Lydia Eloise Hall (1906-1969) Care, Core and Cure Nursing Theory Presentation

Introduction: Lydia Eloise Hall-The Care, Core and Cure Nursing Theory. Theory also referred as “The Three Interlocking Circles Theory” Rationale: Related a portion of Hall’s theory to everyday clinical practice. Hall’s dedication is to achieve interpersonal relationship with the patient and then facilitate healing. Involvement of the patient in decisions regarding health care, utilizing self-efficacy, is still currently utilized frequently.

Overview: Lydia Eloise Hall: Nurse theorist of the Care, Core and Cure model-developed in 1960’s.

Overview: The three circles are independent yet interconnected. Nurse is presented as the primary role in all aspects of the circle-nurse only. Purpose is to achieve an interpersonal relationship with the patient.

Overview: Complex process of teaching and learning. Focused on maintaining optimal health and quality of life for the patient/family. Focused on personalized nursing care rather than merely “routine care”.

Care: consisting of the role of the nurse; “motherly/nurturing” to the patient.

“Everyone in the healthcare profession either neglects or takes into consideration any or all of these, but each profession, to be a profession, must have an exclusive area of expertise with which it practices, creates new practices, new theories, and introduces newcomers to its practice (Hall, 1968).

Overview: Core: involves the patient and application of therapy and use of self-reflection. CORE

Cure: 1st aspect; shared with medicine (assisting the physicians), 2nd aspect; nurse assisting the patient through healing process.   CURE

Overview: Promoted the involvement of the community for all healthcare issues; intertwining many aspects of the healthcare field/process.

Overview: Community recognizes nurses as experts in the body and the know how to modify care depending upon patient involvement, pathology of illness, treatment of illness, and the unique needs of the patient/families.

Overview: Many healthcare professionals rely on each other and share in the patient outcome; core and cure of her theory are the shared components corresponding disciplines

Became known as a pioneer for “nurse-led care”.

Overview: Focuses on the recovery period for the patient and does not incorporate health prevention/promotion. Somewhat broad approach; care portion of theory based upon only nurses care, but in reality is used by multidisciplinary professionals.

The Care, Core and Cure Theory

Critique: Hall’s theory does have a significant importance and paved the way to modern nursing…during the 1960’s. Initiated nurses using critical thinking skills in order to treat the patient rather than just accomplishing a doctor's orders.

Critique: Collaborative care between patient, nurse, family and physician. Hall emphasized the importance of the patient necessity to cultivate a self-identity through self-reflection.

Critique: Hall has developed a theory to encourage patients to use self-guidance in healing (Wiggins, 1980). Theories should lead to positive changes in nursing practice. Hall was an innovator and motivator for nursing practice.

Critique: Pioneer of nurse-led care, who quite possibly paved the path for us today.

Contributions: Established and directed the Loeb Center for Nursing and Rehabilitation at Montefiore Hospital in Bronx, New York, from 1963 to 1969. At the Loeb Center is where she managed to develop her conceptual model; The Care, Core and Cure Model.

Contributions: Loeb Center consisted of 80-bed unit staffed for 24 hour periods. Selected by nurses for their potential to be rehabilitated. Not directed by a physician; nurses in charge. Patient control over healthcare.

Contributions: Served as a research analyst in cardiovascular disease for the heart disease control branch of U.S. Public Health. Served as project director for the Public Health System; division of chronic disease and tuberculosis. She published over 20 articles about the Loeb Center and her theories of long term care and chronic disease control.

Contributions: Hall has said that “any career that is defined around the work that has to be done, and how it is divided to get it done, is a “trade” (rather than a profession). Developed and implemented a program in nursing consultation thus joining a community of nurse leaders- Teachers College

Contributions: Volunteered services to New York City Board of Education, Youth Aid, and various other community associations. Received the Teachers College Nursing Alumni Award for distinguished achievement in nursing, 1967. Inducted into American Nurses’ Association Hall of Fame in 1984.

Theory-Practice Link: Aspects of Hall’s theory only emphasizes achievement on rehabilitation and quality of life. This was revolutionary during her time (Loose, 1994). Use of interpersonal relationships with the patient and family are key for maximal state of wellness. In order for the patient to advance in their quality of life, they must be involved and be able to self-reflect. In my practice I find this true (physical therapy, home exercises and follow-up appointments).

Theory-Practice Link: Patients have become better informed about their illnesses and care through education(Wiggins, 1980). Patient education is monumental in care. This theory is not primarily used by nurses today, many disciplines use this theory, in combination with other theories and models. Limited to only rehabilitative individuals.

Theory-practice link: Hall’s development of the nurse/patient relationship was crucial to problem solving and promoting education. Open communication and trust are necessary to facilitate care-used then and everyday today.

Clinical Practice Example: An example in my practice: Total shoulder arthroplasty; provide patients with emotional support, provide education on procedure and expected outcome post-operatively, facilitate home nursing care, skilled nursing facility, assess for family support, educate on the importance of what to assess for (infection, pain etc.)

Putting the pieces together: Care: Nursing care given before, during and after surgery, exclusive to nursing. Core: Patient involvement in post-operative exercising, sling compliance, using ice machine and pain medications appropriately. Patient’s therapeutic use of self-reflection. Cure: This includes the patient, nurse, physician, floor staff in the hospital, physical therapists, pharmacists, and family members that balance out the rehabilitation for the patient. These are the interventions for the patient.

Lydia Eloise Hall Care, Core, Cure Theory