Transcript Helen c. Erickson

HELEN C. ERICKSON
MODELING AND ROLE MODELING THEORY
PRESENTED BY:
Timothy Amborski
James Furstenau
Kim Karwowski
Kimberly Miller
Ferris State University Nursing 324
Nursing Theorist Group 7 Presentation
February 26, 2012
HELEN C. ERICKSON
HELEN C. ERICKSON
The University of Michigan
PhD, Educational Psychology
1976 – 1984
MS, 1974-76; BSN, 1972-74
Activities and Societies: Sigma Theta Tau, Rho Chapter
Saginaw General Hospital School of Nursing
Diploma in Nursing, Nursing
1954 – 1957
INTRODUCTION
Erickson's Modeling and Role Modeling Theory
The Modeling and Role Modeling Theory was
developed by Helen C. Erickson, Evelyn M. Tomlin,
and Mary Anne P. Swain. It was first published in 1983
in their book Modeling and Role Modeling: a Theory and
Paradigm for Nursing. The theory enables nurses to care
for and nurture each patient with an awareness of and
respect for the individual patient's uniqueness. This
exemplifies theory-based clinical practice that focuses
on the patient's needs(Helen C. Erickson, 2011).
HELEN C. ERICKSON
CREDENTIALS
Clinical Background
ER and Medical - Surgical Nursing
Director of Health Services; San German, Puerto Rico
Independent Psychiatric Nurse Consultant
Current Activities
Actively researching Modeling and Role-Modeling Theory
Professor Emeritus; University of Texas at Austin
Faculty Consultant for MRM; Various Schools of Nursing &
Service Agencies
Board of Directors; American Holistic Nurses Certification
Corporation (The Society for the Advancement of Modeling and
Role Modeling, 2011).
HISTORICAL BACKGROUND
Maslow's Theory of Human Needs was used to help label
and articulate Helen Erickson's observations the unmet basic
needs interfere with holistic growth whereas satisfied needs
promote growth.
The MRM Theory was written over several years.
Culmination of work published in the book, "Modeling and
Role-Modeling: A Theory and Paradigm for Nursing", in
1983 (The Society for the Advancement of Modeling and
Role Modeling, 2011).
INFLUENCE OF PHILOSOPHY
Helen Erickson credits Milton H. Erickson in
the formulation of Modeling and RoleModeling, when he told her to "Model the
client's world, understand it as they do, then
role-model the picture the client has drawn,
building a healthy world for them."(The Society
for the Advancement of Modeling and Role
Modeling, 2011).
INFLUENCE OF PHILOSOPHY
According to Sappington & Kelley:
The Theory of Modeling and Role-Modeling enables the nurse to
care for and nurture each client with an awareness of and respect
for the individuals uniqueness. This type of care giving
exemplifies theory-based clinical practice that focuses on the
clients needs. Care is offered that recognizes that clients have the
knowledge and the ability to understand what has made them
sick, as well as what will make them well (1996).
MODELING AND
ROLE-MODELING THEORY
MRM provides a paradigm and theory for
nursing. MRM is best depicted as a grand theory
encompassing numerous mid-range theories.
MRM has been applied in a variety of clinical
practice settings, educational programs, and
research (The Society for the Advancement of
Modeling and Role Modeling, 2011).
INFLUENCES ON THEORY
CREATION
The Modeling and Role Modeling Theory is unique to
nursing in its inclusion of the concepts from:
Maslow’s theory of hierarchy of needs
Erickson’s theory of psychosocial stages
Piaget’s theory of cognitive development
General Adaptation Syndrome (GAS) by Selye and
Lazarus
Retrieved from http://nursingplanet.com/theory/modeling_and_role-modeling_theory.html
THEORY PREMISE:
ALL PEOPLE HAVE
Commonalities






Holism
basic needs
affiliated-individuation
attachment and loss
psychosocial stages
cognitive stages
Differences





Inherent endowment
model of the world,
adaptation and its potential
stress
self-care and its knowledge,
resources, and action
GLOBAL CONCEPTS
Modeling:
 The nurse seeks to know and understand a patient’s unique model of their
world in order to appreciate its value and significance to the patient.
