Nursing theory-Do you use it at work?

[grdstdnt]

As a new grad student, I'm hearing lots about nursing theory, and how nurses should be utilizing theory in their practice.

What nursing theory/theorist do you or your facility follow?

[llg, PhD, RN]

I have spent most of my career in CNS and staff development roles. I use Benner's work all the time for staff development ... and often use principles from Nightingale, Henderson, Watson, and Swanson as I consider a situation from multiple angles. While my use of theory is rarely overt and mechanistic, I have been influenced by many nurse theorists and their work is a foundation for me as I do my own thinking.

[ZASHAGALKA, RN]

I use Jesus' theory to treat others as you would want to be treated. Elegant in its simplicity.

The stuff the Ivory Tower puts out? drivel. 14 yrs after kicking that stuff to the curb, I'm a better nurse for it.

That's no disrespect to llg, above. I'm glad llg is able to incorporate all those theorists, and that it helps. I think though, that is very unusual. It's one of my favorite questions to ask new nurses, to gauge the response. Normally, I find that most nurses can't even NAME 3 theorists and couldn't truly define what even 1 of them teach.

~faith,

Timothy.

[experiencedrn]

I can tell you that in the 20 years I have been a nurse, I have never put to use anyof it. I pretty much feel it is hogwash, and the theroy and method that is the best is what works the best for you. Follow what is in your heart and your faith.

[llg, PhD, RN]

The inability of nurses to articulate their use of theory is due to that fact that it is usually poorly taught and understood. Most people teaching theory in ADN and BSN programs have not specialized in theory and/or were taught themselves by people with little interest or knowledge about it. It's been a case of "the blind leading the blind" for many years.

Just because the average bedside nurse is not aware of her use of theory does not mean that she is not using it.

It also does not mean that theory is bad.

When students don't learn what they should learn ... it's not the content that is the problem, it is the teaching.

[ZASHAGALKA, RN]

Just because the average bedside nurse is not aware of her use of theory does not mean that she is not using it..

I have to take exception to this. Yes, it does mean that bedside nurse isn't using theory.

Most nursing theory, from my perspective, is aimed at defining a spiritual basis for nursing. The problem with that is that each of us brings our own spirituality to the table. As such, nursing theory isn't foundational as most of us can very conveniently substitute our OWN belief systems for the ivory tower's belief system.

In fact, we are each UNIQUELY designed to adopt our OWN spirituality better than practically anybody else. That being the case, the Tower's ideology is just that: ideology. THIS is why theory is repudiated by MOST nurses.

The fact that someone's own belief systems touches points at times with theory doesn't mean that they are secretly using theory. It means that theory is superfluous at best, repugnant at worst.

No offense, but it's a form of arrogance to suggest that people can't help but use the Ivory Tower's indoctrinations, whether they know it or not. It's akin to: PAY ATTN TO ME; I'M IMPORTANT.

If it were THAT important, it would win in the arena of ideas. Not sadly at all, it doesn't.

More to the point, if theory wants to be relevant, then the theorists need to come to the bedside and NOT the bedside to the theory. There's a word for that, it's praxis.

There IS NO praxis in nursing. At least, in nursing theory.

Praxis: Practical application or exercise of a branch of learning.

~faith,

Timothy.

[Tweety, BSN, RN]

Theorists take a look at what nurses (i.e. me) do and try to describe it.

I agree with llg, most of us are doing bits and pieces of what the theorists describe.

It's like the nurses's process we don't think "O.K. first I'm going to assess this situation and give a diagnosis and then decide what inventions, etc." we just do it.

Some theorists are holistic and this includes the spritual element which separates us from medicine but that's all that the theorists cover.

Anyway to answer the OP, no I do not use a theorist in my practice. However, when I recently studied them I realized that I do incorporate some of those ideas in my practice, or that they have in some cases described accurately what I'm doing. But it's piecemeal rather than one theory.

[Tweety, BSN, RN]

I can tell you that in the 20 years I have been a nurse, I have never put to use anyof it. I pretty much feel it is hogwash, and the theroy and method that is the best is what works the best for you. Follow what in your heart and your faith.

Not a good idea. Nursing is a science and nurses shouldn't be going around doing what they feel in their hearts.

[ZASHAGALKA, RN]

Not a good idea. Nursing is a science and nurses shouldn't be going around doing what they feel in their hearts.

Nursing IS a science, which is the problem I have with theory. It generally tends, in my opinion, to undermine that science in the name of feel good ideology.

THAT is why I say that I sum up my SPIRITUAL basis of nursing with the golden rule.

Everything else: I focus on the science.

I'm a highly trained, highly experienced bedside monitor and interventioner. Theory doesn't adequately address that and so, is irrelevant - at least to me. Caring isn't what I do. That's not to say that I don't care; it IS to say that it says nothing about WHY I'm the valuable asset that I am.

The CORE of nursing knowledge should wrap around the science of nursing, and NOT what each of us is individually empowered to spiritually bring to our own practice.

So, I agree with you, in my own way.

~faith,

Timothy.

[steelcityrn, RN]

I use it at work for the plan of treatment.

[ZASHAGALKA, RN]

Do you know why theory isn't relevant in the trenches?

It lacks praxis. Let me explain.

You have to have a phD in nursing to play in the theory arena. Your ideas have to be accepted in that core group: after all, in order to become a phD in nursing, you must meet approval from other phDs. It is an elite group, and that isn't necessary a complement.

This elite group must pass muster, with itself. There is a political pressure, if you will, to perform for each other. A phD nursing theorist is MORE concerned with what her peers have to say about her work than any bedside nurse.

More to the point, if a bedside nurse questions the validity of a theory, they are met with academic arrogance: you don't have the credentials from which to base your evaluation. THAT is MY point: if a theory isn't such that it can be explained and debated in the trenches, then it's simply not relevant to the trenches.

PRAXIS is about practical application of knowledge. A theory that the average PRACTICING nurse doesn't have the base of knowledge to critique: that is a useless theory.

Martha Rogers was infamous for using psuedo-scientific words and moving the definitions around whenever challenged. Fine, but don't expect her ideas to carry; to have praxis. They don't.

The big word paradigm game impresses a theorist's fellow phDs, even as it says nothing of importance to the trenches. And THAT is why theory doesn't really matter.

If theorists want to be relevant, then their ideas must also be relevant, not to their fellow phDs, but to the trenches of nursing. I have seen no evidence of that.

There IS NO praxis in nursing. It's not the bedside nurse's fault. It is the theorists, themselves, that have made their work optional.

~faith,

Timothy.

[NRSKarenRN, BSN, RN]

Utilizing Betty Newman System's Model for the past 25 years.

As Manager of Central Intake Dept her work influences the information I ask of referral sources in attempt to plan from receipt of referral patient care needs, determine start of care date needed based on home bound status, functional level and support systems available for patient