush and ignoring call of the patient.
He reminded her about the humanistic theory.
Errors and improvement of nursing care:

1. Biased views and personal thoughts toward the client. It can be improved with a client centred relationship.

2. Use of incorrect bracketing view and not able to sense how the client feel. Not able to listen clients call. It can be improved by understanding clients verbal and non verbal communication. Need to understand them from their point of view.

3. Nurse was worried about how she feels assisting client with personal care. Here she needs to use the nursing knowledge which is learnt from the patient caring to extinguish the struggling her self.
Hmmm!! something is missing??
HEART <3 <3 <3
Paterson, J. & Zderad, L.T. (2008). Humanistic nursing. Project Gutenberg eBook. http://www.gutenberg.org/files/25020/25020-8.txt

Parker, Marilyn E. (2006). Introduction to nursing theory. Philadelphia : F.A. Davis, 2006.

Humanistic nursing theory. Retrived from http://www.scribd.com/doc/16070080/HUMANISTIC-NURSING-THEORY
Thank you!
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