What is "Nursing Theory/Model"?

Q. · Feb 14, 2005

Hello,
I am looking into nursing. I keep hearing about the "Nursing Model" and "Nursing Theory." What is it? How is it different than the "medical model?"

First off, there are many, many nursing theories out there. Nursing theories, like any theory of any discipline, are meant to explain behavior, phenonema, etc. There are theories of nursing that explain the grieving process of mothers who experienced perinatal loss, theories that explain how patients view illness, etc.

The nursing model, as opposed to the medical model is simply a thing to describe how nurses practice - a framework of thinking. You might hear how CRNAs (nurse anesthetists, for example) practice under a more medical than nursing model. Nursing tends to be more wholistic, and views patients as sums of their parts rather than just parts; a medical model tends to view patients in specific body systems as opposed to an entire being.

Bottom line, theories and models can be very deep conversations that can go on and on. I would suggest doing a lit search on nursing theories.

Many staff nurses do scoff at nursing theory as they don't see how it pertains to practice. In my opinion, it has everything to do with practice.

Tweety, BSN, RN · Feb 14, 2005

It's an attempt to describe what nurses do. Good answer by Q. above.

I think while it's mind numbingly boring at times, and indeed confusing to study, it's also very important to distinguish nursing as a separate and autonomous practice from medicine. We do not follow just doctors orders, we have a practice that is distinctly nursing.

z's playa · Feb 14, 2005

Mind numbingly boring is the understatement of the year Tweety......I do believe it's more along the lines of coma inducing. :chuckle

Zzzzzzzzzzzz's playa.

llg, PhD, RN · Feb 15, 2005

Q. and 3rdshift guy have given some great answers (as they usually do) and there is not much that needs to be added. But I'll bump the thread along with the following:

While it is terribly important for nursing to distinguish itself from other disciplines at the theoretical/philosophical/body of knowledge level ... that's not the type of issue that the average nurse doing direct patient care sees as important on the average day. However, that doesn't mean that it is not important. It's like being in the military. Some of the politics, funding issues, and research questions seem far removed from the actual solder "in the trenches." However, if the research isn't done and the funding isn't secured, the person on the front line suffers. The same is true of nursing. If some of the academic/theoretical/philosophical work is not done right, the nurses on the front line suffer -- and so do their patients.

Also, it is very unfortunate ... but many (I would say most) nurses have not had a really GOOD class on nursing theory. Too often, those classes are poorly taught and students come out of them hating theory and either wanting to never think about it again or with a false sense of certainty that there is only one theory worth using. If the classes were well-taught, the students would learn to see the value of the subject and be sufficiently versed in it to incorporate a variety of theories into their practice. By doing a bad job of teaching theory, instructors have done the profession a great disservice.

llg

SmilingBluEyes · Feb 15, 2005

Here is a GREAT thread on ONE such theory (is it useful or not?-- they tried to decide):

https://allnurses.com/forums/showthread.php?t=22435&highlight=Nursing+Model+theory

Welcome to the boards!

NurseFirst · Feb 15, 2005

Here is a GREAT thread on ONE such theory (is it useful or not?-- they tried to decide):
https://allnurses.com/forums/showthread.php?t=22435&highlight=Nursing+Model+theory
Welcome to the boards!

I think, according to some nursing board or organization or another (maybe it's just California, but I doubt it)--any nursing school has to base their teaching on a particular theorist. In our school, it is Orem. So much of our paperwork has "describe, according to Orem...". They told us that they chose Orem (and that other schools chose Orem) because she is the least restrictive of the theorists.

It defines what we our objectives are with the patient. With Orem, it is to get the patient to as much independent functioning as possible, so we frequently write NCPs with goals of how to get the pt to be more independent.

NurseFirst

llg, PhD, RN · Feb 15, 2005

I think, according to some nursing board or organization or another (maybe it's just California, but I doubt it)--any nursing school has to base their teaching on a particular theorist.
NurseFirst

Some schools (and some former students) cling to that "1 and only 1 theorist" approach too tightly. Others choose 1 to provide an organizational structure to their curriculum, but allow room for the use of a variety of theories. The problem when people cling too tightly to one theory is that they sometimes become trapped by it and can't think outside the parameters of that one theory. They also fail to benefit from what other theories have to offer. Finally, it goes against the very nature of science -- which is always evolving. By limiting yourself to 1 and only 1 way of thinking, your mind starts to close instead of opening up to the many possibilities out there.

