I do recognize the need for nursing theory

epg_pei · Dec 5, 2005

How was your presentation received from the faculty at your school?

Well, the instructor for that particular course has very open concepts about education...so it was not your standard presentation...we did a Jerry Springer show...our guests were Rogers, Raskin, and Nightingale, as played by students...we even had a Steve...anyway, we basically poked every hole we could in Rogers theory...I don't know if faculty in general ever got wind of what we did, which may be a good thing too....:chuckle

gauge14iv, MSN, APRN, NP · Dec 5, 2005

:yelclap:

I agree Tulip!!! Do we pour vast amounts of money and researchers time and patients lives into therapeutics that don't show evidence over time? No, we abandon them for something else, we keep looking, we learn from what has NOT served us and move on. I don't see that happening with much of theory. We will not attain different results by continuing to do the same thing! Inquiry does not demand that we accept theory at it's face value, inquiry would demand that we keep looking. Maybe the theoretical underpinnings are not it, maybe something else is. But we will never know unless we keep moving and keep asking and keep looking.

To accept theory - any theory - at face value is to resign. If theory isn't it, then perhaps evidence and science is, but won't ever know unless we reject theory as it stands and LOOK for whatever else it might be.

The rejection of theory is the basis of it's proof. Scholars in any field must consider the popular thoery and thought AND consider it's rejection if for no other reason than to prove that it's valid.

krisssy · Dec 5, 2005

The field of Education has theory.....and the vast majority of it is a lot of crap that is TOTALLY useless in the classroom ( I taught for 12 years ). So nursing ought to embrace theory in the same way as education? IT DOESN'T WORK FOR EDUCATION, why the heck would it work for nursing? It isn't going to make other professions automatically respect nursing if we have a base of theory. As another poster pointed out, Med students and law students don't sit around studying a base of theory. I think nursing is on the right track when using evidence to back up practice. That makes sense to me. If it works, use it. If not, don't use it. Any physician has to have evidence that his/her treatment is effective and must decide to continue or try something different based on solid evidence. Theory is not solid evidence.
This might be a bit off topic, but any profession that has a diagnosis "disturbed energy field" is not going to get the respect that it wants. What is the evidence that backs up that diagnosis?

I, also, was a teacher-for 25 years. I was highly respected, teacher of the year, a mentor etc. etc. etc. I never used educational theory. Honestly, I don't even remember what it is. My teaching was based on evidence to back up practice. At the beginning, I learned by watching other teachers who I thought were good at their job and by reading everything that made good sense to me.. Eventually, by trial and error, I learned to be great in my field. I learned by EXPERIENCE and observation of the good and bad teaching skills around me. I learned by observing the children. I learned by doing, reading, listening and observing everything around me. I learned by years and years of very hard work bringing suitcases full of books home each night. I learned by trial and error and trying new things and ways. When something worked, I continued to use it. If it didn't work, that was the end of it. Toward the end of my career, they came out with Educational Standards and constant meetings to discuss them. No one used these standards, and half the teachers didn't even understand them. What the new teachers wanted to know from me was, "How do you do what you do so well?" "Show me, teach me, talk to me, help me, share with me, observe me, let me observe you etc. I spent hours after school showing new teachers how to teach. We talked, and they listened , and they observed, and they learned well. The theories and the standards were words that meant nothing to any of us EXCEPT the people on the committees wasting their time writing about theory and standards that everyone ignored, because they were boring and not practrical at all.

As far as nursing, I am just starting my NP in Psych program this winter. My first course is Theory. I am enjoying listening to what everyone here has to say about nursing theory. I will let you know what I think when the course starts. Please keep sharing your thoughts. I am really looking forward to taking the course so I can share my own opinions! Right now, I agree with this poster, "Evidence to back up practice seems the way to go for me as of now! At least that is what worked when I was teaching. Krisssy

1Tulip · Dec 5, 2005

14 guage is absolutely correct. The object of research is to reject the null hypothesis. If you're not doing that, you are not doing science. And likely you aren't doing scholarship.

