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?

[leosrain, 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

I also use Neuman's systems model (I think that's the correct spelling). However, I do use a simplified version. As part of my final Bachelor's of Nursing project, I created my own practice model/theory.

There are those of us out there that use/appreciate nursing theory, even at the bedside.

[leosrain, BSN, RN]

1. Cleanliness in hospitals -- Nightingale

2. Decent working conditions for nurses -- Nightingale

3. Keeping track of disease incidence rates, etc. (the whole field of epidemiology) -- Nightingale

4. The idea that the unique function of the nurse is that we will do whatever the patient would do for himself if only he could. -- Henderson

5. The approach of thinking in terms of "patient problems" that need to be addressed rather than just a list of job tasks -- Henderson

6. The goal of returning the patient to a state in which he can care for himself independently -- Henderson and Orem

7. The identification of those factors that prevent people from complying with health recommendations -- Pender

8. The field of maternal-infant attachment -- Mercer

9. The idea that beginners think differently than experts and therefore have different educational needs -- Benner

etc. etc. etc.

I think this is a GREAT list! It is a very telling sign that nursing theory DOES trickle down to the bedside. There isn't one thing on that list (except for maternal-infant attachment) that I don't use on a daily basis!

As for a previous post. I am a bedside nurse and I use and appreciate nursing theory. I can name many theorists and how I use their ideas in practice (see above list for examples). I have an appreciation for liberal arts and humanities. I love philosophy and sociology. I love complex ways that scholars have interpreted this world. I see these passions as only contributing to my practice; they certainly don't hinder.

[ERYNN]

Yup..ur So True..

[nanacarol]

Nursing is said to be a science, true, however, people provide the services of nursing and as such a theory is the foundation or beginning point. No matter how you slice it or what name you give it what is done has a theoretical framwork and honest you didn't come up with it all alone. It is the sum total of who you are and what your life experiences have been (what has been read, seen, etc) and faith is good,it too comes from review and acceptance of a theory (a great one). Just because we can't articulate specifics does not or should not discredit the concept of theory. I believe it is theory that moves nursing in the path of being a science.

Yes, I use theory at work, it is my unconscious blue print as I develop treatment options for patients and/or make other practice decisions.

[Chaya, ASN, RN]

Barely. If you dig deep enough the theorist our hospital bases care on is listed in the mission statement. I find theory marginally interesting and marginally useful. A two hour class on the subject would have given me all I know and use on the subject. But my school was of the "load 'em up on academics, they can get practical skills on the job" variety. We got entire semesters of this and similar drivel at the cost of severely abbreviated cliniicals which I would have found infinitely more useful.

Actually, I think nursing theory (and its evil twin, care plans) was a now dated effort to "empower" nurses in practice. They didn't and don't work and should be radically curtailed.

[deeDawntee, RN]

This is a fascinating thread and I have appreciated the debate. I'm sorry that one of the players dropped out.

I have not studied nursing theory much. I have my ADN but am working on prereqs to a BSN. I am not pursuing with much vigor, because studying nursing theory and writing research papers on it really doesn't inspire me.

However, I do have my Bachelor and Master degrees in music and perhaps this doesn't translate exactly, but knowing music theory really helps inform one's performance and in studying composer's works. I can't imagine being a top-rated classical musician without knowing and having a strong grasp and background in music theory. This is also certainly true of composers. I cannot speak to pop or rock or other areas of musicianship, but it is an absolute requirement in professional classical musicianship.

Perhaps there is a correlation as well in medical ethics where knowledge and study of Plato, Kant and other philosophers informs decisions in medical ethics.

How much does philosophy and theory affect any of us in life? Or are philosophers merely reporting on what they see in the world? I believe this would create a similar debate as what has occurred earlier on this thread.

I think care plans are as reasonable as any other tool to communicate the status of a patient to the heathcare team. The hospital system in which I work has recently converted over to all computer charting and it has definitely elevated the nursing documentation to a level equal to any other discipline. And our charting is based on accessing the care plan and writing DAR notes based on variances to the care plan. It actually works very well.

[sanctuary, BSN, MSN, RN]

I like and use Peplau's theory for psych. Not spiritual, but darn good concepts to base my work on. And definite help in justifying interventions, too.

[seenitallERnurse]

Really enjoyed Timothy's comments re: Ivory Tower.

Consider this.

In my experience, all the information I needed was taught in two years and I received an ADN--qualified to deliver nursing care. When any ADN returns/continues on for BSN--what can they teach that you use on your job that you don't already know?

Oh, well, let's see. THEORY, maybe??????????????

As I see it, the academic institutions must find a way to bring in revenue. Since third and fourth year students are already qualified and have all necessary knowledge to be licensed by state boards, institutions decide "We'll teach nursing theory--oooooooh, yeah, that'll work. It sounds real humanities- and arts-like and it'll look good on transcripts for those desiring Masters degrees.

But, NO, I don't know of any theory used in bedside nursing or charting. When I hired in, care plans were brand new. I never knew of a doctor that read one (to approve or gain enlightment)--they were kept in the nurses' paperwork--not the chart. The floor nurses never had time to review them, so care plans were of no benefit to MDs nor nurses.

Nursing (ER and otherwise) is very much gut-instinct at times. You have a "gut" feeling that something has changed or will change. I don't see how any theory can teach you that. I do believe foundational academic courses and bedside experience will help.

So, NO, I don't see practical application of theory in my years of bedside nursing.

[gentle]

Interesting thread.

yes, I do use nursing theory. I have found Sister Callista Roy, Dorothy Orem, and Florence Nightengale to be the most beneficial for me.

I use Sister Callista Roy when explaining to patients' that my goal is to assist them to return to their previous level of adaptation(life). I try to teach the patients how they can care for themselves at home (decrease that self-care deficit). I inform them that eventually, considering the surgery was simple--i.e. closed reduction and pinning, they will return to full functioning but this is not to be expected within the next 2 weeks as it can take 4-6 weeks to make new bone. (At least, that was what I last read.)

I think of Florence Nightingale when I noticed that no one cleaned the nasty dried blood off the new patient's bed rails :angryfire.

To the OP, I think nursing theorists were just trying to explain common sense thought processes to a wide audience of people so that eventually we would all end up on the same page: providing understanding (and occasionally support-via home health) by which patients can safely heal and care for themselves within their own environment.

[anc33]

I felt like I had to comment on this thread because I see so many people reacting so harshly to something that is seemingly so misunderstood.

I use nursing theory everyday in practice, consciously or subconsciously. Orem was very insightful, as was Roy. I also draw from some cognitive-behavioral theorists when trying to teach patients to adopt healthier lifestyles. I am sure that even the naysayers have used nursing theory more than a few times in their career.

Ex. You have a patient, late stage cancer, with limited time left on this earth (I'm talking days here). This patient also has serious skin breakdown and the MD wishes to try out this new bed which is rather cumbersome and limits family contact with the patient. Keep in mind that this patient experiences an inordinate amount of discomfort when being transfered. As the nurse what are you going to do and why? Well the answer is probably something that can be explained or validated by certain nursing theories.

[overthehill]

Here is a quote from one of the "respected" Nursing Theorists:

"Human becoming refers to the human being structuring meaning multidimensionally while cocreating rhythmical patterns of relating and contrancending with possibles."

HUNH???

If that is not Hogwash then I don't know what is. Try telling that to one of your patients and see what happens.

:monkeydance::monkeydance::monkeydance:

[RN BSN 2009]

:trout:oh boy....