CONCEPTUAL FRAMEWORK

Ludwig Von Bertalanffys 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 highlevel 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 and Development-----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 systems 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 LegalEthics 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 peoples 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 clients 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 clients 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 learners 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.
dtl Revised: April 4, 2011

PHILOSOPHY OF THE BACCALAUREATE NURSING 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 4. To prepare a generalist professional nurse with competencies to assume leadership in their professional role. 5. To prepare a generalist professional nurse capable of using emerging technology to stay abreast of changes in the delivery of healthcare in a dynamic society.

Revised: April 4, 2011