Nursing Theory in Professional Practice
Each individual collects, organizes, and
arranges facts to build a knowledge base that defines his personal reality. A
similar organization and structure of facts and events are present in large
bodies of knowledge, through theories, philosophies, concepts, and processes.
Nursing theory is explained and described as well as various nursing theories
are discussed and their current nursing roles are clearly identified in this
paper. Also professional values and characteristic are clearly described.
A theory is a group of concepts that form a
pattern of reality. A theory is a statement that explains or characterizes a
process, an occurrence, or an event and is based on observed facts however
lacks absolute or direct truth. Theories arrange a group of related statement
or concepts so that they give meaning to a series of events. Theories can be
tested, changed, or used to guide research or to provide a base for
evaluation (Blais, 2002).
Nursing theory attempts to describe or explain
the phenomenon (process, occurrence, or event) called nursing. Nursing theory
differentiates nursing form other disciplines and activities in that it
serves the purpose of describing, explaining, predicting and controlling
desired outcomes of nursing practices. Nursing theories identify and define
interrelated concepts specific to nursing and clearly state the relation
between these concepts. Nursing theories must be logical in nature; they
should use orderly reasoning and describe relations that are developed using
a logical sequence. Theories must also be consistent with the basic assumption
used in their development. Nursing theories should be simple and general;
simple terminology and broadly applicable concepts ensure their usefulness in
a wide variety of nursing situations (Blais, 2002).
Florence Nightingale, the nurse who established
the theoretical base of nursing, developed and published a philosophy and a
theory of health and nursing that has served as a solid foundation for the
nursing profession. Her contribution to the nursing theory include
identifying the nurses role in meeting the clients personal needs;
recognizing the importance of the environmental influences on the care of
sick people; and evaluating the standards and acceptance of nursing by
developing sound principles of nursing education. Nightingale also influenced
nursing knowledge and practice by demonstrating efficient and knowledgeable
nursing care, defining nursing practice as separate and distinct from medical
practice (Retrieved October 21, 2002 from,
Betty Neuman’s theoretical model is a total
person approach which can be used to provide an organized approach to a
variety of nursing problem and for understanding humans and their
environment. The model focuses on the client system’s reaction to stress and
the factors of reconstitution or adaptation. The person is an open system
interacting with the environment. Surrounding each person are internal and
external factors that are stressors. Over a lifetime, the person becomes a
normal line of defense that uses biologic, psychologic, sociocultural, and
developmental skills to deal with stressors (Fawcett, 1999).
Dorothea Orem’s theoretical self-care model of
nursing is based on the belief that the individual has a need for self-care
actions and that nursing can assist in meeting that need to maintain life,
health, and well-being. The model is widely used in all areas in nursing.
Self-care as defined by Orem consists of the activities that individuals
carry out on their own behalf. These actions are deliberate, have pattern and
sequence, and are developed from day to day living. Orem suggests that a
person needs nursing when the person has a health-related self-care deficit. Orem has defined three nursing systems on the premise that the nursing system depends on
the self-care needs and abilities of the client. In the first system (wholly
compensatory), the nurse gives total care to meet all needs. In the second
(partially compensatory), both the nurse and the client perform care measures.
In the third case (supportive-educative), the client can carry out self-care
activities but requires assistance and teaching in order to accomplish
wellness (Blais, 2002).
An example patient for the Orem’s theory would
be a trauma patient with a head injury, bilateral hemo-pneumothorax with
bilateral chest tubes, pelvic fracture, and a left tibia fibula open
fracture. This patient goes to the operating room for an exploratory lap and
is stabilize and sent to surgical intensive care unit (SICU). At this point
the patient is wholly compensated in self-care, he unable to care for himself
and would die without nursing care. As the patient progresses he is
transferred out of the SICU and now transitions into a partially compensated
mode of self care where he has started to participate in physical
rehabilitation and self-care. Finally the patient is able to care for himself
with only supportive-educative assistance and is almost ready to go home.
Recovery continues on an outpatient basis until optimal wellness is achieved.
Nursing has developed many useful theories that
enhance the nursing profession. As nursing changes it guides research that
develops new theories. We are able to add to the proven theories and develop
new theories, all of which can be used in strengthening nursing as a
A Celebration of women writers. Retrieved September 17, 2002 from,
Blais, K.K., Hayes, J.S., Kozier, B., and Erb, G. (2002). Professional
nursing practice: Concepts and perspectives (4thEd.). New Jersey: Prentice
Fawcett, J (1999) Analysis and evaluation of conceptual models of nursing
Davis Company, Philadelphia.