University of Kansas School of Nursing
Philosophy, Organizing Framework,
and Curricular Threads
Philosophy
The School of Nursing is a school within the University of Kansas. The
School of Nursing derives its philosophy and purposes from the mission statement
of the University. The faculty have the responsibility for implementing the
three major functions of the University, that is, research, teaching and
service. The nursing faculty believe nursing is a practice discipline that is
both an art and science, in which theories and knowledge from nursing and other
disciplines are used to assist clients toward maximum health and wellness. A
modified systems theory is used as the organizing framework for the
construction and implementation of the nursing curricula. Four major concepts
with definitional statements and subconcepts, comprise the elements of the
system. The major concepts are client systems, environment, health, and
nursing. Through this framework,
faculty express their commitment to teach students theory and research based
humanistic nursing practice, focused on health, wellness and illness of clients
systems of varying complexity, within a rapidly changing health care delivery
system. This is accomplished while taking into account differing perspectives
and values of the client systems served.
Client systems are defined as either the individual, family, group, organization or community. Client systems are interdependent, complex and ever changing. They are hierarchically arranged; that is, each system serves as macrosystem to lower level systems and microsystem to higher level systems. Changes in one part of a system affect the total system. Client systems have needs that evolve throughout their development. They have innate abilities, resources, experiences and value systems that guide decision-making regarding health issues. These decisions influence, and are influenced by, the internal and external environments of the system. Nurses intervene with a client system by participating with that system in identifying health needs and encouraging self-direction and self care consonant with cultural values. This reflects a belief that client systems have different capabilities and desires to learn, adapt and grow, and a right to make both independent and collaborative choices regarding health care.
The environment of client systems consists of natural, biological, psychological, spiritual, behavioral, social and cultural factors. Because client systems are hierarchically arranged, each level serves as environment to adjacent systems. The internal and external environments of client systems are constantly changing and influencing the system, and may result in alterations in health. The five client systems are all affected by their social and cultural environments. Nurses recognize that in providing health promotion, disease prevention, and illness care, they become part of the existing environment of the client system, necessitating both scientific knowledge of how the system functions, and artful collaboration with appropriate components of the system to effect care.
Health is a dynamic state of biological, psychological, behavioral, and social well-being and reflects each client system's ability to alter its environments, or to adjust to or evolve with environmental changes. Wellness and illness are socially and individually defined concepts representing the degree of variation in the client system's ability to alter or adjust to its environments. Consistent with a focus on primary health care, the nurse recognizes the client system's ability and responsibility to engage in self-assessment and health care behaviors. To that end, the nurse and client system collaborate as partners to design, implement, and evaluate client-centered interventions for the promotion and maintenance of well-being, the prevention of illness, and in states of decreased well-being, the restoration of human functioning to its optimal level.
Nursing is a practice profession with a defined body of knowledge and goals. Nursing makes a unique and valuable contribution within the health care system and society. The profession provides a social structure to develop legitimate professional roles for its members. The faculty of the School of Nursing recognize two interrelated aspects of professional practice: the art and the science of nursing. The art of nursing involves intuition, creativity, caring and application of nursing therapeutics, communication skills, and supportive interpersonal processes. These aesthetic considerations are integrated with knowledge from the natural and behavioral sciences through critical thinking and systematic investigation. Together the art and science of nursing provide insights for the profession in meeting its mission of providing for the health care needs of clients in home, community, or institutional health care delivery settings. Fulfillment of this mission involves the use of the nursing process to promote and maintain health and wellness, prevent illness, diagnose and manage potential or actual health problems, facilitate adaptation to health impairments, assist rehabilitation, and maximize the opportunity for dignity in living and dying. Professional nurses recognize the contribution each individual makes to society and the necessity to consider the total person in nurse-client interactions. Further, they apply primary health care concepts in responding to needs of populations and communities consonant with available health care system resources. Nursing's mission is accomplished while taking into account the legal and ethical rights and responsibilities of client systems, other caregivers, and nurses, with full attention given to the influence of historical, political, social, cultural and economic factors. Leadership, collaboration, and consultation among nurses and other health care providers and support systems is critical in meeting client needs. Nursing demonstrates its professional values and accomplishes its mission through research, education and practice.
The University of Kansas School of Nursing offers three degrees in nursing:
baccalaureate, masters and doctoral degrees. Students use research and theory
from nursing and other disciplines throughout the three programs, with content
increasing in complexity at each level. Critical thinking, communication
skills, and problem-solving are required in all three curricula. All students
are considered adult learners. Education for entry into professional nursing
occurs in the baccalaureate program and requires a foundation in the liberal
arts and sciences. Baccalaureate students obtain a basic preparation in nursing
and have didactic and clinical experiences dealing with a variety of client
health and illness needs across the life span in community-based, ambulatory,
long-term and acute care settings. They are prepared for beginning clinical
leadership roles. Masters students expand skills and knowledge to become
advanced practice nurses or administrators, actively identifying research
problems and using research findings in practice. The advanced practice nurse
is prepared in one of three specialty areas, Nurse
Practitioner, Clinical Nurse Specialist, and Nurse Midwife. Nurse leaders are
prepared at for middle management and executive leadership roles.
Doctoral students develop skills in theory development and in the conduct of
original nursing research. In all three programs, faculty serve as role models,
resource persons, and facilitators for student learning.
