Nursing theories offer an organized and systematic way to express statements related to questions in nursing, providing nurses with the opportunity to describe, predict, explain, and control phenomena related to their practice. Originally designed to establish nursing as a recognized profession, nursing theories today help nurses organize the way they deliver care to patients as professionals.
History
Florence Nightingale formulated the first nursing theory when she urged nurses to manipulate the environment (fresh air and clean rooms) to help the patient's body recover from illness or injury. In the 1950s and 60s, nursing theorists promoted other areas of focus: Hildegard Peplau talked about nursing as a therapeutic interpersonal process, Virginia Henderson described 14 basic needs, and Faye Abdellah emphasized holistic care for the patient and family. Nursing theorists continue to develop and test increasingly abstract theories of nursing.
Types
Theories may be derived from deductive or inductive reasoning. There are four successively more abstract types of nursing theories: practice theory, middle range theory, grand theory, and metatheory. A practice theory involves factors or situations related to specific phenomena in nursing; a middle range theory has a limited number of variables that are directly testable within a limited scope of nursing practice; a grand theory looks at a broader scope of knowledge with a distinct nursing perspective; and a metatheory reflects the most global perspective of the profession of nursing.
Core Concepts
Regardless of its type, each nursing theory is made up of a group of four concepts designed to lead a nurse to actions that guide her practice: the person, the environment, health, and nursing itself (goals, roles, and functions). A nurse incorporates these concepts as she reviews, formulates, and delivers nursing care.
Purpose
Nursing theories are designed to establish the foundation of nursing practice, help a nurse decide what he knows and doesn't know, define nursing practice, identify areas where there is insufficient knowledge, and help direct where the profession should go in the future.
Benefits
Nursing theories provide a common language for nurses, serve as a shared foundation for nursing practice across a wide range of environments, improve patient care, enhance the status of the nursing profession, guide nursing research and education, and help maintain boundaries for the nursing profession within multidisciplinary health systems.
Application to Practice
Unfortunately, there is still a gap between theory and practice in nursing, largely because theories are developed in academic settings removed from direct nursing care at the bedside. However, some nursing theories have been widely adapted in clinical settings.
For example, Dorothea Orem's self-care deficit theory is widely used in nursing settings with patient- and family-centered philosophies of care because it directs the nurse to devise strategies to make the patient and/or his family members capable of meeting self-care needs.
Patricia Benner's novice-to-expert model, which describes how new graduates gain expertise, is the foundation of many orientation, education, and career advancement programs.
Tags: nursing practice, Nursing theories, designed establish, foundation nursing, foundation nursing practice, grand theory, middle range