What
Is
Nursing
Theory?
3 min read • July, 05 2023
Nursing theories provide a foundation for clinical decision-making.
These theoretical models in nursing shape nursing research and
create conceptual blueprints, ultimately determining the how and
why that drive nurse-patient interactions.
Nurse researchers and scholars naturally develop these theories
with the input and influence of other professionals in the field.
Why Is Nursing Theory
Important?
Nursing theory concepts are essential to the present and future of
the profession. The first nursing theory — Florence Nightingale's
Environmental Theory — dates back to the 19th century. Nightingale
identified a clear link between a patient's environment (such as
clean water, sunlight, and fresh air) and their ability to recover. Her
discoveries remain relevant for today's practitioners. As health care
continues to develop, new types of nursing theories may evolve to
reflect new medicines and technologies.
Education and training showcase the importance of nursing theory.
Nurse researchers and scholars share established ideas to ensure
industry-wide best practices and patient outcomes, and nurse
educators shape their curricula based on this research. When nurses
learn these theories, they gain the data to explain the reasoning
behind their clinical decision-making. Nurses position themselves to
provide the best care by familiarizing themselves with time-tested
theories. Recognizing their place in the history of nursing provides a
validating sense of belonging within the greater health care system.
That helps patients and other health care providers better
understand and appreciate nurses’ contributions.
Types of Nursing Theories
Nursing theories fall under three tiers: grand nursing, middle-range,
and practical-level theories. Inherent to each is the nursing
metaparadigm, which focuses on four components:
The person (sometimes referred to as the patient or client)
Their environment (physical and emotional)
Their health while receiving treatment
The nurse's approach and attributes
Each of these four elements factors into a specific nursing theory.
Grand Nursing Theories
Grand theories are the broadest of the three theory classifications.
They offer wide-ranging perspectives focused on abstract concepts,
often stemming from a nurse theorist’s lived experiences or nursing
philosophies. Grand nursing theories help to guide research in the
field, with studies aiming to explore proposed ideas further.
Hildegard Peplau's Theory of Interpersonal Relations is an excellent
example of a grand nursing theory. The theory suggests that for a
nurse-patient relationship to be successful, it must go through three
phases: orientation, working, and termination. This grand theory is
broad in scope and widely applicable to different environments.
Middle-Range Nursing Theories
As the name suggests, middle-range theories lie somewhere
between the sweeping scope of grand nursing and a minute focus
on practice-level theories. These theories are often phenomena-
driven, attempting to explain or predict certain trends in clinical
practice. They’re also testable or verifiable through research.
Nurse researchers have applied the concept of Dorothea E. Orem's
Self-Care Deficit Theory to patients dealing with various conditions,
ranging from hepatitis to diabetes. This grand theory suggests that
patients recover most effectively if they actively and autonomously
perform self-care.
Practice-Level Nursing Theories
Practice-level theories are more specific to a patient’s needs or
goals. These theories guide the treatment of health conditions and
situations requiring nursing intervention. Because they’re so
specific, these types of nursing theories directly impact daily
practices more than other theory classifications. From patient
education to practicing active compassion, bedside nurses use these
theories in their everyday responsibilities.
Nursing Theory in Practice
Theory and practice inform each other. Nursing theories determine
research that shapes policies and procedures. Nurses constantly
apply theories to patient interactions, consciously or due to training.
For example, a nurse who aims to provide culturally competent care
— through a commitment to ongoing education and open-
mindedness — puts Madeleine Leininger's Transcultural Nursing
Theory into effect. Because nursing is multifaceted, nurses can draw
from multiple theories to ensure the best course of action for a
patient.
Applying theory in nursing practice develops nursing knowledge and
supports evidence-based practice. A nursing theoretical framework
is essential to understand decision-making processes and to
promote quality patient care.