Theory Application in Nursing Practice

Summary of the Problem

Nurses have to work effectively with many other professionals within the health care facility and beyond it. They have to incorporate the services of lab technicians, general practitioners, dietetics and nutrition, administration, surgeons, and even radiologists among others. It means that their work is not limited in scope to work with other nurses only. Unfortunately, most professional units are built basing on common interests within their roles in the health care industry and solidarity, according to their job descriptions. It makes difficult for lab technicians interact with RNs or surgeons and with nutritionists within the same hospital. These discrepancies are particularly bad for a nurse. The reason is that they limit their efficiency in the frame of the work environment. If the nurse could interact with no issue with each member of staff within the medical institution, it would be likely that he or she could have the rather easy time obtaining any kind of information from any part of the facility as required in the case at hand. In addition, being able to interact with all colleagues without any problems generally creates a better and more supportive work surrounding for the nursing officer. In the end, healthy interpersonal relationships within the health care facility have a positive impact on the medical practitioner’s efficiency and motivation thus influencing sick persons positively as well.

Potential Middle Range Theory that Could Be Applied

In order to get the colleagues within the health care facility to communicate effectively regardless of their specific professions, the best middle range concept would be the Interpersonal Relations Theory by Hildegard Peplau (Alligood & Tomey, 2006). It focuses on a human capital management component that is based on interpersonal relationships within the organization. The theory emphasizes the way how nurses should interact with their patients at the personal level to improve the care quality and provide health promotion based on a cordial relationship. This concept shows medical practitioners how to build and maintain an effective interpersonal connection within the health care setting. It focuses more on patients though the same principles can be applied in relation to other professionals within the health care facility.

The Borrowed Theory

The borrowed theory in this case is a social exchange concept used in social sciences. It should be applied to explain why some relationships are possible and others not. According to this theory, people choose to start and maintain connections that offer them some form of rewards. The concept stipulates that individuals are generally self centered and thus only likely to invest in a relationship that can offer them something (McEwen & Wills, 2011). It thus follows that within a social setting, an individual will only be compelled to start and maintain the connection with another person if it has the following potential. It should give them some rewards like a better social status, information sharing, moral support or anything else that they could consider worth having. Some relationships are even created and maintained for the purpose of companionship for those ones who value a good communication. Therefore, regardless of underlying reasons, people simply need a cause for the connection to be created and maintained. This theory further explains that individuals have either positive or negative feelings about the ties that they are in as a result of several factors. These issues include the cost benefit analysis, the comparison level, and the comparison rate of alternatives. The first factor refers to the process where an individual calculates the value of the relationship by evaluating the potential costs and benefits of the connection in question. The costs are considered to be negative things that one may not like while the benefits are the positive aspects of the relationship. Within the health care setting, the communication between a nurse and a radiologist may have several costs and benefits. First, the latter one may not have much interest in the nurse’s work. Therefore, the medical practitioner will have a hard time approaching the radiologist in the first place. It is a cost. The benefit would, on the other hand, be that the nurse will learn more about radiology from an expert. It is an advantage considering that the medical practitioner can use this information to understand how to deal with a patient prior to and after a session with the radiologist. Primarily, the theory implies that in order for interpersonal relationships to exist sustainably, each of individuals needs to find some benefits rather than just having to deal with costs. The comparison level, on the other hand, refers to what one expects from the relationship as determined by the past experiences. In the health care setting, general practitioners may have a low expectation of their communication with nurses due to limited advantages they may have gained from such communication in the past. As a result, nurses do not expect much. They are thus not likely to make an effort towards the relationship. The comparison level of alternatives implies the following fact. In such a situation where the individuals can have other connections, they are likely to compare the cost benefit analysis outcomes of one relationship with that of others. If a GP could create and maintain a communication with a surgeon, he or she is likely to evaluate the potential cost and benefit of their relationship with that of the medical employee against the connection with a RN. Therefore, surgeons are socially engineered to pick such ties that have the highest rewards over those that have higher costs.

