How do you teach nursing theory?

nurse2033, MSN, RN · Jul 11, 2014

Teaching theory is about showing the reason for theory and introducing students to a number of theories. The students are capable of drawing their own conclusions, in fact that should be a focus of your teaching. Just like buying a car depends on what you need it for, there is no one best theory for nursing practice, or for individual nurses. If you feel a theory is poorly supported, have the students prove or disprove its validity. Having each student pick and present on a theory is a great way to compare them and discuss their pros and cons. I agree that nursing theory can be a bit "out there", but I don't think you can quantify every aspect of nursing. How about have the students write their own theory?

HarryTheCat, MSN, RN · Jul 11, 2014

I would probably be the worst Theory professor in the history of nursing school. OK...I "get" Watson, Ericksson, Orem, and bits of some of the others, but for me, many of them seem to wander off into the ozone layer. Some, like Martha Rogers and Phil Barker, still have me wondering what they were smoking at the time they came up with their "theories". Others seemed to have taken fairly simple concepts and then grind them to death with massive amounts of pedantic gibberish. I wouldn't be surprised to see Nursing Theory books on Amazon with the comment "Customers Who Bought This Item Also Bought": some rope and a stepladder.

CraigB-RN, MSN, RN · Jul 12, 2014

Most of my 20 soothing students don't have the tools to equate themselves. I'm of the thought that theory should be a graduate level subject. Wasted on a 20 yo undergrad.

nurse2033, MSN, RN · Jul 13, 2014

Making theory relevent is a challenge. But it is the core of nursing. Theory tells us what nursing aspires to be, without which, how would we truly know what nursing is? The military uses doctrine, strategy, and core values to define itself. Theory is nursing's equivalent. You need to find the relevance for yourself so you can teach it. I don't get all misty eyed over Jean Watson, for example, but there are important points in theory that do apply to nursing practice. You can trace the theoretical basis for the Nursing Standards of Care from theory which is a good classroom exercise.

llg, PhD, RN · Jul 13, 2014

I teach theory in an RN-BSN program. I like to approach it with a "history of nursing thought" slant. I present the major theories in historical order ... including a discussion of the context in which the theory was developed, it purposes, and the needs/background of the person who developed it.

Who developed this theory? Why was it developed? Can you see how the theorist's background and practice needs influenced the type of theory she developed? (e.g. a theorist specializing in psych would develop a theory that was different than a theory developed by someone whose background was in med/surg and who was looking for a theory to use as a foundation to teach med/surg nursing). In what types of situations might this theory be useful? etc.

I try to convey that the various theories present different ways for nurses to organize their thoughts and information. They are tools that we can use -- and that some tools are better-suited to some situations than others. Also, individual people may prefer one theory over another ... and that's OK. My goal for them is to finish my class with a working knowledge of the major theories that have contributed key ideas to the practice & culture of our profession. I encourage them to identify the key elements of each theory that have "stuck" with us over time -- and remind them that many of the ideas we now take for granted as "obvious" were once new and foreign when they were first introduced by the scholars of days gone by. By the end of the semester, the class is discussing current developments in theory ... professional practice models ... etc.

As for the theories that don't appeal to me personally. I am honest about that to my class, but emphasize that my personal preferences don't determine whether or not it is a "good" theory or not. It is still a valuable theory to our profession because it has been shown to be useful by many people and I try to find the key points of the theory that will be useful to many people.

Great idea for a thread. I hope it doesn't get ruined by a bunch of "theory haters."

CraigB-RN, MSN, RN · Jul 17, 2014

Some of my thoughts on Nursing Theory come from my background. My father is a PhD Occupational therapist. My wife is a PA, One of my best friends in a Dentist, another of my friends is a PhD physical therapist.

None of them have theories of practice that nursing seems to need. The few that I find useful, are the ones that came from other areas and were modified to work in nursing. i.e Benner My first exposure to her theory was from her mentors the Dreyfus brothers. I am primarily a clinical educator and education theories tend to have more use to me.

I like the idea of teaching it as history and focusing on the need that the theory was supposed to fill and leaving it to the student after that. Gives good exposure to the theories without supporting one over the other. I still feel that it is time wasted on undergrads that could be used for other things. Although I do wonder how much of those issues are in the way it's being taught

i was discussing the concept with a faculty member in the sociology department. My first Masters was in Sociology. After scanning through the curriculum, his comment was that nurses needed a lot of internal validation for what they did, because they weren't getting it from external sources. I haven't had a chance to follow up on whether he thought that was a good thing or a bad thing.

