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]

My favorite nursing Dx thus far has been "Disturbed Energy Field." I took the liberty of trying to use this as much as possible (out of humor and spite) on my care maps. :chair:

[grandmawrinkle]

There are exactly two nursing theories I give two seconds of thought --

Orem -- if I had to choose a theory that aligned with my own practice, it would be hers. To refresh your memory, she says (more or less) that nurses do for the patient what the patient cannot do for themselves, and the goal of care is to get the patients in a well enough spot to do their own self care. Well, duh.

Benner -- the novice to expert business. This has been widely incorporated into promotion programs and clinical ladders across the country -- it works because it can actually be applied.

I have a liberal arts/soft sciences background FYI and even I think most of this stuff is bunk. Nursing is a highly practical, applied field of employment. There is hardly anything practical or applied about most nursing theories.

[lxpatterson]

Ellekat: I wish you were on faculty at my university! While many of the theory profs have admitted that nursing theory is a mish-mash of borrowed ideology and models from different disciplines, none of them have outright suggested what I thought was patently clear: that the impetus to create nursing theory was/is not to improve practice but a means to improve the status of a traditionally female-dominated (and less respected) profession.

As to your comment about the wage bias for male nurses, even though I would be a beneficiary, I think it's absolutely stupid. The experienced nurses I've met are worth two or three starting nurses. This is evident in the lab where the older nurses can make up a bed with a patient in it in the same amount of time it takes 3 students to do so, and can render a snap cardio dx without a Blackberry or Mosby.

[sunnycalifRN]

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

LOL!! I totally agree, although I only have about 5 years experience! During nursing school, we had a guest speaker, a graduate from our school many years earlier. During her presentation, she said exactly what you said!!

It was hilarious!! All the instructors jumped up and said, "Now that's just one nurse's opinion!!" We were all applauding the speaker!!

[Hydrocodone APAP]

Natural feeding is always a good heredity and health.

[Oh'Ello, BSN, RN]

The only "theory" that holds any water for me is Lasater and the Clinical Judgement modeling. Its not even so much a nursing theory as a nursing education theory and honestly I find it more relevant to patient care than any of the caring nonsense.

Really helped to shape my understanding of what critical thinking is, and what steps are needed along the way to achieve it.

[BittyBabyGrower, MSN, RN]

After 30 years of nursing, the only time I see nursing theory pop

up is when we are up for our magnet renewal and we have to know what theorist we follow lol

[llg, PhD, RN]

I am an experienced nurse -- with about 15 years of clinical practice experience as a staff nurse and CNS. I also have about 15 years of experience working in a hospital as a Professional Development Specialist -- and I also a part time faculty member who teaches nursing theory. In my opinion ...

1. The OP was right when he said that nursing theories are a reflection of their times. Theories are developed by people and the work those people do will be influenced by their environments. When I teach theory, I present them as somewhat a "history of nursing thought" that evolves over time rather than as rigid descriptions of "natural laws." As our culture changes, so will our theories and philosophies.

2. People with a strong grounding in physical science often have trouble relating to the more "out there" theories in any field. Nursing has some theories that are extremely philosophical/spiritual. So do the academic disciplines of English, Philosophy, Religion, Gender Studies, Fine Arts, etc. Those people strongly oriented towards the physical sciences are not going to relate to the theories in those fields either. That doesn't make them all hogwash. It's OK not to like/relate to every theory. Find the ones you like and let the others go.

3. The role of theory is to describe, explain, and predict things. There are dozens and dozens of nursing theories to choose from. Some are very concrete. Some are very abstract. Some relate more to the direct physical care of the patient. Some relate more the patient's sense of emotional/spiritual well-being. If they help nurses organize their thoughts about those topics, then they are worthwhile for those nurses to use. As I say, "Choose the ones you like. Lose the ones that you don't."

4. Most undergraduate nursing theory courses are taught by faculty members who have very little education in nursing theories and/or nursing philosophy. They took their 1 class as an undergraduate ... and probably 1 more class as part of the MSN program that was really just a continuation of their undergraduate experience. A few may have 1 or 2 additional classes at the doctoral level while they were focusing on becoming an advanced practice nurse. Few really focused on theory/philosophy in grad school as they were more focused on their clinical practicums or research. So, when it comes to teaching undergraduate nursing theory courses, it is usually a case of the blind leading the blind. (A similar thing happens in undergrad nursing research classes, but that is for another thread.) I think nursing theory is horribly taught to most nurses and that is a big part of the reason there is such a big gap between the average practicing nurse and the nurse theorists.

5. My belief that undergraduate nursing theory and research are 2 of the worst-taught classes in America is why I volunteer to help teach them at a local university. My theory class is well-received. Please don't cast us all in the same light just because you had a bad teacher.

[Horseshoe, BSN, RN]

I agree with much of the above, but I can't stop chuckling over the fact that the OP didn't want to be perceived as "an insensitive loaf."

[nursel56]

My belief that undergraduate nursing theory and research are 2 of the worst-taught classes in America is why I volunteer to help teach them at a local university. My theory class is well-received. Please don't cast us all in the same light just because you had a bad teacher.

Not going to quote the whole thing, but this post would make a great article all on it's own. Those of us who were around when Jean Watson's theories were getting a lot of recognition, for example-- didn't find it was "out there" for it's time. It was perfectly in keeping with other trends in all areas of popular culture, including academic scholarship.

I think theory is valuable even where it's integration with direct patient care isn't immediately obvious.