LOCAL CONCEPTUAL MODELS SIS CAROL AGRAVANTE
Earned Bachelor’s Degree in Nursing in St. Paul College Manila in 1964 (Magna cum Laude, first placer in the Board exam for Nurses on the year 1964)
Finished her Master’s Degree in Nursing Education in Catholic University Univers ity of America in19 1970 70
Obtained her Doctoral degree in nursing in University of the Philippines Manila on April 2002
Currently, Sr. Carol is the president of the St. Paul University of Iloilo since her installation last 2004.
Aside from that she is the current president of the Association of the Deans of the Philippine Colleges of Nursing.
Complete title of the model is: The CASAGRA Transformative Leadership Model: Servant – Leader Formula & the Nursing Faculty’s Transformative Leadership Behavior .
The theory “CASAGRA “CASAGRA Transformative Leadership” Leadership” is a psycho spiritual model. It is coined after the name of the investigator: Sr. CArolina S. AGRAvante
designed to lead to radical change from apathy or indifference to a spiritual person .
Main Propositions
psycho-spiritual ual model, was an effective means CASAGRA transformative transformative leadership is i s a psycho-spirit
for faculty to become better teachers and servant-leaders.
Care complex is a structure in the personality of the caregiver that is significantly related to the leadership behavior.
The CASAGRA servant-leadership formula is an effective modality in enhancing the nursing faculty’s servant-leadership behavior.
Vitality of Care Complex of the nursing faculty is directly related to leadership behavior
The model is a Three-Fold Transformation Leadership Concept rolled into one, comprising of the following elements: A. Servant-Leader Spirituality; Spirituality; B. Self-Mastery expressed Self-Mastery expressed in a vibrant care complex; C. Special Expertise level Expertise level in the nursing field one is engaged in. These elements rolled into one make-up the personality of the modern professional nurse who will challenge the demands of these crucial times in society today.
THE THREE-FOLD TRANSFORMATION LEADER CONCEPT IN DETAIL
I. The Servant-Leadership Spirituality here is prescribed to run parallel to the generic elements of the transformative leadership model.
This formula consists of a spiritual exercise, the determination of the vitality of the care complex in the personality of an individual and finally a seminar workshop on transformative teaching.
The servant-leader formula prescription includes a spiritual retreat that goes through the process of awareness, contemplation, story telling, reflection, and finally commitment to become servant-leaders in the footsteps of Jesus.
Servant-leader formula is the enrichment package prepared as intervention for the study which has three parts that parallel the three concepts of the CASAGRA transformative leadership model, namely: o
o
o
the care complex primer Care complex is the nucleus of care experiences in the personality of a nurse formed by a combination of maternal care experiences, culture based-care practices indigenous to a race and people, and the professional training on care acquired in a formal course of nursing. a retreat-workshop on Servant-leadership Retreat-workshop is the spiritual exercise organized in an ambience of prayer where the main theme is the contemplation of Jesus Christ as a Servant-leader. a seminar-workshop on Transformative Teaching for nursing faculty. Transformative teaching may also be termed Reflective teaching, an umbrella term covering ideas, such as thoughtful instruction, teacher research, teacher narrative, and teacher empowerment.
II. The Self-Mastery consists of a vibrant care complex possessed to a certain degree by all who have been through formal studies in a care giving profession such as nursing.
III. The Special-Expertise level is shown in a creative, caring, critical, contemplative and collegial teaching of the nurse faculty who is directly involved with the formation of the nursing. THE THEORY AS ASSERTED The CASAGRA Servant-Leadership Theory is the major breakthrough that the nursing profession urgently needs. The harmony and synergy in being a servant and a leader as well must be manifest in the nursing graduate by TRANSFORMING faculty with the servant-leader formula.
The professional nurse must harmonize and manifest the other side of the service coin, which is the conscious choice to aspire to lead while washing ones another's feet as Jesus did.
Transformative teaching for nursing guarantees the nursing st udents’ formation as nursing leaders in the art of caring which only an artist for whom caring is second nature can teach. This is the first lesson learned by nursing students at the lap of the nursing faculty of her school.
The transformative teacher is basically the one who looks into her self vis-à-vis her profession, sees her assumptions and feelings in the light of the nursing profession in modern days, how her own philosophy of life affects her professional life and her students.
Worldwide leadership crises have demanded the nursing leaders to REVISIT the formation of future nursing leaders. The TIME to revisit the leadership formation as modeled by nursing faculty is NOW. The focus is on leadership style of Jesus himself who has become the model in the nursing profession of service as synonymous with leadership. The nursing profession needs leaders who will model for the profession that which is beautiful, true, and good in this new millennium.
