Concept Analysis: Invulnerability

Selection of a Concept

In the following paper, the concept of invulnerability is explored based on nursing, education and public health perspectives. It should be noted that nurses are exposed to many infectious diseases such as HIV, Hepatitis B and C, meningitis, tuberculosis and others. For this reason, nurses are expected to take utmost caution while at their workplace. The often adopted precautions include using gloves, protective eyewear, gowns, needle-protective devices, etc. Despite the obvious need to take care, some nurses fail to take the precautions. Thus, they remain exposed to the above mentioned dangers.

 

Swallow (2006) indicated that there were about four hundred thousand incidents of exposure to needle stick injuries annually. In a bid to prevent the emergence of such scenarios, relevant authorities took measures such as educating nurses on staying safe. The emotional and financial costs attached to needle stick injuries remain high and as a result, focusing on the problem is timely.

It is held that invulnerability is a critical variable that plays a significant role in the state of affairs. The variable comes in the review of the literature on needle stick injuries. Some of the researchers who have considered the issue of compliance with safety requirements are Clarke, Rockett, Sloane and Aiken (2002). The researchers established that almost 60 % of nurses did not show much concern to contracting blood borne illnesses out of needle stick injuries. With another 60 % indicating that they only thought about the issue once in a month, it appears that such injuries were of little concern among the nursing community. Based on the authors’ conclusions, invulnerability was a variable that demanded adequate attention.

Aim of Analysis

The analysis framework by Walker and Avant (2010) is used in examining and defining invulnerability. The analysis is expected to add to the body of existing nursing knowledge which appears deficient in reference to the understanding of the concept. Hence, the analysis has the following aim identifying the possible uses of the invulnerability concept. The possible uses of the concept are presented on the basis of literature review.

Uses of the Concept

In order to develop a clear understanding of the concept, a review of literature is conducted. I used the term invulnerable in searching the literature. Many of the results coming up were vulnerability or vulnerable. It became apparent that invulnerable was not the opposite of the term under study although it was used to contrast vulnerability. However, focusing on vulnerable and vulnerability failed to yield the expected results. An extended search of literature revealed that the concept is used in such fields as medicine, nursing, psychology, sociology, public health and education.

Several scholars have attempted to define the concept of vulnerability. Invulnerability is seen as the absence of a possibility of being harmed (Aalsma, Lapsley & Flannery, 2006). Snyder (1997) saw invulnerability as a protective psychological process where information is distorted to avoid the occurrence of negative outcomes. As Snyder (1997) observed, a big number of people were of the opinion that nothing bad could befall them. This is a display of unique invulnerability. Based on the literature such terms as impregnable, risk-taking, unique invulnerability, indifference and risk-taking are closely related to the concept.

Three Defining Attributes

Based on the model of Walker and Avant, defining attributes are central to the concept analysis since such attributes offer significant insight into understanding the concept in question. In the understanding of Walker and Avant’s model (2010), such attributes emerge over time based on the variations of the concept understanding. Upon the synthesis of the concept, the following attributes are essential. The first one is that invulnerability has an attribute of illusion. It is an individual’s illusion that predisposes him / her to invulnerability. The implication is that the perception is erroneous. Secondly, there is an attribute of confidence. Confidence flows from the illusion revealing that there is no danger in doing or avoiding to do something. The third element is danger. The illusion, coupled with false confidence exposes an individual to danger. The danger involves a possibility of being harmed.

Two Model Cases

As identified by Walker and Avant (2010), model cases reflect exemplary cases developed on the basis of antecedent and other attributes. In practice, model cases may be factual, based on the literature or designed by the writer. All the cases presented are constructed by the author.

Jane, a newly registered nurse had practiced for ten weeks in the position of a care nurse. Jane worked in a large city healthcare facility. Often, she felt comfortable, which encouraged her to care for terminally ill patients. On one occasion, Jane was ordered to give a-4 mg morphine intravenous to a 21-year old traumatized patient. Jane entered the medication facility room and left with a 9 mg morphine vial. In practice, Jane required another registered nurse to sign the medication before its administration. However, Jane chose to go administer before coming back for the signature since no nurse was in at that time. Upon entering the room, Jane used her teeth to pull off cap from the needle. She administered the dosage without confirming the patient’s name. Moreover, Jane was not well prepared to use needle-protective devices. This led her to leave the unprotected needle besides the bed as she went to do other assignments. In the following shift, a technical worker was injured by the contaminated needle that was left besides the bed.

