 Imogene King

- Considers watching her nursing students become successful practitioners, teachers and
researchers her greatest accomplishment.
- named as the “Living Legend” by American Academy of Nursing; inducted in the Hall of Fame of
Florida Nursing Association

Interacting Systems Framework and Theory of Goal Attainment

Dynamic Interacting System Framework - Represents personal, interpersonal and social system as the
domain of nursing. The unit of analysis in the framework is human behavior in a variety of social
environments.
King’s model of transactions
Goal Attainment Theory
ACTION - activities that are towards the accomplishment of certain act.
REACTION - is a from of reacting or a response to a certain stimuli
INTERACTION - is any situation wherein the nurse relates and deals with a patient or clientele
OPEN SYSTEM - is the absence of boundary existence

Proposition of King’s Theory

If perceptual accuracy (PA) is present in nurse-patient interactions (I), transaction (T) will occur.
PA (I) T
If nurse and client make transactions (T), goals will be attained (GA).
T GA
If goals are attained (GA), satisfaction (S) will occur.
GA S
If goals are attained (GA), effective nursing care (NCe) will occur
GA NCe
If transactions (T) are made in nurse-client interactions (I), growth and development (GD) will be
enhanced.
(I)T GD
If role expectations and role performance as perceived by nurse and client are congruent (RCN),
transaction will occur.
RCN T
If role conflict (RC) is experienced by nurse and client or both, stress (ST) in nurse-client interactions (I)
will occur.
RC (I) ST
If nurses with special knowledge and skills communicate (CM) appropriate information to clients, mutual
goal setting (T) and goal attainment (GA) will occur. [mutual goal setting is a step in transaction and thus
has been diagrammed as transaction]
CM T GA
Metaparadigm
Person - Individuals are open systems in transaction with the environment.
Health - Health implies continuous adjustment to stress in the internal and external environment through
optimum use of one’s resource to achieve maximum potential for daily living.
Environment - Understanding of the ways that human beings interact with their environment to maintain
health is essential for nurses.
Nursing - Nursing is an interpersonal process of action, reaction, interaction, and transaction.
 Hildegard Peplau

Psychodynamic Nursing, Interpersonal Relations in Nursing

Interpersonal Relations in Nursing
The nurse-patient relationship is a four-phase phenomenon. One can view them as separate entities, but
they could overlap with each other over the course of the nurse-patient interaction.
Nurse-Patient Relationship
 Orientation - The individual has a felt need and seeks professional assistance.
 Identification - The patient identifies with those who can help him (relatedness).
 Exploitation - The patient attempts to derive full value from what he is offered through the
relationship.
 Resolution - The patient gradually puts aside old goals and adopts new goals.

Nursing Roles
 Role of the Stranger
 Role of a Resource Person
 Teaching Role
 Leadership Role
 Surrogate Role
 Counselling Role

Metaparadigm
Person - Man is an organism that lives in an unstable equilibrium.
Health - A word symbol that implies forward movement of personality
Environment - Existing forces outside the organism
Nursing - A significant, therapeutic, interpersonal process.

 Ida Jean Orlando

 Nursing Process Theory

Nursing Process Theory - Orlando describes her model as revolving around five major interrelated
concepts:
 The function of professional nursing
 The presenting behavior of the patient
 The immediate or internal response of the nurse
 The nursing process discipline
 Improvement

