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CONCEPTUAL FRAMEWORK
Ludwig Von Bertalanffy’s General System Theory (1968) and
Halbert L. Dunn Concept of High Level of Wellness (1973) have been
selected to provide orientation for the framework. Both are utilized
to conceptualize the human being as a system which needs to adapt
to change in order to attain, maintain and/or regain optimum levels
of wellness or integrity. This approach serves to visualize the human
being as an integrated system along health-illness continuum
throughout his/her life process.
The faculty conceives the human being as an integral and
unique entity with dignity and sensitivity; as a whole, composed of
biopsychosocial, spiritual and communicative dimensions. The
human being has the potential for growth, for reasoning and for
decision making; influenced by heredity, environment and by basic
human needs. The human being is an open living system, which is
constantly changing, and being changed by the environment.
A system is defined as a group of elements in interaction,
organization, integration and interdependence. The human being as
a system is also composed of elements in interaction, organization,
integration and interdependence working toward growth and the
maintenance of their integrity. As an open system, the human being
exchanges matter, information and energy with the environment, in
order to attain goals
According to Dunn, high level of wellness implies well-being of
mind, body and spirit. It includes the well-being of individuals,
families and community life. The state of wellness is dynamic and is
defined as an integrated method of functioning, which is oriented
toward maximizing the potential of the individual. This method
requires the individual to maintain a continual balance and a
purposeful direction within his/her environment. For the individual,
the family and the community, the concept of high-level of wellness
embodies the preventive aspects of diseases, disabilities and social
breakdowns.
Health is a relative state of well-being, which involves the ability
of the individual to adapt to the internal and external environments. It
is closely related to the needs of maintaining personal dignity within
the social context, and facilitates the adaptation to the environment.
The state of well being provides the coping mechanisms to confront
situations of daily living and a dynamic equilibrium that permits the
person to use fully the available energies. The adaptation allows the
individual to maintain an optimum level of functioning.
The conceptual models in nursing reveal many similarities to the
postulates of the General System Theory. The conceptual models of
nursing view the human being, the recipient of nursing services, as an
integral being. The human being, in interaction with his/her
environment, has defense and internal regulatory mechanisms which
function on the principle of homeodynamics. The professional nurse
system establishes an interpersonal dynamic relationship with the
human being-client system to identify behavioral responses that affect
the integrity of the person as a whole. The goal of nursing is to assist
the human being in the dynamic adaptation to the environment and to
attain and maintain an optimal level of wellness. To fulfill this goal the
nurse utilizes the nursing process.
Based on a critical analysis of the General System Theory and of
the Dunn Concept of High Level of Wellness, three interrelated systems
have been identified: Human Being-Client System; Professional
Nurse System; and Social System. Through their interrelationship of
these three systems, the body of knowledge of the program is
conveyed. In order to operationalize the essence of the systems
throughout the curriculum, major concepts inherent to each system
were identified: Adaptation, Role and Communication.
This conceptual framework has a humanistic and preventive
approach to health care. The human being as an open system
interchanges material, information and energy in the search for high-
level of wellness. The family, the community and the health-care team
symbolize social energy systems. The General System Theory, High
Level of Wellness concepts and nursing conceptual models and
theories contribute to the interpretation of human responses and to
the implementation of this conceptual framework for the practice of
professional nursing.
The curriculum of the Baccalaureate Nursing Program has been
developed within the conceptual framework described above. In
addition to the three major concepts, the faculty has identified two
basic concepts as horizontal strands within the conceptual framework:
basic human needs and the nursing process. The concepts
progressively integrate the content throughout all levels of the
curriculum. The faculty has also identified as vertical strands those
concepts, which in sequence produce depth and breadth at different
levels of advancement throughout the curriculum. These vertical
strands include the following concepts: health-illness continuum,
health teaching, leadership, growth and development, legal,
ethics and values, research and interpersonal relationships.
The following is an analysis of the relationship between the identified
systems, major concepts and the unifying strands.
Human being- client system---ADAPTATION--Growth andDevelopment-----Health Illness Continuum
Human being the client system is an open system that
interchange, material, information and energy in search for
high level of wellness. In order to achieve the high level of
wellness, the human being is in a continuous process of
adjustment or modification.
