Theory is defined as "a belief, policy, or procedure proposed or followed
as the basis of action". Nursing theory is "an organized framework of
concepts and purposes designed to guide the practice of nursing". The
first nursing theories appeared in the late 1800s when a strong emphasis
was placed on nursing education. Nursing theories are developed to
explain and describe nursing care, guide nursing practice and provide
a foundation for clinical decision making.
There are many different
types of nursing theories. Nursing theories can be divided into "grand
theories" that are applicable on a broad scale, "middle-range theories"
that apply to a smaller subset of situations and "nursing practice theories"
that guide nursing practice. Theories can be further divided into categories
including holistic, systems, adaptation and behavioral orientations.
Who Develops Nursing Theories?
The majority of nursing theories are developed by nurses, but at times other healthcare
professionals, such as physicians have provided input into the development of nursing
theories. Nurses may develop a theory on their own or in collaboration with other nurses.
Nurse theorists often have a desire to explain, predict and describe elements of nursing
care and practice. Nurse theorists frequently draw from their academic and clinical
experiences when formulating their theories. Many of the most clinically applicable
nursing theories have been developed by nurses who are active in nursing practice and
most acutely aware of the current state of the healthcare environment. Other times,
nurse theorists are inspired by the works of previous nurse theorists and incorporate
portions of another nursing theory into their own.
Nursing Theory and Nursing Practice
Nursing theories affect everyday nursing practice. Most nurses employ a number of theories
in practice rather than using one theory exclusively. Using a variety of nursing theories
during a given day, allows the nurse to choose the best theory to fit the situation. In an
ideal setting, nursing theories serve to provide underpinnings to nursing care in every
patient encounter. They help nurses use critical thinking skills, analytical skills and
improve concept comprehension. Nursing theories improve patient care, patient outcomes,
and nurse-patient communication. Through the use of nursing theories in practice, new
knowledge and data are gleaned that can influence the future of nursing practice.
Nursing Theory and the Nursing Process
The nursing process is a scientific method used to ensure quality patient care that was
first described in the 1950s and encompassed three steps. Today there are six steps in
the nursing process: Assessment, nursing diagnosis, outcome identification, planning,
implementation and evaluation. Each of these steps can be further divided into a number
of individual steps, all with the goal of improving patient care. Many nursing theories
incorporate the nursing process into their foundations. Other theories expand upon the
nursing process and may add additional steps. Nursing theories can be helpful at all
stages of the nursing process and may guide a nurse to perform specific actions or make
certain decisions during patient care.
Nursing theories are a relatively new component of the nursing profession. Despite
their recent appearance, nursing theories have a made a strong and lasting impact on
the education, training and development of professional nurses. They have also influenced
patient care and outcomes in everyday nursing practice. As the nursing profession continues
to evolve and define itself, new nursing theories will be needed to guide nurses practicing
at the bedside. Future nurse theorists should remain true to their clinical roots, making
sure that theories continue to be applicable to nursing practice in the ever-changing