Problem
Nursing school question regarding theory-practice gap
Case study
You are a staff nurse working in an intensive care unit and assigned to care for a 75-year-old African American man who had coronary artery bypass graft surgery four days ago. The patient has a history of chronic obstructive pulmonary disease exacerbated by heavy smoking. His postoperative course has been difficult, and he has suffered several setbacks. Staff members, despite their diligent efforts, have not been able to wean him off the ventilator since the surgery. He has required frequent suctioning throughout the shift, and he is being evaluated for the development of ventilator-associated pneumonia.
Today, when returning from lunch, you observed that an experienced nurse was suctioning your patient. His secretions were thick, and you observed that the nurse was instilling saline into the patient's endotracheal tube as she was suctioning him. The patient turned red and began coughing, and it was obvious he was in distress.
How do I show the alignment of nursing theory, specifically Orem's self-care deficit theory and its relation to the nursing process (include critical thinking and clinical decision making) for an improved nursing care plan with a diagnosis of ineffective airway clearance?