Page 653 - alligood 8th edition_Neat

634 UNIT V Middle Range Nursing Theories

MAJOR CONCEPTS & DEFINITIONS —cont’d
and weaknesses, the Tidal Model seeks to reveal very much on what the person is experiencing
resources available to the person—both personal now and what needs to be done now to address,
and interpersonal—that might help on the voy- and hopefully resolve, the problem.
age of recovery. 2. What works? We need to ask “what works”
3. Respect for the person’s wishes, rather than being (or might work) for the person under the
paternalistic, and suggesting that we might present circumstances. This represents the
“know what is best” for the person. “person-centered” focus of care. Rather than
4. Acceptance of the paradox of crisis as opportu- using standardized techniques or therapeutic
nity: Challenging events in our lives signal approaches, which may have general value,
that something “needs to be done.” This might we aim to identify either what has worked
become an opportunity for a change in life for the person in the past or what might work
direction. for the person in the immediate future, given
5. Acknowledging that all goals, obviously, belong their history, personality, and general life
to the person. These represent the small steps on circumstances.
the road to recovery. 3. What is the person’s personal theory? We need
6. The virtue in pursuing elegance: Psychiatric to consider how this person understands her
care and treatment are often complex and or his problems. What “sense” does the person
bewildering. The simplest possible means “make” of her or his problems? Rather than
should be sought, which might bring about giving persons professionalized explanations
the changes needed for the person to move of their difficulties in the form of theory or
forward. diagnosis, try to understand how they under-
stand their experience. What is the person’s
Getting in the Swim—Engagement personal theory?
Beliefs § 4. How do we limit restrictions? We should
When people are in serious distress, they often feel aim to use the least restrictive means of
as if they are drowning. In such circumstances, helping the person address and resolve
they need a “lifesaver.” Of course, lifesavers need to their difficulties. The Tidal Model tries to
engage with the person—they need to get close—to identify how little the nurse might do to
begin the rescue process. To get in the swim and to help the person, and how much the person
begin the engagement process, we need to believe might do to bring about meaningful change.
the following: Together, these represent the least restrictive
n That recovery is possible intervention.
n That change is inevitable—nothing lasts
n That ultimately, people know what is best for them Continuum of Care ¶
n That people possess all the resources they need As needs flow with the person across artificial
to begin the recovery journey boundaries, care is seamless with the intention of
n That the person is the teacher, and we, the help- the person returning his or her “ocean of experi-
ers, are the pupils ence” within his or her own community. Across
n That we need to be creatively curious to learn the care continuum, people may need critical or
what needs to be done to help the person now! immediate, transitional or developmental care.
Practical immediate care addresses searching for
Therapeutic Philosophy || solutions to the person’s problems, generally in the
1. Why this—why now? We need to consider, first short term, and focuses upon “what needs to be
of all, why the person is experiencing this par- done, now.” People enter the care continuum for
ticular life difficulty now. The focus of care is immediate care when experiencing an initial mental