Nursing Process Theory

Nurse's Responsibility - Consists of "whatever help the patient may require for his needs to be met.
Need - Situationally defined as a requirement of the patient which, if supplied, relieves or diminishes his
immediate distressor and improves his immediate sense of adequacy or well-being"
Presenting Behavior of Patient - Any observable verbal or nonverbal behavior.
Immediate Reactions - Includes the nurse and patient's individual perceptions, thoughts, and feelings.
Nursing Process Discipline - Includes the nurse communicating to the patient his or her own immediate
reaction, clearly identifying that the item expressed belongs to the nurse, and then asking for validation or
correction.
Improvement - Means to grow better, to turn to profit, to use to advantage.
Purpose of nursing - To supply the help a patient requires in order for his needs to be met.
Automatic nursing action - Those nursing actions decided upon for reasons other than the patient’s
immediate need.
Deliberative nursing action - Those actions decided upon after ascertaining a need and then meeting
this need.
Metaparadigm
Person - Assumes that people are sometimes able to meet their own needs for help is some situation;
however, they become distressed when they are unable to do so.
Health - Assumes that freedom from mental and physical discomfort and feelings of adequacy and well
being contribute to health
Environment - Assumes that a nursing situation occurs when there is a nurse-patient contact and that
both nurse and patient perceive, think, feel, and act in the immediate situation
Nursing - She states that the function of professional nursing is conceptualized as finding out and meeting
the patient’s immediate need for help.

 Joyce Travelbee
Human-to-Human Relationship Model

Human-to-Human Relationship
Her theory was greatly influenced by her experiences in nursing education and practice in Catholic charity
institutions. Concluded that nursing care rendered to patients lacked COMPASSION. Thought that
nursing care needed a “humanistic revolution”

Human-to-Human Relationship
Interactional Phases
 ORIGINAL ENCOUNTER - This is described as the first impression by the nurse of the ill person
and by the ill person of the nurse.
 EMERGING IDENTITIES - This phase is characterized by the nurse and patient perceiving each
other as unique individuals.
 EMPATHY - This phase is characterized by the ability to share in the other person’s experience.
 SYMPATHY - Goes beyond empathy; Occurs when the nurse desires to alleviate the cause of the
patient’s illness or suffering.
 RAPPORT - The nurse and the ill person are relating as human being to human being.

Metaparadigm
Person - A human being is a unique, irreplaceable individual who is in continuous process of becoming,
evolving and changing
Health - It is measured by subjective and objective health
Environment (not defined)
She defined human conditions and life experiences encountered by all men as sufferings, hope, pain and
illness.
Nursing - An interpersonal process whereby the professional nurse practitioner assists an individual,
family, or community to prevent or cope with the experience of illness and suffering and, if necessary to
find meaning in these experiences.
GOAL OF NURSING - To assist an individual or family to prevent or cope with illness, regain health, find
meaning in illness or to maintain the highest maximal degree of health.
FRAMEWORK - Interpersonal process is viewed as a human-to-human relationship formed during illness
and the “experience of suffering”.