ZASHAGALKA, RN · Dec 5, 2005

I, also, was a teacher-for 25 years. I was highly respected, teacher of the year, a mentor etc. etc. etc. I never used educational theory. Honestly, I don't even remember what it is. My teaching was based on evidence to back up practice. At the beginning, I learned by watching other teachers who I thought were good at their job and by reading everything that made good sense to me.. Eventually, by trial and error, I learned to be great in my field. I learned by EXPERIENCE and observation of the good and bad teaching skills around me. I learned by observing the children. I learned by doing, reading, listening and observing everything around me. I learned by years and years of very hard work bringing suitcases full of books home each night. I learned by trial and error and trying new things and ways. When something worked, I continued to use it. If it didn't work, that was the end of it. Toward the end of my career, they came out with Educational Standards and constant meetings to discuss them. No one used these standards, and half the teachers didn't even understand them. What the new teachers wanted to know from me was, "How do you do what you do so well?" "Show me, teach me, talk to me, help me, share with me, observe me, let me observe you etc. I spent hours after school showing new teachers how to teach. We talked, and they listened , and they observed, and they learned well. The theories and the standards were words that meant nothing to any of us EXCEPT the people on the committees wasting their time writing about theory and standards that everyone ignored, because they were boring and not practrical at all.
As far as nursing, I am just starting my NP in Psych program this winter. My first course is Theory. I am enjoying listening to what everyone here has to say about nursing theory. I will let you know what I think when the course starts. Please keep sharing your thoughts. I am really looking forward to taking the course so I can share my own opinions! Right now, I agree with this poster, "Evidence to back up practice seems the way to go for me as of now! At least that is what worked when I was teaching. Krisssy

And this is essentially how every good nurse become a good nurse: by individual observaton and incorporation of what works.

Now, if nursing leaders want to examine and expound about what works and pass along those pearls of wisdom, that would be a wonderful base of knowledge to instill into our students.

With the world looking to medicine to back up its practice with evidence, this would be an appropriate path for our researchers and leaders to follow.

As of now, bedside nurses can only really start to 'get it' when they chuck the theory garbage to the curb and realize that it is what it is: just a horrible, insensitive, inside joke. You can't really laugh, you can really only just be embarrassed. And then move on.

~faith,

Timothy.

grannynurse FNP student · Dec 5, 2005

For the record, I have a PhD in one of the biological sciences and have done research for 14 years with a break of 3 years to teach Pharm and Pathophys on the graduate level. I hope to start a job as a bedside per diem nurse on a neuro unit this month. I have an application in for a tenure track position in a SON and, if hired, would need up to date clinical skills.
None of which makes my opinion on Nsg. Theory any better than anyone elses'. I'm not sure I understand GrannyNurses' objection to my/our doubts about Nsg Theorists. I think she is suggesting that the anti-Theorist rhetoric is maybe anti-intellectual or anti-nursing scholarship. (She can correct me if I'm wrong.)
It is, indeed, my strong feeling that the bedside (broadly defined) is the well from which we must draw our definitions of nursing. That context and none other. If it were shown that working nurses object to, do not use, feel frustrated and intimidated by discussion of nsg. theory, then it's time to ask why we are expending a huge (HUGE!!!) amount of academic capital preserving it.
Somewhere, somehow, that discussion must take place.

I find that some of those who object to nursing theory are generally anti-nursing scholarship. By this I mean, they are generally not supportive of nursing research that is esoteric in nature, to them. And by that, they appear to demand that all nursing theory and practice be founded in the practical application only. Theory, regardless of the field of study, is an attempt to formulate and explain the phenomenon. The objective of it is formulation of generalizations to explain relationships in a given field of study. It primary use in practice is to provide insight regarding nursing practice (you can substitute any profession) and to guide practice. Theory is meant to identify the focus, means, and goals of practice. The use of it helps to enhance communication, increasing autonomy and goals of practice. Scholarship, for many, beyond the basics, is difficult to understand. Some want theory distilled to the lowest common denominator. They either refuse to recognize or really fail to understand, that new theories are responsible for the development of lanuage to explain their theories. Rather then attempt to understand, they dismiss nursing theory as pointless and irrelant to their practice. I wonder what Florence Nightengale would have to say?

