Is nursing theory actually used by working nurses?

  1. 4
    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?
    lxpatterson, lindarn, in2bate71, and 1 other like this.

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  2. 44 Comments...

  3. 28
    I know that I just don't give a rat's behind about nursing theory, or nursing diagnosis.

    I am part of a team that practices medicine. My role/scope is that of a nurse, within this team.

    Screw NANDA, give me straight up clinical pathways devised by my team to follow.
    prettymica, anon456, skisgirl276, and 25 others like this.
  4. 10
    Quote from onaclearday
    I know that I just don't give a rat's behind about nursing theory, or nursing diagnosis.

    I am part of a team that practices medicine. My role/scope is that of a nurse, within this team.

    Screw NANDA, give me straight up clinical pathways devised by my team to follow.
    Kudos x infinity!

    That's the way I see it.

    It seems that nursing tries way too hard to justify its role in healthcare and define its nature. Powerful lobbying. The DNP. Theories out the rectum. You're a nurse. People know that. The patient needs to be driving your practice and not some stupid theory. Geez, I took criminology (read: criminal theory) back when I was in college and was in law enforcement for a good while (still am), but do you honestly think I applied any of those theories when taking crackheads and wife beaters off the streets? Heck no! I just became attuned to the situation, much like a nurse does to patients, and did the job.

    And the theory PAs follow is cure the dang patient. What's wrong in that?
  5. 10
    Nursing theory is important to nursing practice in the same way Philosophy is important to living. We all know that in life not everyone studies Philosophy but, whether they know it or not, everyone lives by a philosophy. Studying a little philosophy can help us know more about how we live and, sometimes, to live better. Studying a little nursing theory can help us know more about our practice and, sometimes, to practice better.
    elkpark, NurseKatie08, lindarn, and 7 others like this.
  6. 9
    I've been a nurse for 15 years, and I don't think about "nursing theory" unless a question like this comes up. Jeez...who among us runs around thinking about NANDA and theory???

    However, it does drive my practice, because I buy into Henderson and Watson in as much as they fall in with my own philosophy: Encourage independence and autonomy, promote wellness.

    Or, as my mother's theory would say, "Those that can, should. Is your arm broken?"
    tewdles, lindarn, BCRNA, and 6 others like this.
  7. 5
    Well it helped to a certain extent but no I don't go in every day and think about Florence and her exact ways.

    I do consider the person, their environment and what's happening to it, and the type of care I intend to/provide. I think that's what most theories covered, the rest were useless to me and it honestly took up loads of hours writing them when I would have preferred more clinical practice times and skill development. I do believe certain theories are important to know and understand but my nursing program spent too much time on theory and not enough time on what to do!

    I graduated with: having put in one female catheter, doing two IM injections, and probably 3 subcutaneous, minimal IV medication practice you can forget about IV starts (Just did my first couple last month!). I did two suctions on a trache patient, no ostomy care, minimal feeding tubes BUT I could tell you every theorist that ever touched nursing. We had 3 theory courses in the program, where it went into deep details about the history and theories involving nursing. Give me a break....we don't NEED all this just show me how to put in a catheter!
    It really upset me that I spent thousands of dollars and now I am in debt only to know I felt like **** saying "Oh I never done that before" to almost every small skill by end of fourth year.

    Besides, theories are just a bunch of people's opinions that were validated by another's opinion. I could just make up a theory now and maybe it will be practiced 50 years from now. So just take what you can from it and the rest you will likely never remember it.
    Just my opinion.
    AmericanRN, annister, lindarn, and 2 others like this.
  8. 5
    our health system chose betty neuman's system model in 1990's for their care philosophy.

    luckily, my bsn program in 1979 was based on this theory.... still influences me today with every homecare referral i obtain and process....along with thousands of careplans i've hand written in 25+ yrs as homecare rn--- computerized since 2002!

    her archives are now housed at my alma mater: neumann university
    Last edit by NRSKarenRN on Dec 24, '10
    elkpark, VickyRN, NurseKatie08, and 2 others like this.
  9. 7
    Depends on what you're referring to; I just finished a refresher course in circulating and recovery room practice, and when my fellow students were struggling with the learning material, I pointed out to them that these are things we do every day, without even thinking about it.

    I think a lot of the nursing theory is like that, we do it habitually; we just don't make the connection and say, "right, what does my nursing theory say about this?"
    pers, tewdles, annister, and 4 others like this.
  10. 6
    I think that while many non-academic practicing nurses are not able to recite the names of theorists and their associated theories by memory they are in fact using certain theories in practice (depending upon the area of nursing). Nursing is becoming increasingly more evidence-based practice because our practice is being guided by theory and has been proven with research. I think that the drive from academics to emphasize nursing theory is to elevate nursing so that nursing can be respected as a both a profession and a healthcare dicipline (among the ranks of medicine, physical/occupational therapy, pharmacy etc.)
    elkpark, pers, NRSKarenRN, and 3 others like this.
  11. 1
    The only thing I remember about Florence is that she was "the lady with lamp" during the Krim War, changing nursing professionalism.
    Before my final exams I was able to explain a lot of nursing theories, but now
    when practising nursing I try to work with compassion - this leads automatically to evidence-based nursing and lifelong learning.
    During my nursing education we had to state a reason why we are caring a particular way, that's probably why I catch myself reasoning with Orem and Peplau.
    Orem is omnipresent in Germany, don't ask me why...
    lindarn likes this.

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