 Madelline Leininger
Culture Care: Diversity and Universality Theory
-Focuses on describing, explaining and predicting nursing similarities and differences focused primarily on
human care and caring in human cultures.
- Human beings are believed to be caring and to be capable of being concerned about the needs, well-
being, and survival of others
-The theory does not focus on medical symptoms, disease entities or treatments.
-It is instead focused on those methods of approach to care that means something to the people to whom
the care is given.
1. Care (Noun) -Abstract and concrete phenomena related to assisting, or enabling experiences or
behaviors toward or for others with evident or anticipated needs to ameliorate a human condition or
lifeway.
2. Caring (Gerund) -Actions and activities directed towards assisting, supporting, or enabling other
individuals or group with evident or anticipated needs to ameliorate a human condition or lifeway, or to
face death.
3. Culture-The learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group
that guides their thinking, decisions, and actions in patterned ways.
4. Culture Care -The subjectivity and objectivity learned and transmitted values , beliefs, norms, and
lifeways that assist, support, facilitate, or enable other individual or group to maintain their well being and
health, to maintain their human condition and lifeway, or to deal with illness, handicaps or death.
5. Cultural Care Diversity -The variabilities and/or differences in meanings, patterns, values, lifeways, or
symbols of care within or between collectivities that are related to assistive, supportive, or enabling
human care expressions.
6. Cultural Care Universality -The common, similar or dominant uniform care meanings, patterns,
values, lifeways, or symbols that are manifest among many cultures and reflect assistive, supportive,
facilitative, or enabling ways to help people.
7. Nursing -The learned humanistic and scientific profession and discipline that is focused on human
care phenomena and activities to assist, support, facilitate, or enable other individual or group to maintain
their well being in culturally meaningful and beneficial ways, or to help people face handicaps or death.
8. Worldview -The way people tend to look out on the world or their universe to form a picture or value
stance about their life or world around them
9. Cultural and Social Structure Dimensions --The dynamic patterns and features of interrelated
structural organizational factors of particular culture, which includes religious, kinship, political, economic,
educational, technological, and cultural values and ethnohistorical factors, and how these factors may be
interrelated and function to influence human behavior in different environmental contexts.
10. Environmental Contexts --The totality of an event, situation, or particular experience that gives
meaning to human expressions, interpretations, and social interactions, particularly physical, ecological,
sociopolitical, and/or cultural settings.
11. Ethnohistory -Those past facts, events, instances, and experiences of individuals, groups, cultures,
and institutions that are primarily people centered and that describe, explain, and interpret human
lifeways within particular cultural contexts and over short or long periods.
12. Generic (Folk or Lay) Care System -Culturally learned and transmitted, indigenous, folk knowledge
and skills used to provide assistive, supportive, enabling, or facilitative toward or for another individual,
group, or institution with evident or anticipated needs to ameliorate a human lifeway or health condition, or
to deal with handicaps and death situations.
13. Professional Care System -Formally taught, learned, and transmitted professional care, health,
illness, wellness, and related knowledge and practice skills that prevail in professional institutions usually
with multidisciplinary personnel to serve consumers.
14. Health -The state of well being that is culturally defined, valued, and practiced, and reflects the ability
of the individuals to perform their daily role activities in culturally expressed, beneficial, and patterned
lifeways.
15. Cultural Care Preservation or Maintenance -Those assistive, facilitative, or enabling professional
actions and decisions that help people of a particular culture to retain and/or preserve relevant care
values so that they can maintain their well being, recover from illness, or face handicaps, and/or death.
16. Cultural Care Accommodation or Negotiation -Those assistive, facilitative, or enabling professional
actions and decisions that help people of a designated culture to adapt to, or negotiate with, others for
beneficial or satisfying health outcome with professional health care providers.
17. Cultural Care Repatterning or Restructuring -Those assistive, facilitative, or enabling professional
actions and decisions that help clients reorder, change, or greatly modify their lifeways for new, different,
and beneficial healthcare patterns while respecting the clients cultural values and beliefs still providing a
beneficial or healthier lifeway than before the changes were coestablished with the clients.
18. Cultural Congruent (Nursing) Care -Those cognitively assistive, supportive, facilitative, or enabling
acts or decisions that are tailor made to fit with individual, group, or institutional cultural values, beliefs,
and lifeways to provide or support meaningful, beneficial, and satisfying healthcare or well-being services.
Sunrise Model
The Sunrise Model symbolizes the rising of the sun. The upper half of the circle depicts components of
the cultural & social structure and worldview factors that influence care and health through language,
ethnohistory, and environmental context.
Metaparadigm
Person - Refers to families, groups, and communities.
Health - Refers to the state of well being that is culturally defined, valued, and practiced.
Environment - Included events with meanings and interpretations given to them in particular physical,
ecological, sociopolitical or cultural setting.
Nursing - Refers to the learned humanistic and scientific profession and discipline that is focused on
human care phenomena and activities to assist, support, facilitate, or enable other individual or group.

 Nola Pender
Health Promotions Model
The Health Promotion Model
The health promotion model notes that each person has unique personal characteristics and experiences
that affect subsequent actions. The set of variables for behavioral specific knowledge and affect have
important motivational significance. These variables can be modified through nursing actions. Health
promoting behavior is the desired behavioral outcome and is the end point in the HPM. Health promoting
behaviors should result in improved health, enhanced functional ability and better quality of life at all
stages of development. The final behavioral demand is also influenced by the immediate competing
demand and preferences, which can derail an intended health promoting actions.
Major Concepts
Health promotion is defined as behavior motivated by the desire to increase well-being and actualize
human health potential. It is an approach to wellness.
On the other hand, health protection or illness prevention is described as behavior motivated desire to
actively avoid illness, detect it early, or maintain functioning within the constraints of illness.
Individual characteristics and experiences (prior related behavior and personal factors).
Behavior-specific cognitions and affect (perceived benefits of action, perceived barriers to action,
perceived self-efficacy, activity-related affect, interpersonal influences, and situational influences).
Behavioral outcomes (commitment to a plan of action, immediate competing demands and preferences,
and health-promoting behavior).

