In your response to another’s post, write how this theory could or could not be applicable to advanced practice in your track. 250 words for each post there should be two separate post response to each student. When writing the response please put Student 1 post and Student 2 post so that I can know the difference
Student 1
Kurt Lewin’s Planned Change Theory
Major Theme
Kurt Lewin’s Planned Change Theory is a fairly simple concept that has been applied to many different career fields such as healthcare and business. Lewin established three major stages of planning change. The first stage is called unfreezing. Unfreezing is where people realize that change is needed. Within this stage, Lewin introduces three concepts that can trigger the need for change: driving forces, restraining forces, and equilibrium (Petiprin, 2020). This means that change can happen because people realize there’s a better way to do something, because the current way isn’t working anymore, or a combination of both. The next stage is called change, which “involves a process of change in thoughts, feeling, behavior, or all three, that is in some way more liberating or more productive” (Petiprin, 2020, para 6). This is the actual implementation of the change. The last stage, refreezing, can be the most difficult. Refreezing involves maintaining the change, making it the new normal (Petiprin, 2020).
Implications
Change is the only thing that is constant in the healthcare field. However, in healthcare “almost two-thirds of all change projects fail for many reasons, such as poor planning, unmotivated staff, deficient communication, or excessively frequent changes” (Barrow et al., 2021, para 1). Change is needed to keep up with evidence-based practice and evolving modern technology. Barrow et al. (2021) discusses the difficulties with initiating and maintaining new fall prevention interventions on a unit that recently had an increase in falls. They mention that one of the biggest issues was that the staff kept reverting to old practices (Barrow et al., 2021). Refreezing is one of the most difficult stages of change, and this is where we, as nurses, must be open-minded and willing to give things a chance.
Lens
Through the lens of a nurse, the Planned Change Theory is seen everywhere. I especially see nurse managers working hard at making the refreezing stage successful. Nurse managers often develop competitions and prizes to reinforce changes. For example, if the unit is trying to initiate a new policy on core measures for catheter-associated urinary tract infections (CAUTI), they may create prizes for staff who watch educational videos on the new changes. The nurse managers continue to enforce the new policies by giving positive feedback and giving staff recognition for adhering to it. These interventions are what allow for change to flourish and continue to evolve.
Reference
Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2021). Change management. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK459380/
Petiprin, A. (2020). Lewin’s change theory. Nursing Theory. https://nursing-theory.org/theories-and-models/lewin-change-theory.php
Student 2
Person- Center Theory
Major Theme
Carl Roger’s theory dates to the middle of the 20th century with its initial application in psychotherapy (Joseph, 2015). His practice of person-centered care was a very different approach that focused on mutual respect, nonjudgment, and empathy. During this time psychiatrists were prone to direct the interactions with patients. Carl Roger’s theory encouraged “clients” to lead the therapy session (Joseph, 2015). He then would follow their lead and provide feedback. He spent a great deal of time gaining a complete picture of the client’s “perceptual fields” so that he could later more accurately aid them with sensitively and accuracy (Eghigian, 2010). His approach ultimately empowered clients and helped them maintain their independence and autonomy while working through issues that troubled them.
Implications
Since its introduction, patient centered care has been applied in a multitude of disciplines beyond psychiatry. One implication is regarding the treatment of patients with chronic pain. There is an enormous difference amongst patients who are validated versus patients who are delegitimized by healthcare providers regarding the presence of pain. Chronic pain is “intensely personal” and frequently can impact one’s “self-esteem, self-identity, and ultimately self-efficacy” (Howarth, Warne, Haigh, 2014). Chronic pain leaves patients reliant on a physician and it reduces their autonomy (Howarth et al., 2014). Specifically, it changes their own perception of themselves and makes it harder for them to address their pain and ultimately move forward when they feel isolated and invalidated. This study identified that patients treated using the patient centered care model experienced “validation by the provider”, “validation by the individual”, “rediscovered personhood”, and experienced “restored faith” (Howarth et al., 2014). By being validated by a provider, patients were able to develop a partnership and obtain some control over their pain. Being validated also led to lower incidence of depression, greater self-efficacy, improved faith in the care team, and a feeling of greater control over their lives (Howarth et al., 2014).
Lens
Through the lens of a critical care nurse, pain management can be viewed based on subjective and/or objective data. Sometimes we are treating pain in a patient who is not fully conscious or who is unconscious. In this scenario, we utilize an assessment that includes body movements, facial features, withdrawal reflexes, and occasionally even heart rate and blood pressure. I never stopped to consider that my own belief in a patient’s pain may also impact their management of pain and their trust in me.
Eghigian, G. (2010). From madness to mental health psychiatric disorder and its treatment in Western civilization. Rutgers University Press. https://doi.org/10.36019/9780813549095
Howarth, M., Warne, T., & Haigh, C. (2014). Pain from the inside: understanding the theoretical underpinning of person-centered care delivered by pain teams. Pain Management Nursing., 15(1), 340–348. https://doi.org/10.1016/j.pmn.2012.12.008
Joseph, S. (2015, March 3) Carl Roger’s Person-Centered Approach. Psychology Today. Retrieved October 6, 2022, from https://www.psychologytoday.com/us/blog/what-doesnt-kill-us/201503/carl-rogers-person-centered-approach