 The nurse uses the information to develop an image and understanding from
the patient’s perspective.
Role Modeling:
 The nurse’s role is to facilitate and nurture the individual in attaining,
maintaining, and promoting health.
 It accepts the patient unconditionally and allows for unique individual
interventions.
 According to this concept, the patient is the expert in their own care
and knows the best how they need to be helped.
CLIENT-FOCUSED
The theory enables the nurse to care for and
nurture each client with an awareness of and
respect for the individual’s uniqueness. It’s based
on the client’s needs. Clients have the ability and
knowledge to understand what has made them
sick. It empowers the patient to grow to heal.
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8708346
HOLISTIC NURSING
HOLISTIC NURSING
According to Erickson:
Holistic nurses believe that the human being, composed of a mind, body and
soul integrated into an inseparable whole that is greater than the sum of the
parts, is in constant interaction with the universe and all that it contains. Health
and well-being depend on attaining harmony in these relationships. Healing is
the journey toward holism. Using presence, intent, unconditional acceptance,
love, and compassion, holistic nurses can facilitate growth and healing and help
their clients to find meaning in their life experiences, life purpose, and reason for
being (2007).
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17544676
HOLISTIC VIEW
Encourage independence
Establish trusting patient/nurse relationship
Focus on the clients’ strengths
Establish goals focused on the clients’ view of
effective recovery
Provide patient opportunity to be involved
MODELING AND ROLE-MODELING
FOUNDATION OF CARE
The five goals of nursing intervention include:
1.
2.
3.
4.
5.
Promote client control
Build trust
Affirm and promote client’s strengths
Promote clients positive orientation
Set health directed goals
Retrieved from http://nursingplanet.com/theory/modeling_and_rolemodeling_theory.html
MODELING AND
ROLE MODELING THEORY
 It’s UNIVERSAL!
 Care focused on the client’s needs and can be used
in all area’s of nursing.
 It involves an “open/holistic view” and applies to all
aspects of nursing care.
WHY USE THIS THEORY?
Walsh, VandenBosch, and Boehm state, “this theory has drawn
together previously developed knowledge and added new ideas
and ways of looking at nursing. It describes the scientific bases
useful for our profession and our unique contribution to clients
via the art and science of nursing practice,” (1989).
“It is a complex theory because of the integration of several
theories and ways of looking at man. Although the theory
contains many levels of meaning, its basic concepts make sense,
and can be readily applied to nursing practice,” (Walsh,
VandenBosch, and Boehm, 1989).
DISADVANTAGES TO THEORY
USAGE
 Time consuming: when a nurse has multiple patients and
limited time, it may be difficult to fully implement MRM.
 Patients are coming into the hospital setting with several comorbidities and issues.
 A patient might be private in nature, thus not divulging all the
information needed to implement MRM.
 MRM works on the premise that each patient is knowledgeable
about their needs and their wants, which may not be the case.
NURSING CASE STUDY
Health History:
Mr. Smith is a 55 year old obese male who has been admitted to the
medical/surgical unit this morning, after presenting to the emergency department
last night. Mr. Smith’s wife found him lying on the floor and mildly confused,
when she came home from work yesterday evening.
Mr. Smith has been diagnosed with diabetes mellitus, after his blood test results at
the emergency department indicated his glucose level was 620 mg/dl. He has no
history of a diagnosis of diabetes, however, states that his father has been a
diabetic for the past twenty years.
Mr. Smith lives with his wife and has a son that lives nearby. His wife and son have
been at his bedside at the hospital. Mr. Smith and his wife state they have no
knowledge about diabetes, and are anxious about it, but are willing to learn. Mrs.
Smith reports that the patient has been having episodes of extreme thirst,
irritability, and sweats for the past month, but did not want to go to the doctor.
Mr. Smith’s health history also includes hypertension and hyperlipidemia.