Adaptation is a basic concept to the understanding of the human
being- client system. The human being is in a constant process of
growth and development that take place in a non-uniform process,
following different patterns and rate. These patterns are universal and
basic to all human beings, but accomplished in a manner and time
unique to each individual. The human being as an open system is
constantly receiving information from the environment, which
influences and/or alters his/her physical, psychosocial and spiritual
well-being creating specific needs in each individual. In order to
achieve the high level of wellness the human being is in a continuous
process of adjustment or modification. The human health transcends
the biological health and depends on conscious and deliberate choices
to select lifestyles and adapt to experiences. This relationship provides
for the adaptation and maximization of the human being-client
system’s potential for achieving equilibrium within the health illness
continuum. The professional nursing system develops and implements
the nursing process in a dynamic relationship with the client system.
Professional nurse system----ROLE----Leadership----
Research— Legal—Ethics and Values
Professional Nurse Systems encompasses the behaviors
established by the profession in order to implement the nursing
process that addresses the needs of human being-client system.
Role is a basic concept to the understanding of the professional
nurse system. The professional nurse role is governed by legal, ethics,
values and professional standards that regulate the practice of nursing.
The professional nurse considers the values, legal and ethical aspects
of the professional role and the human being-client system while
providing health services. Each human being is unique in structure
and function and is constantly relating and interrelating with an ever-
changing environment. The professional nurse role includes the ability
to use critical thinking skills within each situation and to make
professional judgment to deal with human responses.
The professional nurse as a leader needs to be dynamic,
visionary and an agent of change. In order to produce innovative ideas
and policies to improve the health care system the professional nurse
should be able to work with people and develop effective relationships.
Nursing research is an essential component for the development of
scientific knowledge to the professional nurse system which provides
evidence-based health care. The knowledge derived from research
uses the unique perspective of the discipline as well as other allied
sciences in the search of high level of wellness for the human being-
client. Therefore, nursing research generate a body of knowledge for
the implementation of evidence based nursing care to promote and
maintain health, prevent and manage illnesses and provide
rehabilitation and end of life care.
The legal practice of nursing is based on standards of care and in
the applicable laws. Ethical nursing practice is promoted by applying
ethical thinking, values and moral reasoning to the decisions and
actions inherent to the care of clients. Ethics are based on moral
reasoning and reflect sets of values unique to the professional nursing
code.
Social system-----COMMUNICATION--- Interpersonal
Relationship--Health Teaching
The social system consists of groups in constant change and in
common goals and interests. It encompasses economical, political,
ecological, demographical and cultural changes that influence the
practice of professional nursing. Communication is the basic concept
used for understanding of the human being within the social system.
As a system the human being-client is constantly reacting to the input
received from the social system. Communication is considered an
essential and dynamic process through which interpersonal and
interdisciplinary relationships are guided to fulfill the human basic
needs. Interpersonal relationship encourages the exchange of ideas,
problem solving, understanding of other people’s views, and decision
making which ultimately leads to promote teamwork and professional
growth and maturation.
The communication process facilitates the implementation of
the nursing process as it is use in the assessment of educational
needs, as well as the development of health teaching in a diverse
social system. Health teaching is a process that assist the client, acting
separately or collectively to achieve a high level of wellness. This
process begins with the assessment of the client’s educational needs,
the interpretation and integration of information, followed by a planned
intervention in order to
increase knowledge and produce a change in attitude or behavior
which will benefit the client’s health status.
This conceptual framework developed by the faculty provides for
the curriculum organization and is used for content selection and
sequence. The elements that provide the conceptual structure for the
program are represented in the following Diagram.
DESCRIPTION OF THE CONCEPTUAL FRAMEWORK
The diagram illustrates the interaction and interrelation of
elements inherent to the framework. The circles represent the three
systems through which the body of knowledge of nursing is
transmitted. Continuous feedback between the Human being- Client
System, the Professional Nurse System and the Social System are
represented by the overlapping of the circles. The major concepts
inherent to each system are represented and interrelated in the center
of each circle: Adaptation, Role and Communication. The horizontal
strands, which are Basic Needs and Nursing Process, are inherent
to each system. These horizontal strands integrate and applied content
throughout the curriculum. The vertical strands (health-illness
continuum, growth and development, research, legal, ethics
and values, leadership, interpersonal relationship, health
teaching) are found surrounding the other elements of the diagram.
These concepts permeate throughout the curriculum and provide in-
depth and breadth of knowledge through the levels of the curriculum.
That is, as learning experiences become more complex they build
successively upon each other to add depth and breadth to the
learner’s knowledge, conduct and skills as he/she progresses from one
level to another.