The faculty believe that nursing education, practice and research are inextricably intertwined. Through faculty practice contracts negotiated in primary, secondary and tertiary care settings, faculty provide expertise, model interdisciplinary collaboration for students, and create opportunities for research. Use of advanced information technology allows the extension of faculty expertise into rural communities. Faculty practice in the community further creates the opportunity for cultural encounter, a necessary experiential component of cultural competence. Practice in the community and in institutional settings makes apparent power relationships which affect access to care and may interfere with client systems' abilities to actively collaborate in their own health care. Faculty draw on these practice experiences in teaching students in all three programs.
In keeping with the mission of the University, the School of Nursing faculty also participate in service to the School, the Medical Center, the University and the community. The faculty support the need for continuing education in nursing as a means to improve the delivery of health care and knowledge of policies related to health care, and as a means for meeting informational needs in rural and underserved areas. Service activities often are linked to faculty research and practice interests and thus may serve as an additional resource for teaching.
In summary, the concepts of client system, environment, health and nursing comprise the elements of the School of Nursing philosophy and organizing framework. A visual model depicting their relationships follows.
Organizing
Framework
The educational programs of the University of Kansas School of Nursing are organized in relation to four major concepts: client system - individual, family, group, organization and community; environment - internal and external; health - wellness/illness; and nursing - art and science. This organizing framework provides a means for understanding complex client systems and the changing relationships inherent within them. The concepts are defined as follows:
- Client systems (individuals, families, groups, organizations, and communities) consist of interrelated components that are in continuous interaction with their internal and external environments.
- Environment includes
two components: internal and external. These consist
sof natural, biological, psychological, spiritual, behavioral, social, and cultural factors. - Health is the ability to adjust to or evolve with environmental changes. The relative state of wellness or illness is dependent upon the degree of balance both within the client system and between the client system and the external environment.
- Nursing, as an art and science, is the means of assisting client systems to maintain or restore balance and to prevent further system imbalance as client systems grow and develop over time.
Curricular Threads
Following from the four concepts explicated in the University of Kansas School of Nursing philosophy, the faculty have identified five related horizontal threads that construct the curricula. These threads are 1) human functioning and health, 2) focal client systems, 3) nursing therapeutics, 4) health care delivery systems, and 5) professional values. The concept of environment is embedded in each. Course and terminal objectives are stated in terms of the five threads. Each course addresses components of the threads, with specific content increasing in complexity throughout the curricula. The five threads serve as broad categories under which a variety of content can be expressed. They are not considered mutually exclusive. It is recognized that the rapid evolution of nursing science, practice, and education demands on-going reexamination of categories and concepts. The five threads, with example content presented as sub-sets, are defined below. The lists of content examples are not intended to be exhaustive.
HUMAN FUNCTIONING AND HEALTH: Human functioning refers to basic biological, psychological, spiritual, behavioral, social and cultural processes. Health is a dynamic state of well-being in relation to these processes, and reflects the client system's ability to adapt to its environments. The goal of nursing is to assist client systems toward optimal functioning. Concepts that may be included in this thread are the following: holistic health perspective; health promotion; health education; concepts of primary, secondary, and tertiary care; risk factors; resilience factors; health indicators; outcome measures; and epidemiology of health and illness.
FOCAL CLIENT SYSTEM: A focal client systems is the entity
toward which nursing therapeutics are directed in a given situation. Example concepts include the following:
individuals, families, groups, organizations, communities, cultures and society; diverse
populations; aggregates, including elders, high risk groups and others; urban
and rural populations.
NURSING THERAPEUTICS: Nursing therapeutics refers to the work of nursing, including application of cognitive, behavioral, psychomotor and affective processes to the design of nursing interventions with client systems. Example concepts include the following: the art and science of nursing; diagnosing potential or actual health problems; interrelationship of theory, practice and research; knowledge and use of practice and other theories; population-based needs assessment; critical appraisal and use of research findings; use and evaluation of therapeutic nursing interventions; health restoration; knowledge of disease processes; processes of critical thinking, problem solving and communication; cultural competence; nursing process; clinical/critical paths; client system's health and illness model; outcome criteria.
HEALTH CARE DELIVERY SYSTEMS: The health care delivery system is the complex set of interrelated elements and processes organized within a society for the express purpose of delivering health care services to designated populations. Nursing practice is an element of the health care delivery system. Example concepts include the following: history of health care in the U.S.; elements of primary, secondary, and tertiary care; economics of health care, for example, managed care, capitation, and fee for service; work design, including case management, differentiated practice, patient care delivery systems, patient-focused care; determining and measuring outcomes of health care; community-based care; primary health care; local participation; rural health; electronic interface among providers; interdisciplinary collaboration; power relationships (economic and political); high technology home care; system productivity.
PROFESSIONAL VALUES: Professional values represent the foundational beliefs from which standards of ethical practice are derived. Example concepts include the following: the art of caring; collegial relationships including language differences among professions; communication, including interpersonal, written, oral, and electronic; professional development including continuing education, certification, legal and ethical issues, leadership and management, standards of practice; professional roles; trends; governance; cultural competence.
Approved 12/16/94
Implementation date: Fall, 1995
Updated: 05/14/01
Final Revision Pending.