What is "Nursing Theory/Model"?

[jstuben]

Hello,

I am looking into nursing. I keep hearing about the "Nursing Model" and "Nursing Theory." What is it? How is it different than the "medical model?"

Also, I've heard some nursing students, as well as employed nurses criticize nursing theory and the model. I've never really gotten an answer that I understand.

Can anyone out there explain what the nursing theory/model is, and especially how they specifically use it in their practice.

Thanks!

[SusanJean]

Oh my, I just woke up and am still on my first cup of coffee, so I can't get in too deep here - and I'm just learning my theory now. School introduces at least 8 theorists, we learn about all, pick one we like the best and follow a patient through the semester while applying said theory to care.

Basis for all theorists is excellent foundation in knowledge, otherwise pt. care is compromised. (there are 3 other criteria for any nursing theory but I can't think of them right now...need coffee.)

SJ

[Forcemaster]

When nursing care is broken down into its constituent elements it could be described as an art and science involving the application of knowledge and skills related to basic social sciences, physical sciences, bio-behavioural sciences, ethics, contemporary issues and nursing knowledge (Potter & Parry, 2001). Now this may seem quite a handful for the front-line nurse to get their heads around, but nursing theories have been developed compromising some, and hopefully ALL of the above concepts to make the links all these elements have with the day to day practice of nursing more obvious.

A nursing theory, in reality, is a set of concepts, definitions, relationships and assumptons that project a purposive systematic view of phenomena by designing specific inter-relational concepts for the purpose of designing, describing, explaining and predicting the nursing care that you deliver on a daily basis to those under your care, whether you call them clients or patients, or even a pain in the &$$!

But what does this really mean for your practice?

Now this is a tough question to ask because, the thing is there are different types of theory. Now I won't bore us all with a great description of these, i'll just mention them by style as 'grand theories', 'middle-range theories', 'descriptive theories' and 'prescriptive theories'.

But which do we use, of why should we use them at all?

Well a good theory can provide a foundation of knowledge for the direction and delivery of your practice... but to find a theory that works for you, you first need to analyse what your views of nursing are, what the views of your colleagues are and take into account the philosophy of your care environment.

Now historically, nursing theories were studied in an isolated academic environment indpendent of nursing practice and many nurses still argue (as you have seen here) that nursing theories are not relevant to what occurs in clinical practice. To them I say this... for nursing to grow as a profession, knowledge is needed to predict with confidence the types of nursing interventions that will improve client outcomes. Nurses now and in the future need to have models of care from which their practice is based (Porifice, 1990 and Dean, 1995) because theory is the generation of nursing knowledge for use in practice... that is it is used to develop methods of applying knowledge to practice in the form of a nursing process...

As an art, nursing relies on knowledge gained from practice and reflection of past experiences. As a science, nursing draws on scientifically tested knowledge that is applied in the practice setting (Kikuchi, Simmons and Romyn, 1996). But it is the 'expert' nurse who transports the art and science and nursing into the realm of effective wholistic caring.

[Forcemaster]

Finally, one last thought about this discussion about so-called nursing "theory". What ever was the point of changing the description of a certain sound in the lungs from "rales" to today's accepted word, "crackles"? It is all nonsense. The sound is the same. The significance of this sound in a patient's lungs has not changed at all. Changing the name of something does not represent any advancement in knowledge for nursing or any other discipline. The concept has been around for ages. If nursing wants true recognition as a profession it should get away from such silly exercises in renaming things that are already known.

Maybe it's because when you tell a patient they have rales they have no idea what you are talking about... but when you tell them their lungs have crackles they smile thinking they have a type of breakfast cereal in their chest??? :rotfl:

[Tweety, BSN, RN]

Was it a nurse who came up the idea of changing the name to crackles? While we're at it, who inveted decubitus??

[llg, PhD, RN]

thanks !!! :blush: (we need a blushing smilie, not just the imbar one...)

]

nursefirst

thanks for seeing that i was trying to definitely not be too critical of your previous post. i thought you raised some good points -- and while i couldn't whole-heartedly agree, i didn't totally disagree, either. i suspect that, if the 2 of us sat down in a room and put our heads together, we would come to a middle ground approach that we would both support.

thanks for the conversation,

llg

[Q.]

But if you think medicine hasn't changed words, or made up complex sounding words for simple concepts ... whoo boy!!! Are you in for a surprise.

:chuckle Exactly. My first thought is Chronic Fatique Syndrome vs Fibromyalgia. Aren't they the same or did one replace the other?

[Q.]

Changing words or phrases and simply, arbitrarily,assigning certain phrases as "accepted" for use, as I said before, represents no advancement in anything and most certainly does not designate nursing as a profession with its own scientific body of knowledge. It is simply the adoption of a jargon to describe things nurses and others have known for years.

Which perhaps might be a valid point, if we were talking about nursing diagnoses. But we're not - we're talking about nursing theory which is a completely different topic.

Again, nursing diagnoses are intended for nursing students to conceptualize and compartmentalize nursing practice when they are learning. It helps them organize their thoughts.

[SmilingBluEyes]

rofl.....Where is the brick wall thingy when we need it?

I hear ya, Suzy. I have been reading up on nursing theorist/theory. I find some of it fascinating, some "way out there", some zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz........

I am thinking many theories should apply to be a well-rounded nurse. Is that just me?

That is prolly the ONE thing I lacked in my ADN program; study of nursing theoriest/theory. We just skiffed Watson and Orem...not the many others. Do BSN programs have a class just on theory/theorists, or are they mostly MSN studies? Seems my RN- BSN bridge program did not get into it much, when I was in , and I did not see much referral to this in the synopsis of the classes I had to take.

Anyhow, interesting thread, sorry for the hijack. My ignorance is showing here..... :chair:

[zenman]

That is prolly the ONE thing I lacked in my ADN program; study of nursing theoriest/theory. We just skiffed Watson and Orem...not the many others. Do BSN programs have a class just on theory/theorists, or are they mostly MSN studies?

In my MSN program, teams of two each had to develop our own nursing model. Wish I still had it somewhere.

[SmilingBluEyes]

now THAT would be quite a stimulating exercise, zenman.

[Tweety, BSN, RN]

I am thinking many theories should apply to be a well-rounded nurse. Is that just me?

Deb, I think that's what most of us do without thinking. We follow a mish mash of theories and that's o.k. If I were to follow you around for a day and describe what you do in terms of nursing, I probably would be able to apply a couple more than one theorist, depending on the patient.

Theory helped me to understand what I do. It helped me appreciate that there can be a more holistic approach to nursing rather than doing tasks. But do I subsribe to a theory? No I don't. Based on my own values, beliefs, knowledge base, etc. I approach nursing.

It's hard to find a "one size fits all" approach, IMO.

Am I making any sense?

[SmilingBluEyes]

perfect sense, tweety!