Throughout the curriculum the general education and related
science courses provide a broad base for building the cognitive,
psychomotor and affective behaviors specific to nursing. The nursing
courses provide competencies to the practice of professional nursing.
Knowledge is organized from simple to complex and from general to
specific. It takes into consideration the elements in curriculum
development such as: program philosophy, purposes, student profile
and outcomes, theories and concepts related to professional nursing,
horizontal and vertical strands of the curriculum. In each course, the
faculty identifies the human being-client system as an open system
having basic human needs and seeking high level of wellness in the
health-illness continuum.
The general education courses within the curriculum provide the
liberal education recognized in the philosophy as an essential part for
the development of a professional nurse. In addition, they serve as the
basis for developing skills of critical thinking, and decision-making and
provide the learner with a broader concept of the person as an integral
being in an open system. To further ensure that the purposes and
outcomes of the program are met, the learner is given the opportunity,
within the program of study, to select several elective courses both in
the area of nursing, as well as in the area of general education and
sciences. The inclusion of these elective courses, the use of various
teaching and learning strategies and, the use of a variety of clinical
settings for clinical practice serve to promote the individual growth of
the student within the teaching and learning process.
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Revised: April 4, 2011
PHILOSOPHY OF THE BACCALAUREATENURSING PROGRAM
The Department of Nursing functions in harmony with the
philosophy of the University of Puerto Rico. As stated in the University
Law of 1966, this philosophy is committed to the principles and
practices of democracy, to the development of mature individuals
capable of living competently in society, to the pursuit of truth and to
serve the people of Puerto Rico. It also recognizes that the duty of the
University is to preserve the contributions of the past, to be involved
with and to enrich the present and to be dedicated to the future
welfare of human kind. In addition to complying with the objectives of
the University, the Baccalaureate Program in Nursing promotes
education, research and professional service in nursing.
Essential to the preparation of a professional nurse is the
knowledge and skills inherited from the general education and nursing
courses. These knowledge and skills will provide the students with
competencies to reason and to think critically to provide the freedom
of mind and the self-assurance basic to a personality willing to be
committed to the service of humanity. The general education courses
provide the foundation of knowledge necessary to integrate the
theoretical basis for professional nursing practice.
The faculty of the Baccalaureate Nursing Program believes that
life is a process of continuous movement through a series of sequential
growth and developmental phases. We believe that the human being
is an integral entity with sensitivity, values, needs and a unique ability
to reason. The human being is viewed as an open system in
continuous communication, in constant change, contributing to his/her
biopsychosocial and spiritual environment and being influenced by it.
The human being adapts to change in their basic needs to attain,
maintain and/or regain an optimal level of wellness. As a system the
human being is constantly reacting to the social system.
The faculty believes that professional nursing is an essential
service to society, dedicated to the promotion and maintenance of an
optimal level of wellness. It is believed that the focus of nursing care is
the promotion, maintenance of health, prevention, management and
rehabilitation of illness and care/comfort of the client facing end of life.
Professional nursing is part of an interdisciplinary effort which uses a
theoretical framework based on social strengths, needs, current
healthcare trends, changes in society, the expanding role of the nurse
and the nature of the educational institution of which it is a
component.
The faculty believes that professional nursing has an
independent role within the practice of nursing and a collaborative role
with other professionals and non-professionals members of the health
care team. The professional nurse can provide quality and safe nursing
care for clients in diverse health care settings.
The nursing process is a systematic approach that the nurse
uses to assess, establish a nursing diagnosis, formulate and implement
a plan of care and evaluate expected outcomes. This purposeful
intervention, as well as the application of professional judgment,
requires accountability, leadership principles, responsibility, and
authority.
The faculty believes that the learner is a unique individual with a
particular rate of development within the teaching and learning
process. This process, focused on the learner, is designed to develop
an inquisitive and analytical mind and stimulates intellectual curiosity
and creativity. It foster lifelong learning. A positive attitude toward
the increase of knowledge is essential and the learner must assume
responsibility for his/her learning, professional and personal
development. Success in this area prepares the learner to function as
a leader, assume responsibility as a citizen and be assertive in his/her
professional actions to the society it serves.
Purposes of the Baccalaureate in Nursing Program:
1. To prepare a generalist professional nurse committed to the
service of humanity.
2. To prepare a generalist professional nurse with the
necessary competencies to provide quality and safe
evidence-based nursing care in diverse settings.
3. To prepare a generalist professional nurse to examine
research critically and evaluate its relevance