“Dr. Meleis’ Transitions Theory relates and discusses understanding the nature of and responses to change, facilitating and supporting the experience and responding to it at all different phases, and remaining or becoming before during or at the end, wherever the elusive ending point is, is what the theory is all about.” (Ley, P. (1988) Transitions include any and all transitions thruought the lifespan, whether it is a hospital admission, graduating nursing school, giving birth to a new child, any transition is considered. This theory provides as a guide for nurses to provide care at any time during this transition. The three paradigms that make up this theory are 1. Role theory 2. Lived Experience and 3. Feminist Postcolonialism. Role theory is the transitioning of role, switching roles or taking on a new role. An example is a new parent and having new responsibilites they are obligated to uphold. The lived experience is subjective, and related to how we view the transition happening and which phase is taking place at that time. Feminist Postcolonialism is a paradigm that questions power societies and relationships in institutions and that links societal and political oppressions that shape the response to change events. We must take into consideration culture, race, ethnicity, nationality and gender.
There can be several disadvantages for certain populations within our healthcare system. For example those who are not employed full time and or their employer does not provide medical benefits. This limits where they can seek care and can maximize what they will be charged. It is very common for people to put off their health issues until they become severe as they are financially unable to afford preventative care. This is the reason most people seek care at their nearest ER, when they are in serious condition. They may recieve a prescription and education before leaving the hospital, yet will not maintain due to lack of funds or seeking further education on their heath issues therefore becoming non compliant.
As Nurse Practitioners it is important that we educate all people within our communities about certain healthcare issues they are experiencing. Risks and long term effects are disclosed, not used as a scare tactic but to allow the magnitude of the illness to be known. It is also important to be familiar with resources such as free clinics, free diagnostic testing, discounted services or housing that may be needed depending on community needs.
Ley, P. (1988). Psychology and medicine series. Communicating with patients: Improving communication, satisfaction and compliance. New York, NY, US: Croom Helm.
Parker, M. E. (2015). Nursing theories and nursing practice. Philadelphia, PA.: F.A. Davis Company.
Lizandra Alvarez Hernandez
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In today’s complex health care systems patients continue to face many challenges regardless of the improvements being made in order to better care. Many laws and policies have been proposed and are being mandated that involve healthcare. Many resources continue to be allocated with the purpose to create better care flow in the United States. The majority of the population here in the US continues to not be able to afford care therefore not able to access preventive services that are vital for their well- being. Patients that do not have preventive health are most likely to end up hospitalized or at a more advanced stage of the illness. Also, most patients are not well educated or informed in most of their medications, making it harder for them to enjoy the full benefit of these medications. Instead, they are facing more troubles like drug overdose and irreversible side effects. Others continue to not be able to access medications needed for their diseases and for prevention. This creates great stress and problems in the American population. Language barriers is also a big issue that causes patients to not understand requirements of their disease process and also follow up. These challenges continue to affect Americans daily.
Nurse Practitioners are vital members of the health care system. What this means is that they are in charge of providing services that will facilitate changes for patients and communities. Before the transition, they can use research as a way to develop strategies and guides to help develop this transition of care. During the transition, they must apply practice to their care. It’s focusing on the particular population or individual and family in order to learn and continue facilitating care. Finally, Nurse Practitioners must continue to educate others and themselves in order to provide the best possible care.
Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington (DC): National Academies Press (US); 2011. 3, Transforming Practice. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209871/
Salmond, S. W., & Echevarria, M. (2017). Healthcare Transformation and Changing Roles for Nursing. Orthopedic nursing, 36(1), 12–25. doi:10.1097/NOR.0000000000000308
Gretell Alfonso Discussion 6
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The Transition theory by Dr. Meleis puts into words exactly how I felt as a nurse at the beginning of my transition from a student to the real world as a registered nurse. When I got my first job as a nurse, I had to adapt to many changes. For example, I had to adapt to responsibility changes and learn how to manage my time correctly. As registered nurses our role holds a huge responsibility which builds a lot of pressure specially when we start as new nurses. My personal transition to a registered nurse was not difficult but it wasn’t easy either. Knowing that I play an important role in my patients lives makes me want to achieve more and perform at my best potential, but also always keeping an open mind to improve every time. Therefore, as a registered nurse I completely relate to Dr. Meleis transition theory.
