Calling all nursing theory Advocates!

Kyrshamarks, BSN, RN · Jul 1, 2008

Here is the real theory on nursing. The doctor orders it and we do it. the patients are not there long enogh to make any theories really matter.

MikeyJ, RN · Jul 1, 2008

I actually have not learned any nursing theories, with the exception of some theories in community health (which are not nursing theories, but rather theories on public health).

I have heard of some nursing schools who focus very heavily on nursing theories and I really don't understand why. I find some theories generally interesting but most are fairly useless if you ask me.

CraigB-RN, MSN, RN · Jul 1, 2008

I'm told it is important to understand the relevance of nursing theories for my practice. All I see are people with ideas/views/approaches to nursing that differ from each other. Don't we all view nursing/life from our own set of lens anyway? Why do we need to pick a theorist to identify with? Someone help me see why this matters.

Nursing theory is a tool, just like Nursing DX, but unfortunately there is a group of academics who have taken it to heart and tried to make it the Core of nursing. Understanding why you do something, can make you a better nurse.

It's s tool to help you as a provider, identify why and how you practice. The problem is that no one has adequately figured out how much nursing theory is needed.

So as a student, like the previous poster said, just do what the Dr. ordered. :)

After that it is up to you.

ceecel.dee, MSN, RN · Jul 1, 2008

Understanding why you do something, can make you a better nurse.
So ... just do what the Dr. ordered. :)

Studying the theorists just portrays how the brains in nursing work out the puzzle of figuring out how best to holistically approach/understand patient's needs...non of them are perfect, but many have some basic similarities. If studying them helps nurses understand why you do something, and can make you a better nurse, why not try to apply some of that abstract thought to your patient care?

Being a good nurse requires MUCH more than just doing what the Dr. orders.

llg, PhD, RN · Jul 1, 2008

"Understanding the relevance" of theory does NOT mean picking one and only one to identify with. Nursing theories are simply tools to use to help organize nursing concepts and relationships. Just as you would never expect to build a house using only 1 tool (e.g. a hammer)... you should not expect to understand or practice nursing using only 1 theory.

Unfortunately, nursing has suffered because it theories have been badly taught in our schools -- often by faculty members who were assigned to teach the theory class, but who had not special knowledge of it. Thus a negative viscious cycle was born. Theory was poorly taught at the beginner level ... and those student went on to become the faculty who teach theory to future students. Of course there are exceptions to that -- but an appalling number of people theory have no special preparation to do so. You wouldn't want to learn a clinical topic from someone with no special knowledge of that clinical area ... the same should be true of teaching theory. But unfortunately, undergraduate faculty members are usually hired to teach clinical, then get assigned to teach some of the other courses whether they have special knowledge of those subjects or now.

Nurses need theory to organize our thinking so that our decision-making is coherent -- rather than being haphazard, disorganized, internally contradictory, etc. The beginner-level nurse "just following orders" and "just following the usual protocols," may not see a need for it as that nurse is not engaging in a lot of autonomous practice that requires independant, original thought. However, as you move beyond "just following standard procedure" and into the development of orginal programs and more autonomous practice, you should find that you need to have a framework that pulls together your thoughts into some sort of workable "picture of the world and how it works." That framework (or picture of the world) is what a theory is. You can't make independent decisions without one.

Generations of nursing scholars have proposed a wide variety (hundreds) of theories over the years. Some of them are very proud, philosophical statements about nursing in general. Some are very specific statements about an individual, narrowly-defined topic. Some of them may relate very directly to your particular specialty practice. Others will not. Some will be consistent with your philosophical outlook on life. Others will not be.

Be open-minded and look through the massive "tool-box" of nursing theory and find those that include concepts that you can relate to. Challenge your mind to grow a bit by making an effort to wrap your head around some of the more challenging, abstract ones that don't match well with your personal intelectual background and tendencies. That's the fun of it -- and that's where the growth occurs. We learn and grow as professional nurses as we explore the concepts and relationships included in the various theories and do the work of applying them to our practice.

Have fun.