History of the Borrowed Theory

The social exchange theory was first introduced in 1958 by George Homans with the following definition. Social exchange is a process where two or more persons exchange a tangible or intangible activity that is either rewarding or expensive to them (Appelrouth & Edles, 2016). The theory was later modified and improved by Peter Blau and Richard Emerson as well as John Thibault and Harold Kelley. Levi-Strauss is also known to have studied it. He came up with a number of modifications of his own as well (Appelrouth & Edles, 2016). One of the most basic propositions of this concept is that people are likely to choose a relationship alternative providing the kind of rewards that they are interested in. It means that a person is likely to create and maintain connections that benefit them in a way that they recognize and appreciate. For example, the nurse may value a relationship with a nutritionist. However, the latter one may prefer to work with a GP instead. Generally, the difference in interest is based on individual definitions of relevance. The reason is that the nurse would like to learn from the nutritionist though the latter one is also looking to learn from the medical practitioner. In this case, the reward is an opportunity to study. Therefore, each member withina social circle is looking to gain rather than to give.

Previous Applications of the Borrowed Theory

In the study entitled “Factors Related to Initiating Personal Contacts on Internet Dating Sites: A View from the Social Exchange Theory,” the theory is applied to help unraveling the mystery of how individuals get to start dating online. This research generally has established that in order to initiate a contact with an unknown person on the Internet, people generally analyzed the person’s profile and sought out potential benefits they could get from the individual (Shtatfeld & Barak, 2012). It could be a financial stability, intellectual motivation, companionship or anything as stated in the individual’s online dating information. This study thus has applied the concept to understand what attracts persons to certain relationships. The fact that the individuals were meeting online meant that there had been no prior knowledge of one another and thus no variables like a pre-existing relationship that could deter the accuracy of conclusions.

On the other hand, Grey’s (1980) work “Exchange and Access in Fieldwork” is the study that tries to establish the relationship between researchers and participants of the research. It has been found out that the members are considered as givers in the context of the work. Therefore, for them to agree to be in that relationship with researchers there is a need for scholars to offer something in return. They may not have to pay the participants but they could suggest some information regarding the aims and objectives of the study. For example, more basketball fans are known to participate in a basketball survey if they are told that the research is aiming to improve the status of their game within their vicinity (Grey, 1980). Consequently, the borrowed theory has helped to understand how to motivate the participants to take part in the study.

Application of the Borrowed Theory in the Identified Problem

The social exchange theory helps to explain the difficulties that nurses are facing when it comes to interacting with the members from other professions within the health care facility. This concept explains that people are only likely to formulate and maintain connections that have more rewards than costs for them. However, in the health care setting, the medical practitioners seem to be the only ones who can attain the balance in terms of getting more rewards than costs. All other professionals seem to be limited in their scope of advantages from the communication with nurses. With this understanding, it should be easier for the management to find a way of ensuring that the nurse’s role in the health care industry is taken more seriously, especially towards the way how other professions can benefit from interacting with them (Weiss, Malone, Merighi, & Benner, 2002). However, it is a long term objective that may not be of significant pro to the company for a while. A more desirable course of actions would be for the nurses to find a way to have more benefits for other professionals. The medical practitioners are the primary caregivers. Thus, they are able to interact personally with the patients more than the members of any other unit. They, therefore, have a better knowledge and understanding of the sick person. More often, a better relationship built on trust and genuine care. The social exchange theory in this case helps to create a framework that will help nurses to become the valuable teammates rather than just distant colleagues within the health care facilities.

Integrating the Application of the Borrowed Theory and the Middle Range Theory

The borrowed theory in this case helps to understand the situation. It is in order to find a possible solution. In the case of disconnection among nurses and other professionals in the health care organization, the identified problem is as follows. Other employees do not find many benefits in interacting with medical practitioners. Thus, a solution would be for nurses to offer their relationship with patients as an added advantage. It may give other employees within the facility an insight on how to deal with certain sick persons in complex situations (Alligood & Tomey, 2006). It will allow medical practitioners to actually be considered as worthy of creating and maintaining connections with. In the end, nurses will have an easier time interacting with the members from other professionals within the organization. The applicable middle range theory in this case has been the interpersonal relations theory. It encourages nurses to work with one another at a personal level just as if they work with their patients (Benner et al., 2002).

Considering other employees as human beings and making personal connections being of interest to them is a good way to reach out and build bridges that are currently nonexistent. In order to integrate the two theories into practice, there is a need to appreciate the scope and focus of each concept. The middle range theory focuses on the following issues. It includes the things what the nurse can do, the way how she/he should think about the whole situation, and what the medical practitioner needs to invest in order to build these connections with people from other professional units within the health care organization.

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