Title: N3006 Nursing Metaparadigm Nurses
1N3006Nursing MetaparadigmNurses Environment
2Objectives
- Identify the interrelationship between
environment human health - Explore the roles of nurses in environmental
health - Examine social justice issues of environmental
exposures
3No amount of medical knowledge will lessen the
accountability for nurses to do what nurses do,
that is, manage the environment to promote
positive life processes.
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5Metaparadigm
The most global perspective of a discipline and
acts as an encapsulating unit or framework,
within which the more restricted structures
develop. Eckberg and Hill, 1979, p.927
6Metaparadigm
Each discipline singles out phenomenon with which
it will deal in a unique way that distinguishes
it from other disciplines.
7Metaparadigm of Nursing
- Person
- Environment
- Health
- Nursing
8Metaparadigm of Nursing
Person
Environment
Health
Nursing
9- N3006
- Nursing Metaparadigm
- Relationship of the Environment to Health
10 WHO
- Poor environmental quality is directly
responsible for 25 of all preventable ill health.
11Human Biology
Health Status
Life-Style
Environ- ment
Healthcare System
12EPA Fish Advisories
- Fresh water or ocean fish contain more than the
maximum amount of mercury allowed. - By the end of 1996, there were 2,200 fish
advisories in 47 states.
13CDC Top Ten for 21st Century
- (2) Eliminate health disparities
- (3) Focus on children's development
- (4) Achieve a longer "healthspan"
- (5) Integrate physical activity healthy
eating into daily lives
14CDC Top Ten
- (6) Cleanup and protect the environment
- (7) Prepare to respond to emerging infectious
diseases - (10) Use new scientific knowledge and
technologies wisely
15Vulnerability of Children
- Permanent damage possible
- Metabolic and physiological processes
- Diet differs- qualitatively quantitatively
- Normal exploratory behavior
- Cumulatively exposed to more in their life
- No political voice
16Human Biology
Health Status
Environ- ment
Life-Style
Reference Dever, G.E.A (1991), Community health
analysis A global awareness of the local level
(Second Edition), Maryland Aspen
Healthcare System
17Human biological factors
- genetics
- physiological function
- maturation
18Health care delivery system
- availability
- accessibility
- adequacy
19Lifestyle includes
- employment
- consumption patterns
- leisure activities (with the associated risks)
20Environmental Component
- physical
- psychological
- social environment
21Environment
Socio-cultural
Biological
Physical
Politico-economic
22Metaparadigm of Nursing
Person
Environment
Health
Nursing
Physical
Biological
Politico-Economic
Social-Cultural
23Roles of CH Nurse
- Clinician
- Educator
- Advocate
- Manager
- Collaborator
- Leader
- Researcher
24Community Health Nursing
-
- Emphasis on health of populations
- Address personal environmental aspects of health
25Community Health Nursing
- Deal with community factors that inhibit or
facilitate healthy living - Interventions Levels of prevention
- Identifying at risk groups
26Levels of Prevention
- Primary
- Secondary
- Tertiary
27Natural History of Disease
The description of the events which precede its
development and occur during its course as well
as its outcomes.
28Stages in the Natural History of a Condition
Exposure to agent
Symptom development
Pre-exposure Stage
Pre-clinical Stage
Clinical Stage
Resolution Stage
29Stages in the Natural History of a Condition
Pre-exposure Stage Factors present leading to
problem development
Pre-clinical Stage Exposure to causative agent
no symptoms present
Clinical Stage Symptoms present
Resolution Stage Problem resolved. Return to
health or chronic state or death.
30Stages in the Natural Hx of a Condition Their
Relationships to Levels of Prevention
Pre-exposure Stage Factors present leading to
problem development
Pre-clinical Stage Exposure to causative agent
no symptoms present
Clinical Stage Symptoms present
Resolution Stage Problem resolved. Return to
health or chronic state or death.
Primary prevention
Secondary prevention
Tertiary prevention
31- Protection
- of the environment
- is the most
- fundamental form
- of
- primary prevention
32Precautionary Principle
- When an activity raises threats of harm to human
health or the environment precautionary measures
should be taken even if some cause and effect
relationships are not fully established
scientifically.
33Nurses Environmental Health
- How will our profession change in an age of
environmental crisis?
34Nurses as Environmental Stewards
- Trusted health professionals
- Knowledge workers
- Values/passion
- Privileged intimacy
- 2.7 million nurses
- Nurses are everywhere
- Guide to the community
35IOM Recommendations
- Basic Knowledge Concepts
- Assessment Referral
- Advocacy
- Ethics
- Risk Communication
- Legislation and Regulation
36The Challenges of Connecting to Nurses A
S.W.O.T. Analysis
37Strengths
- Continuous learners
- Advocates for patients
- Team players ideal partners
- Skilled communicators
- Value competency/ quality care
- Holism
38Weaknesses
- Unaware of significance of environment-health
connection - Untapped role in health promotion
- Lack role models in practice
39Weaknesses
- Lack skills to advocate for populations
- Assume environment is responsibility of public
health nurses - Don't know they need to know
40Threats
- Continue to select non-environmental CE
activities - HCDS focus-episodic care to acute and chronically
ill
41Threats
- Increasing environmental threats to health
- Nursing shortage
- Missed diagnoses
- Missed opportunities
- Reimbursement
42Opportunities
- Unanswered patient questions
- Vulnerable populations
- Environmental concerns in own community
- Unexpected national events
43- The lived experience of the Akwasasne people
44Simple truths in an ecosystem
- We all live downstream
- Humans cannot outlast the ecosystems they
depend upon - We cannot maintain healthy humans on a sick
planet
45Scientific evidence
- Scientific evidence will only increase the
accountability for nurses to protect the
environment to promote positive life processes.
46Nursing is a progressive art in which to stand
still is to go back. Florence Nightingale