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?

[Tweety, BSN, RN]

I think at this point we should be reminded of the original question: What nursing theory/theorist do you or your facility follow?

If you or your facility don't utilize theory, perhaps it's best to pass this thread by.

[ZASHAGALKA, RN]

You're reading things into my post that aren't there, Timothy, there is no reason for me to even try to communicate with you anymore.

Saying that I have contempt for staff nurses, etc. is totally out of line.

You owe me an apology. ... and I won't "play" with you anymore until I get it.

"The role of the staff nurse has not been designed with theory in mind. The staff nurse role has evolved to serve the need for certain tasks to be completed"

You said what you said. I quoted YOU. YOU stated theory doesn't work well at the bedside because bedside nursing is a task oriented role, a role 'not designed' to be able to incorporate such conceptualization. Surely, as an academic, you know that 'task oriented' is code for professionalism, or lack thereof. You said it, not me.

I could say that you owe me an apology, but I won't. It's not important, in any case. I WILL say that I waited to respond, until I wasn't quite so upset about what YOU said. If I might be constructive, reread what you wrote. I submit that you might not have MEANT what you said. But, you said what you said.

(I DID clean up what I wrote.)

In any case, Peace.

~faith,

Timothy.

[ZASHAGALKA, RN]

I think at this point we should be reminded of the original question: What nursing theory/theorist do you or your facility follow?

If you or your facility don't utilize theory, perhaps it's best to pass this thread by.

Tweety, I understand. I mentioned earlier that I didn't want to hijack the thread. The OP didn't come back, however.

Look, asking about what kind of theory you use surely invites the null hypothesis of NOT using theory. It is a valid discussion, from the framework of a new nurse asking about the use of theory in the workplace. In fact, my statement that theory isn't used much in the workplace was not contested. It certainly pertains to an OP seeking understanding about the use of theory in the workplace to point out that it isn't used as much as school would suggest.

I apologize, to you, if the thread got out of hand. That was not my intent. My points were valid, and the last points, I responded to what I felt NEEDED to be addressed. I cleaned up the sharper edges of that response.

I did not wish to be confrontational.

It appears this thread is done, anyway.

~faith,

Timothy.

[TheOldGuy]

Hi Guys...getting a little humid here!

Everybody's right! Which means that everybody has made some good points - how about a little synthesis......

As has been pointed out, nursing theory is an attempt to describe what nurses do. The problem is, that's not really what a "theory" is supposed to be. Most nursing theory courses are kinda like psychology "theory" courses which aren't really theory at all but instead opinions of why people sometimes behave in certain ways (that is unless they are behaving differently - so obviously more study is necessary!!).

Nursing is science but its also "connection". I remember reading somewhere that pts aren't "doctored" back to good health, they're "nursed". Nursing is technique and skill and science and perception and empathy and a bunch of other things. Good nursing is really hard to "quantify".

Personally, I think the theory and process type classes are overemphasized in nursing curriculum while hard sciences, assessment and skills don't get enough emphasis.

I think nursing ed would benefit from more focus on disease process and treatment - physiology/pathophysiology and pharmacology. I think there is a real need to beef up clinical experience as well in most nursing programs. Since most programs today require specific coursework in patho and pharm as prerequisites, nursing core courses could do a better job of building on that fundamental knowledge. I envision nursing "teaching" hospitals along the lines of residency programs....

My 2 cents!

[llg, PhD, RN]

"The role of the staff nurse has not been designed with theory in mind. The staff nurse role has evolved to serve the need for certain tasks to be completed"

You said what you said. I quoted YOU. YOU stated theory doesn't work well at the bedside because bedside nursing is a task oriented role, a role 'not designed' to be able to incorporate such conceptualization. Surely, as an academic, you know that 'task oriented' is code for professionalism, or lack thereof. You said it, not me.

I could say that you owe me an apology, but I won't. It's not important, in any case. I WILL say that I waited to respond, until I wasn't quite so upset about what YOU said. If I might be constructive, reread what you wrote. I submit that you might not have MEANT what you said. But, you said what you said.

(I DID clean up what I wrote.)

In any case, Peace.

~faith,

Timothy.

I accept your apology. I see that you assumed that I was using the idea of being "task oriented" as a code for a lack of professionalism. That was not the case. Your assumption was wrong. I DO believe that staff nurses are professionals -- ALL of them, regardless of their educational level. I don't think doing "tasks" makes one not a professional.

Perhaps if you would get to know me before making assumptions that I am using "code words," you wouldn't hate me so much. You would find that I do NOT have contempt for staff nurses ... that I have great respect and affection for staff nurses ... that I have spent very little of my career working in academia ... that I have spent most of my career working in hospitals, fighting to help staff nurses and improve their working conditions. I am viewd by most staff nurses who work with me as being their advocate and supporter. But of course, you would never know that because you would rather assume that I am using "code words" that make me your enemy than be open to the possibililty that someone who likes theory might NOT be the enemy.

[ZASHAGALKA, RN]

I accept your apology. I see that you assumed that I was using the idea of being "task oriented" as a code for a lack of professionalism. That was not the case. Your assumption was wrong. I DO believe that staff nurses are professionals -- ALL of them, regardless of their educational level. I don't think doing "tasks" makes one not a professional.

Perhaps if you would get to know me before making assumptions that I am using "code words," you wouldn't hate me so much. You would find that I do NOT have contempt for staff nurses ... that I have great respect and affection for staff nurses ... that I have spent very little of my career working in academia ... that I have spent most of my career working in hospitals, fighting to help staff nurses and improve their working conditions. I am viewd by most staff nurses who work with me as being their advocate and supporter. But of course, you would never know that because you would rather assume that I am using "code words" that make me your enemy than be open to the possibililty that someone who likes theory might NOT be the enemy.