NURSING CASE STUDY
Continued page 2
Diagnostic Measures:
At this time, his vital signs are as follows: B/P 128/72, Pulse 88, Respirations 18,
and Temp 97.2F. His oxygen saturation is 98% on room air. His blood glucose
level in the E.D. at 8 p.m. last night was 620 mg/dl. All other labs were within
normal limits. Mr. Smith denies any pain. He presented as confused and slightly
agitated in the E.D. but is now alert & oriented x 4, calm, and cooperative. His
heart sounds are a regular rate and rhythm without any murmurs. Lung sounds are
clear to auscultation. Bowel sounds are active in all four quadrants. No edema
present, and pedal pulses are palpable. He has a peripheral IV placed in the dorsal
left hand. His skin was cool and clammy in the E.D. but is now warm and dry. He
has a superficial abrasion on his right elbow, which he and his wife attribute to his
fall. Mucous membranes are pink but tacky.
NURSING CASE STUDY
Continued page 3
Diet:
Once Mr. Smith was admitted to the hospital, he was ordered to follow a
special diet, incorporating ADA guidelines. He and his wife state that they are
unfamiliar with carbohydrate counting, calorie counting, and diet terms, such
as “concentrated sweets”. It is also important for him to have adequate
hydration, because he is showing mild signs of dehydration.
NURSE CASE STUDY
Continued page 4
Drug Therapy:
Mr. Smith has been ordered to start a long-acting insulin to be taken at
bedtime, and a short-acting insulin as needed following a sliding scale. He is
also being started on an oral diabetic medication to be taken daily with his
breakfast. He is going to continue on his daily oral anti-hypertensive
medication and his daily bedtime cholesterol medication. Mr. Smith has been
ordered to monitor his blood sugar before each meal and at bedtime, and keep
a log of his results to report to his primary care physician. He has been
ordered to attend outpatient diabetes diet teaching classes to learn calorie
counting and carbohydrate counting upon discharge from the hospital.
NURSING CASE STUDY
Continued page 5
Nursing Care Plan:
Helen C. Erickson’s Modeling/Role Modeling theory emphasizes
facilitation, nurturing, and unconditional acceptance. She uses 5 goals
in her theory:
1. Build trust.
2. Promote patient’s positive orientation.
3. Promote patient’s control.
4. Affirm and promote patient’s strengths.
5. Set mutual, health-directed goals.
How can you utilize her theory to educate this newly diagnosed diabetic
patient and his wife on blood sugar monitoring and insulin use?
ANSWER KEY TO CASE STUDY
Please see separate attachment.
Thank you!
REFERENCES
Alligood, M. R. (2009). Nursing Theorists and Their Work. Maryland Heights, MO:
Mosby Elsevier.
Erickson, H. C., (2011). Retrieved from Nursing theory: http://nursingtheory.org/theories-and-models/erickson-modeling-and-role-modelingtheory.php
Erickson, H. (2007, June). Philosophy and theory of holism. Nurs Clin North
Am, 42 (2). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17544676
Modeling and Role Modeling Theory. (2012, January 28). Retrieved from
http://nursingplanet.com/theory/modeling_and_role-modeling_theory.html
REFERENCES
Nursing-theory.org (2011). Biography and Career of Helen C. Erickson. Retrieved
from http://nursing-theory.org/nursing-theorists/Helen-C-Erickson.php
Sappington, J., & Kelley, J. (1996, June). Modeling and Re-Modeling Theory. Journal
of Holistic Nursing, 130. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/8708346
The Society for the Advancement of Modeling and Role Modeling. (2011, February 14).
Retrieved from http://www.mrmnursingtheory.org
Walsh, K., Vandenbos, C., and Boehm, S. (1989). Modelling and role-modelling:
integrating nursing theory into practice. Journal of Advanced Nursing 14, 755.
Retrieved from
http://deepblue.lib.umich.edu/bitstream/2027.42/74308/1/j.13652648.1989.tb01640.x.pdf