Page 655 - alligood 8th edition_Neat

636 UNIT V Middle Range Nursing Theories

changing (Jackson & Stevenson, 2004, p. 35). Profes-
sional nursing performance is described in three roles Major Assumptions
identified as (1) ordinary-me, (2) pseudo-ordinary/ Two basic assumptions underpin the Tidal Model.
engineered-me, and (3) professional-me. Relation- First, “change is the only constant.” Nothing lasts. All
ships are fluid, requiring nurses to “toggle” or switch human experience involves flux, and people are con-
back and forth from highly professional to distinctly stantly changing. This suggests the value of helping
ordinary presentations of self, and all relationships people become more aware of how change is happen-
differ depending upon the required role (Jackson & ing within and around them in the “now” (Barker &
Stevenson, 1998, 2000). The “pseudo-ordinary or Buchanan-Barker, 2004a). Second, people are their
engineered-me is likened to a see-saw” (Jackson & stories. They are no more and no less than the com-
Stevenson, 2004, p. 41). Sometimes people need plex story of their lived experience. The person’s story
someone to take care of them, other times someone is framed in the first person, and the story of how they
to take care with them (Barker, Jackson, & Stevenson, came to be here experiencing this ‘problem of living’
1999a; 1999b). The studies suggested that nurses contains the raw material for solutions (Barker &
respond sensitively to persons’ and their families’ Buchanan-Barker, 2004a).
rapidly fluctuating human needs. They need to “tune The Tidal Model rests on the following assumptions:
in to what needs to be done now,” to meet the per- • There are such “things” as psychiatric needs.
son’s needs (Barker, 2000e). Nurses are translators for • Nursing might in some way meet those needs
the person to the treatment team and the “glue” that (Barker & Whitehill, 1997, p. 15).
holds the system together (Stevenson & Fletcher, • Persons and those around them already possess
2002, p. 30). the solutions to their life problems.
The second study focused on the nature of em- • Nursing is about drawing out these solutions
powerment and how this is enacted in relationship (Barker, 1995, p. 12).
between nurses and persons-in-care and resulted The Tidal Model assumes that when people are
in the Empowering Interactions Model (Barker, caught in the psychic storm of “madness,” it is
Stevenson, & Leamy, 2000). This was developed with “as if” they risk drowning in their distress or foun-
Flanagan’s Critical Incident Technique (Flannagan, dering on the rocks; it is “as if” they have been
1954) within a cooperative inquiry method (Heron, boarded by pirates and have been robbed of some of
1996), using a modified grounded theory approach their human identity; it is “as if” they have been
(Glaser & Strauss, 1967). The study developed washed ashore on some remote beach, far from
Peplau’s assumptions about the importance of spe- home and alienated from all that they know and
cific interpersonal transactions, and it provided understand.
guidance and strategies for nurses within collabora-
tive nurse-person relationships. Strategies included Nursing
the following: “Nurses are involved in the process of working with
• Being respectful of people’s knowledge and expertise people, their environments, their health status and
about their own health and illness their need for nursing” (Barker, 1996a, p. 242). Nurs-
• Putting the person in the driver’s seat in relation to ing is continuously changing, internally and in rela-
the interaction tion to other professions, in response to changing
• Seeking permission to explore the person’s experience needs and changing social structures. “If any one
• Valuing the person’s contribution thing defines nursing, globally, it is the social con-
• Being curious as a way of validating the person’s struction of the nurse’s role” (Barker, Reynolds, &
experience Ward, 1995, p. 390). Nursing as nurturing exists only
• Finding a common language to describe the situation when the conditions necessary for the promotion of
• Taking stock growth or development are put in place (Buchanan-
• Reviewing collaboratively, and inspiring hope Barker & Barker, 2008). Nursing is “an enduring
through designing a realistic future together human interpersonal activity and involves a focus on