Is Nursing practice patterned after certain nursing theorists?

RedCell · Jun 24, 2008

I believe that real world nursing has nothing to do with any energy orbs, circles of defense, or any other hoopla nursing theory that instructors try to shove down your throat. In fact, you should ask your theory instructor the last time they actually participated in any kind of bedside care. At best, Henderson got it right by saying nursing attempts to do for patients what they cannot do for themselves.

Unforunately, they will probably be teaching you how to perfect a concept map on one of these jokers rather than teaching you how to distinguish the difference between something simple such as A-fib and a sinus rhythm. Wait until you have to take a Cultural "Sensitivity" class. If you really want to learn be prepared to do a lot of self study.

The theory stuff gets even worse when you go for your MSN.

allnurses Guide · Jun 25, 2008

I just finished a paper linking Jean Watson's caring theories to my practice as a hospice nurse and "Nearing Death Awareness".

Like you, I had not given any thought to nursing theories and my practice as a nurse.

(bumping this up for ya Nancy) . . . . .

steph

CoffeeRTC, BSN, RN · Jun 25, 2008

I believe that real world nursing has nothing to do with any energy orbs, circles of defense, or any other hoopla nursing theory that instructors try to shove down your throat. In fact, you should ask your theory instructor the last time they actually participated in any kind of bedside care. At best, Henderson got it right by saying nursing attempts to do for patients what they cannot do for themselves.
Unforunately, they will probably be teaching you how to perfect a concept map on one of these jokers rather than teaching you how to distinguish the difference between something simple such as A-fib and a sinus rhythm. Wait until you have to take a Cultural "Sensitivity" class. If you really want to learn be prepared to do a lot of self study.
The theory stuff gets even worse when you go for your MSN.

Couldn't have said it better!

llg, PhD, RN · Jun 25, 2008

I don't base my practice on just one particular theorist ... but I use aspects from many different theorists on a regular basis.

For example: I often use the principle that "nurses do for the patient what he would do for himself if he could" (Henderson) and also frequently think in terms of Henderson's levels of compensation even though I don't use that term in my head. Patients can be totally dependent on the nurse, partially dependent on the nurse, or be ready for independence.

Also, the question as to whether we think in terms of "patient problems a la Henderson" or "nursing tasks a la Abdullah" is as interesting today as it was when the question was first raised.

Manipulating the patient's enviornment to promote healing, rest, recovery, etc. (Nightingale) is also a daily application of theory.

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

In my staff development practice, Patricia Benner's "novice to expert" model is very commonly used on a regular basis by people who need to know the differences between a beginner-level nurse and an competent one and an expert one. It's commonly used as a basis for planning preceptor programs and other educational programs.

As a NICU nurse, I have also used Ramona Mercer's work. Some of the more esoteric theories are more difficult to grasp and to apply to daily practice -- particulary for people who are beginners in the world of nursing theory. But those theories (such as Rogers and Porifice) offer some profound perspectives that can enrich one's understanding of the world -- and therefore find use in practice. As a NICU nurse, I have found it helpful to think about the patient's energy -- providing it, conserving it, not wasting it, etc. I have also found it helpful to think in terms of patterns of behavior -- a perspective found in both Rogers' and Porifice's theories. However, I can see that most people not accustomed to thinking in theoretical terms would have trouble applying those two esoteric theories in practice.

Some of the more contemporary theories, such as Swanson's Caring Theory, Kocaba's Theory of Comfort, and the Synergy Model developed by the Association of Critical Care Nurses may be less well-known to students (who tend to study the classics in school rather than the contemporary theorists) -- are much more in sync with the contemporary mindset. Anyone looking to apply theories should not just stick to the old work, but should also look at the current theories.

I believe theory is taught VERY badly in most nursing schools. It's taught badly by instructors who themselves never learned it properly. It's a shame -- because it has a lot to offer.

leslie :-D · Jun 25, 2008

wonderful post, ilg.

op and all new bsn students, thank you.

gives one much to think about.

leslie

VivaRN · Jun 25, 2008

Thanks llg. I am so glad you are on here because of the perspective and knowledge you bring.

