Nursing Theorist theoretical.foundation.nursing.

2019

Care, Cure and Core

The Three C’s of Lydia Hall
LYDIA HALL AND HER THEORY

 Lydia Hall was born in New York City on September 21, 1906.
 She promoted involvement of the community in health-care issues.
 She derived from her knowledge of psychiatry and nursing experiences in the Loeb Center the
framework she used in formulating her theory of nursing.

The theory contains of three independent but interconnected circles:

a) the core-
b) the care
c) the cure-

POINTERS:
 According to the theory, the core is the person or patient to whom nursing care is directed and needed.
The core has goals set by himself and not by any other person, and that these goals need to be
achieved. The core, in addition, behaved according to his feelings, and value system.
 The cure, on the other hand is the attention given to patients by the medical professionals. The model
explains that the cure circle is shared by the nurse with other health professionals. These are the
interventions or actions geared on treating or “curing” the patient from whatever illness or disease he
may be suffering from.
 The care circle explains the role of nurses, and focused on performing that noble task of nurturing the
patients, meaning the component of this model is the “motherly” care provided by nurses, which may
include limited to provision of comfort measures, provision of patient teaching activities and helping the
patient meet their needs where help is needed.
CONCLUSION:

 It is easy to understand from the model that in all of the circles of the model, the nurse is always
presents the bigger role she takes belongs to the care circle where she acts a professional in helping the
patient meet his needs and attain a sense of balance.

References George, J.B.; Nursing Theories: The Base for Professional Nursing Practice; 2000.

The Helping Art of Clinical Nursing

Ernestine Wiedenbach

 Ernestine Wiedenbach was born in August 18, 1900, in Hamburg, Germany.

 Wiedenbach's conceptual model of nursing is called ' The Helping Art of Clinical Nursing".

CONCEPTS AND DEFINITIONS

I. The patient- "Any individual who is receiving help of some kind, be it care, instruction or advice from a
member of the health profession or from a worker in the field of health." The patient is any person who
has entered the healthcare system and is receiving help of some kind, such as care, teaching, or advice.
The patient need not be ill since someone receiving health-related education would qualify as a patient.
II. A need-for-help- is defined as "any measure desired by the patient that has the potential to restore or
extend the ability to cope with various life situations that affect health and wellness. It is crucial to
nursing profession that a need-for-help be based on the individual perception of his own situation.
III. Nurse- The nurse is functioning human being. The nurse no only acts, but thinks and feels as well.
IV. Knowledge- encompasses all that has been perceived and grasped by the human mind. Knowledge
may be :
o factual
o speculative or
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o practical
V. Judgment- Clinical Judgment represents the nurse’s likeliness to make sound decisions. Sound
decisions are based on differentiating fact from assumption and relating them to cause and effect.
Sound Judgment is the result of disciplined functioning of mind and emotions, and improves with
expanded knowledge and increased clarity of professional purpose.
VI. Nursing Skills are carried out to achieve a specific patient-centered purpose rather than completion of
the skill itself being the end goal. Skills are made up of a variety of actions, and characterized by
harmony of movement, precision, and effective use of self.
VII. Person- Each Person (whether nurse or patient), is endowed with a unique potential to develop self-
sustaining resources. People generally tend towards independence and fulfillment of responsibilities.
Self-awareness and self-acceptance are essential to personal integrity and self-worth. Whatever an
individual does at any given moment represents the best available judgment for that person at the time.

KEY ELEMENTS
Wiedenbach proposes 4 main elements to clinical nursing. 
a. The Philosophy- The nurses' philosophy is their attitude and belief about life and how that effected
reality for them.
b. The Purpose- Nurses purpose is that which the nurse wants to accomplish through what she does. It is
all of the activities directed towards the overall good of the patient.
c. The Practice- Practice are those observable nursing actions that are affected by beliefs and feelings
about meeting the patient’s need for help. 
d. The Art- understanding patients’ needs and concerns; developing goals and actions intended to
enhance patients ability and directing the activities related to the medical plan to improve the patient’s
condition. 

CONCLUSION:
 Nursing is the practice of identification of a patient’s need for help through observation of presenting
behaviors and symptoms exploration of the meaning of those symptoms with the patient determining the
cause(s) of discomfort, and determining the patient’s ability to resolve the discomfort or if the patient has
a need for help from the nurse or other healthcare professionals.
 Nursing primarily consists of identifying a patient’s need for help.

Human-To-Human Relationship Model

Joyce Travelbee(1926-1973)
 “The nurse is responsible for helping the patient avoid and alleviate the distress of unmet needs.” –
Travelbee
 Joyce Travelbee (1926-1973) developed the Human-to-Human Relationship Model presented in her
bookInterpersonal Aspects of Nursing (1966, 1971).
 She dealt with the interpersonal aspects of nursing.
 She explains “human-to-human relationship is the means through which the purpose of nursing if
fulfilled” 

Development of the Theory
 Travelbee based the assumptions of her theory on the concepts of existentialism by Soren Kierkegaard
and logotherapy by Viktor Frankl.
 Existential theory believes that that humans are constantly faced choices and conflicts and is
accountable to the choices we make in life
 Logotherapy theory was first proposed by Viktor Frankel, a survivor of Auschwitz, in his book Man's
Search for Meaning (1963).

Basic Concepts
a. Suffering
"An experience that varies in intensity, duration and depth ... a feeling of unease, ranging from mild, transient
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mental, physical or mental discomfort to extreme pain and extreme tortured ..."
b. Meaning
Meaning is the reason as oneself attributes
c. Nursing
is to help man to find meaning in the experience of illness and suffering.
has a responsibility to help individuals and their families to find meaning.
The nurses' spiritual and ethical choices, and perceptions of illness and suffering, is crucial to helping to find
meaning.
d. Hope
Nurse's job is to help the patient to maintain hope and avoid hopelessness.
Hope is a faith that can and will be change that would bring something better with it. 
Hope's core lies in a fundamental trust the outside world, and a belief that others will help someone when you
need it.
e. Communications
"a strict necessity for good nursing care"
f. Using himself therapeutic
" one is able to use itself therapeutic."
Self-awareness and self-understanding, understanding of human behavior, the ability to predict one's own and
others' behavior are important in this process.
g. Targeted intellectual approach
Nurse must have a systematic intellectual approach to the patient's situation.

Description of the theory

 Travelbee believed nursing is accomplished through human-to-human relationships that begin with the
original encounter and then progress through stages of emerging identities, developing feelings of
empathy, and later feelings of sympathy.
 The nurse and patient attain a rapport in the final stage. For meeting the goals of nursing it is a
prerequisite to achieving a genuine human-to-human relationships.
 This relationship can only be established by an interaction process.

It has five phases.

i. The inaugural meeting or original encounter
ii. Visibility of personal identities/ emerging identities.
iii. Empathy
iv. Sympathy
v. Establishing mutual understanding and contact/ rapport
 Travelbee's ideas have greatly influenced the hospice movement in the west.

Conclusion
 Travelbee's theory has significantly influenced nursing and health care.
 Travelbee's ideas have greatly influenced the hospice movement in the west.