llg

tridil2000, MSN, RN · Feb 15, 2005

Hello,
I am looking into nursing. I keep hearing about the "Nursing Model" and "Nursing Theory." What is it? How is it different than the "medical model?"
Also, I've heard some nursing students, as well as employed nurses criticize nursing theory and the model. I've never really gotten an answer that I understand.
Can anyone out there explain what the nursing theory/model is, and especially how they specifically use it in their practice.
Thanks!

without nursing theory, you might as well just do anything the doctor says and follow blindly..... take the orders and execute them.

theory defines what we do and why we do it. it defines the basis of our practice and validates our functions.

it's very philosophical stuff and even i agree can be boring, but without it we're not professionals, we're robots... glorified techs.

when i took theory, i enjoyed the exchanges we had in that class. it was very liberating to hear and say how and why we practice the way we do.

NurseFirst · Feb 15, 2005

Some schools (and some former students) cling to that "1 and only 1 theorist" approach too tightly. Others choose 1 to provide an organizational structure to their curriculum, but allow room for the use of a variety of theories. The problem when people cling too tightly to one theory is that they sometimes become trapped by it and can't think outside the parameters of that one theory. They also fail to benefit from what other theories have to offer. Finally, it goes against the very nature of science -- which is always evolving. By limiting yourself to 1 and only 1 way of thinking, your mind starts to close instead of opening up to the many possibilities out there.
llg

As someone who has degrees in both biological sciences (Microbiology) and social sciences (Psychology), I think I can confidently say that how theory works varies depending upon the "scientific" subject involved. Understanding how to operate in one theory, I think, is hard enough; it does, as you say, give structure to the curriculum. I have not detected anything in my nursing courses, directly, that involves even understanding the "scientific method" (nor did any of the classes I had to re-take as pre-reqs to the nursing program). You need a framework to start with.

Rather than thinking it is against the very nature of science, I would say that having a theory provides the context by which something is understood, and how things are determined to be studied. If you read Thomas Kuhn's "The Structure of Scientific Revolutions" you will find that, generally, there is one predominant theory in a particular area of science at a time.

Learning the predominant theory is undergrad work; learning other theories and how to question them is grad work. Nursing science is, perhaps, unique in having a number of theories which are considered to be somewhat on a par with each other. I would maintain, however, that learning one nursing theory is the subject of undergrad education and learning substantially about other theories is grad work.

In short, people need to learn to walk before they can run. Learning one theory is walking; learning substantially about another theory, sufficient to compare and contrast, is running.

JMO

NurseFirst

sblanchet · Feb 15, 2005

Nursing theory is a fantasy, plain and simple. Sitting around "theorizing" about where imaginary patients fall on "the health/illness continuum" is more properly called engaging in conjecture. There is no more proof that any answer is correct than there is that if you step on a crack you will break your mother's back. In addiiton while nursing set out to separate itself from medicine and develop its own scientific model in order to be recognized as a separate profession, this has not been accomplished. Learning to call simple things like wounds, "alterations in skin integrity", is not a separate scientific body of knowledge or way of looking at the same thing by different disciplines. It requires no specific set of knowledge and is more properly called memorizing jargon. Jargon is not knowledge.

NurseFirst · Feb 15, 2005

nursing theory is a fantasy, plain and simple. sitting around "theorizing" about where imaginary patients fall on "the health/illness continuum" is more properly called engaging in conjecture. there is no more proof that any answer is correct than there is that if you step on a crack you will break your mother's back. in addiiton while nursing set out to separate itself from medicine and develop its own scientific model in order to be recognized as a separate profession, this has not been accomplished. learning to call simple things like wounds, "alterations in skin integrity", is not a separate scientific body of knowledge or way of looking at the same thing by different disciplines. it requires no specific set of knowledge and is more properly called memorizing jargon. jargon is not knowledge.

i disagree. just like handles allow you to manipulate the pots and pans on your stove, words are "handles" for manipulating concepts. this includes "jargon". jargon, in a particular field, tends to be a shorthand for a constellation of concepts, or used to embody a particular way of looking at things unique to a field or profession.

i would think that an "alteration in skin integrity" is not necessarily a wound, either. if i look at a stage 1 decubiti, i don't see a wound--i see a change in the skin. not only that, you can't really disconnect "alteration in skin integrity" from being part of a nursing diagnosis, which has three parts. i would think that an "alternation in skin integrity" might include such things as decreased skin elasticity; dryness; and other changes. (but, what do i know? i'm still a nursing student.) at least, for me, "alteration in skin integrity" is not equal to "wound". any other opinions?

nursefirst