CraigB-RN, MSN, RN · Jul 1, 2008

"Understanding the relevance" of theory does NOT mean picking one and only one to identify with. Nursing theories are simply tools to use to help organize nursing concepts and relationships. Just as you would never expect to build a house using only 1 tool (e.g. a hammer)... you should not expect to understand or practice nursing using only 1 theory.
Unfortunately, nursing has suffered because it theories have been badly taught in our schools -- often by faculty members who were assigned to teach the theory class, but who had not special knowledge of it. Thus a negative viscious cycle was born. Theory was poorly taught at the beginner level ... and those student went on to become the faculty who teach theory to future students. Of course there are exceptions to that -- but an appalling number of people theory have no special preparation to do so. You wouldn't want to learn a clinical topic from someone with no special knowledge of that clinical area ... the same should be true of teaching theory. But unfortunately, undergraduate faculty members are usually hired to teach clinical, then get assigned to teach some of the other courses whether they have special knowledge of those subjects or now.
Nurses need theory to organize our thinking so that our decision-making is coherent -- rather than being haphazard, disorganized, internally contradictory, etc. The beginner-level nurse "just following orders" and "just following the usual protocols," may not see a need for it as that nurse is not engaging in a lot of autonomous practice that requires independant, original thought. However, as you move beyond "just following standard procedure" and into the development of orginal programs and more autonomous practice, you should find that you need to have a framework that pulls together your thoughts into some sort of workable "picture of the world and how it works." That framework (or picture of the world) is what a theory is. You can't make independent decisions without one.
Generations of nursing scholars have proposed a wide variety (hundreds) of theories over the years. Some of them are very proud, philosophical statements about nursing in general. Some are very specific statements about an individual, narrowly-defined topic. Some of them may relate very directly to your particular specialty practice. Others will not. Some will be consistent with your philosophical outlook on life. Others will not be.
Be open-minded and look through the massive "tool-box" of nursing theory and find those that include concepts that you can relate to. Challenge your mind to grow a bit by making an effort to wrap your head around some of the more challenging, abstract ones that don't match well with your personal intelectual background and tendencies. That's the fun of it -- and that's where the growth occurs. We learn and grow as professional nurses as we explore the concepts and relationships included in the various theories and do the work of applying them to our practice.
Have fun.

The eternal debate, the one that has been being tossed around all of the 30 years I've been doing this. It's well said, but oh so much like a text book. So tell me any other profession that needs a theory to organize their thinking? I'm truly not trying to be sarcastic here. I've got grad degrees in other areas than nursing, I've worked in collaborative area's i n health care with everyone from PharmD, to engineers to physicists, to OT/RT and In 30 years I've never seen anyone else spend any time on anything like nursing theory.

It is like you said a tool, nothing more. And I fully agree that the people teaching it in most places shouldn't be. I think over the years Nursing Theory has become an entity unto itself and not just a tool. We should be spending the time spent on nursing theory, teaching students how to develop as people, how to have a life outside of nursing, and how to thrive in a profession, that inherently isn't supportive. Using these theories as examples, might be one way to provide the tools. It is however an area, that passing or failing will be measured in years not the end of the semester. Hard to give that a grade.

As to my earlier do what the Dr Ordered comment, I need to make sure I label sarcasm when i speak it. Of course I'm sure most people recognized I was only talking about doing what needed to be done to pass the class. :)

It is hard to see the importance/relevance of some of these theories, SOme like beginner nurses working their way up to competent nurses area easier to swallow than the one's that talk about spirituality and such. When your ready/studying them, make sure you take the time to realy identify what you disagree with, not only what you agree with. Both can teach you a lot.

Penguin67 · Jul 1, 2008

The eternal debate, the one that has been being tossed around all of the 30 years I've been doing this. It's well said, but oh so much like a text book. So tell me any other profession that needs a theory to organize their thinking?
By definition, a profession must have a theoretical basis. So, to answer the question that you posed, all professions have theories that guide the work of their profesisonals. Until nursing doctoral programs become more common, in the early 80's, nurses obtained doctoral degrees in other professions, such as education, public health and administration. HAve you ever heard of borrowed theory? That is when a nursing theory really doesn't seem to fit a nursing project, so we borrow a theory form another profession, such as education, psychology, biology, etc...Now that the knowledge base of nursing has grown substantially and theories have not only been developed, but tested and shown to be worthy, nursing has a tremendous amount of knowledge on which to further promote the profession. No, it is not the glorious part of nursing, and usually not too exciting, but theory development and testing is a must for the profession to remain viable and to promote knowledge development via nursing research.
Most nursing schools and hospital nursing units use an eclectic approach to nursing theory application in practice, and utilize several theorists to guide their work. It is unusual these days to find a single theorist who guides one workplace, but it can be done, it just takes alot of work and buy in from the empoyees.
I honestly didn't "get" nursing theory until I took a theory course in the master's program, and didn't begin to comprehend the relevance of theory to research and practice until the many doctoral level theory courses that I took. It takes time.:heartbeat

Bill E. Rubin · Jul 1, 2008

You might also look upthe following nurse theorists and their theories and see what you find (you may find something Googling them):

Florence Nightingale

Jean Watson (caring theory)

Madeleine Leininger

Orem (self-care model)

Peplau

Henderson

Ida Orlando

llg, PhD, RN · Jul 1, 2008

. When your ready/studying them, make sure you take the time to realy identify what you disagree with, not only what you agree with. Both can teach you a lot.

I definitely agree with that. The process of learning the theory well enough to critique it knowledgably teaching you a lot -- as does the process of comparing it to your own beliefs and then formulating an argument to refute that theory. That process of learning, critiqueing, formulating and expressing your own ideas ... that's what academic work is about ... and one way in which new theory is developed.

.... Then someone comes along and says that your ideas are a bunch of hogwash and the process continues.