Our program is guided by constructivist theory and grounded in evidenced based practice paradigms. While our educational approach toward our ADN nursing students is prescriptive and lock-step, such that students follow carefully designed courses and programming steps, the role of constructivism in our RN to BSN program is one where the learner is treated as an adult; the student is able to make decisions about his or her educational needs and be an active participant in that educational process. Constructivism is used to ground the acquisition of knowledge and define the learning process (Dantanio & Beisenherz, 2001). Because the baccalaureate level of nursing education prepares generalists who learn to critically think and use the literature to ground their nursing practice (Adelman, 2002), constructivism as a programmatic educational theory allows the student to be a part of the learning process and not simply have knowledge delivered to the student (Legg, Adelman, Mueller, & Levitt, 2009).
The faculty believes that baccalaureate graduates practice within three interrelated roles: the provider of care, the manager of care, and the member of the profession (AACN, 2008). These roles are actualized through core competencies that differ in complexity from the practice of ADN to baccalaureate level (New York State Articulation Model, 2006). The faculty believes that the essential components of a baccalaureate education include:
Liberal Arts education is an integral part of our program to provide our students with the ability to integrate and apply behavioral, biological, social, historical, political, and economic concepts into their practice. We believe that the professional nurse is knowledgeable about leadership and management for changing health care environment and communicates effectively with clients and professional peers. Furthermore, the BSN graduate assumes responsibility to maintain and advance the nursing profession and is prepared for entry into graduate nursing education (AACN, 2005)
The conceptual framework of the RN to BSN program at SUNY Delhi builds on the existing framework for the associate degree program. The faculty believes that each client is a unique individual with unity of body, mind, and spirit. Furthermore, we believe that each client has a hierarchy of needs which must be met to enable the individual to maintain function at an optimal level. The nursing metaparadigm of the four concepts of nursing (i.e., client [individual, family, community], environment, health, and nursing) which operate in dynamic interaction reflecting the faculty's belief about the context of the nursing profession and that nursing practice is built upon nursing knowledge, theory, and research.
Client: The faculty views every individual, family, and/or community as unique and dynamic, having aspects which are physical, social, cultural, psychological, developmental, and spiritual in nature. The client is ultimately responsible for his or her own growth, health, values, and search for fulfillment and has the right to exercise freedom of choice in determining and attaining his or her individual goals. Nursing's role is to consider the interconnected components in assessing, planning, implementing, and evaluating the health status of individuals, families, and communities, and this is guided by evidence at all steps of the process.
Environment: The concept of environment extends from the physical environment to include external elements such as living conditions, sanitation, and air and water quality (Nightingale, 1992). Internal environmental factors that affect health include personal psychological processes, religious beliefs, ethnicity, culture, and personality. All clients affect, and are affected by, their internal and external environments. Responding to internal and external environmental factors may result in either wellness or alterations of well-being in the area of human needs, thus influencing the individual's requirements for nursing care. Nursing's role is to foster or stabilize the client through environmental intervention. Cultural and ethnic diversity exert a major influence on the client, healthcare beliefs, healthcare practices, and receptivity to new information which may affect health-seeking behaviors. Therefore, to provide comprehensive healthcare, nursing seeks to understand and influence the interaction between the internal and external environments, as well as health values, perceptions, and beliefs. In order to maximize health, a concerted effort to encourage health-promoting activities must take place simultaneously with the elimination of identifiable stressors that interfere with the attainment of human needs.
Health: Health is a complex phenomenon characterized by dynamic interaction between the internal and external environments and the client's physical, psychological, social, cultural, developmental, and spiritual balance. The client, whether the individual, family, or community, experiences health and illness on a continuum from high-level wellness to very serious illness and death. We believe that health should be maintained at an optimal level for each individual, family, or community. We associate optimal health with a harmonious balance among all aspects of the client and with successful adaptation to the stressors of an ever-changing environment. Optimal health involves a mutual commitment to growth and learning that is based upon collaboration between the client and the healthcare team. We acknowledge that health is a continuum and is defined by the client, the starting off point for the nurse in planning appropriate nursing care.
Nursing: Nursing is an art and a science propelled by humanistic values. Nursing as a science is grounded in theoretical knowledge, scientific inquiry, and research. Nursing as an art seeks to synthesize scientific knowledge, aesthetic knowledge, and self-knowledge to provide direct care; promote, maintain and restore health; and prevent illness. The purpose of nursing is to assist individuals, families, and communities to achieve an optimal level of health through therapeutically exploring the impact of these experiences. The nurse/client relationship is the essence of nursing. The nurse brings to this relationship, through knowledge of arts and sciences and an understanding of self, the ability to therapeutically interact with each human system in a holistic way. Nurses promote social justice, influence public policy, and help meet the needs of society to improve health and health care delivery.
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