PURPOSE: It is important to understand how middle-range theory can help you in your everyday environment as a nurse. In the previous assignment, you identified a practical problem that emerged from th

Middle-Range Theory


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Application of Middle-Range Theory to Compassion Fatigue

Brief Problem Summary

Compassion fatigue or burnout is not taught in most therapy education programs.

Medical clinicians are in the field because they care and empathy towards a patient makes

them want to intervene. It, however, gets to a point where they get tired because of hearing

and seeing so many tragedies, working on them while still taking home the fatigues of the

day. This cycle needs a break. A practitioner should be fit – emotionally, physically and

psychologically, as burnout can make a nurse lose elasticity and the motivation to work

(Fawcett, 2008). It can be seen as sucking the life and joy out of the practitioner.

At times, they do not do well at their job while showing signs of secondary post-

traumatic stress disorder. Though there are different ways of dealing with compassion

fatigue, it is of great importance to minimize it. Exercising, playing, laughing, rest – all these

help in preventing compassion fatigue

Description of Middle-Range Theory

Theorists should develop models relative to nursing science, and focus on their

content, not form. They sacrifice some form of depth, and scope to gain precision and it

precisely explains how something works. The advantage of this is that it becomes more

researchable and can be applied to nursing practice (Levine, 2016).

A few examples include Kolcaba’s Comfort Theory where nurses facilitate health-

seeking behaviour by attempting to relieve any stressors (physical, emotional, social or

environmental). In Penders Health Promotion Theory, nurses ought to understand that a

patient’s personality and experiences affect their willingness to change and adopt healthy

behaviour. Others as AACN’s Synergy Theory may change a nurse’s competency to a

patient’s needs thus facilitate the patient’s improved health outcomes (Johnson, 2009). Others

help a patient convert anxiety into constructive actions as a means to control or reduce it.

This nurse-patient relationship is characterised by the nurse serving as the resource persons,

counsellor and a representative.

These theories are important in making them all-rounded and educated nurses and

also understanding why they do what they do, Everything done is evident-based, and research

betters the evidence to understand the motives behind doing what nurses do and their

expected results.

When it comes to using the theories in everyday life, it is essential to know that some

factors are more reliable than others when looking for the most appropriate method. A

thoughtful model should be both exciting and comfortable for the nurse. This will be better at

directly contributing to human survival as well as nursing as a discipline. Also, it would

impair the healing, and the caring process should a patient be in a hostile or offensive

environment. For other concepts, cultures play a vital role in caring for humans in ways of

expression and trends. An example is the Jehovah’s Witness and not allowing the

consumption of blood products. 

Nurses are the largest in the healthcare group who work in most healthcare areas

making a difference in the lives of people. Understanding how these theories will facilitate

health-seeking behaviour in patients relieves stress as environmental, physical, emotional or

spiritual. Also, by understanding a patient’s characteristics and experiences a nurse can

navigate the motivations and their willingness to adopt healthy behaviour. Also, as they want

to improve on patients outcomes, a nurse will match their competencies to those of the

patient’s needs (King, 2007).

Using the Comfort Theory, a nurse promotes health-seeking behaviour by eliminating

any form of distress to the patient. Nurses provide comfort and are there for the patient

physically, emotionally and even physiologically. In compassion fatigue, caregivers feel the

fatigue that comes with the giving of care and empathy to the countless number of people

repeatedly until they think like their li life quality is plummeting. By providing the

understanding and the care the patient needs to navigate these issues in life, a patient starts on

their journey to wellness. But it can also be through referrals and not just through patient care

(Fawcett, 2008).

For Pender’s Health Promotion Theory, positive health is just not about not having a

disease, but rather it is a holistic state of wellbeing. This theory advocates for a healthy

lifestyle in a bid to improve a patient’s quality of life. It helps one understand the relationship

between a person and their environment. This approach is used to stop illnesses, in this case,

anxiety, depression or other related disorders. By assessing the multiple dimensions of the

individual, it becomes easier evaluating the course of action, if the patient is committed to

change and the behavioural outcomes. As it is about health promotion, we will look at things

as regulating the stress factors to motivate healthy behaviour.

American Association of Critical Care of Nurses Synergy theory is a model based on

the needs of a patient, which drives a nurse’s competencies and is aligned to patient outcome.

Well-educated and confident nurses are essential when it comes to meeting the needs of

patients. When looking at compassion fatigue, knowing what symptoms to look out for will

be better even when it comes to treating it. Symptoms as fatigue, depression and tension are

based on their foundation cause and the issue is treated maybe through medication or


By focussing on Peplau’s Interpersonal Theory, a nurse knows what role they are cast

in and understand what treatment to give. As they play many different characters as teacher,

leader and surrogate, they teach, inform, lead and even make the patient understand the

feelings surrounding their health (King, (2007). With this comes the burden of listening to a

patient and it is the nurse’s behaviour that signals interests or otherwise concerning a patients

case. When PTSD hits, a patient may need more of a councillor and a listening ear without

interrupting or feeling judged. Again, about listening, it becomes repetitive for the patient and

the nurse zones out. As for patients who reported respect and excellent listening skills from

their nurses, they tended to transition very well from orientation to the working phase. The

nurses were described as caring, genuine and humane.

However, models as Peplau’s Interpersonal Theory and the comfort theory are

appropriate in cases of compassion fatigue and other PTSD. The reason why is because a

nurse acts and becomes all that a patient could need while being healthy. Aspects of a nurse,

as a caring, one who listens, informs, educates and corrects, are better at dealing with patients

and enhancing their wellbeing. Also, by making a patient comfortable and eliminating

stressor, they can better focus on their health and improvement.

History of Middle-Range Theory′s Origins

Florence Nightingale was the pioneer of public health, and she was the mother of

nursing. Because of her, it is the most respected professional in the world. After a year of

getting employed, she became the Head of Nursing. She helped a team of solders by

providing health services, food and water. She understood that during the war they were

under pressure and other injured and offered help. As with comfort theory, she eliminated

death by two-thirds and was awarded by the queen for it. She had intrapersonal skills that

changed her from stranger to doctor in the eyes of the patient’s.

Incorporating Theories into Practice

By using these theories in my practice, I would seek to understand and learn what the

patient is suffering from to know what I am dealing with. Some patients choose to isolate

themselves, and others use and abuse substances. In as much as the patient is depleted of

energy, getting to know what causes these negative health behaviours will shed light on what

the problem is. Also when I get to play many characters to a patient, I will be able to

understand their history and what triggers these effects of health behaviour and eliminate

them or improve on them. In addition, by making them comfortable, a patient will get better

quickly and focus on their health more. These would help in changing a patient’s behaviour

and lifestyle to suit their health and will enable me as a health professional to better detect

flaws, or when things are not going right.


Fawcett, J. (2008). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing

Models and Theories. 2(1), 34 – 38

Johnson, F. (2010). The Behavioural System Model for Nursing. 13(2), 207-216.

Johnson, F. (2009). The Behavioural System Model for Nursing. 20(2), 200 – 205

Carl, M. (2016). . 21(2): 31 – 37.

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