I *do* recognize the need for nursing theory - page 8

but I am a bit appalled by the theory and research classes requird for my NP program while we covered the entire cardiovascular system in 1.2 hours of Patho. Why is that ?????????????????? We have... Read More

  1. by   Kelly_the_Great
    Quote from grannynurse FNP student
    And what theory a practitioner subscribes to or does not, is quite irrelvent. Offering of services has little to do with the theoretical bases of the profession offering said service.
    I thought theory was supposed to guide practice?


    Quote from grannynurse FNP student
    Nursing theory has been an attenpt to describe a given phenomena by explaining the relationship between the phenomena, then predicting the consequences or prescribing nursing care.
    Didn't you say above that it's irrelevant?


    I'm just not understanding your explanation. Maybe it's my lack of logical understanding/processing or education. Your argument appears contradictory to me.
  2. by   grannynurse FNP student
    Quote from Kelly_the_Great
    Why is the consideration of reimbursement looked down upon as an invalid concern for nurses?

    GrannynurseFNP, didn't you say you had an MBA earlier? I'm kind of surprised that you wouldn't be aware of the trends of payors towards reimbursing care which is delivered by EBP standards.
    I studied for my MBA from 1974-76. Neither my insurance nor many others demand EBP standards. Most require an op report, special testing and the correct code for billing. And that code does not included EBP standards.

    Grannynure
  3. by   grannynurse FNP student
    Quote from Kelly_the_Great
    I thought theory was supposed to guide practice?




    Didn't you say above that it's irrelevant?


    I'm just not understanding your explanation. Maybe it's my lack of logical understanding/processing or education. Your argument appears contradictory to me.
    Its is suppose to guide practice but it is not necessarily what many nurses do.
    Ever read any of the numerous articles, in professional literature that incorporate a theory and its impact on certain types of nursing practice. I believe that nursing practice should follow a nursing theory. However, I am in the minority. I incorporate the transcultural theory into my area of practice because of the types of patients I have worked with. But a large number of practicing nurses cannot name a nursing theorist, who guides their practice. Or was I wrong when I saw that some have posted, to use my term, they don't have time for this type of goggbly goup. And see it as irrelvent to their nursing practice?

    Grannynurse
  4. by   gauge14iv
    So I could order physical therapy for gastritis and the insurance company would pay for that?

    I could order Amoxil as a treatment for an acute MI and I wouldnt be sued? Why not? Because the evidence does not show that Amoxil has any effect on MI.

    I could treat a patient using a substance I just happen to believe in for something it is not indicated for (maybe the drug rep told me what a great drug it was) and not expect there to be any ramifications? Drugs and their uses are not based on evidence?

    Would I keep my license very long if I chose to practice based on my beliefs instead of the evidence that is covered daily in scientific peer reviewed journals around the world?

    What if I don't happen to believe Vioxx harms patients so I tell them to order it from Canada? Patient dies from heart attack due to Vioxx use. I ignored the evidence - who's liable?

    You think you practice without evidence? It isn't possible - as a nurse, an NP or even an MD anymore. I will tell you however, that I can practice without theory without fear of being sued or losing my license!
    Last edit by gauge14iv on Dec 6, '05
  5. by   gauge14iv
    As for placing theory in a research article - we were told we HAD to if we wanted to get published...and if we wanted to meet the requirements for the assignment...

    SO we found one that fit and stuck it in there - I rarely find them to be of any real significance!
  6. by   1Tulip
    I think we're sort of off the rails here. EBP is related to our discussion of nsg theory only in as much as there is an outside social force (third-party payers, governmental agencies, etc.) that is/are demanding hard data validating the effectiveness of specific practices.

    Since nsg theory can't predict any outcomes, it can't be used to formulate best practices. So, EBP and Nsg theory are related to each other like chocolate and tennis shoes. Not possible to relate within the same discussion.

    I mean Watson and Rogers were bankrupt and bogus long before EBP came along.
  7. by   gauge14iv
    One poster (or more) has suggested that EBP be the basis for defining nursing rather than theory - that was how we ended up with that factoring in to the discussion.
  8. by   ZASHAGALKA
    Quote from grannynurse FNP student
    Grannynurse
    I just wanted to say that I know that your opinion is outnumbered in this particular thread like 4:1 and I while I don't agree w/ your opinion, I appreciate you sticking in this outnumbered discussion.

    I'm not trying to be part of a gang up on you - just, like you, I'm passionate about the topic.

    I've discussed it elsewhere on this site (where you were a not quite so outnumbered contributor), and prob will again.

    Thanks for sticking in here.

    ~faith,
    Timothy.
  9. by   Gennaver
    Quote from 1Tulip
    Before saying anything, let me admit that I believe nursing theory has been hugely detrimental to our growth as a science and a profession. That is an absolute bias of mine. You are entitled to take what I say with a whole pound of salt if you like.

    ...

    I have my MSN and have taught extensively. I've now got a PhD. I've taught on a faculty that was obsessed with Jean Watson. ....