Subconcepts
Personal Factors
Personal factors categorized as biological, psychological and socio-cultural. These factors are predictive
of a given behavior and shaped by the nature of the target behavior being considered.
a. Personal biological factors -Include variable such as age gender body mass index pubertal status,
aerobic capacity, strength, agility, or balance.
b. Personal psychological factors -Include variables such as self esteem self motivation personal
competence perceived health status and definition of health.
c. Personal socio-cultural factors -Include variables such as race ethnicity, acculturation, education and
socioeconomic status.
Perceived Benefits of Action -Anticipated positive outcomes that will occur from health behavior.
Perceived Barriers to Action -Anticipated, imagined or real blocks and personal costs of understanding
a given behavior.
Perceived Self Efficacy -Judgment of personal capability to organize and execute a health-promoting
behavior. Perceived self efficacy influences perceived barriers to action so higher efficacy result in
lowered perceptions of barriers to the performance of the behavior.
Activity Related Affect -Subjective positive or negative feeling that occur before, during and following
behavior based on the stimulus properties of the behavior itself.
Activity-related affect influences perceived self-efficacy, which means the more positive the subjective
feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate further
positive affect.

Interpersonal Influences -Cognition concerning behaviors, beliefs, or attitudes of the others.

Interpersonal influences include: norms (expectations of significant others), social support (instrumental
and emotional encouragement) and modeling (vicarious learning through observing others engaged in a
particular behavior).
Primary sources of interpersonal influences are families, peers, and healthcare providers.
Situational Influences - Personal perceptions and cognitions of any given situation or context that can
facilitate or impede behavior. Include perceptions of options available, demand characteristics and
aesthetic features of the environment in which given health promoting is proposed to take place.
Situational influences may have direct or indirect influences on health behavior.
Commitment to Plan Of Action - The concept of intention and identification of a planned strategy leads
to implementation of health behavior
Immediate Competing Demands and Preferences - Competing demands are those alternative
behaviors over which individuals have low control because there are environmental contingencies such
as work or family care responsibilities.
Competing preferences are alternative behaviors over which individuals exert relatively high control, such
as choice of ice cream or apple for a snack
Assumptions
Individuals seek to actively regulate their own behavior.
Individuals in all their biopsychosocial complexity interact with the environment, progressively
transforming the environment and being transformed over time.
Health professionals constitute a part of the interpersonal environment, which exerts influence on persons
throughout their life span.
Self-initiated reconfiguration of person-environment interactive patterns is essential to behavior change.

Different Views of Non-nursing Theories

Systems Theory
 It provides another approach for studying individuals in their environments and is used by many
disciplines.
 General System Theory includes purpose, content, and process, breaking down the “whole” and
analyzing the parts.
 The relationships between the parts of the whole are examined to learn how they work together.
Von Bertalanffy (1969, 1976) developed general systems theory which assumes the following:
 All systems must be goal directed
 A system is more than the sum of its parts
 A system is ever changing, and any change in one part affects the whole
 Boundaries are implicit, and human systems are open and dynamic

