Theories of Nursing

Over the past century, nursing has become one of the most diverse of all health care professions. The move toward theory-based nursing practice has brought the skill of nursing into view as an academic discipline and profession. The study of nursing theories can help the nursing student understand the field from multiple viewpoints and can afford them the ability to formulate their own concept of what it means to be a nurse and how their actions, understanding and dedication all fit into what nursing is really all about: patient care.

Nursing Theory at Work

• All nursing theories have several essential working parts. They must include a method of assessment to determine a patient's individual needs and a method of measuring and implementing appropriate patient care. These theories are used to describe, disseminate, develop and use previous and present knowledge in nursing. Over the past 20 years, the nursing profession has recognized four levels of Nursing Theory: Practice Theory, Middle Range Theory, Grand Theory and Metatheory.

Four Levels of Nursing Theory

• Practice Theory traces the outline for nursing practice. The objectives and actions are set to meet specific objectives. There are four steps in the development of the Practice Theory, which are, factor isolating, factor relating, situation relating and situation-producing control.

  Middle Range Theory has a stronger relationship to research and practice. It provide the nursing student with "the best of both worlds," abstract enough to be scientifically interesting and easily applicable in nursing practice.

  Grand Theory focuses on the global viewpoint and concepts that is the framework that defines broad perspective for nursing practice.

  Metatheory is the highest level of theory, which is abstract and not easily testable. It provides the meanings and structures interconnecting events and situations observed by nurses around the world.

Giving the Nursing Profession a Healthier Outlook

• There are over 25 nursing theorists who have made significant contributions to the field of nursing. We take a quick look at just a few:

  Betty Neuman developed the Neuman Systems Model in 1970 at the University of California, Los Angeles. It is a model developed as a way to teach introductory nursing courses to nursing students. The goal of the Neuman Systems Model is to provide a holistic overview of the psychological, physiological, developmental and sociocultural developmental aspects of human beings.

  Jean Watson developed the Theory of Human Caring between 1975 and 1979. This theory brings meaning and focus to nursing as an emerging discipline and a distinct health profession with its own unique values, knowledge and practices.

  Dorothea Orem's Self-Care Deficit Nursing Theory comes from her belief that individuals have the capacity to care for themselves and their dependents. Her theory explains that nurse have to supply the care patients need when they cannot care for themselves.

  Ida Jean Orlando (Pelletier) developed her theory in the late 1950s from her observations she documented between nurses and patients. She formulated the Deliberative Nursing Process, which helps nurses find out the nature of a patient's distress by using their perception, thoughts about the perception and the true meaning of a patient's behavior.

Nursing First Lady: Florence Nightingale

• We can't talk about nursing theorists and not acknowledge Florence Nightingale. She is considered to be the first nursing theorist. Her nursing notes in 1860 became the true basis of nursing research and practice. These notes, titled "Notes on Nursing: What it is, What is not," listed some of her theories that served as foundations of nursing practice then and are still used today. Florence Nightingale's beliefs about nursing have influenced the profession of nursing for over 150 years. She was the first to view the nurse as more than a simple "yes-ma'am" carrying out the orders of the doctor but instead a caregiver who has influence over the environment to effect the patient's overall well-being.

Using Nursing Theories of the Past in Health Care Today

• So many aspects of nursing has changed since Florence Nightingale's era. But what remains is the need for a true understanding about total patient care -- from initial meeting through diagnosis, treatment, recovery or unfortunate death. The good news for the nursing profession today is that despite all the concentration being placed on technology and advances in medical research, nursing has not lost its concentration on what matters most: total patient care and compassion.