Nursing Theory Explained
The advent of increased interests in nursing education around 1800 AD paved way for a multitude of suggestions and ideas as to how the field and profession of nursing can be better defined, taught, and practiced. These needs gave birth to over 20 verified theories in the field of nursing, the first one being Florence Nightingale‘s Environmental Theory and the latest one – Jean Watson’s Theory of Human Caring– was published in 1979.
Nursing theory is specially organized into a metaparadigm of four concepts; person, health, nursing, and environment.
Nursing Theory Metaparadigm
Person refers to the patient in question. Dr. Jacqueline Fawcett implored that patients have differently unique physical, social, emotional, and religious dimensions, and ought to be attended to in their unique forms.
Environment refers to the situational context upon where nursing care is being provided. The concept of environment in nursing covers not just the physical environment but rather the cultural factors that encumber patient care, and nurses are required to attend to these factors when delivering patient-centered care. Technology has come to enhance this environment, and here are some of the technological strides in the field of nursing.
Health is the primary concept in nursing theory, and the main responsibility in the profession. Nurses have a duty to avail quality healthcare to patients, which covers not only physiological health but rather mental and social well-being.
Nursing concept revolves around nurses themselves; their responsibilities, qualities, skills, experience, knowledge, and attitude. Nursing education provides the knowledge and skills necessary for provision of quality care, while nurses ought to seek experience and display proper attitude when handling patients.
Florence Nightingale’s Environmental Theory (1800) – emphasizes the importance of a clean environment in the setting where healthcare is administered. Nightingale opined that sickness is the absence of comfort and a clean environment, by providing comfort, helps in the healing process of the patients.
Hildegard Peplau’s Interpersonal Relations Theory (1952) – emphasizes on the importance of the nurse-patient relationship, and it being anchored on a positivity framework. Peplau detailed the nurse-patient relationship into three stages; initial orientation, a dynamic working stage, and a courteous termination.
Virginia Henderson’s Nursing Need Theory (1955) – establishes that nursing is part of human beings’ basic wants, and nurses have a hefty responsibility to help people with fundamental human needs such as breathing, feeding, cleanliness, relieving, walking, as well as maintaining a comfortable posture.
Faye Abdellah’s 21 Nursing Problems Theory of Nursing (1960) – laid the ground for the development of the nursing theory from disease-centered to patient-centered care. Abdellah’s theory defines nursing as a science and art that brings together the skills and competencies of individual nurses in to centralize their care to helping people from their sicknesses and deliver well-being.
Ida Jean Orlando’s Deliberative Nursing Process (1962) – provided the framework for treatment management, giving a detailed procedure through which the nursing process goes through; assessment of the patient’s subjective and objective data, diagnosis of the problem(s) leading to insufficient health, implementation of the care plan that was formed in the previous diagnostic stage, and evaluation of the patient’s progress after implementation of the care plan, towards the goal of the patient’s treatment process.
Martha Roger’s Science of Unitary Beings (1970) – defines people as “unitary human beings”, insisting that human beings/patients cannot be separated from their immediate environment. The environment interacts with the patient in the entire nursing process, and is pivotal in the most important of them – the healing process.
Dorothea Orem’s Self-care Deficit Theory (1971) – assumes that people have the ability to take care of their health and those of others. Self-care deficit implies that the inability of people providing their own self-care indicates the importance of nursing to come in and provide the needed care.
Imogene King’s Theory of Self Attainment (1971) – opines that patients as rational human beings, in a conducive environment, undergo growth and achievement of life goals in three realms; personal, interpersonal, and social growth. Personal growth entails the development and refinement of individual traits such as body image. Interpersonal is growth of the patient’s relationships with others, and social growth is attainment of organization, authority, power, and status.
Betty Neuman’s Systems Model (1972) – analyses the human body as a composite system embodied with a line of resistance. The system tends to react to various stressors in the form of physiological, psychological, developmental, sociocultural, and spiritual systems. Sickness is the jeopardizing of the line of resistance, and treatment seeks to restore this line if the energy is sufficient.
Jean Watson’s Theory of Human Caring (1979) – requires that nurses, during provision of care in any stage of the nursing process, exhibit sincere compassion, and establish a trustful relationship with the patient while administering care. Watson provides ten (10) principles around this theory, including self awareness of one’s egoistic levels, and institution of the spirit, mind and body in the treatment process.
Sister Callista Roy’s Adaptation Model (1979) – establishes that human are adaptive beings who rely on environmental factors to build their personal integrity, which comprises of four modes; physiological mode of biological and physical well-being, self-concept mode of individual awareness, role function mode of adaptation to different roles in the society, and interdependence mode of relating and adapting to the social frameworks we are set in.
Patricia Benner’s Novice to Expert Theory (1982) – outlines the growth of nurse professionals through skills acquisition, both practically and situationally. Benner’s competency process has five steps; novice, advanced beginner, competent, proficient, and finally an expert. The five steps have specific milestones that have to be achieved such as graduation, employment etc.
Katherine Kolcaba’s Comfort Theory (1990) – accentuates the importance of patient comfort during the nursing process. Kolcaba defined comfort in three dimensions; relief, which comes in the form of pain management; ease by incorporation of a friendly psychosocial environment, and transcending by making sure the patient rises above pain and sickness to achieve ultimate comfort.
Madeleine Leinenger’s Transcultural Nursing Theory (1991) – implies that nursing as a field is too critical to not embrace humanity in totality; together with the socio-cultural frameworks present within human beings. According to Leinenger, nurses ought to be cognizant of cultural differences between patients, and practice independently devoid of any judgements or prevailing cultural rigidities.
|Kicker: Nursing theory is the backbone of practical practice in situational fields of nursing. Routine practices such as the nursing process and formation of a nursing care plan were introduced through theoretical works of nursing scholars, and the world of nursing can surely tell of the monumental role played by nursing theory in delivery of care.