Dr. Meleis transition theory consists of the process we experience as nurses, patients and leaders. One of the many roles we play as nurses is being an advocate or the voice for our patients which I believe is one of the most important ones. However, the transition theory also talks about other roles we play as nurses which I have personally have felt to play such as a parenting role, patient role, and wellness role. I believe that as nurses we play one and each of these roles may times during our shift due to the variety of patients we see and their cases being different to one another. “Nurses model behavior, allow clients to rehearse their role, providing them with support while they are developing these roles”. (Smith, M. 2015. Pg. 362)
While studying the transition theory, I realized even more that as nurses we play an important role in many ways to our patients. We serve as advocates to not only make sure they get the correct care but also by making sure they are receiving the correct resources possible to assist them with their recovery. Many of the challenges that clients experience today in the health care system is to even receive health care service. There are many people out there that don’t have healthcare insurance which limits them to receiving the resources they need. Along with the same people, there is lots of them that are not educated well and are unfamiliar with how to take care of a certain situation, or how to manage their illness or disease process. I’ve been a witness of many patients encountering money issue problems when purchasing their maintenance medication such as for blood pressure. When I think of becoming a nurse practitioner many issues that I witness patients having today come to mind and the insurance issues is one of them. However, we have to understand that nothing is perfect and we should use our voice even more as nurse practitioners to assist our clients access their resources by knowing a list of pharmacies that will give blood pressure medication for free or for a less price then certain locations to be able to offer it to our clients. This will in return raise the compliance with medications being met and serve as a preventable method to strokes and other issues we deal with in America most of the time. I would also have a list or create my own program where patients could go to get educated about their disease process or illness for free which will also assist many patients to understand their lives more.
As a nurse I believe we have the power to make a difference in each patients lives we touch for the better, but as a nurse practitioner we can go a further step to not only assist our clients but also our community over all.
Smith, M. C., & Parker, M. E. (n.d.). Nursing Theories and Nursing Practice (4th ed.). Davis.
Transition to nursing practice: From student to registered nurse: Transition to nursing practice: From student to registered nurse. (2018). Learning Disability Practice (2014+), 21(6), 13. doi:http://dx.doi.org/10.7748/ldp.21.6.13.s15
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Rosie Jean Louis: Discussion 6
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The healthcare system has evolved to become more dynamic, owing to the complexity being experienced in the system. In the recent past, efforts the healthcare system have given much focus on preventive and promotional health strategies for quality improvement. Agreeably, nurses are the backbone of the healthcare system and have been in the forefront formulating policies and strategies that will see overall health status improved among individuals and communities (Douthit, Kiv, Dwolatzky & Biswas, 2015). However, with these tremendous improvements and advancements in the healthcare system, challenges still exist such as lack of access to preventive services, high health illiteracy on the management of diseases and illnesses as well as limited education on medication necessary for tertiary care. The modern-day healthcare has given much focus to preventive health services whereby health stakeholders come together to offer knowledge on preventive services such as immunization, vaccination, screening, and testing to prevent diseases. A majority of people are not aware of how to access these services or even establish who is eligible as some of them have eligibility criteria (Cherry & Jacob, 2016). Additionally, issues of access to preventive services are brought about by geographical location, and this prevents some people who may be residing far distances from the service provider (Douthit, Kiv, Dwolatzky & Biswas, 2015).
The transition can be described as changing or moving from one stage/ level/condition to another. It is a process that is quite complex and unique. Family nurse practitioners (FNP) have numerous roles that facilitate the process of transition. The family nurse practitioner is majorly tasked with family-focused care and engages patients on a long term basis to ensure they understand themselves, their illness and the specificity of care they require so that they can be able to undertake measures that are practical to facilitate better health outcomes (Penn Nursing, 2016). For instance, during childhood to adulthood transition, people experience certain changes that require one to understand these changes to undertake personal initiatives that are aimed at improving health status (Cherry & Jacob, 2016). The FNP also has a role in advocating for the communities, families, and patients they represent. This advocacy can be at the policy level to influence policy decisions that are going to favor the process of transition fully. Moreover, the FNP is tasked with education and training to empower the patient or communities through knowledge and information that will help them makes informed care choices (Penn Nursing, 2016). The FNP guides them as they instill health literacy skills to inform behavior and hence lead to better care outcomes.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public health, 129(6), 611-620.
