is nursing theory important to nursing practice

[precious nikz]

hello everyone...pls help me with our debate this Monday.. our clinical instructor gave us the topic,,"IS NURSING THEORY IMPORTANT TO NURSING PRACTICE?,, and we are in the negative side,.the decision was given through toss coin,.

PLS HELP US WITH OUR STAND,,NURSING THEORY IS REALLY IMPORTANT BUT MAYBE THERE ARE SOME THINGS TO BE ARGUED ABOUT IT..AND NURSING IS NOT REALLY ALL ABOUT THE THEORIES ITSELF..

PLSSS.....:cry:

[Multicollinearity, BSN, RN]

Every profession has theories that provide conceptual foundations and frameworks for their profession. I was just off in google-land reading about grounded theories within medicine, theories in medical anthropology, theories within clinical psychology, etc.

Not specific to a single profession, but I suppose the germ theory of disease seems pretty basic, but it sure wasn't at one time. Just because it's basic and commonly known doesn't mean it shouldn't have a name and label.

I suppose we could exist OK without any theories of our own, but then wouldn't we exist as borrowers from other professions' theories?

[Multicollinearity, BSN, RN]

My nursing school didn't have a strong emphasis on nursing theory while I was there. I graduated from a ADN program. I think when it comes to actual practice at the bedside, it's not important. I think what we're taught and how we care for the patients, use our knowledge, and coordinate care are all things we do regardless of what theory it happens to fall under.

For someone that has never really been exposed to the theory of nursing, I don't feel that I'm lacking when it comes to my practice.

Edit: After researching a bit, it seems that Nursing Theory is another name for Evidence-based Practice, which makes sense to me.

Nursing theory and evidence-based practice are not the same.

[Music in My Heart]

Understanding that theory is the backbone of all clinical care perfomed by a nurse.

Can you provide an example of how care would be different for a specific patient if one were to have no knowledge of (pick your grand theory)?

Maybe you did not get enough theory while you were in school?

Well, I don't know how much is enough but we had a steady diet of it for three semesters.

Two that you discussed, Benner and Roy are two very classic nursing theorists!

Yes, I know that.

Research the two and you will be amazed at the connection between what you do as a nurse and what they wrote.

I have researched them. While I agree that they do describe some elements of daily nursing function, I don't see how that function would be different if the theories were never learned. Unlike some kinds of theories, nursing theory seems to follow the action, to describe it, not to serve as a foundation principle from which the practice follows.

In that regard, it's kind of like music theory... the theory followed the practice, is not strictly necessary in order to play music, and simply provides a description to what experienced musicians have already learned through the practice of their craft.

[Music in My Heart]

I suppose we could exist OK without any theories of our own, but then wouldn't we exist as borrowers from other professions' theories?

Perhaps. Would that necessarily be a bad thing?

[CraigB-RN, MSN, RN]

1. A few of those nursing theories aren't actually origional. Benner just took an already established education theory and put it in nursing context. Johnson's theory is many thousands of words to describe a quote by Voltair, Medicine is the art of entertaining your patient while they heal themselves. I know a simplification.

2. We teach theory wrong. It should only get a mention in undergrad nursing education. The average nursing student doesn't have the framework to really understand, integrate, synthisise the concepts. (can you tell I'm in grad school?) Nursing theory is probably best delivered at higher levels of education. I can't remember any of my origional theory classes, they were over 30 years ago. I do remember the day were I thought, hmm there is something to this theory stuff. That's when I decided to pursue grad school.

3. Nursing theory is a tool, nothing more, nothing less. It's a way to look at how we do things and why we do things. It's a way to begin to touch on the affective domain. It's not the end all that some educators try to make it. Just like nursing diagnosis and care plan. Thay are a tool to teach a way of thinking.

4. having been an educator, the primary theory that I use is Benner. I don't even consider it a theory, but a fact. It's based on the old apprentice, journyman master concept, that probably Joseph used on Jesus to teach him carpentry.

All in all you do what you have to do, to get through school. Just like writing. The writing you do for nursing school of all levels is so far from the realities of nursing practice. Some people will never think of nursing theory again, and they may be the best nurses you've ever met. Some people will think way to much about them and not be a nurse that i'd want my family have take care of them.

[RNperdiem, RN]

Nursing is a performing art.

How you perform is what makes the difference in patients' lives.

The longer I am a nurse, the more action is what counts.

Theory has it's place too.

Being able to describe theories I read from the swimming manual does not make me a strong swimmer.

