Is nursing theory actually used by working nurses?

[BCRNA]

In school I was always told how important nursing theory is in guiding nursing practice and improving care. Both in undergraduate and graduate school my teachers ridiculed PAs for not having a theory that guides their practice. Are there any nurses that actually use a nursing theory in practice? Are there any nurses that can name one nursing theorist and explain the theory? I have also found that the teachers in my theory classes have very elitist attitudes when it comes to the theories. I have encountered one hospital that prides itself on basing its nursing care on one particular theorist. No nurse I have worked with in the last 10 years basis there care on a theorist, they can't name a single one. How can theory be what drives our practice, when it is never used. And my teachers have even admitted that some are too complicated for many entry level nurses to truly understand.

At first I just told myself I am not experience enough or know enough about nursing to understand it. I have been a nurse for almost ten years and now realize that its not just me not grasping its importance, its just not important. My opinion now is that nursing theory was created to justify nursing as an academic discipline in a time when no one believed nursing belonged in a university. Then it was used to justify doctoral level nursing. I think nursing theory could be used to guide nursing, but it just isn't being used in actual practice. I know many nurses are going to read this and consider it heresy, but just ask the nurses you work with about the theorist they know and how they use them, my bet is that very few could even name a theory. Seems to me that only PhD nurses use theory for their research, but it fails completely when it comes to actually guiding practice. Just wondering what everyone else's opinion was on the topic, I have asked graduate faculty about theory in practice and usually get very negative feedback with derogatory comments about nurses in practice not being the academic elite, that it takes experts in nursing theory to understand the nuances of it. There again, if it is to complicated for practicing nurses to understand, can it really be guiding there practice?

[Wishinonastar, BSN]

I agree NANDA is very much used in certain areas of nursing, and it supports documentation that gets us paid by insurance. Also, of all the things that I learned and used in nursing school I agree with the previous post that Maslow's Heirarchy is the one thing I remember very well and have used consciously throughout my career.

I am sure that other theories from nursing, psychology, education and all the other building blocks that we learn to shape us into nurses affect my practice, but I don't think to myself "how would Newman or Rogers handle this?". No, instead I make choices on how to handle things based on my education and experience without thinking about theory. Perhaps as a new nurse I thought about theory more, but as I became more capable and experienced I just did not have to question why or how to practice nursing, all those theories just became part of the nurse that I am.

One thing I will add is that I think that the tools that we collect in nursing school are like mechanics tools, and different areas of nursing might require more of the use of certain tools. I don't think any of us has a complete picture of what other practicing nurses might need or use in their specialty area.

Sesquipedalian Loquaciousness-A predilection by the intelligentsia to engage in the manifestation of prolix exposition through a buzzword disposition form of communication notwithstanding the availability of more comprehensible diminutive alternatives. LOL

[CrazziiRN913, ADN, BSN]

The way that ot was explained to us in fundamentals is basically as a nurse how can you know where you are going if you don't know were you came from....

[BCRNA]

I completely agree that Maslow's theory is good, I actually used that alot in nursing. But it isn't a nursing theory. It is psychology. We borrowed it because it fits so well. Most of the graduate level instructors I have talked to cringe when I bring up Maslow. They say it is old and out dated, that it is overdone.

I would like to see nursing theory to either be applied more at the undergraduate level and used in beginning nursing practice, or for graduate level theory teachers to stop claiming it is the "factor" that truly drives nursing. It has alot of potential, but isn't used. I find it odd that nursing theory can be omitted from nursing practice, and yet still be a very good nurse. Some of the best nurses I know never took a theory class. Every nurse has there philosophy of care and practice, but you can't claim that is nursing theory. Everybody has their own philosophy, just being an rn doesnt make it nursing theory. Nursing theory as I refer to it is the theories created by nursing theorists to guide nursing. Not personal philosophy, they can be very similiar; but they aren't the same thing.

[ImThatGuy, BSN, RN]

Why can't the philosophy simply be something along the lines of "treat the patient and get them out of whatever clinical setting they're in ASAP?" Yes, I realize there's more complexity than that, but isn't that the ultimate goal of healthcare?

Are theories needed? Honestly, since I can't name or recall any nursing theories (don't care to either) are they even necessary in practice? Let's look at some other allied health professions. Do they have specific theories that attempt to govern their practices? I ask because I don't know.

[Preeps]

We used Betty Neuman. Really what a joke. Trying to make something so simple complicated. I say don't get bogged down in theory but use compassion and safe, evidence based practice as your guide.