    Whew! It's so refreshing to vent!
    Hi Tulip,

    Happy to read you vent, glad you did. I feel lucky that during my undergrad studies (BA in Sociology with Psychology minor) that my theory professor was so practical. He was also the chair of the department and even though he shared which was of the many sociology theories he favored his taught them in a way were we could see who built off of who and what where the pros and cons each offered. None of them were taught as the one and only.

    I am noticing now in my Masters Entry to Nursing program that the nursing profs really don't seem to 'get' theory themselves! I am surprised at this. How they teach -A- theory as if it were some sort of gospel.

    Something I noticed too is that the nursing theory profs don't seem to truly realize that all disciplines are based on theory, (sure they give passing mention to it but, seem to have lost their own perspective).

    Sociological theory really was a hard class but, gave me an appreciation for Theory moreso than my psych theory classes. I hope to pursue a PhD in nursing, (and possibly in Sociology too, if I can).

    I agree that something is either lacking or skewed in the way nursing theory is taught.

    Gen
    p.s. it is nice to vent
  10. by   grannynurse FNP student
    Quote from gauge14iv
    So I could order physical therapy for gastritis and the insurance company would pay for that?

    I could order Amoxil as a treatment for an acute MI and I wouldnt be sued? Why not? Because the evidence does not show that Amoxil has any effect on MI.

    I could treat a patient using a substance I just happen to believe in for something it is not indicated for (maybe the drug rep told me what a great drug it was) and not expect there to be any ramifications? Drugs and their uses are not based on evidence?

    Would I keep my license very long if I chose to practice based on my beliefs instead of the evidence that is covered daily in scientific peer reviewed journals around the world?

    What if I don't happen to believe Vioxx harms patients so I tell them to order it from Canada? Patient dies from heart attack due to Vioxx use. I ignored the evidence - who's liable?

    You think you practice without evidence? It isn't possible - as a nurse, an NP or even an MD anymore. I will tell you however, that I can practice without theory without fear of being sued or losing my license!
    Prescribing medication outside its stated use will generally be covered (if the patient has prescription coverage). If you inform the patient of the reasons for withdrawal of Vioxx, he accepts the risks and obtains the medication from outside the country, he or his family is unlikely to be successful, in a suit. You see, to obtain drugs, in Canada, you need a prescription, one written by a Canadian physician. You can go on line it obtain medications on line but I wouldn't ever advise a patient to do so. And I use to obtain my prescriptions in Canada, after seeing a doc there. You are presenting outrageous situations that rarely ever take place, in real life, in my experience.

    And these situations have very little to do with theory, unless you consider the adaptation theory and its impact on a patient's and nurse's role. If you consider this, then the practitioner has adapted to a role that is generally unacceptable by his/her peers. And the patient, who follows such advice is adapting his/her role to either meet a need or to gain the practitioner's approval. A patient who says, no way and changes practitioners, is also adapting his/her role in a more positive manner.

    Grannynurse
  11. by   grannynurse FNP student
    Quote from 1Tulip
    I think we're sort of off the rails here. EBP is related to our discussion of nsg theory only in as much as there is an outside social force (third-party payers, governmental agencies, etc.) that is/are demanding hard data validating the effectiveness of specific practices.

    Since nsg theory can't predict any outcomes, it can't be used to formulate best practices. So, EBP and Nsg theory are related to each other like chocolate and tennis shoes. Not possible to relate within the same discussion.

    I mean Watson and Rogers were bankrupt and bogus long before EBP came along.

    And Orem or Roy or Travelbee or Lenienger? Are they all bankrupted and bogus as well. While I do not agree with the theories of Watson or King, I see their place and role in the formulation of nursing theory.

    Grannynurse
  12. by   ZASHAGALKA
    This might be a surprise considering all my rants on the topic . . .

    But I'm not AGAINST theory - I'm not even totally against some of theory being taught.

    I'm against the pedastool they are placed upon.

    As long as they are the prime focus, nursing suffers.

    If I could chuck them all so we could start over and get our priorities right, I would.

    They may have their place, but they are currently so OUT OF PLACE that my disdain is absolute.

    ~faith,
    Timothy.
  13. by   Gennaver
    Quote from ECU_CRNA2B
    I happen to agree with the others on this post and not your sentiment. You say that to sustain ourselves as a profession we need to examine what makes us nurses...what other profession does this?? ...K
    Hi there,

    I thought all 'disciplines' did this, (not professions, all 'jobs' can be a profession right?)

    While I was working towards a BS in Biology, (changed it though, left it as an associates), we had basic theory for a semester which all we talked about was, "what makes science a discipline?" When I switched to Sociology and Psychology I experienced the same thing, "what makes us a discipline." When I took a cross-listed class for Law, Gender Studies and Sociology I had the triple whammis of "What makes law a discipline, what makes feminist studies a discipline" and so on.

    Another thing that irks me in nursing theory is that it seemingly denies the existence of -other- disciplines as a whole and yet tries to permeate itself through those very disciplines themselves as if it is the one and only. Ay ay ay.

    Gen

    Gen

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