Nursing theories & professional ethics in the Kenntnisprüfung

Mr D., 58, has newly diagnosed insulin-dependent diabetes. He is mobile and oriented and wants to inject his insulin himself in future. Which nursing system according to Orem fits, and what is your main task?

• Wholly compensatory – I take over the injections until he is discharged
• Partly compensatory – I inject in the morning, he takes over the evening dose
• Supportive-educative – I guide, train and advise him on the injection
• No nursing system – he can do everything himself, there is no nursing task

Explanation: Mr D. can in principle perform self-care himself, but he lacks knowledge and practice – that is the supportive-educative system: guidance, training, advice. Taking the injections off him or splitting them would make him unnecessarily dependent; claiming there is no need at all overlooks the knowledge deficit.

In the professional discussion (Fachgespräch) the examiner asks: “Which nursing model do you work with?” Which answer is most convincing?

• Name a model, e.g. Krohwinkel’s AEDLs, and show with the case how it structures the information gathering
• I work according to the ward’s care plan, because theory is hardly needed in everyday hospital work anyway
• I work according to the expert standard on fall prevention (Expertenstandard Sturzprophylaxe), because it is the most important nursing model in Germany
• List as many theorists as possible with their year of publication, without addressing the case

Explanation: What convinces is naming a model and applying it to the case – that shows system and justification (competence area V). An expert standard is not a nursing model but an evidence-based quality instrument on one topic; mere listing without reference to the case shows rote learning instead of understanding.