[Moogie]

Every profession has theories that provide conceptual foundations and frameworks for their profession. I was just off in google-land reading about grounded theories within medicine, theories in medical anthropology, theories within clinical psychology, etc.

Not specific to a single profession, but I suppose the germ theory of disease seems pretty basic, but it sure wasn't at one time. Just because it's basic and commonly known doesn't mean it shouldn't have a name and label.

I suppose we could exist OK without any theories of our own, but then wouldn't we exist as borrowers from other professions' theories?

Perhaps. Would that necessarily be a bad thing?

I think so. In order to be recognized as an academic discipline, separate from medicine and other health sciences, nursing needs to have its own body of knowledge. Grand theories act as the foundation for nursing practice; mid-level theories are utilized to develop nursing actions in specific clinical areas.

Nursing has been struggling to be recognized as an academic discipline ever since the 1960s, when the ANA published a position paper that supported baccalaureate education as the entry level to practice. What does this have to do with actually being a nurse? Plenty. When most nursing education took place in hospital schools (diploma programs), the profession was very much under the control of medicine. Now, there's a lot to be said in favor of diploma programs, mostly the fact that diploma grads typically have much more clinical experience---and are therefore more technically skilled---than other entry-level graduates. But the biggest downside of these schools was that they didn't teach nursing theory---sure, they touched on Florence Nightengale and Hildegard Peplau, but for the most part, the curricula were medically based. Nurses were taught---TRAINED---to be the handmaidens of the physician. In many cases, they were taught specifically what their doctors wanted, how to take care of their doctors' patients, how to anticipate and carry out their doctors' orders. Indeed, physicians often taught some of the nursing classes, mostly anatomy, physiology and pathophysiology.

Moreover, nursing has been struggling to be recognized as its own profession. One of the characteristics of a profession is that there is a specific body of knowledge to that profession. If nursing research would cease and all nursing theories vanished, we would be back to borrowing theories from a plethora of other disciplines. Where, then would we find knowledge specific to nursing?

These arguments may seem silly to those who are working in direct patient care, some of whom seem to follow a sort of Zen-like philosophy of nursing. They practice nursing and nursing is defined by their actions. And, for the individual practitioner, that works. But looking at the larger picture---at nursing as a profession and a discipline---we can't just do. We have to think and express ourselves in academic language---yes, in order to obtain legitimacy among academia as well as among other health professions.

Is the quest for legitimacy just for show? No. Look at the respect other health care professionals give each other. How are pharmacists and physical and occupational therapists respected in comparison to nurses? Administration often sees nurses as expendable, a "dime a dozen." Have any of us ever heard administration say that about master's prepared physical therapists? Do we EVER hear administrators think of doctors as expendable?

Additionally, nursing theory provides the foundation for nursing research, which is important to help develop nursing practice. If it wasn't for nursing research, we'd still be putting Maalox on decubiti like we did thirty years ago when I was in school. Now I'd like to think that my education from eons ago is still relevant; in terms of clinical knowledge, what I learned was obsolete before I hit my five year anniversary as an RN. But in terms of basic nursing knowledge---the theoretical foundations---it's still there. What I learned in school was refined and made relevant through my experience---which has led to an increased desire for more knowledge so I can be a more effective, current nurse.

Believe it or not, I really do use nursing theory as a basis in my practice, whether that practice is teaching students or passing out meds in LTC. Jean Watson's ideas remain as influential to me now as they were when I first learned about them. I also look to Benner's theories, especially her Novice to Expert model, and I've used Pender as the foundation for community health nursing. Now, is the day ever going to come when we see Moogie's Grand Theory of Nursing and the Universe? Probably not. But I do have my personal philosophy of nursing that has been born out of my education, my experiences, my core values in life, and every little thing that has to do with nursing, no matter how grand or trivial.

BTW, just a quick note to the OP and other nursing students---just remember that your instructors might be lurking on these boards as well, so don't just ask any of us for the answers. Look, listen, read, reflect---and then make your own conclusions.

