Julia Costales has just started her MSN program and took her first theory course. She plans to be an acute care nurse practitioner. She is currently working as a staff nurse in the local VA’s inpatient medical unit.
Ms. Costales has been very skeptical about the usefulness of theory in practice. She was not persuaded by studying the nursing theories and believed that some of the sociologic and behavioral ones were just “common sense.” On a recent day, she was collaborating with the unit CNS, JoAnne Schultz, regarding a particularly complex patient. JoAnne seemed amused when Ms. Costales told her about her views on theory. JoAnne challenged her to look at the patient they were caring for and see how many theories she could identify that would help them guide his care. JoAnne wanted Julia to start with obvious ones: those from the biomedical sciences. Read the brief history of Julia’s patient and help her out by naming the theories from the biomedical sciences that she should consider.
The patient: Mr. Joe Atkinson is a 62-year-old Vietnam veteran who had a difficult time transitioning back to society after the war. He suffered from posttraumatic stress syndrome (PTSD), began to abuse alcohol and eventually IV heroin, and became homeless. However, during one of the annual Stand Downs,* he was able to enter recovery and has been sober since 1999. Unfortunately, he also contracted HIV during the time he was using drugs. He is currently hospitalized because he was recently diagnosed with Burkitt Lymphoma and is initiating treatment. In addition, he suffers from sensory peripheral neuropathy (possibly due to some of the early medications for HIV), causing chronic pain. Mr. Atkinson is very concerned about the current illness and hospitalization because he has recently started a new job.
*Stand Downs are “typically one to three day events providing services to homeless Veterans such as food, shelter, clothing, health screenings, VA and Social Security benefits counseling, and referrals to a variety of other necessary services, such as housing, employment and substance abuse treatment. Stand Downs are collaborative events, coordinated between local VAs, other government agencies, and community agencies who serve the homeless” (http://www.va.gov/homeless/standdown.asp).
1. What are some of the theories from the biomedical sciences that JoAnn thought Julia should identify?
2. How could Julia apply each theory in considering Mr. Atkinson’s case?
3. What other theories do you think JoAnne might consider in his care (also consider theories from previous chapters).