I don't hate you, at all.

I had been debating issues with you.

And, task-oriented IS code for not having the means to conceptualize. It is an example used in most nursing programs, a key definition of the distinction of professionalism, taught in the first week of such programs. You could not but know that.

In any case, intended or not, it is an insult, a demeaning way to put what I do, at the bedside, hundreds of times per shift.

(I could link to SEVERAL places on this site where "task-oriented" is used in just that context. A frequent comment on the BSN/ADN debates goes along THIS line: a monkey can be trained to do tasks.)

~faith,

Timothy.

[llg, PhD, RN]

I don't hate you, at all.

I had been debating issues with you.

~faith,

Timothy.

Now you are saying I am a liar. That's not debating the issues. That's a personal attack.

I'm not going to allow myself to be attacked/bullied by you with your wrong assumptions and your filtering of everything I say through your disdain for nursing academics.

Sometimes, the best way to deal with a bully is not to play.

Good bye.

[ZASHAGALKA, RN]

Now you are saying I am a liar.

Who's making assumptions, now?

I clarified my comments, and took a step back. I offered you an opportunity to do the same, as this started by your statement that was demeaning to bedside nurses, whether you MEANT it to be demeaning, or not. You chose this response, instead. Perplexing.

I was trying to resolve this.

~faith,

Timothy.

[ZASHAGALKA, RN]

http://www.linfield.edu/portland/nursing/praxis/PraxisManual.pdf

"In essence, praxis is "thoughtful action"—the kind of action that brings elements of intention, mindfulness and critical thinking into nursing practice. This is distinguished from task oriented "doing." While the latter is an important part of nursing practice, it is not praxis. The purpose of this document is to define the concepts of praxis, critical thinking and nursing practice; describe qualities of a praxis facilitator/educator; and provide examples of how praxis is used in nursing courses. The ultimate aim is to provide the reader with usable information. The term "educator" could be anyone working with nursing students where "teachable moments" occur.

"Praxis refers to a relationship between theory and practice in which students create/construct knowledge and meaning from their experiences. Within a praxis framework, students assess a situation, understand it through reflection and discussion, and make sound judgments that lead to justifiable actions. They are able to perceive situations within their larger context, make generalizations from their experiences, and take action as a responsible professional to modify/develop all levels of practice."

I make the argument that the problem with theory is that there is little praxis to it: it doesn't translate well to the trenches. This definition defines praxis in contrast to being 'task-oriented', or simply "doing".

At issue is that I think the lack of praxis comes from the fact that the theory itself lacks practicality, and NOT because bedside nurses are simply 'task-oriented', or lack the ability/desire to grasp theory. It's not that bedside nurses aren't capable of embracing theory; it's that theory, in its current form, isn't capable of embracing bedside nurses. If a theory doesn't embrace the bedside, then, however practical it might be, it is not a theory relevant to the practice of nursing.

I don't argue that theories aren't ATTEMPTING to address the bedside. I'm arguing that the evidence shows it is doing so unsuccessfully. As a result, when it comes to theories, maybe we need a new paradigm.

Notice, I'm trying to move PAST the last exchanges and back to the context of a discussion.

~faith,

Timothy.

[NRSKarenRN, BSN, RN]

Somtimes just walking away from a heated thead is a good idea to reflect and recharge.

[overthehill]

I have been a nurse (male) LPN for the past fifteen years (second career) and spent six years on a Med Unit, four years on a Surgical Unit, and the past five years in MICU/CCU and I can't remember anytime during that entire period any of the nurses - RN or LPN - on any of those units talking about "nursing theory." We have been too busy running around giving meds, hanging IV's, taking care of our patients needs, interacting with doctors and family members, putting in hep locks, hanging blood, doing our charting etc. to be sitting around discussing "theory." Perhaps those in the "Ivory Tower" might be discussing these profound matters, but not the nurses on the floors. We're too busy being "nurses" and not theorists. Sorry to sound so negative, but that's just the way it is at my hospital.

I have to agree with ZASHAGALKA and experiencedrn - HOGWASH!!!

[AC439]

I usually do not response to debate threads but since this thread seems already got nasty, so what I'm gonna to say shouldn't make the matter worse.

First, I totally agree with Timothy. When I first heard about "nursing dx" in school, I was laughing. I thought the school was joking but unfortunately this was part of the nursing education. IMHO, the so called nursing theories are nothing but trying to make a big deal out of common sense (or even nothing). They are written in a way that "sounds" professional but when you read it, you've got no real meat from it.

In real world, nobody cares about the care plan, nursing notes or admission paper. What important is to carry out the MD's order correctly, know how to read labs and when to call the doc.

The docs only care about labs, diagnostics reports and the pt is still breathing. Due to the knowledge gap, many docs don't want to talk to nurses. This is not to say all nurses are incompetent but unfortunately many of us don't meet the MD's expection. If we are at the MD's level, we will be doctors. I have also seen some MDs respect nurses, but seems to be limited to those top of the line nurses that knows how doctors thinks and what they want.

Nursing is not a science. That's what I was told by my nursing school director. Most nursing instructors don't know science. I wish my nursing education were science based. I personally think the nursing education is a dianosaur. IMHO, to train better nurses, they should drop the nursing theories and spend more time teaching scientific materials. Teach the nurses to apply basic science/physics/chemistry/maths to their everyday work. I don't think things will change. I believe those people that designed nursing education are trying to spin off from medical and build their own empire. Students are therefore required to follow their "thoughts". Does it work in real world? I'll let you figure out the answer.

No, I have not used any nursing theory at work. I only use them on paper (charting) to fulfill institional requirement. I know how to take care of my patients (and MDs), properly.