post-baby boom generation and nursing theory

[lxpatterson]

Hi,

I'm a nursing student starting a post-grad (post BSc) BSN program. Perhaps I should be posting in the school section but I just want to hear what working RNs.

Nursing school has been quite a shock to me since (perhaps naively) I expected a meds/OT/PT/pharm -lite education; I discover now that only half my course-load is in what might be considered conventional medicine, while the other half is in "nursing theory".

Now I come from a biochem/neurosciences background, so I admit that I am set to be biased against viewing practice through a "spiritual lens" and various theories of "caring". But I know I am not the only one who thinks it's flaky, since the majority of my classmates have a biology, microbiology and pre-med type background. Still, I am afraid to kick up too much of a fuss since I am not here to rock the boat but to obtain a degree with a good GPA, and also I don't want to be known as an insensitive loaf since a) I am male and b) most of these professors are ultra-earnest activist types who get upset when we are not demonstrative enough about social justice concerns.

I am just wondering how "nursing theory" is regarded by experienced clinicians (such as yourself). I am also wondering how it is regarded by younger nurses and whether it is more highly regarded by older nurses. Looking at the types that teach the theory courses, I kind of get the impression that the work of peplau, rogers and so on are a product of their times (the groovy '60s) and resonate with a certain demographic; which however are less well regarded by the younger generation.

What do you think?

[felineRN]

I am in no way an experienced nurse. However, having spent half my life writing papers on such theories and theorists, I think the majority of these concepts are a) Common sense restated in high-brow academic verbage b) Poppycock.

I feel that in many settings, it is near impossible to apply many of the theories of caring/compassion learned in nursing school. When I was a nursing student I had the time to make an assessment of a patient's stage of coping, barriers to learning etc... The reality is that I have 3 other patients on an insulin drip and I need to truncate such social assessments upon admission.

The only theory (that is non-nursing) that I can realistically apply is Maslow's hierarchy of needs.

Nursing theories (much like theories from other disciplines) can really only exist in a vacuum or academic arena.

By the way, I'm a snot nosed 20 something.

[Kyrshamarks, BSN, RN]

As a nurse with about 25 years experience I can honestly say all nursing theories are bull crap.

[lxpatterson]

Feline, from what I've seen (which is about a month's worth), I can agree with you on that point: that a lot of it is restated common sense. Like the nursing process with orientation, working phase, termination...it's not exactly the communist manifesto; it isn't much of a paradigm shift from the conventional medical "SOAP". I don't know, maybe I'm missing the point.

What really bothers me is that not only is a lot of it untested by any sort of empirical data, the instructors indicate that it is undesirable or impossible to sully these theories with anything so base as evidence. So if I am writing a paper, on what grounds do I critique them on? I spent many years in research and medical writing, so I have some capacity to put together a reasonably publishable paper for a peer-reviewed rag, but this type of paper is all new to me.

[HamsterRN, ADN, RN]

For those with a science focused background, Nursing "Theories" cause an understandable amount of aggravation and annoyance. I find it helps to not think of them as scientific theory's, but as philosophical theories, since most of them don't come anywhere near meeting the requirements of a scientific theory and you'll go nuts if you hold them to that standard.

There are some Nursing theorists that come closer to scientific theories such as Benner, then there are those who are complete Loons (Watson). I know it's annoying for a science minded person, but it seems to be part of the hazing process to become a nurse. Just try and focus on the Benner's of the Nursing Theory world as much as possible and avoid the Watsons whenever possible.

[noahsmama]

I'm also a second degree nurse with previous training in science (PhD in Chemistry). Nursing "theory" drove me batty too. I have not found it to be even the tiniest bit useful as a working nurse. To me, learning nursing theory goes into the same category as learning how to answer NCLEX style question, namely "things they make you do to become a nurse that you won't ever have to do again once you become a nurse".

Unfortunately, for now you have no choice but to grin and bear it but you can console yourself with the fact that "this too shall pass".

[MisterSimba, BSN]

My first BA was a double major in English and Philosophy, so when I spent tons of time in nursing school writing papers for not only theory class but also leadership and research classes, it drove me nuts. It's no wonder new grads require extensive new grad programs - because we spend so much time on the "fluff" and not enough time in the hospital or skills lab. I really would have appreciated more clinical hours, more time in the skills lab, and the opportunity to do an externship. Oh well, at least nursing school is over and I passed the NCLEX in 75 questions...now I just need a job.

[Ellekat]

As an experience clinician (17 years) and an older nurse (55), I must admit my reaction was the same as yours towards nursing education. Nursing was my second degree. I have totally forgotten any theoretical knowledge and feel that much time/energy/money is wasted that could be used in aquiring useful knowledge. This may have come from the '60's, but remember that nurses my age could not easily get jobs in other fields in the '60's or even the '70's and early '80's. I felt at the time that much of the theorectical work was done to meet criteria for raising wages, as nursing was in the "pink ghetto".

The higher wages are what have attracted many into nursing, so it was a price that had to be paid; that it was proof that nursing was worth $$$. As a male, you will probably receive better wages than your female coworkers (after ten years of nursing, I got a raise to meet the pay they were giving a brand-new rn/coworker who was male) and be treated either much better or be treated really poorly-there doesn't seem to be much middle ground for men in nursing from what I've seen, although hopefully that is changing.

I would like to see the BSN become a truly scientific degree that requires an understanding of where medicine is going (genetics, nanotechnology, etc) instead of focusing on where it's been, and that will incorporate nursing into medicine. Get your degree and hopefully an advanced degree and try to become a driving force for change-it is needed.

[MisterSimba, BSN]

"I would like to see the BSN become a truly scientific degree that requires an understanding of where medicine is going (genetics, nanotechnology, etc) instead of focusing on where it's been, and that will incorporate nursing into medicine. Get your degree and hopefully an advanced degree and try to become a driving force for change-it is needed."

Well said! :yeah:I couldn't agree more! I was pretty surprised that the prerequisites that I took at a community college were very challenging, and nursing school was so easy by comparison. My physiology professor ran the class like we were med students, and then I got to nursing school and felt like everything was watered down sooo much. I worked very hard to get into nursing school, and it seems like once I got in, it was a breeze except for all the busy work I had to do!

[nursel56]

I don't think theorists live in a vacuum, or at least were created in a vacuum, as I remember that era very well. It was the heyday of such icons as Desiderata, Fritz Perls posters with the Gestalt Prayer, the smash best-seller I'm OK, You're OK, and Pet Rocks. I'm not a psychologist, but it appears that early theories seem to be based on "gestalt" or whole form. It's maddeningly unscientific by design, because supposedly the whole form of a person is not reducible into components such as physical, spiritual, and emotional.

Right about then nurses were attempting to define themselves as professionals in their own right, so it appeared to dovetail pretty nicely at the time. Many younger students are taught that a Nursing Diagnosis (based on theory) is a care plan and use the terms interchangeably. Care plans pre-date "caring theory".

You are likely to find that people who have spent the majority of their careers steeped in that feel differently than the rank and file of us oldsters who were more than thrilled to get rid of our orange shag carpet and our Birkenstocks. :)

[OCNRN63, RN]

I think nursing theories are a bunch of stuff and nonsense. In 25y I haven't once given any of them a second thought.

[netglow, ASN, RN]

2nd career here. Got into this for the heavy science and not for fluff. Almost quit during my first semester because I thought my program was a scam. Nursing DX? What a joke - wasn't going to waste my money on that crap. I used to snark and say, "So.... exactly when are they gonna tell us how not to kill someone?!?!"