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 The personal philosophy must include the following domains: Nursing, Environment, Health and Person. You should include your personal definition of each domain and how these fit into your philosophy of nursing. In preparing your philosophy the faculty require that you review the philosophies of Miami Dade College, Benjamin Leon School of Nursing and at least one hospital. A limit of 1 to 3 pages is acceptable in APA format.  

Describe the rationale for the application of ethical guidelines in data collection. Using an article that you cited in the Article Analysis 1 or Article Analysis 2 assignments (see attachments), evaluate the article from a Christian worldview perspective and identify potential ethical considerations that may have occurred when sampling, collecting data, analyzing data, or publishing results. Provide rationale and support for your evaluation.

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format.

 Reply for the following discussion: More than 200 words, APA format, Refences at least 2.

The development of nursing knowledge is an ongoing process, and nursing grand theories play a significant role in shaping the direction of nursing practice and research. Grand theories, such as those proposed by Florence Nightingale, Dorothea Orem, and Jean Watson, provide a comprehensive framework that helps guide nursing practice across various settings. These theories offer broad, general principles that are applicable across different contexts and emphasize the importance of the nurse-patient relationship, the promotion of health, and holistic care. According to Alligood (2017), grand theories contribute to the organization and systematic development of nursing knowledge, allowing for the creation of consistent and coherent care approaches. By offering a conceptual foundation, they enable nurses to assess patient situations, develop effective interventions, and improve care outcomes. Furthermore, the continued development and refinement of these grand theories foster innovation within nursing, guiding research that can lead to improved care models and better patient outcomes.

However, there is also a valid case for questioning the relevance of grand theories in modern nursing practice. As healthcare environments become more complex, with a strong focus on evidence-based practice, clinical guidelines, and the integration of new technologies, the abstract nature of grand theories may become less applicable to the day-to-day needs of nursing practice. Meleis (2018) argues that the rapid pace of medical advancements and the increasing need for specialized knowledge can render grand theories somewhat outdated. The emphasis on evidence-based practices and specific clinical models, which are based on empirical research, may be more immediately useful in addressing the dynamic demands of modern healthcare. For example, grand theories often fail to account for the intricacies of contemporary patient care, such as the management of chronic illnesses or the application of advanced technologies, which require more specific and practical approaches.

Moreover, the shift toward middle-range theories, which are more directly applicable to specific clinical situations, provides a more adaptable and context-sensitive framework for practice and research. These theories, according to Meleis (2018), offer more practical solutions to immediate nursing challenges, making them better suited for contemporary healthcare systems that are complex and ever-changing. While grand theories may still have value in providing overarching guidance for nursing, middle-range theories and evidence-based practice models may be more appropriate for addressing the specific challenges of today’s healthcare landscape.

• Describe a project that has been implemented in your setting. This can be the adoption of a new form for teaching or recording assessments, a new piece of equipment, or any new or changed policy or procedure that affects patient care. Why was a decision made to make the change? Was a problem identified, or did someone read/hear about the change and suggest it be brought to your setting?
• Find a research study or report of a practice change project related to the project that your setting implemented. How strong was the evidence (provide the relevant descriptive statistics from the study or report and interpret their strength).
• How were the staff members informed that the change was coming?
• How were staff members educated on the change? How long did the training take? What was involved?
• What was the reaction of staff members to the change?
• Describe what went well and what challenges were identified as the change was actually implemented.
• Did the change make the intended difference in the outcome? What was the actual data used for evaluation of the success of the project?
• Has the change been sustained over time?
• What are the barriers to change in your setting?
• What are the facilitators to change in your setting?

See Attachment

Nursing has undergone significant evolution over the years, transitioning from a role primarily focused on caregiving to an advanced, evidence-based profession integral to healthcare. This transformation has been evident across all areas of nursing, from acute care to community health. However, I would like to focus more specifically on the field of mental health nursing, which is the area in which I practice. The evolution of psychiatric-mental health nursing has been marked by significant changes over time, reflecting advancements in research, treatment modalities, and the recognition of mental health as a critical component of overall well-being. Despite these developments, historical challenges such as societal perceptions, stigma surrounding mental illness, lack of formal education, and limited recognition as a scientific discipline have shaped the field’s progression.

One of the earliest challenges in psychiatric nursing was the pervasive stigma surrounding mental illness. Historically, individuals with psychiatric conditions were often institutionalized with minimal medical care, and nursing interventions were largely custodial rather than therapeutic (McCurry et al., 2019). The absence of standardized psychiatric nursing education contributed to this issue, as mental health nurses were often seen as attendants rather than skilled professionals. Over time, the integration of psychiatric nursing into formal curricula and the emergence of therapeutic approaches, such as cognitive-behavioral therapy and psychopharmacology, have strengthened the profession.

Another significant challenge was the exclusion of psychiatric nurses from higher education and scientific research. In the early 20th century, psychiatric nursing lacked specialized training programs, limiting its development as a distinct discipline. As a result, the profession was slow to adopt evidence-based practices, which are now foundational to modern psychiatric nursing (Porter-O’Grady et al., 2020). The establishment of psychiatric-mental health nurse practitioner (PMHNP) programs has played a crucial role in advancing mental health nursing by integrating research, clinical expertise, and leadership.

Stigma and gender biases have also shaped the evolution of psychiatric nursing. Historically, psychiatric care was male-dominated, with physicians leading treatment efforts and nurses relegated to supportive roles. This dynamic limited the ability of nurses to contribute meaningfully to psychiatric interventions and policy development (D’Antonio, 2020). Today, PMHNPs play an essential role in diagnosing and treating mental illnesses, advocating for mental health policies, and leading community-based interventions. The expansion of the Doctor of Nursing Practice (DNP) degree has further strengthened the role of psychiatric nurses in healthcare leadership.

Despite these challenges, psychiatric nursing has evolved into a highly respected, research-driven field with a critical role in mental health care. The establishment of the DNP with a focus on psychiatric-mental health exemplifies the profession’s commitment to integrating science and clinical expertise. The DNP emphasizes evidence-based practice, healthcare policy, leadership, and quality improvement, further advancing psychiatric nursing (AACN, 2021). By continuing to address historical barriers and embracing innovation, psychiatric-mental health nursing will remain at the forefront of mental healthcare transformation.

References

American Association of Colleges of Nursing (AACN). (2021). The essentials: Core competencies for professional nursing education. Retrieved from https://www.aacnnursing.org/Education-Resources/AACN-Essentials

D’Antonio, P. (2020). Nursing history review, volume 28: Official journal of the American Association for the History of Nursing. Springer Publishing Company.

McCurry, M. K., Revell, S. M., & Roy, S. C. (2019). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 20(3), e12265.

Porter-O’Grady, T., Clavelle, J., & Iro, E. (2020). Quantum leadership: Creating sustainable value in health care. Jones & Bartlett Learning.