llg, PhD, RN · Jul 17, 2014

1. I think there is some truth to the sociologist's comment about nurses needing validation. Nursing has been in a unique position ... considered as a "handmaiden" of the physician ... doing work once done by household servants ... doing work associated with the uneducated, lower classes, prostitutes, etc. It was not considered an appropriate type of work for a respectable woman. Even today, many people think of nurses as simply "following doctors' orders" and doing menial tasks -- and many people would not want their daughters to become nurses and have to deal with naked bodies, drug addicts, body fluids, etc. Also, nursing has had to "campaign" and "prove itself worthy" of offering graduate degrees. The first doctoral degrees in nursing were not established until after I was an adult. (In the 1970's) We have a very recent history of having to establish that a sufficient body of scholarly work existed to justify recognition as a full academic discipline. Hence, the need to create lots of theories fast -- back in the 1960's, 70's, and 80's. So everybody educated in nursing during those days emphasized theory development and analysis. People who were student then became the nursing leaders of today.

2. I feel strongly that we can and should improve the quality of the theory-teaching in nursing. Most nurses learn theory in a class taught by someone who is "not really into it" -- a clinical instructor who got tapped to teach that classroom class. They may have no special interest in theory, education about it, or experience with it. They'll just go through the textbook and spout the same old platitudes about it. Students endure the class rather then being stimulated ... and vow to never think about it again after class is over. It's a shame. It is a class that could help our students appreciate the "meat" of our profession and inspire nurses to help move our scholarship forward. It could also be the class through which students learn to think conceptually and use models in their practice -- which would improve their thinking. At my hospital job, I work with many nurses who struggle with learning new things or performing higher level tasks because they can't apply an idea or model to a concrete situation. They can't take things they read or hear and apply them to practice. A good introductory theory class in school might have helped them develop those types of skills.

CraigB-RN, MSN, RN · Jul 18, 2014

I am going to admit right up front publicly that I"m a cynic. Those some people who can't think conceptional about something or grasp those higher level skills, are the same people that don't "get" the theory. Now the people that may need those educational theories are the ones that need to teach those nurses or manage those nurses. Part of my prejudice about theory is the area's I work in. Emergency, Flight Medicine, retrieval medicine. Not exactly the most touchy feely area's.

I guess after 36 years I'don't understand the "meat" of our profession myself.

I do however use theories every day. Bloom, Piaget, Erickson, Skinner and even Pavlov as well as others. But I use them as an educator, not as a nurse. My students don't need to know them. Some do recognize them though. Especially my higher level students, specifically my grad students but that is supplemental to their education. Unless I'm teaching pt education then they need to understand some of those concepts.

Even my social work friends chuckle when reading some of these theories.

Whispera, MSN, RN · Jul 18, 2014

As a teacher, I'm often amazed by the inability of some to grasp concepts that I consider simple, and the above-and-beyond ability of some to understand tons more than I expect them to understand.

I think theory falls into the "why do we do what we do?" category and if a theory fits, use it and talk about it. That makes it real and more likely to be understood and remembered...

llg, PhD, RN · Jul 18, 2014

I appreciate your perspective, Craig ... and ability to discuss these issues without turning the thread into a hateful diatribe against all nurse theorists and philosophers. (We have had a few threads like that here on allnurses, and I have grown tired of them.)

I agree with you that it is difficult to see the applicability of most nursing theories to your specialty -- but my perspective on that issue is a bit different. Rather than conclude that ED nurses "don't need theory," I conclude that ED nurses have yet to develop good theories that are useful in every-day practice to them. The type of person who choosed ED (etc.) as a specialist may not be the kind of person who is drawn to theory. That doesn't mean that nursing SHOULDN'T have theories based in your field, just that the work has not been done yet.

I also think that there is probably more applicability than you think. The first 2 homework assignments I give my students in the RN-BSN class I teach use a case study in an ED. Students are asked to consider 5 different theories ... and say how the focus of the nursing care would be different using each one. For example, if using Nightingale, the nurse would focus more on the environment (cleanlines, smells, sounds, light, etc.) Nursing based on Henderson would focus on her "14 patient needs" and assessments would include determining how much help the patient needed with each one. Nursing based on Abdullah would focus on her identified "nursing problems." Nursing based on Watson would include more about the touchy-feely part. etc. The discussion of how the ED would be designed, the patient assessments would look, etc. differently using each theorist is often quite a rich discussion -- and opens a lot of people's eyes on how our theories and philosophies influence our care even when we don't consciously realize it.

CraigB-RN, MSN, RN · Jul 18, 2014

I don't think theory is completely useless. (although a few of them are pretty far out there) i'm just not sure of their utility in the way we teach it now.

As a teacher I enjoy the challenge of finding a way for those students who just aren't getting it to actually get it. A class were everyone sucks it up like a sponge, processes it and spits is back out at you is actually pretty boring.

I'm in the process of shifting to all clinical education and seminars now. Going to be mixed bab, nursing students, PA students, Med students and residents.