Change Theory
 People grow and change throughout their lives.
 This growth and change are evident in the dynamic nature of basic human needs and how they
are met.
 Change happens daily.
 Change involves a modification or alteration.
 It may be planned or unplanned.
Although a variety of change theories exist, Kurt Lewin (1962) developed the classic theory of change,
which identifies the following six components:
1. Recognition of the area where change is needed
2. Analysis of a situation to determine what forces exist to maintain the situation and what forces are
working to change it.
3. Identification of methods by which change can occur
4. Recognition of the influence of group mores or customs on change
5. Identification of the methods that the reference group uses to bring about change
6. The actual process of change.
Unfreeze – involves finding methods of making it possible for people to let go of an old pattern that was
counterproductive
Change or Moving – or moving to a new level involves a process of change of thoughts, feelings,
behavior, or all three, that is in some ways more liberating or more productive
Refreeze – is establishing the change as a new habit, so it now becomes the “standard operating
procedure.” Without some process of refreezing, it is easy to backslide into the old ways.
Developmental Theory
 Categorize a person’s behaviours or tasks into approximate age ranges or in terms that describe
the features of an age group.
 Allow nurses to describe typical behaviours of an individual within a certain group, explain the
significance of those behaviours, predict behaviours that might occur in given situation, and provide
rationale to control behavioural manifestations.

Needs Model/Theory
 Human needs are ranked on ascending scale according to how essential the needs are for
survival.
o Maslow’s hierarchy provides a framework for recognizing and prioritizing basic needs.
o People must meet lower level needs to some degree before they can address higher level needs.
o A person is not motivated by all five categories of human needs at the same time.
o They can learn to delay meeting their needs and modify the specific behaviours that satisfy
needs, depending on each need’s motivational strength.
o If a need goes unmet, physical illness, psychological disequilibrium or death can occur.
Abraham Maslow (1970), perhaps the most renowned needs theorist, ranks human needs on five levels.
The five levels in ascending order are as follows:
1. Physiologic Needs
 Fundamental motivating forces and provide the base for Maslow’s pyramid
 Oxygen, food, water, elimination, activity, rest, temperature, maintenance, and
sexuality are essential for existence.
2. Safety and Security Needs
 The need for safety has both physical and physiologic aspects. The person needs to
feel safe, both in the physical environment and in relationships.
3. Love and Belonging Needs
 It includes giving and receiving affection, attaining a place in a group, and
maintaining the feeling of belonging.
4. Self-Esteem Needs
 The individual needs both self-esteem and esteem from others.

5. Self-Actualization
 The need for self-actualization is the innate need to realize fully all of one’s abilities
and qualities, that is, to maximize one’s potential.
Interlinking Relationships of Factors Affecting Health

1. Physical – state of well-being void of disease or illness.

2. Emotional (Psychological) – refers to our emotional and mental states, our thoughts and feelings.
It involves awareness and acceptance of a wide range of feelings in oneself and others, the ability to
express emotions, to function independently and to cope with the challenges of daily stressors.
3. Mental (Intellectual) – refers to your ability to think and learn from life experience, being open to
new ideas, and the ability of one to question and evaluate information.
4. Social – the ability to interact effectively with other people and the social environment, to develop
satisfying interpersonal relationships, and to fulfill social roles. It involves participation in the community
and making contributions to society. Additionally social implies living in harmony with fellow human
beings, developing positive independent relationships with others, and practicing healthy sexual
behaviors.
5. Spiritual – Its essential component is a belief in some meaning or order in the universe, a higher
power that gives greater significance to individual life. People with good spiritual health identify their own
basic purpose in life; learn how to experience love, joy, peace and fulfillment; and help themselves and
others achieve their full potential.

Core Values

1. Human Dignity
 The term "dignity" is defined as "the state of being worthy of honor or respect".
 When this concept is associated with the adjective "human", it is used to signify that
all human beings possess inherent worth and deserve unconditional respect,
regardless of age, sex, health status, social or ethnic origin, political ideas, religion, or
criminal history. (Wikipedia The Free Encyclopedia, 2008).
 In nursing you are taught to treat all patients with dignity, you are to treat each person
as equal and not refuse care to anyone regardless of their past or other factors. You
 treat each patient as you would treat your own loved ones if you were to care for
them.

2. Integrity
 Integrity is the basing of one's actions on an internally consistent framework of principles.
(Wikipedia The Free Encyclopedia, 2008).
 Nurses have set values of integrity they work together as a whole with others to benefit
everyone involved.
 Nurses also behave honestly, fairly, and ethically are truthful. They are truthful,
trustworthy, and fair in all efforts, while holding themselves to the highest standards of
professional and ethical conduct.
 Nurses provide an environment of openness; they are honest in their approach to one
another and those they serve.