STRENGTHS
o
It provided the task of the formation of the nurse leaders at the baccalaureate level so that the profession assured the graduates possess the mind and heart of a nursing leader who is of the nursing profession
o
It can also be use in other educational settings not just on nursing profession
WEAKNESSES/LIMITATIONS o
CASAGRA transformative leadership limits only on Roman Catholic and Christians nursing educators.
o
Did not consider other religion to this study. In the Philippines we have a variety of religion present. Every religion has its own traditions and practices to be considered.
o
According to the study the control and study groups were selected from the same faculty in the two schools, it is highly possible that experience could have been discussed casually in faculty room and in some way must contam inated the intervention.
USEFULNESS (PRACTICABILTY) It is significant to the nurse educators. It will help them to achieve the vision-mission as a network of innovative, competent empowered educators towards excellence in national and global development. The theory could be the answer in the modern-world challenges in nursing education that is centered on the teaching of Jesus, a paradigm of peace.
Carmelita Divinagracia
Finished her Masteral degree in Nursing in 1975 and a doctoral degree holder in 2001
She has been lauded for developing the art and competency of teaching nursing.
She has lectured and written about her work as a nurse and how she has used her hands-on experience to develop better ways to teach nursing.
Her love for nursing and her dedication to carve out learning tools for nursing students has been a commendable and rare field of discipline.
As a teacher, she could not be anything else but a perfect thesis adviser. She has teamed up with the Commission on Higher Education for the drafting of a higher standard of competency in nursing schools in the Philippines.
She was the former president of the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the dean of UERMMMC College of Nursing. She is also a member of CHED’s Technical Committee on Nursing Education. On 2008, Dean Divinagracia received the Anastacia Giron Tupas Award.
Sis Lety Kuan
Born on November 19, 1936 in Katipunan-Dipolog, Zamboanga del Norte
Sister Letty G. Kuan is a nurse with two (2) Master’s Degrees, MA in Nursing and MS in Education major in Guidance Counselling.
Holds a Doctoral Degree in Education major in Guidance Counselling. All these postgraduate studies were obtained from the University of the Philippines - Diliman, Quezon
City
For her vast contributions to the University of the Philippines - College of Nursing faculty and academic achievements, she was awarded the distinctive post of Professor Emeritus, a title awarded only to a few who met the strict criteria set by the University of the Philippines in September 2004.
She has clinical fellowship and specialization in Neuropsychology obtained from University of Paris, France in (Salpetriere Hospital). Neurogerontology in Watertown, New York (Good Samaritan Hospital) and Syracuse University, New York
About her Theory: “Retirement and Role Discontinuities” Basic Assumptions and Concepts:
Physiological Age -> is the endurance of cells and tissues to withstand the wear-and-tear phenomenon of the human body. Some individuals are gifted with strong genetic affinity to stay young for a long time.
Role -> refers to the set of shared expectations focused upon a particular position. These may include beliefs about what goals or values the position incumbent is to pursue and the norms that will govern his behavior. It is also the set of shared expectations from the retiree’s socialization experiences and the values internalized while preparing for the position as well as the adaptations to the expectations socially defined for the position itself. For every social role, there is complementary set of roles in the social structure among which interaction constantly occurs.
Change of Life -> is the period between near retirement and post retirement years. In medico-physiologic terms, this equates with the climacteric period of adjustment and readjustment to another tempo of life.
Retiree -> is an individual who has left the position occupied for the past years of productive life because he/she has reached the prescribed retirement age of has completed the required years of service.
Role Discontinuity ->is the interruption in the line of status enjoyed or role performed. The interruption may be brought about by an accident, emergency, and change of position or retirement.
Coping Approaches ->refer to the interventions or measures applied to solve a problematic situation or state in order to restore or maintain equilibrium and normal functioning.
Determinants of positive perceptions in retirement and positive reactions toward role discontinuities:
1. Health Status – refer to physiological and mental state of the respondents, classified as either sickly or healthy. 2. Income – (economic level) refers to the financial affluence of the respondent which can be classified as poor, moderate or rich. 3. Work Status 4. Family Constellation – means the type of family composition described either close knit or extended family where three more generations of family members live under one roof; or distanced family, whose member live in separate dwelling units; or nuclear type of family where only husband, wife and children live together. 5. Self-Preparation
CONCEPTUAL MODEL
Strengths
The theory can be applied not only for the population undergoing retirement process, but also for the population that is undergoing life transitions.
The theory is easy to understand, wherein most people can relate to the effects of role change.
Weakness/ Limitations
The theory focuses too much on the positive determinants. Retirement adjustment is clearly a multidimensional process but the theory only used a single indicator which is the positive determinants to retirement.
Usefulness
The theory is useful in geriatric nursing where nurses can derive a plan of care to help the patient to have ease of movement through a transitional process
If individuals have a better understanding of the retirement process and their new role, they will prepare and adjust better. (Kelly & Swisher, 1998)
Carmencita Abaquin
Obtained her Master’s Degree in Nursing from the University of the Philippines College of Nursing.
