LYDIA ELOISE HALLLYDIA ELOISE HALLCare, Core and CureCare, Core and Cure

Presented byPresented byBahadur AliBahadur Ali11stst year MScN year MScN

Dow University Of Health SciencesDow University Of Health Sciences

OBJECTIVESOBJECTIVES

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Look into background of Lydia E Hall.Look into background of Lydia E Hall. Know Hall's theory assertions.Know Hall's theory assertions. Discuss theory overview.Discuss theory overview. Understand 3 Cs (core, care & cure)Understand 3 Cs (core, care & cure) Define Hall's nursing paradigms.Define Hall's nursing paradigms. Major assumptionsMajor assumptions Discuss strengths and weaknesses.Discuss strengths and weaknesses. Application of Hall's theoryApplication of Hall's theory

LYDIA ELOISE HALL LYDIA ELOISE HALL (1906-1969)(1906-1969)

LYDIA ELOISE HALLLYDIA ELOISE HALL Was born in new York city Was born in new York city

on 21on 21stst sept 1906. sept 1906. Basic nursing education in Basic nursing education in

1927.1927. Bachelor in public health Bachelor in public health

nursing in 1937.nursing in 1937. Master's in teaching Master's in teaching

Natural sciences in 1942.Natural sciences in 1942. First director of leob centre First director of leob centre

for nursing.for nursing. Nursing experience in Nursing experience in

clinical, education, clinical, education, research and supervisor research and supervisor role.role.

Theoretical Assertion

Lydia E Hall believed that patient Lydia E Hall believed that patient outcomes are improved by direct care as outcomes are improved by direct care as given by the professional nurse. She stood given by the professional nurse. She stood against the turning over of care when a against the turning over of care when a patient is stabilized to practical nurses and patient is stabilized to practical nurses and argued against the concept of team argued against the concept of team nursing. She saw nursing as interacting nursing. She saw nursing as interacting with the person, called "the core," the with the person, called "the core," the body, called "the care," and the disease, body, called "the care," and the disease, called "the cure."called "the cure."

RN-CARE MODEL

In 1962 In her Loeb center she hired, In 1962 In her Loeb center she hired, “ “only licensed Nurses”.only licensed Nurses”. Loeb was run by nurses, had all RN staff and medicine served only as Loeb was run by nurses, had all RN staff and medicine served only as

an ancillary service.  Hall increased staffing during evening and night an ancillary service.  Hall increased staffing during evening and night shift and hired no nursing aides.  The only auxiliary staff she hired shift and hired no nursing aides.  The only auxiliary staff she hired were called messenger-attendants with a ratio of two RNs to one were called messenger-attendants with a ratio of two RNs to one messenger and who, “get fired if they ever try to substitute for a messenger and who, “get fired if they ever try to substitute for a nurse”.nurse”.

In today world of evidence-based medicine it seems that Lydia Hall’s In today world of evidence-based medicine it seems that Lydia Hall’s theory has vanished from American nursing, theory has vanished from American nursing, with one exception--Hahnemann Hospital--which in 2012 brought which in 2012 brought back all-RN care. back all-RN care.

THEORY OVERVIEWTHEORY OVERVIEW

Theory developed in late 1960`s.Theory developed in late 1960`s. Nursing care can be delivered on three interlocking Nursing care can be delivered on three interlocking

levels.levels. Cure = Disease.Cure = Disease. Care = Body Care = Body Core = Patient.Core = Patient. Defined nursing as care performed by trained nurses.Defined nursing as care performed by trained nurses. Care focused on maintaining optimal health and Care focused on maintaining optimal health and

quality life from birth to end of life.quality life from birth to end of life. Care is ongoing matrix of learning and teaching.Care is ongoing matrix of learning and teaching.

3 CIRCLES (3Cs)3 CIRCLES (3Cs)

The CareThe Care

Nurturing component of care and is exclusive to nursing.Nurturing component of care and is exclusive to nursing. Motherly care and comfort of patient.Motherly care and comfort of patient. Provides teaching and learning activities.Provides teaching and learning activities. Nurses goal is to give care and comfort to the patient.Nurses goal is to give care and comfort to the patient. Nurses provides bodily care for the patient.Nurses provides bodily care for the patient. Patient may explore and share feelings with the nurse.Patient may explore and share feelings with the nurse. When functioning in the care circle, the nurses apply When functioning in the care circle, the nurses apply

knowledge of the natural and biological sciences.knowledge of the natural and biological sciences. The patient views the nurse as potential comforter, one who The patient views the nurse as potential comforter, one who

provides care and comfort through the lying of hands.provides care and comfort through the lying of hands.