3. Autonomy

 Autonomy (Greek: auto – self; nomos – “determination or law”:

 Self-determination or self-government.
 Autonomy in nursing gives the patients a right to informed consent. The patient is given
the facts and consequences to their health choices and has the right to choose to go
through the procedure or not, unless that person is declared incompetent and then a
medical power of attorney or health care surrogate is appointed to them to make
decisions.

4. Altruism
 Altruism is selfless concern for the welfare of others. (Wikipedia The Free Encyclopedia,
2008).
 Everyday nurses put their own lives in danger to care for patients in their time of sickness
or death.
 Nurses are ethically required to take care of patients sometime risking their own safety
and health. Whether it be a putting themselves in the way of a physically aggressive
patient to protect the other patients or staff, or entering a room to care for a patient with
HIV, TB, MRSA or other contagious diseases.
 Nurses must put the welfare of their patients first.

5. Social Justice
 Social justice refers to the concept of a society in which justice is achieved in every
aspect of society, rather than merely the administration of law.
 Nurses are required to uphold freedom of choice in their patients' care, while upholding
their dignity.

Care Enhancement Qualities including Core Values

 Love of God
 Caring
 Love of People
 Love of Country

Love of God
  The bible indicates that love is from god. In fact, the bible says "god is love.“. Love is one of the
primary characteristics of god. Likewise, god has endowed us with the capacity for love. This
capacity for love is one of the ways in which we are "created in the image of god."
 For god so loved (agape) the world, that he gave his only begotten son, that whoever believes in
him should not perish, but have eternal life. (john 3:16)
Caring
 The core of nursing practice
a. Compassion
 Deep awareness of the suffering of another coupled with the wish to relieve it.
 Compassion is when you see that someone needs help and you want to help them.

1. Promote sweetness
2. Show how to be gentle
3. Enforce rules
4. Provide structure
5. Expect her to help

b. Conscience
 The awareness of a moral or ethical aspect to one's conduct together with the urge to prefer right
over wrong: Let your conscience be your guide.
 A source of moral or ethical judgment or pronouncement: a document that serves as the nation's
conscience.
 Conformity to one's own sense of right conduct: a person of unflagging conscience

c. Competence
 The quality of being competent; adequacy; possession of required skill, knowledge, qualification,
or capacity.
Here are a few tips on becoming an expert.
1. Set your goal
2. Plan your strategy
3. Study thoroughly
4. Perform diligently
5. Strengthen it by visualizing
6. Add positive emotions
7. Ask for help and accept feedback
8. Choose your environment
9. Commitment is essential
10. Persist

d. Confidence

 Confidence is generally described as a state of being certain, either that a hypothesis or

prediction is correct, or that a chosen course of action is the best or most effective
 Self-confidence is having confidence in oneself

 Remember that no one is perfect

 Identify your successes
  Be thankful for what you have
 Look in the mirror and smile

e. Commitment

 Commitment means the duty or pledge to something or someone

How to Become a Committed Adult Learner

1. Not everyone learns from books
2. Broaden your definition of learning
3. Do things
4. Create
5. Take classes, both formal and informal
6. Teach others

Love of People
 Respect for the Dignity of Each Person Regardless of Race, Creed, Color & Gender
 The Essential Teaching Of Jesus: "Love All People As Yourself

How to Respect Other People

1. Always think before speaking.
2. Empathize with the other person.
3. Refrain from criticizing other people’s beliefs different from yours.
4. Don’t push your beliefs.
5. Understand that everyone you meet is unique.
6. Listen to what other people have to say even if you don’t agree.

Love of Country
 It's always good to love your country. After all, it's where you live. Here are some tips that can
help you discover how great your country really and truly is!