When I was a young nurse, I took two classes taught by Jean Watson. Her explanation of her theory was somewhat difficult for me to grasp but I struggle through it. I also later took a class taught by Imogene King. Her theory of goal attainment was more palatable to my taste, although I really follow Leininger's Transcultural Theory. Formulating a theory is not a task for the faint of heart. It is a difficult task and it is one that our profession needs to embrace, instead of dismissing it as something unnecessary to our practice. If that happens, then nursing will no longer be a prossion, just a technical job. And despite what many appear to believe, nursing theory does take its bases from bedside nursing.

Grannynurse:balloons:

Kelly_the_Great · Dec 6, 2005

If all one can do is articulate the negative and their own failure to understand, even attempt to understand, they are clearly lacking in cognitive abilities.

Why would you say they are lacking in their cognitive abilities?

The statements of dissent I have seen thus far, have been presented in a manner that is indicative of persons who posses above standard/superior intellect (imo).

Of course, as I stated earlier, I'm not at all as educated and for that matter as intellectual as many (maybe even all) of the posters on this thread but I can appreciate and recognize intellegent discourse when I see it. And am really enjoying this discussion. :)

I hope the thread can continue in a spirit sharing wisdom versus challenging others' knowledge and intellect if there is disagreement.

grannynurse FNP student · Dec 6, 2005

Why would you say they are lacking in their cognitive abilities?
The statements of dissent I have seen thus far, have been presented in a manner that is indicative of persons who posses above standard/superior intellect (imo).
Of course, as I stated earlier, I'm not at all as educated and for that matter as intellectual as many (maybe even all) of the posters on this thread but I can appreciate and recognize intellegent discourse when I see it. And am really enjoying this discussion. :)
I hope the thread can continue in a spirit sharing wisdom versus challenging others' knowledge and intellect if there is disagreement.

I am sorry if you feel disrespect. However, I stand by what I have posted. Many of those who dismiss nursing theory and say it has no place in nursing, demonstrate their own inabilities to comprehend the abstractness of theory. And I have attempted to maintain an theorical discussion, with the result being only one poster responding in kind. All others have either posted a reference to an individual who has no base for his criticism, or have dismissed theory with out an adequate explanation, other then to claim it doesn't relate to THEIR clinical practice.

Grannynurse:balloons:

Kelly_the_Great · Dec 6, 2005

I am sorry if you feel disrespect. However, I stand by what I have posted. Many of those who dismiss nursing theory and say it has no place in nursing, demonstrate their own inabilities to comprehend the abstractness of theory. And I have attempted to maintain an theorical discussion, with the result being only one poster responding in kind. All others have either posted a reference to an individual who has no base for his criticism, or have dismissed theory with out an adequate explanation, other then to claim it doesn't relate to THEIR clinical practice.
Grannynurse:balloons:

No, I didn't feel disrespected b/c I didn't think you were referring to me.

I just wondered why you attacked their cognitive abilities. That was my question. I wondered this b/c, to me, the posters have had valid arguments and have presented them in an intelligent manner.

Oh well. I suppose it really doesn't matter. I'm just very interested in our intraprofessional interactions and I was just curious.

Since theory is such an emphasized aspect of nursings' core curriculum, I'm sure there will be many others who echo your views relating to the importance of theory.

In the meantime, I'm enjoying the discussion and feel very fortunate to have stumbled upon it! :)

gauge14iv, MSN, APRN, NP · Dec 6, 2005

Humor me and ponder this for a few minutes -

Lets say (just for the sake of this) you were raised in a catholic home, in a catholic community and schooled in a catholic church, in addition you attended a catholic university and worked at catholic institutions. And lets say you are very involved in the catholic church you attend.

How likely would it be that you would readily convert to judaism without a second thought? How indoctrinated would you be in the ways of catholicism? Right down to your view and vision of the world, of people as humans, your relationships with others, your choices in life, your family structure and the friends you chose to surround yourself with...all of these would be influenced to some degree by your catholic religion, would they not?

And how much of that religion would be based on what you THINK you know, as opposed to what you actually are 100% certain of?

So nurses are "brought up" in one theory or another...we think we know certain things about certain theories. We are given a few favorite theories which are handed down in schools based on what that school chooses to teach. Do we take those at face value? Or do we question them?