An expert in Medical Surgical Nursing with subspecialty in Oncologic Nursing, which made he r known both here and abroad
She had served the University of the Philippines College of Nursing, as faculty and held the position as Secretary of the College of Nursing.
Being appointed as Chairman of the Board of Nursing speaks of her competence and integrity in the field she has chosen
Her theory: “PREPARE ME” Interventions & the Quality of Life of Advance Progressive Cancer Patients
BASIC ASSUMPTIONS AND CONCEPTS PREPARE ME (Holistic Nursing Interventions) are the nursing interventions provided to address the multi-dimensional problems of cancer patients that can be given in any setting where patients choose to be confined. This program emphasizes a holistic approach to nursing care. PREPARE ME has the following components: 1. Presence – being with another person during the times of need. This includes therapeutic communication, active listening, and touch. 2. Reminisce Therapy – recall of past experiences, feelings and thoughts to facilitate adaptation to present circumstances. 3. Prayer 4. Relaxation-Breathing – techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle t ension, and anxiety. 5. Meditation – encourages an elicit form of relaxation for the purpose of altering patient’s level of awareness by focusing on an image or thought to facilitate inner sight which helps establish connection and relationship with God. It may be done through the use of music and other relaxation techniques. 6. Values Clarification – assisting another individual to clarify his own values about health and illness in order to facilitate effective decision making skills. Through this, the patient develops an open mind that will facilitate acceptance of disease state or may help deepen or enhance values. The process of values clarification helps one become internally consistent by achieving closer between what we do and what we feel.
Origins of the theory The incidence of cancer has significantly increased not only in th e Philippines but also worldwide
Meaning of theory 1. Terminally-ill patients especially cancer patients require holistic approach of nursing in different aspects of man namely the emotional, psychological, social and spiritual. In this premise, patients with incurable disease require multidimensional nursing care to improve quality of life.
2. PREPARE ME nursing interventions are effective in improving quality of life in terminally-ill patients.
3. Utilization of intervention as a basic part of care given to cancer patients, likewise, incorporation in the basic nursing curriculum in the care of these patients. PREPARE ME must be introduced and focus during training of nurse both in academe and practice.
4. Development of training programs for care provider as well as health care profession where intervention is a part of treatment modalities.
5. The nurse must be honest about the feedback on his/her condition. Nurses must do this so that they would know what the expectations of the patient and the family so that they may render a holistic caring style for the patient together with his family in his dying days. This would help the patient and family address the needs of the patient in any manner possible. (physical, emotional and spiritual)
6. The nurse must help make a supportive environment for the patient and his family in his dying days. An environment like this would promote dignity in his days left thus helping the patient accept his fate and help him/her be ready for the afterlife. The family is also guided in this rough time addressing their grieving process by instilling in them that death is part of life.
CONCEPTUAL MODEL
Holistic Nursing Interventions “Prepare Me” Presence Reminisce Therapy Prayer Relaxation-Breathing Meditation
SYMPTOM RELIEF QUALITY OF LIFE
Terminally ill Patients (Cancer) Physical Psychological Social Religious Level of Independence
Strengths:
It provides us standardized and holistic approach in addressing the needs of terminally ill cancer patients.
It can also be used for other terminal cases.
Weakness/ Limitations:
More time is needed to make the patient interested in PREPARE ME interventions because they are already experiencing loss of interest in things
"Understaffing in Philippine hospitals is prevalent. (Inamarga, 2009)
In the Philippine setting, due to understaffing and financial constrain, time for bed side care is limited
Usefulness 1.
This theory is useful in addressing the needs of terminally-ill cancer patients. This encompassed different aspects including family relationship and self-actualization.
2.
Appreciating the impact of a relative's cancer and offering guidance and support via patientcentered counseling can enhance quality of care
Cecilia Laurente
Local nursing theorist in the Philippines, who focused her works on helping a patient through support systems specifically the family.
She has a publication entitled "Categorization of Nursing activities as Observed in Medical Surgical Ward Units in Selected Government and Private Hospitals in Metro Manila
She became a dean of the College of Nursing in UP Manila from 1996-2002
Theory of nursing practice and career
In the recent study of Laurente she states that another entry point of helping the patient is though the family, when nurses can be of great assistance to prevent at the very beginning serious complications. The nurse can help strengthen the family’s term of knowledge, skills, and attitude through effective communication, employed informative, psychotherapeutic, modeling, behavioral, cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated.
References:
Octaviano, Eufemia F., RN, RM, MN, EdD, Balita, Carl E.,RN, RM, MAN, DrHum. “Theoretical Foundations of Nursing:The Philippine Perspective” , 2008
Retrieved from:
http://nurseslabs.com/new-prc-board-nursing-members/ http://www.scribd.com/doc/79461231/Casagra-Theory
http://nursingcrib.com/nursing-notes-reviewer/sister-letty-g-kuan/