In the second case, Ronald, a newly hired nurse came to the hospital facility where he worked, and headed straight into the assignment room. Ronald was aware of a patient he had been nursing for a long time. He made for the medicine drawer and accidentally picked a double dosage which he proceeded to administer to the patient without double checking the details.

The above model cases are developed based on all defining attributes of the concept invulnerability. It is clear that the individuals in question have illusions and confidence which they use in their work thus leading to harm.

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In an analysis of this nature, considering such cases as alternative cases, borderline, related, contrary, invented, or illegitimate is also helpful. In this scenario, two contrary cases are considered. It should be noted that contrary cases represent what the concept is not (Walker & Avant, 2010). The value of developing contrary cases is to aid the comprehension of the concept under review.

Dickson, a practicing and registered nurse worked in a health center. He was put into perspective to highlight a contrary case. The nurse had been in orientation for five months. However, the health center had a routine which was beyond Dickson’s grasp. Dickson was anxious as he displayed a high-level of nervousness when caring for the critically ill patients. Dickson feared that he was likely to make a mistake which could harm the patients. This was attributable to an error he committed during the first week of his induction.

The second case involves Leon, registered nurse working for a government health facility. Despite being inducted in performing her duties, Leon ignored basic guidelines on task performance arguing that paying attention to detail was a waste of time. Leon never bothered to check updated requirements.

It is evident that the contrary case lacks any of the defining attributes of the concept being reviewed. Although some antecedents such as education, experience or exposure are present, they appear to have a negative influence.

One Antecedent and One Consequence

Walker & Avant (2010) observed that the identification of antecedents was significant in analyzing concepts as such reflects the incidents or events that precede a concept. A review of literature shows there are many antecedents of invulnerability. They include age, experience and routine. This paper focuses on age. According to Denscombe & Drucquer (1999), there is a relationship between a sense of invulnerability (risk-taking behavior) and age. The authors observed that an increase in age coincided with a decrease in risk-taking behavior. However, researchers such as Millstein and Halpern-Felsher (2002) questioned the finding, observing that there was no evidence to suggest that an increase in age was related to a decline in invulnerability. Despite the contestations, it is held that age has a bearing on risk-taking behavior. For that reason, age is seen as a primary antecedent in invulnerability.

According to Walker & Avant (2010), consequences are outcomes followed after the concept. It is thought that the first concept of invulnerability is a decline in a person’s anxiety. As Thompson et al. (2002) observed, individuals were at a risk posed by nervousness and anxiety. Thus, understanding such risks was pivotal in lowering the anxiety level. The best example of the above allegation is based on blame games. When a victim of an unfortunate event is blamed, chances of becoming more agitated increase.

Empirical Referents

Walker & Avant (2010) identified empirical referents as categories of events that demonstrate concept occurrence. Empirical referents remain useful since they offer clear and observable aspects which help in determining the existence of a concept among clients. Some of the researchers including Breheny & Stephens (2004) have tried to understand risk behavior and perceived invulnerability using a qualitative approach. However, it should be noted that no measuring instrument of invulnerability has been developed for use in the nursing field. Hence, various referents such as one based on a qualitative assessment of individuals’ invulnerability could be useful.

Concluding Statements

The nursing profession encounters many concerns which need attention. One of the challenges related to invulnerability is risk-taking behavior. It emerges that nurses are exposed to many infectious diseases such as HIV, Hepatitis B and C, meningitis, tuberculosis and others. Based on such risks, nurses are expected to take utmost caution when working. Often, some precautions such as using gloves, protective eyewear, gowns, needle-protective devices, etc. are adopted. In spite of the need to take care, some nurses fail to observe the recommended precautions. Based on the analysis of the concept of invulnerability, it suffices to reckon that the risk-taking behavior can be resolved.

Despite the possible effects of the concept, invulnerability remains a relatively unknown, albeit in the nursing field. Using Walker and Avant’s framework of analysis, it is held that this paper makes a significant contribution on the understanding of the term. However, as remarked, concepts are dynamic since their usage keeps changing over time. For this reason, it is necessary to continue exploring and developing the concept with a view to easing its understanding.

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