A nurse in a clinical unit tells a new nurse that there is no need to push an IV med slowly - does that new nurse take that at face value or does she do some further investigating to determine what the best practice might be?

To squelch the questioning of theory is to squelch the stream of clinical inquiry. Nurses can no longer be expected to stand idle while another medical professional kills a patient with a practice that is not evidence based, but yet thats essentially what those who say we should not question theory are asking us to do!

We make it all up really - we just think we know (and theorists think they know) what nursing is. Not everyone agrees upon a given theory, and really, those who know theory tend to pull parts and pieces from various theories and use what works for them. Since none of us agree on one theory, the profession is in eternal divide and conquer mode.

The point is - what we are doing really isn't working for us as a profession. As a whole, we don't embrace and believe in theory. Many (maybe even most I would venture to say) nurses are dissenters where theory is concerned. We aren't a unified body - not even in theory. And since we can't be unified in the beliefs that underly our profession, then theory really needs to examined. To throw ALL of it out would be throwing out some valuable stuff, but to not question it at all is to know only one religion and take heresy for fact.

We question because we can, I don't believe humans were meant to follow anything in blind faith - thats MY belief...

krisssy · Dec 6, 2005

Humor me and ponder this for a few minutes -
Lets say (just for the sake of this) you were raised in a catholic home, in a catholic community and schooled in a catholic church, in addition you attended a catholic university and worked at catholic institutions. And lets say you are very involved in the catholic church you attend.
How likely would it be that you would readily convert to judaism without a second thought? How indoctrinated would you be in the ways of catholicism? Right down to your view and vision of the world, of people as humans, your relationships with others, your choices in life, your family structure and the friends you chose to surround yourself with...all of these would be influenced to some degree by your catholic religion, would they not?
And how much of that religion would be based on what you THINK you know, as opposed to what you actually are 100% certain of?
So nurses are "brought up" in one theory or another...we think we know certain things about certain theories. We are given a few favorite theories which are handed down in schools based on what that school chooses to teach. Do we take those at face value? Or do we question them?
A nurse in a clinical unit tells a new nurse that there is no need to push an IV med slowly - does that new nurse take that at face value or does she do some further investigating to determine what the best practice might be?
To squelch the questioning of theory is to squelch the stream of clinical inquiry. Nurses can no longer be expected to stand idle while another medical professional kills a patient with a practice that is not evidence based, but yet thats essentially what those who say we should not question theory are asking us to do!
We make it all up really - we just think we know (and theorists think they know) what nursing is. Not everyone agrees upon a given theory, and really, those who know theory tend to pull parts and pieces from various theories and use what works for them. Since none of us agree on one theory, the profession is in eternal divide and conquer mode.
The point is - what we are doing really isn't working for us as a profession. As a whole, we don't embrace and believe in theory. Many (maybe even most I would venture to say) nurses are dissenters where theory is concerned. We aren't a unified body - not even in theory. And since we can't be unified in the beliefs that underly our profession, then theory really needs to examined. To throw ALL of it out would be throwing out some valuable stuff, but to not question it at all is to know only one religion and take heresy for fact.
We question because we can, I don't believe humans were meant to follow anything in blind faith - thats MY belief...

Great post Gauge14iv, I recently took a refresher course. If I followed everything I saw and was told with "blind faith", I would have bathed a patient with MRSA without gloves, left meds on the patient's nightstand while she was in the bathroom, not put a gown on AND ENTERED A ROOM WHERE THE PT. WAS IN ISOLATION -AMONG OTHER THINGS. When a nurse being precepted is told something that she or he thinks is wrong, it MUST of course be questioned. I am taking a graduate theory course in Jan. After this discussion, I am truly lookng forward to taking it, and I intend to read, and decide what I personally believe in. Thank you again for a very intersting and terrific post. Krisssy

gauge14iv, MSN, APRN, NP · Dec 6, 2005

If I hadn't been so dumbfounded by the verbage at times, theory class would have been a lot more fun if I'd been argumentative about it!!!!!

I *do* recognize the need for nursing theory

I do recognize the need for nursing theory