Do you find the nursing theorists/theories you studied in school useful in real life?

[DichloroacetateAl]

I'm studying Porifice's theory of humanbecoming. I find it hard to implement in the clinical setting. Did the theories that you studied in college come in handy in the clinical setting?

[Bortaz, MSN, RN]

I would be hard pressed to remember a single one of them, honestly.

[SuesquatchRN, BSN, RN]

Suesquatch,RN, isn't nursing theory part of evidence based practice, or is it something separate?

Separate. Now, nursing theories can be tested, as can any hypothesis, but something like hand hygiene is not distinct to any nursing theory. Does that make sense?

[wooh, BSN, RN]

I used to think it was stupid. But I now think (and this is not based on pursuing a post-grad degree in nursing, just on looking at the world of nursing) that a lot of what we think of as "common sense" in nursing is actually based on some of that theory. We just don't realize we're using something that got knocked into the back of our heads. I think learning the theory (and how to careplan,) teaches us to think through situations. And that's the biggest thing that I think a nurse does, and the difference between an ok nurse and a great nurse. An ok nurse will get all the work done, not make any mistakes. But to do the job really well, we think through what needs to be done and what needs to happen to get the patient to the optimal outcome. (Although I admit, the nursing diagnosis thing is ridiculous, we could learn it just as well by saying "asthma" rather than "impaired gas exchange.")

[SuesquatchRN, BSN, RN]

" But I now think (and this is not based on pursuing a post-grad degree in nursing, just on looking at the world of nursing) that a lot of what we think of as "common sense" in nursing is actually based on some of that theory. "

But the theories came AFTER the common sense, to explain human behavior and what had already been observed. Which is, actually, what makes most hypotheses. Observation, placing those into an explanatory framework, testing.

[dudette10, MSN, RN]

think learning the theory (and how to careplan,) teaches us to think through situations. And that's the biggest thing that I think a nurse does, and the difference between an ok nurse and a great nurse. An ok nurse will get all the work done, not make any mistakes. But to do the job really well, we think through what needs to be done and what needs to happen to get the patient to the optimal outcome. (Although I admit, the nursing diagnosis thing is ridiculous, we could learn it just as well by saying "asthma" rather than "impaired gas exchange.")

Yes, yes, and yes.

Here's a very simple example, but one we encounter every day. I had a patient that was reported off to me two shifts ago as using a bedpan. Ok, sure. She had a condition that caused pain upon standing. That condition was being treated, and she had pain management meds on board. I knew she lived with her daughter, who was functioning normally, and that the patient was mobile at home until the condition worsened.

I continued to "allow" her to use the bedpan through my shift.

On the next shift (24 hours later), there was a commode at the bedside, and the patient was using it! A nurse within those two shifts thought through what I didn't. This patient needed to increase her toileting functioning because that was her baseline prior to being hospitalized.

You're right. I didn't make any mistakes during my shift, but I didn't do what my patient needed me to do. I could have ordered her a commode and encouraged her to use it, but I didn't. Bedpan? Ok. Here it is.

Self-care deficit r/t toileting...

[mappers]

I know teach clinicals for a college and I have a better appreciation for nursing dx now. When I'm trying to teach a student how to think like a nurse, how to prioritize and then come up with what they should do for their patient, the care plan is very useful. It helps me better judge how well they are connecting the dots and pulling it all together.

[SuesquatchRN, BSN, RN]

You're right. I didn't make any mistakes during my shift, but I didn't do what my patient needed me to do.

Which nursing theory would have fixed that?

[turnforthenurse, MSN, NP]

nope, nope, and nope.

[llg, PhD, RN]

Which nursing theory would have fixed that?

Orem -- Self care deficit, need for patient to progress in toileting practices to be able to go home

Henderson -- Same idea

Benner -- beginner nurse just "followed the routine" while more advanced nurse intervened to think of things to do to help the patient progress

Newman's System Model -- understanding that bedpan use would complicate home care

Any of the caring theorists -- actually helping the patient move forward (rather than just maintaining a routine that keeps the patient totally dependent) is an act of caring and compassion

Abdullah -- assistance with elimination -- working to maintain normal/previous patterns of elimination

etc. etc. etc. I could go on and on.

[llg, PhD, RN]

In evaluating staff nurse performance ... I find that the best nurses have more theoretical knowledge and have greater intellectual ability to think in terms of concepts, relationships, models, etc. It's not that any on theory or model is perfect, it's that nurses need to be able to think conceptually in order to be great.

And the best (only?) way to teach conceptual/theoretical thinking is to practice it. Hence, the need to explore and use relevant theories in school and to continue to do so after graduation. We can debate the merits of any particular theory all we want ... but it's hard to ignore the fact that conceptual/theoretical thinking is superior to simply following standard orders and protocols written by someone else that may or may not work well for a particular situation.

Concepts, models, theories, etc. are how the brain organizes its thoughts. If you have organized thoughts, you have a model or theory of some type. If you don't use any models or theories, your thoughts are completely unorganized and random. That's not good for patient care. The only real question "What concepts and models are the most useful?" and not "Should we have models and theories at all?"

[GitanoRN, BSN, MSN, RN]

what can happen and what does happen are wildly different things.

my sentiments exactly....

[SuesquatchRN, BSN, RN]

See, llg, this strikes me, again, as a care plan issue based in common sense, with no special theory being needed to let dudette know that she'd need to be able to get on and off the pot when she got home. Whatever did we do before the 1970s when this stuff was first introduced?