1. MODELING AND ROLE MODELING THEORY
Helen c. Erickson
MODELING AND ROLE MODELING THEORY

2. Timothy Amborski James Furstenau Kim Karwowski Kimberly Miller
Presented by:
Timothy Amborski James Furstenau Kim Karwowski Kimberly Miller
Ferris State University Nursing 324
Nursing Theorist Group 7 Presentation
February 26, 2012

3. The University of Michigan Saginaw General Hospital School of Nursing
Helen C. Erickson
HELEN C. ERICKSON
The University of Michigan
PhD, Educational Psychology
1976 – 1984
MS, ; BSN,
Activities and Societies: Sigma Theta Tau, Rho Chapter
Saginaw General Hospital School of Nursing
Diploma in Nursing, Nursing
1954 – 1957

4. Erickson's Modeling and Role Modeling Theory
Introduction
Erickson's Modeling and Role Modeling Theory
The Modeling and Role Modeling Theory was developed by Helen C. Erickson, Evelyn M. Tomlin, and Mary Anne P. Swain. It was first published in in their book Modeling and Role Modeling: a Theory and Paradigm for Nursing. The theory enables nurses to care for and nurture each patient with an awareness of and respect for the individual patient's uniqueness. This exemplifies theory-based clinical practice that focuses on the patient's needs(Helen C. Erickson, 2011).

5. Helen C. Erickson credentials
Clinical Background ER and Medical - Surgical Nursing Director of Health Services; San German, Puerto Rico Independent Psychiatric Nurse Consultant Current Activities Actively researching Modeling and Role-Modeling Theory Professor Emeritus; University of Texas at Austin Faculty Consultant for MRM; Various Schools of Nursing & Service Agencies Board of Directors; American Holistic Nurses Certification Corporation (The Society for the Advancement of Modeling and Role Modeling, 2011).

6. Historical Background
Maslow's Theory of Human Needs was used to help label and articulate Helen Erickson's observations the unmet basic needs interfere with holistic growth whereas satisfied needs promote growth. The MRM Theory was written over several years. Culmination of work published in the book, "Modeling and Role-Modeling: A Theory and Paradigm for Nursing", in 1983 (The Society for the Advancement of Modeling and Role Modeling, 2011).

7. Influence of Philosophy
Helen Erickson credits Milton H. Erickson in the formulation of Modeling and Role- Modeling, when he told her to "Model the client's world, understand it as they do, then role-model the picture the client has drawn, building a healthy world for them."(The Society for the Advancement of Modeling and Role Modeling, 2011).

8. Influence of Philosophy
According to Sappington & Kelley: The Theory of Modeling and Role-Modeling enables the nurse to care for and nurture each client with an awareness of and respect for the individuals uniqueness. This type of care giving exemplifies theory-based clinical practice that focuses on the clients needs. Care is offered that recognizes that clients have the knowledge and the ability to understand what has made them sick, as well as what will make them well (1996).

9. Modeling and role-modeling Theory
MRM provides a paradigm and theory for nursing. MRM is best depicted as a grand theory encompassing numerous mid-range theories. MRM has been applied in a variety of clinical practice settings, educational programs, and research (The Society for the Advancement of Modeling and Role Modeling, 2011).

10. Influences on theory creation
The Modeling and Role Modeling Theory is unique to nursing in its inclusion of the concepts from:
Maslow’s theory of hierarchy of needs
Erickson’s theory of psychosocial stages
Piaget’s theory of cognitive development
General Adaptation Syndrome (GAS) by Selye and Lazarus
Retrieved from

11. Theory premise: all people have
Commonalities
Differences
Holism
basic needs
affiliated-individuation
attachment and loss
psychosocial stages
cognitive stages
Inherent endowment
model of the world,
adaptation and its potential
stress
self-care and its knowledge, resources, and action

12. Global Concepts
Modeling:
The nurse seeks to know and understand a patient’s unique model of their world in order to appreciate its value and significance to the patient.
The nurse uses the information to develop an image and understanding from the patient’s perspective.
Role Modeling:
The nurse’s role is to facilitate and nurture the individual in attaining, maintaining, and promoting health.
It accepts the patient unconditionally and allows for unique individual interventions.
According to this concept, the patient is the expert in their own care and knows the best how they need to be helped.

13. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8708346
Client-focused
The theory enables the nurse to care for and nurture each client with an awareness of and respect for the individual’s uniqueness. It’s based on the client’s needs. Clients have the ability and knowledge to understand what has made them sick. It empowers the patient to grow to heal.
Retrieved from

14. Holistic nursing

15. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17544676
Holistic nursing
According to Erickson:
Holistic nurses believe that the human being, composed of a mind, body and soul integrated into an inseparable whole that is greater than the sum of the parts, is in constant interaction with the universe and all that it contains. Health and well-being depend on attaining harmony in these relationships. Healing is the journey toward holism. Using presence, intent, unconditional acceptance, love, and compassion, holistic nurses can facilitate growth and healing and help their clients to find meaning in their life experiences, life purpose, and reason for being (2007).
Retrieved from

16. Encourage independence Establish trusting patient/nurse relationship
Holistic View
Encourage independence
Establish trusting patient/nurse relationship
Focus on the clients’ strengths
Establish goals focused on the clients’ view of effective recovery
Provide patient opportunity to be involved

17. Modeling and role-modeling Foundation of care
The five goals of nursing intervention include:
Promote client control
Build trust
Affirm and promote client’s strengths
Promote clients positive orientation
Set health directed goals
Retrieved from modeling_theory.html

18. Modeling and role modeling theory
It’s UNIVERSAL!
Care focused on the client’s needs and can be used in all area’s of nursing.
It involves an “open/holistic view” and applies to all aspects of nursing care.

