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.

dtl

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

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