The personal philosophy must include the following domains: Nursing, Environment, Health and Person. You should include your personal definition of each domain and how these fit into your philosophy of nursing. In preparing your philosophy the faculty require that you review the philosophies of Miami Dade College, Benjamin Leon School of Nursing and at least one hospital. A limit of 1 to 3 pages is acceptable in APA format.  

Select a child/adolescent or adult patient from your clinical experience who presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. When you submit your SOAP note, you should include the complete SOAP note as a You must submit your SOAP Note using Turnitin.

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 Reply for the following Discussion, more than 200 words and Turnitin less than 20 %. at least 2 References. APA format.

Nursing theories are philosophical constructs that attempt to explain, describe, or predict phenomena that occur during nursing care by serving as guides in clinical practice, education, and nursing research (Im, 2021). According to the philosophical level of abstraction, the body of nursing theories is composed of the metaparadigms of nursing (least specific level), grand theories, middle-range theories, and practice theories (highest level of specificity) (Im, 2021). Grand theories of nursing address global aspects of the nursing universe, examples of these theories include: General Systems Theory by Imogene King, Conservation Model by Myra Estrine Levine, Nursing Process Theory by Ida Jean Orlando, Theory of Human Becoming by Rosemarie Rizzo Parse, Adaptation Model by Sister Callista Roy, Emancipated Decision Making in Health Care by Wittman-Price, Self-Care Theory by Dorothea Orem (Im, 2021). The development of the grand theories of nursing was a momentous step in the development of nursing and the attainment of an identity (Im, 2021). They were initially used as theoretical frameworks in clinical practice and research; however, their high level of abstraction limited their applicability (Im, 2021). Many of these theories are now considered obsolete because they are very abstract and their adaptation to specific clinical crossroads is not very useful (Im, 2021). In the research branch, the grand theories have lost steam as well, especially in a modern research field more focused on evidence (Im, 2021). Midrange theories have taken over the role those grand theories once played as more specific and more detailed philosophical constructs about nursing phenomena, and clinicians and researchers find midrange theories to be a more accurate guide to decision-making (Wijaya et al., 2022). Although grand theories of nursing are considered obsolete in current practice, they were a milestone in the development of nursing as a scientific discipline with its own identity. 

 Reply for the following discussion: More than 200 words, APA format, Refences at least 2.

The development of nursing knowledge is an ongoing process, and nursing grand theories play a significant role in shaping the direction of nursing practice and research. Grand theories, such as those proposed by Florence Nightingale, Dorothea Orem, and Jean Watson, provide a comprehensive framework that helps guide nursing practice across various settings. These theories offer broad, general principles that are applicable across different contexts and emphasize the importance of the nurse-patient relationship, the promotion of health, and holistic care. According to Alligood (2017), grand theories contribute to the organization and systematic development of nursing knowledge, allowing for the creation of consistent and coherent care approaches. By offering a conceptual foundation, they enable nurses to assess patient situations, develop effective interventions, and improve care outcomes. Furthermore, the continued development and refinement of these grand theories foster innovation within nursing, guiding research that can lead to improved care models and better patient outcomes.

However, there is also a valid case for questioning the relevance of grand theories in modern nursing practice. As healthcare environments become more complex, with a strong focus on evidence-based practice, clinical guidelines, and the integration of new technologies, the abstract nature of grand theories may become less applicable to the day-to-day needs of nursing practice. Meleis (2018) argues that the rapid pace of medical advancements and the increasing need for specialized knowledge can render grand theories somewhat outdated. The emphasis on evidence-based practices and specific clinical models, which are based on empirical research, may be more immediately useful in addressing the dynamic demands of modern healthcare. For example, grand theories often fail to account for the intricacies of contemporary patient care, such as the management of chronic illnesses or the application of advanced technologies, which require more specific and practical approaches.

Moreover, the shift toward middle-range theories, which are more directly applicable to specific clinical situations, provides a more adaptable and context-sensitive framework for practice and research. These theories, according to Meleis (2018), offer more practical solutions to immediate nursing challenges, making them better suited for contemporary healthcare systems that are complex and ever-changing. While grand theories may still have value in providing overarching guidance for nursing, middle-range theories and evidence-based practice models may be more appropriate for addressing the specific challenges of today’s healthcare landscape.