19. Why use this Theory?
Walsh, VandenBosch, and Boehm state, “this theory has drawn together previously developed knowledge and added new ideas and ways of looking at nursing. It describes the scientific bases useful for our profession and our unique contribution to clients via the art and science of nursing practice,” (1989). “It is a complex theory because of the integration of several theories and ways of looking at man. Although the theory contains many levels of meaning, its basic concepts make sense, and can be readily applied to nursing practice,” (Walsh, VandenBosch, and Boehm, 1989).

20. Disadvantages to theory usage
Time consuming: when a nurse has multiple patients and limited time, it may be difficult to fully implement MRM.
Patients are coming into the hospital setting with several co- morbidities and issues.
A patient might be private in nature, thus not divulging all the information needed to implement MRM.
MRM works on the premise that each patient is knowledgeable about their needs and their wants, which may not be the case.

21. Nursing Case Study
Health History: Mr. Smith is a 55 year old obese male who has been admitted to the medical/surgical unit this morning, after presenting to the emergency department last night. Mr. Smith’s wife found him lying on the floor and mildly confused, when she came home from work yesterday evening. Mr. Smith has been diagnosed with diabetes mellitus, after his blood test results at the emergency department indicated his glucose level was 620 mg/dl. He has no history of a diagnosis of diabetes, however, states that his father has been a diabetic for the past twenty years. Mr. Smith lives with his wife and has a son that lives nearby. His wife and son have been at his bedside at the hospital. Mr. Smith and his wife state they have no knowledge about diabetes, and are anxious about it, but are willing to learn. Mrs. Smith reports that the patient has been having episodes of extreme thirst, irritability, and sweats for the past month, but did not want to go to the doctor. Mr. Smith’s health history also includes hypertension and hyperlipidemia.

22. Nursing Case Study
Continued page 2 Diagnostic Measures: At this time, his vital signs are as follows: B/P 128/72, Pulse 88, Respirations 18, and Temp 97.2F. His oxygen saturation is 98% on room air. His blood glucose level in the E.D. at 8 p.m. last night was 620 mg/dl. All other labs were within normal limits. Mr. Smith denies any pain. He presented as confused and slightly agitated in the E.D. but is now alert & oriented x 4, calm, and cooperative. His heart sounds are a regular rate and rhythm without any murmurs. Lung sounds are clear to auscultation. Bowel sounds are active in all four quadrants. No edema present, and pedal pulses are palpable. He has a peripheral IV placed in the dorsal left hand. His skin was cool and clammy in the E.D. but is now warm and dry. He has a superficial abrasion on his right elbow, which he and his wife attribute to his fall. Mucous membranes are pink but tacky.

23. Nursing case study
Continued page 3 Diet: Once Mr. Smith was admitted to the hospital, he was ordered to follow a special diet, incorporating ADA guidelines. He and his wife state that they are unfamiliar with carbohydrate counting, calorie counting, and diet terms, such as “concentrated sweets”. It is also important for him to have adequate hydration, because he is showing mild signs of dehydration.

24. Nurse case study
Continued page 4 Drug Therapy: Mr. Smith has been ordered to start a long-acting insulin to be taken at bedtime, and a short-acting insulin as needed following a sliding scale. He is also being started on an oral diabetic medication to be taken daily with his breakfast. He is going to continue on his daily oral anti-hypertensive medication and his daily bedtime cholesterol medication. Mr. Smith has been ordered to monitor his blood sugar before each meal and at bedtime, and keep a log of his results to report to his primary care physician. He has been ordered to attend outpatient diabetes diet teaching classes to learn calorie counting and carbohydrate counting upon discharge from the hospital.

25. Promote patient’s positive orientation. Promote patient’s control.
Nursing case study
Continued page 5
Nursing Care Plan:
Helen C. Erickson’s Modeling/Role Modeling theory emphasizes facilitation, nurturing, and unconditional acceptance. She uses 5 goals in her theory:
Build trust.
Promote patient’s positive orientation.
Promote patient’s control.
Affirm and promote patient’s strengths.
Set mutual, health-directed goals.
How can you utilize her theory to educate this newly diagnosed diabetic patient and his wife on blood sugar monitoring and insulin use?

26. Answer key to case study
Please see separate attachment. Thank you!

27. References
Alligood, M. R. (2009). Nursing Theorists and Their Work. Maryland Heights, MO: Mosby Elsevier. Erickson, H. C., (2011). Retrieved from Nursing theory: theory.org/theories-and-models/erickson-modeling-and-role-modeling- theory.php Erickson, H. (2007, June). Philosophy and theory of holism. Nurs Clin North Am, 42 (2). Retrieved from Modeling and Role Modeling Theory. (2012, January 28). Retrieved from

28. References
Nursing-theory.org (2011). Biography and Career of Helen C. Erickson. Retrieved from Sappington, J., & Kelley, J. (1996, June). Modeling and Re-Modeling Theory. Journal of Holistic Nursing, 130. Retrieved from The Society for the Advancement of Modeling and Role Modeling. (2011, February 14). Retrieved from Walsh, K., Vandenbos, C., and Boehm, S. (1989). Modelling and role-modelling: integrating nursing theory into practice. Journal of Advanced Nursing 14, 755. Retrieved from tb01640.x.pdf