“When push comes to a shove, we will seldom disappoint ourselves. We all harbour greater stores of strength than we think. Adversity brings the opportunity to test our mettle and discover for ourselves the stuff of which we are made.”
Do not underestimate the power of a person to cope. He may be dependent now but deep within him lies the energy to adapt.
I remember a particular a particular patient when I was still an ICU nurse. He was a pastor afflicted with a serious liver problem. Specialists come and go at his ICU bed but they cannot seem to diagnose the problem. Time is running out and the pastor is slipping fast. He’s bleeding and God knows how many units of blood have been transfused to him. He went into coma. Doctors were giving up, and so were we. We’ve primed the family but they just won’t give up…yet. The wife is always there at his side during visiting hours, always cheerful and full of hope. So is the daughter who even lets her dad listen to praise songs as if he is not comatose. Many days passed and to our amazement, the pastor woke up from coma. It’s been uphill from there. Everything just fell into the right place. He was transferred to a regular room and eventually discharged with a clean bill of health.
Amazing? What could it be? A miracle? Or could it be the medications working, or the transfusion? Or the family’s fervent prayers? We couldn’t tell but one thing is certain: human beings are made to persist. And that is what Sister Callista Roy believed, too.
Sister Callista Roy is a member of the Sisters of Saint Joseph of Carondelet. She received a bachelor of science in nursing from Mount Saint Mary’s College in
PHILOSOPHICAL UNDERPINNINGS OF THE THEORY
Johnson’s nursing model was the impetus for the development of
MAJOR ASSUMPTIONS, CONCEPTS AND RELATIONSHIPS ASSUMPTIONS
In the Adaptation Model, assumptions are specified as scientific assumptions or philosophical assumptions.
- Systems of matter and energy progress to higher levels of complex self- organization.
- Consciousness and meaning are constitutive of person and environment integration
- Awareness of self and environment is rooted in thinking and feeling
- Humans by their decisions are accountable for the integration of creative processes.
- Thinking and feeling mediate human action
- System relationships include acceptance, protection, and fostering of interdependence
- Persons and the earth have common patterns and integral relationships
- Persons and environment transformations are created in human consciousness
- Integration of human and environment meanings results in adaptation (Roy&Andrew, 1999, p.35).
- Persons have mutual relationships with the world and God
- Human meaning is rooted in the omega point convergence of the universe.
- God is intimately revealed in the diversity of creation and is the common destiny of creation.
- Persons use human creative abilities of awareness, enlightenment, and faith.
- Persons are accountable for the processes of deriving, sustaining and transforming the universe (Roy & Andrew, 1999, p. 35).
Reading through Roy’s adaptation theory, I now understand man’s immense capacity to adapt. I believe in a higher power, I believe in miracles, but I believe, too, that the greater miracle is the perfect interplay of all the factors that push a person to adapt at various modes.
The Four Modes of Adaptation
- Physiologic-Physical Mode
Physical and chemical processes involved in the function and activities of living organisms; the underlying need is physiologic integrity as seen in the degree of wholeness achieved through adaptation to change in needs.
- Self-concept- Group Identity Mode
Focuses on psychological and spiritual integrity and sense of unity, meaning, and purposefulness in the universe.
- Role Function Mode
Roles that individuals occupy in society, fulfilling the need for social integrity. It is knowing who one is in relation to others.
- Interdependence Mode
individually and in groups and the adaptation potential of these groups.
So how did the pastor recover? At the physiologic level, it was good that he was brought to the ICU immediately since the basic physiologic needs are met at once. He was intubated (for oxygenation), an NGT was put in place (for nutrition), a foley catheter was inserted (for elimination), and enema was also done to facilitate elimination of wastes.
Visitors were restricted early on to provide optimum rest and to minimize cross contamination. Isolation measures were also instituted. Routine ICU care, so to speak. Every time the patient is assigned to me, I try to talk to him as if he listens and can answer. His churchmates were also there every time they are allowed to see him telling him that they are waiting for him at their church. The wife and the daughter never gave up on him. They are always there to tell him how much they love and need him. The adaptation process was a long one, but he did adapt and went on to recover. The ICU environment is not a very ideal place for adaptation, but given the situation and condition of the patient at that time, it was the best place to support the body’s power to adapt.
Hamner in 1989 discussed the
The adaptation model is also useful in educational setting.
In the early 1980’s the
2. Developing teaching tools suitable for student learning.
3. Sequencing of content for student learning
4. Obtaining competent role models.
If research is to affect practitioners’ behavior, it must be directed at testing and retesting conceptual models for nursing practice.
Cutay, Rose Ann
De Jesus, David
Thank you for your contributions.