The CoreThe Core

Patient care is based on social sciences.Patient care is based on social sciences. Involves therapeutic use of self and is shared with Involves therapeutic use of self and is shared with

other team members.other team members. By developing interpersonal relationship with the By developing interpersonal relationship with the

patient, the nurse is able to help the patient verbally patient, the nurse is able to help the patient verbally express feelings regarding the disease process and its express feelings regarding the disease process and its effects.effects.

Patient is able to gain self-identity and further Patient is able to gain self-identity and further develop maturity.develop maturity.

Patient is able to make conscious decision.Patient is able to make conscious decision.

The Cure Cure based on pathological and therapeutic sciences.Cure based on pathological and therapeutic sciences. Application of medical knowledge by nurses.Application of medical knowledge by nurses. Nurse assisting the doctors in performing different Nurse assisting the doctors in performing different

procedures.procedures. Nurse is patient advocate in this circle.Nurse is patient advocate in this circle. The cure aspect is different from the care circle because The cure aspect is different from the care circle because

many of nurse's actions changes from a negative quality of many of nurse's actions changes from a negative quality of avoidance of pain rather than a positive quality of comfort.avoidance of pain rather than a positive quality of comfort.

Nurses role changes to positive quality to negative quality. Nurses role changes to positive quality to negative quality.

Interaction of all three aspectsInteraction of all three aspects

Emphasis placed on the importance of total Emphasis placed on the importance of total person.person.

Importance placed on all three aspects Importance placed on all three aspects together.together.

All three aspects interact and changes in size.All three aspects interact and changes in size.

Hall's Nursing ParadigmHall's Nursing Paradigm

IndividualIndividual

HealthHealth

nursing nursing

INDIVIDUALINDIVIDUAL

Persons who are more than 16 years old and in the long-term illness are the focus of Hall's wok.

Hall emphasizes the importance of an individual as unique, capable of growth, learning and requiring a total person approach.

HEALTHHEALTH

Inferred to be a state of self-awareness with Inferred to be a state of self-awareness with conscious selection of behaviors.conscious selection of behaviors.

Hall stresses the need to help the person Hall stresses the need to help the person explore the meaning of his or her behavior to explore the meaning of his or her behavior to identify and overcome problems through identify and overcome problems through developing self-identity and maturity.developing self-identity and maturity.

NURSINGNURSING

Identifies and consisting participation in the Identifies and consisting participation in the care, core and cure aspects of patient care.care, core and cure aspects of patient care.

Care is the sole function of nurses.Care is the sole function of nurses. Major purpose of care is to achieve an Major purpose of care is to achieve an

interpersonal relationship with the individual.interpersonal relationship with the individual.

AssumptionsAssumptions

The motivation and energy necessary for The motivation and energy necessary for healing exist within the patient, rather healing exist within the patient, rather than in the health care team.than in the health care team.

The three aspects of nursing should not be The three aspects of nursing should not be viewed as functioning independently but viewed as functioning independently but as interrelated.as interrelated.

The three aspects interact, and the circles The three aspects interact, and the circles representing them change size, depending representing them change size, depending on the patient’s total course of progress.on the patient’s total course of progress.

StrengthsStrengths

The use of the terms care, core, and The use of the terms care, core, and cure are unique to Hall.cure are unique to Hall.

Hall’s work appears to be Hall’s work appears to be completely and simply logical. completely and simply logical.

WeaknessWeakness

Acute stage patients are not included.Acute stage patients are not included. Only applicable to adult patients.Only applicable to adult patients. Only tool of therapeutic communication is reflection.Only tool of therapeutic communication is reflection. Family mentioned only in cure circle.Family mentioned only in cure circle. Only related to those who are ill.Only related to those who are ill.

Application

In Geriatric Nursing.In Geriatric Nursing. In Operation Room.In Operation Room. In Critical Care Unit.In Critical Care Unit. In Dialysis UnitIn Dialysis Unit

REFERENCESREFERENCES

http://www.truthaboutnursing.org/press/pioneers/lydihttp://www.truthaboutnursing.org/press/pioneers/lydia_hall.html#ixzz2rezuRHtia_hall.html#ixzz2rezuRHti

http://nursingtheories.info/lydia-eloise-hall-nursing-thhttp://nursingtheories.info/lydia-eloise-hall-nursing-theory-care-core-cure-model/eory-care-core-cure-model/

http://nursing-theory.org/theories-and-models/hall-carhttp://nursing-theory.org/theories-and-models/hall-care-cure-core-theory-of-nursing.phpe-cure-core-theory-of-nursing.php

http://nursingtheories.weebly.com/lydia-e-hall.htmlhttp://nursingtheories.weebly.com/lydia-e-hall.html