Penn Nursing. (2016). The power of nurses – afaf meleis (English) [Video file]. Retrieved from http://videos.nursing.upenn.edu/index.php/panmcc-afaf-en/
Discussion # 6: Manuel M Cabrera
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One has to acknowledge the fact that patients have to deal with a series of challenges that limit their ability to receive high-quality care. For example, many individuals are not able to access appropriate services due to financial barriers. The transitions theory seeks to address some of these issues by recognizing preventive and therapeutic actions as vital elements of healthcare and supporting the establishment of equitable systems of healthcare delivery (Meleis, 2015, p. 363). Family nurse practitioners are expected to play the roles of change facilitators and protect the interests of the patients. Such prominent figures as Afaf Meleis have identified the connection between equality and health outcomes and her leadership in this area has influenced the deve1opment of nursing as a whole (American Academy of Nursing Policy Conference, 2015). Similarly, family nurse practitioners are provided with opportunities to identify the issues faced by vulnerable populations and attempt to address such problems by engaging in health policy-making. The lack of medication required for tertiary care also could be addressed via participation in the political process. It may be necessary to transition to leadership roles to influence the followers and alter their perspective on health issues. Cultural competence is of utmost importance because it helps to apply the knowledge effectively when treating and supporting individuals that represent different cultures (Penn Nursing, n.d.). Family nurse practitioners should play the roles of educators because vulnerable groups do not always have access to the information regarding disease management, and cultural competence helps to avoid communication issues. Patterns of response may differ from one patient to another, and family nurse practitioners have to determine whether it is appropriate to play the roles of resource persons, caregivers, or counselors depending on the situation. Overall, the framework developed by Meleis helps the nurses to manage transition experiences and address the challenges.
American Academy of Nursing Policy Conference. (2015, November 4). A living legend [Video file]. Retrieved from https://www.youtube.com/watch?v=ZJGdPgHPeGY
Meleis, A. I. (2015). Transitions theory. In M. C. Smith & M. E. Parker (Eds.), Nursing theories and nursing practice (4th ed.) (361-380). Philadelphia, PA: F. A. Davis Company.
Penn Nursing. (n.d.). The power of nurses – Afaf Meleis [Video file]. Retrieved from http://videos.nursing.upenn.edu/index.php/panmcc-afaf-en/
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Dr. Meleis’ transition theories have been nothing but phenomenal to the field of nursing. They have helped shed light on some of the many challenges patients are forced to go through in the current health care system which directly or indirectly impact their health (Meleis, & Sawyer, & Messias, & Schumacher, 2009). The system is composed of an array of decentralized sectors making it too complex hence in turn disadvantage the patients.
The system poorly accommodates the needs of patients. Many patients have chronic diseases and the system is lacking in programs competent to handle chronic illnesses adequately hence difficult for patients to obtain proper care (Plsek, & Greenhalgh, 2013). The system fails to address the increasing consumerism in patients. Due to the internet, patients have access to health information online hence want to participate in decision making concerning their care, but the system lacks a forum to understand, communicate and foster informed decision making for patients. The system is short for workforce and the current force is dissatisfaction filled. Shortages of nurses and their dissatisfaction limits the services patients get as well as access to quality care, inadequately meeting the patient needs.
A family nurse practitioner plays a huge role in the transition process. They ought to promote the well-being of the patient and his/her family by helping them conceptualize the change and possible consequences of this change via a series of support systems (Barnes, 2015). Also, they can avail to the patient, his/her family and the community at large strategies, skills, and knowledge of the transition, to allow them to competently deal with the entirety of the process. They may assist the patient understand the developmental, illness, health, situational and organizational changes with respect to the person, the society, and the family thus lessening the single or multiple transition phase for everyone involved.
Barnes, H. (2015, July). Nurse practitioner role transition: a concept analysis. In Nursing Forum (Vol. 50, No. 3, pp. 137-146).
Meleis, A. I., Sawyer, L. M., Im, E. O., Messias, D. K. H., & Schumacher, K. (2009). Experiencing transitions: an emerging middle-range theory. Advances in nursing science, 23(1), 12-28.
Plsek, P. E., & Greenhalgh, T. (2012). The challenge of complexity in health care. Bmj, 323(7313), 625-628.