[travel50]

"Let's hope the caring ideal continues to seem like common sense to you -- and to many others. But don't forget the fact that it seems like common sense to you because somewhere along the line, you acquired that value and internalized it -- probably from Jean Watson or someone like her that taught you about the importance of caring." orig poster, llg

Thanks for your post llg. Guess I sounded negative, but I didn't mean to be. But these things do just seem so basic to me. I did not learn to care about people from a theorist. My mother was an LPN, and sisters old enough to be my mother were a physician and a nurse practitioner. Caring was understood. It didn't matter if it was a patient, a neighbor or a stray kitty I rescued...you cared and were expected to always show that. Same as the theory of helping patients do as much for themselves as possible, same as behavioral theories, etc. It was just all part of my life. And I guess I have no understanding of the person who does not care. Yes, in reading some posts, and in being a director of nursing, I see nurses who do not seem to care. I wonder why they are nurses. And if they are working for me, they are quickly terminated. I think the only theorists I have enjoyed reading about were the very first ones...it was all new for them.

[jjjoy, LPN]

But without theory, nursing as a profession cannot and will not advance. We used to have to "borrow" theories from other professions and disciplines and we don't have to do that as much now that nursing theory is emerging.

To help my students understand nurisng theory, I ask them to think of their own religion and how it pretty much guides your life, the decisions you make, the way you live, etc...That is how nursing theory should be for nurses.

I do think some of these nursing models are useful tools to framing nursing as a profession... although sometimes they might end up constraining it... such as models that specifically separate nursing from medicine by cutting out medical diagnoses and treatments, and where does that leave nurse practitioners?

I think nursing theory is one of many ways the field can advance; the question is how much do they impact each individual nurse's professional practice? If a nurse doesn't learn or embrace any formal nursing theory, can they still adequately practice nursing?

Drawing a parallel to religion would seem to hurt the argument for the necessity of nursing theory. Clearly, not everyone practices a religion and they still lead what they consider to be meaningful, productive and satisfactory lives.

Finally, if a "borrowed" theory (tweaked to fit nursing) works, who cares if it's "borrowed"? Nursing by nature overlaps with many fields such as education, public health, & medicine.

[Moogie]

2. We teach theory wrong. It should only get a mention in undergrad nursing education. The average nursing student doesn't have the framework to really understand, integrate, synthisise the concepts. (can you tell I'm in grad school?) Nursing theory is probably best delivered at higher levels of education. I can't remember any of my origional theory classes, they were over 30 years ago. I do remember the day were I thought, hmm there is something to this theory stuff. That's when I decided to pursue grad school.

Interesting point. I was taught minimal theory in my ADN program, a bit more in my BSN program, but got the full treatment when I started grad school. The concepts I learned in grad school totally changed the way I think about nursing---but there is no way I would have been ready to absorb any of them when I was still learning the fundamentals of nursing.

I knew I was a nursing nerd when I realized I no longer thought of theory as bull**** but as something fascinating and relevant to my career. I'm even comfortable with mid-range theories and that sort of scares me. (Bwahahahahaha---invasion of the nursing body snatchers....)

[jjjoy, LPN]

I think so. In order to be recognized as an academic discipline, separate from medicine and other health sciences, nursing needs to have its own body of knowledge. Grand theories act as the foundation for nursing practice; mid-level theories are utilized to develop nursing actions in specific clinical areas.

Moreover, nursing has been struggling to be recognized as its own profession. One of the characteristics of a profession is that there is a specific body of knowledge to that profession. If nursing research would cease and all nursing theories vanished, we would be back to borrowing theories from a plethora of other disciplines. Where, then would we find knowledge specific to nursing?

Look at the respect other health care professionals give each other. How are pharmacists and physical and occupational therapists respected in comparison to nurses?

Can't you have a body of knowledge specific to a profession without having any grand theories? Do pharmacists have a grand theory of pharmacy? Do civil engineers a grand theory of civil engineering? Nurses can publish research on topics relevant to nursing without any grand theories in the background... such as ways to reduce the incidence of pressure ulcers or effective post-op teaching strategies.

As you note, many theories were initially developed as a way to legitimatize nursing as a profession as it struggled to pull itself from being considered subject to physicians. Creating theories that cut medical diagnoses and ordered treatments out of the picture was one way to prove that nursing was more than just one small subset of medicine. I definitely think such theories played an important role in the development of nursing as a profession. But how much of a role do such grand theories play in the *practice* of nursing several decades later?

[TrailBlazerRN]

Personally, I believe many of the nursing theories are kind of outdated. Also, the theories are not necessarily applied while practicing nursing, Roach's 6 C's don't exactly cross my mind when i enter a patients room. Additionally I think that some of the theories are kind of wacked.. i dont exactly remember which, maybe one about transpersonal caring? Not sure. Anyway, it can be argued both ways, as Florence Nightengale's practice of making patients as comfortable as possible in a tranquil environment (etcetc) is still applied in nursing today.