[Natasha A., CNA, LVN]

I'm learning about nursing theory in pre lvn class and find it quite interesting.

[anon456, BSN, RN]

I think even nurses who wanted to practice nursing theory would have a very hard time implementing it because they would already be swamped with caring for a full load of patients, turning, changing, measuring, assessing, medicating, teaching, and all the more practical things that we do.

[LadyFree28, BSN, LPN, RN]

I use Novice to Expert by Benner; for my own practice, peer practice and my pts and their families.

[Guest27531]

The usefulness of Nursing Theory in nursing practice is like Philosophy in life...most people don't realize they are living their lives (i.e. Practicing) by it but they are. The more we realize there is the possibility to actually know the reason we are doing something (or not doing something) the better our life (practice).

I'm glad you are enjoying it...it should be interesting!!

[LucyLou88, MSN, RN, NP]

The short answer? No. "I have a theory about nursing theory. It's the handiwork of very lonely nurses with graduate degrees who have too much time on their hands on Friday nights," said a good friend of mine who is a nurse working on her Phd. As a grad student, in an MSN, FNP program, I have to agree. There is an incredible amount of wasted energy going into the theory of theory (that's a real thing, call Metatheory), in an attempt to make nursing more "professional." In reality, the kid that is always using big words, and trying to get invited to the best parties, is the one who gets the least respect. If you want respect, and to be invited to the big meeting, do something significant. Stop sitting around making up convoluted, half baked theories to define your profession on an existential level. Leave that to the I. Kants of the world, and start solving real problems. Let's study, as nurse researchers, the correlation between neurological disorders in children, and vaccinations given before one year. That might help someone, and generate new knowledge that other professions are afraid to generate. Or, the significance of the nutritional deficits offered by the typical American diet and lower IQ? Hey! Maybe we could study preoperative self esteem, and postoperative report of satisfaction on the results in cosmetic surgeries. That may give us a heads up when we are dealing with a malcontent client who will never be happy no matter what we do. Let's study something in our research world besides the theory of theories, and why we need them. Maybe then, we can stop trying so hard to invited to the big table. Pardon my rant. Again, the short answer is no.

[cardiacfreak, ADN]

When a pt is coding who cares about theory, IJS. Is theory important? Probably, but with a heavy pt load, all I care about is that each pt is breathing when I clock out.

[dudette10, MSN, RN]

At the risk of having rotten tomatoes thrown at me, I can see the value of nursing theory. However, it is impossible to directly translate nursing theory into practice for a bedside nurse. Theories are just ideas that are researched through operationalizing the theory. What comes out of that research is indeed used by bedside nurses, and it is taught as nursing interventions, especially where patient education is concerned. Where nursing education fails is connecting those theories to the interventions; usually they are taught separately with no connectors. I believe that's why so many nurses pooh-pooh nursing theory.

I.m doing some work for my MSN, and I have a medical example of theory which, I think, is a great illustration of how theory becomes tangible in practice. It just so happens that this particular medical theory has impacted respiratory therapy, medicine, and nursing. It the muscle theory associated with heart failure.

In 1996, a group of medical researchers theorized that the sensation of dyspnea and exercise intolerance in HF was not fully explained by cardiopulmonary models at the time. Instead, they posited that there is something abnormal about the inspiratory muscles in HF patients, essentially providing another explanation for dyspnea and exercise intolerance, which, if shown to be correct, would provide additional modes of treatment. Nearly 20 years and 100s of research studies later, it is widely accepted that 30 to 50% of HF patients have inspiratory muscle abnormalities and that providing inspiratory muscle training (IMT) can reduce dyspnea and exercise intolerance.

Bandura's Self-Efficacy theory and Orem's Self-Care Deficit theory have been researched and operationalized for nursing to help patients manage their own conditions at home. Benner's Novice to Expert Theory has been researched and operationalized for nursing to train new grads and increase performance among established nurses. Lewin's Change Theory has been used to foster change at the bedside, especially where nursing myths and "we've always done it this way" abound.

In a way, yes, theory is for academia. It is academia's responsibility to develop the research studies necessary to operationalize theories and develop nursing interventions. But, theory does have a major role in practice; it's just not always directly translatable.

ETA: I've actually read Benner's original article on Novice to Expert. It is surprisingly short, and she developed her theory out of another theory and applied it to nursing (can't remember the name of it, though). The one part that stuck with me is that she states that many nurses get "stuck" at the competent level of nursing for their entire careers, and they never progress to the proficient or expert levels. Although years of experience are a factor in progression through the stages, knowledge and intrinsic motivation are equally important.