Nurses earning their Master of Science in Nursing (MSN) in Nursing Education online at Northeastern State University (NSU) take a course titled Theoretical Foundations for Nursing Practice. With today's emphasis on evidence-based practice, why are nurses spending time on theory?
Staying professionally relevant is critical for nurses and requires a commitment to lifelong learning. Nursing theory provides a framework for ongoing pursuit of improved outcomes.
What Is Nursing Theory?
A theory is a group or set of ideas intended to explain facts or events. Einstein's theory of relativity and Darwin's theory of evolution are familiar examples. Nursing theories may not have such well-known names, but they also serve as frameworks or structures to organize a body of knowledge.
Applying nursing theory to practice decisions can help RNs develop the analytical mindset and critical thinking skills important to quality care. The application of nursing theories will vary depending on patient needs.
Following is a look at five theories and their relevance to nursing practice today.
Nightingale's Environment Theory
Florence Nightingale is considered the first nursing theorist and a trailblazer in nursing.
Nightingale's Environment Theory reflects her experience in the Crimean War, where she found appallingly unsanitary conditions and more soldiers dying from diseases such as dysentery than from their wounds. Her work to improve care conditions is credited with saving many a soldiers' lives.
As Nursing Theory explains, this patient-care theory was "pioneering at the time it was created," but "the principles it applies are timeless." Nightingale's theory prioritizes managing the environment to restore health. Key factors include:
- Fresh air
- Clean water
- Sufficient food supplies
- Efficient drainage
- Cleanliness (of the patient and the environment, such as bedding)
- Lighting (including sunlight if possible)
This holistic approach is relevant across healthcare settings today. For example, noise and light may interrupt a patient's normal sleep patterns. Simply making the necessary adjustments as safety allows can help restore more restful and healing sleep.
Benner's Novice-to-Expert Theory
Benner developed this straightforward concept of nursing based on five levels of nursing experience: novice, advanced beginner, competent, proficient and expert.
As Nursing Theory explains, each step builds on the previous step — from a nurse who is just starting out to a seasoned professional who is highly proficient. Nurses advance through a combination of education and experience. In practice, Benner's model is useful in assessing a nurse's professional growth and opportunities for learning.
Henderson's Nursing Need Theory
Virginia Henderson, co-author of Textbook of Principles and Practice of Nursing, promoted the importance of increasing a patient's independence to speed progress following hospitalization.
In Henderson's words, "The nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible."
Known as the "Nightingale of Modern Nursing," Henderson emphasizes 14 components of care. These basic human needs fall into four categories:
- Physiological (breathe normally, get adequate nutrition, sleep/rest, dress appropriately)
- Psychological (communicate, learn)
- Spiritual (worship)
- Social (work, recreational activity)
A case study shows how Henderson's theory enables nurses to "improve the standard of caring by assessing patient needs and developing a pragmatic plan of care." This case, which involved a patient who had attempted suicide, was managed using Henderson's theory to guide the six steps of the nursing process.
Mercer's Maternal Role Attainment Theory
Secure attachment and bonding makes a crucial difference in a child's life. Ramona Mercer, a nurse in maternity and newborn care, developed a model to promote maternal identity and bonding. The four phases include:
- Anticipatory: Begins in pregnancy; includes adapting to the maternal role and expectations
- Formal: Assuming the maternal role at birth; learning caretaking as defined by the social system
- Informal: Developing ways of being a mother that work with individual lifestyle and goals
- Personal: Internalizing the maternal role
This model can be applied as a nursing intervention in "nontraditional" situations such as adoption and foster care. In the case of adolescent mothers, it can guide additional assistance as needed to help teens integrate maternal identity.
King's Theory of Goal Attainment
When it comes to our health, we all have goals. On that note, most nurses enter the profession with a desire to help people attain their health goals. King's Theory of Goal Attainment relates to this goal-oriented nurse-patient relationship in the promotion of health.
As Nursing Theory explains, "The nurse and patient communicate information, set goals mutually, and then act to achieve those goals." A study on the application of King's theory examines this in the context of family healthcare, including with children who have Type 1 diabetes.
Compassionate care forms the core of nursing. Integrating theory into practice can help RNs better understand patients' needs to deliver appropriate, quality care.
Learn more about NSU's MSN in Nursing Education online program.
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