In nursing school I used to think theories were a bunch of hooey, laughed myself silly over "connected-reconnectedness" or whatever... but once I started practicing I realized how, if nursing has no theory or philosophy (or if you have no theory or philosophy as a nurse), it becomes a set of tasks.

Think about it.

allnurses Guide · Jun 25, 2008

Thanks llg. I am so glad you are on here because of the perspective and knowledge you bring.
In nursing school I used to think theories were a bunch of hooey, laughed myself silly over "connected-reconnectedness" or whatever... but once I started practicing I realized how, if nursing has no theory or philosophy (or if you have no theory or philosophy as a nurse), it becomes a set of tasks.
Think about it.

That is a good point.

steph

llg, PhD, RN · Jun 25, 2008

Thanks llg. I am so glad you are on here because of the perspective and knowledge you bring.
In nursing school I used to think theories were a bunch of hooey, laughed myself silly over "connected-reconnectedness" or whatever... but once I started practicing I realized how, if nursing has no theory or philosophy (or if you have no theory or philosophy as a nurse), it becomes a set of tasks.
Think about it.

Exactly. Without a theoretical/philosophical foundation, nursing activities are just a series of tasks that we are paid to do becuase someone tells us to do those tasks. Professional nursing can and be so much more.

whitmore pugs · Jun 25, 2008

Thank you so very much for your responses. I am still muddling my way through the nursing theory book, of which some of the info is pretty confusing. However, I must admit that many of the issues that have been brought up by nurse theorists have opened my eyes to the fact that nursing is more than "just bedside care", and that certain theories can enhance personal growth and development. I shall keep my mind open to learning, and continue reading. Thank you again. Nancy

jjjoy, LPN · Jun 26, 2008

In my opinion, a good nursing theory should be fairly easy to grasp and apply day to day. There may be other, interesting, useful esoteric philosophies of nursing out there, but for the basics of 'what is nursing?' and foundational bedside care, there's no need to make it difficult or complex.

My experience with nursing education across the board, though, was that it seemed things that were quite simple (eg basic skills and concepts like sterile fields) were often strung out and nit-picked to death as if they were more complex and difficult to grasp conceptually while complex skills (eg prioritizing, delegating) were cursorily given lots of lip service but little practical application or detailed exploration as if they said it enough - "you need to learn to prioritize/delegate" - that you'd somehow magically learn how to do it.

Anyway, I think a foundational nursing theory should be simple because that kind of = theory is developed as a framework through which different activities and observations can be viewed for consistency and to hypothesize on unexplored areas - for example, if there's a new technology developed, would it be considered 'nursing care' or not?

I do admit, though, a bias toward scientific theories as opposed to philosophical theories, especially in regard to applied clinical nursing practice. As you noted, llg, many instructors of nursing theory aren't well-grounded in theory. Some instructors can confuse students (confused me, anyway) by implying that esoteric nursing theory is equivalent to scientific theory.

While nursing isn't *just* about task performance, task performance *IS* a major component of nursing care and I do think merits more attention in school/training. Of course, not just task performance, but also the ability to recognize when tasks are needed (eg a patient needs to be suctioned) and an understanding of why one is doing the task and how it works to help the patient. To me, THAT is the important "why" and "bigger picture" that new nurses need to learn so that they aren't just "doing" and overly task-focused.

Any overarching nursing theory at that level, I think should be basic like "helping the patient acheive their highest level of self-care" or "assisting the patient cope with illness" - nothing tricky or hard to figure out.... why give water, oxygen, etc? To help the patient maintain the highest level physiological well-being (prevent dehydration, etc) ... beyond that it's the reason are in the realm of physiology and not unique to nursing. Why encourage a patient to brush their own teeth, etc? Because, according to basic nursing theory based on solid psychological and physiological ground, nurses role is to assist the patient to attain their highest level of self care. No need to get more complex on a theoretical level than that for beginner level. Perhaps there's a better name out there for that than theory. Anyway, there's enough other material to cover such as the psychological and physiological concepts that play into what is good nursing care.

But to be able to apply an esoteric nursing theory doesn't seem like high-priority entry-level stuff.

Well, just my not-so-well-thought-out-thoughts that only marginally relate to the OP's initial inquiry!!!