 Patriotism
1. Be an active citizen.
2. Study the history of your country.
3. Focus on current events.
4. Read stories, tall tales, and patriotic legends of your country.
5. Have a hero.
6. Wear patriotic colors.
7. Fly a flag
8. Celebrate holidays.
9. Encourage children to love their country so they will have respect someday as a citizen.
10. Don't be prejudiced or biased.
11. Abusing your country or taking advantage of any of its systems or programs is not a good
way to show your love.
12. You certainly do not have to agree with every event and decision made in your country's
history to love your country
  Preservation and Enrichment of the Environmental and Cultural Heritage
1. Cultural heritage
Physical or "tangible cultural heritage" includes buildings and historic places, monuments, artifacts, etc.,
that are considered worthy of preservation for the future. These include objects significant to the
archaeology, architecture, science or technology of a specific culture.
2. Natural Heritage
"Natural heritage" is also an important part of a culture, encompassing the countryside and natural
environment, including flora and fauna, scientifically know as biodiversity

V. Core competencies under the 11 Key Areas of Responsibility

1. Patient care competencies

 Cluster of key areas of responsibility that include safe and quality care, communication, health
education and collaboration and teamwork.
a. Safe and Quality Nursing Care
o Promotes achievement of client outcome by providing nursing care that enhances the
care delivery in any setting and across the life span in order to protect client, family,
significant others and other health care personnel.
Examples:
 Safe and quality nursing care
 Medical and surgical asepsis
 Safety use of the equipment
 Use of restraints/safety devices
 Handling hazardous and infectious materials
 10 golden rules in drug administration
 Home safety

b. Communication
o The nurse utilizes principles of communication in the care of clients/families and
communities
 Nursing informatics
 Nurse clients relationship
 Inter and intra personal communication
 Effective/functional communications
 Therapeutic relationship
 Elements of communication

c. Collaboration
o The nurse establishes collaborative relationship with colleagues and other members of
the health team
 Inter and intra-professional relationship
 The health care delivery system
 Health/hospital team
 Referral

d. Health Education
 o The nurse utilizes principles in teaching/learning in addressing the health problems of the
clients/family/significant others
 Clients education
 Principles in teaching/learning
 Discharge planning
 Learning domains
 Teaching strategies
 Barriers to learning

2. Enhancing
 Cluster of key areas of responsibility that ensures safe and quality nursing care to include
research and quality improvement

a. Research
o Nursing research advances the discipline of nursing, helps develop nursing knowledge
and improves nursing care
 Evidence-based practice
 Research methodologies
 Research process
 Sources of knowledge
 COPAR –Community Organizing Participatory Action Research

b. Quality Improvement
o The nurse participates in activities towards quality care management that will ensure
quality patient care.
 Total patient care
 Individualized nursing care

3. Empowering
 Cluster of key areas of responsibility that mandate compliance to the standards of legal, ethico-
moral responsibilities and personal and professional development

a. Legal Responsibilities
o The nurse adheres to practice in accordance with the laws, policies and guidelines
affecting nursing.
 Sanitation law (PD 856)
 Reproductive right
 Bill of rights
 Informed consent
 Provision on health, women and family
 Contracts and other legal forms
 RA 9173

b. Ethico-moral responsibilities
 o The nurse observes ethico-moral considerations in the practice of the profession.
 Accountability
 Professionalism
 Confidentiality
 Privacy
 Ethical principles
 Code of ethics
 Patient’s bill of rights
 Ethical dilemma

c. Personal and Professional development

o The nurse accepts responsibility for one’s personal and professional development in the
practice of nursing.
 Nursing theories
 Historical development in nursing
 Nursing as a science, art, professional vocation
 Professional decorum

4. Enabling
 Cluster of key areas of responsibility that provide support to effective and efficient performance of
patient care competencies including management of resources and environment and record
management

a. Management of Resources and Environment

o Includes managerial and supervisory skills that enhance nursing care delivery to protect
clients, family, significant others.
 Establishing priorities
 Case management
 Advocacy
 Continuity of care
 Resources of management
 Triage

b. Records Management
o The nurse maintains accurate and updated documentation of patient care.
 SOAPIE charting / FDAR charting
 Legal imperatives in record keeping
 The nursing care plan
 Kardex
 Confidentiality and privacy of patients records

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