Theoretical concepts and frameworks

¶ … Utility of the Knowledge of Nursing Theory in Patient Care

When people describe nursing theories and theoretical concepts, they frequently try to separate the theory from the practice of nursing. However, this is a critical mistake. Theory and practice are inseparable. While there are many established nursing theories, it is important to look at the origins of those theories. They developed, not in an isolated academic setting, but because they reflected the issues that were presented to nurses in the field and reflect how those nurses dealt with questions and concerns that frequently arise in the context of nursing practice. As a result, it is important to keep in mind that theory and practice are not distinct from one another. On the contrary, theory should be viewed as a type of practice because theories involve: asking certain questions, questioning the status quo, seeking the most plausible or meaningful answers, and building a logical structure for those answers (Goodson, 2010, p.78). In other words, nurses who are confronted with particular patient issues or illnesses are relying, not only on nursing theory, but also on other medical theories to practice with those patients.

Moreover, disregarding theory can be time consuming and inefficient for the patient. While nurses are able to observe patients and develop their own theories, the individual knowledge of a particular nurse cannot compare to the collective knowledge of nursing as a profession. Therefore, relying on individual experience rather than on the collective body of nursing knowledge and theory would result in a nurse practicing at a disadvantage, which would result in lower quality of patient care. An ill patient comes to a nurse with medical questions. "Scientific theories- when they have already been proposed and tested- provide clean, decluttered explanations to answer these questions" (Goodson, 2010, p.77). This makes nursing theory a critical part of the practice of nursing.

The Effectiveness of Contemporary Nursing Theories

One of the most fascinating components of contemporary nursing theories is that they are not all equally applicable to all healthcare scenarios. Instead, some of them are tailored to the specific area of nursing in question and do not contribute anything meaningful to other healthcare scenarios. This is not a weakness of those theories, because many of them acknowledge their limitations and are clearly about being tailored to a specific scenario. Instead, what that reveals is the complexity and breadth of the modern nursing profession. However, after briefly reviewing the contemporary nursing theories covered in the textbook, I was struck by the efficacy and universal applicability of feminist nursing theory. Although there are two approaches to feminist nursing theory, I found both of them to be applicable in my healthcare setting and have determined that both should shape my practice, probably more than they have to this point in time.

Care-focused feminists, generally, support the idea that care can be more feminine it has been traditionally. The American medical model has emphasized a masculine approach to medicine that has taken the nurturing aspect away from healthcare providers. Care-focused feminists look at traditionally feminine forms of providing care and suggest that they are at least as good, if not better than, masculine approaches. In practice, this would translate as treating patients as individuals, nurturing them, and finding out about their larger concerns not simply their health issues. Perhaps even more important than care-focused feminist theory is power-focused feminist theory. "Women everywhere, to some extent or another, have less power, authority, and autonomy than men do" (Tang, 2010, p.166). This power differential can have important health consequences, so knowledge of this theory must play a role in practice.

Why Theory Critique and Development are the Underpinning for Professional Nursing

Beth Rodgers points out that when people talk about nursing as a profession, they frequently discuss what nurses do (Rodgers, 2010, p.19). The skill-focuses aspects of patient care, such as drawing blood, giving immunizations, and otherwise providing care become the focus of what it means to be a nurse. However, these skills, while necessary for most nurses in their occupations, are only a small part of what it means to be a nurse. Instead, as the profession has developed, it has become clear that nurses use a variety of subtle skills and knowledge in the daily practice of their professions. For older nurses, much of this knowledge was learned on the job and through personal experience. However, modern nurses are being educated in theory, so that they benefit, not only from their own personal experience, but from nurses who came before them.

In fact, it is the seemingly intangible aspect of nursing care that benefits from the teaching and critique of theory to nurses as they learn. Nurses "form important working relationships with patients to help them achieve their health and wellness goals; they counsel, educate, guide, facilitate, assess, plan, evaluate, and engage with people as individuals or in groups or communities on a variety of levels consistent with a holistic approach to health concerns and health promotion" (Rodgers, 2010, pp.19-20). It is in these interactions that nurses turn to theory about humans, both individually and in group settings, to help guide how the nurse interacts with a particular patient or a particular group.

Part of this increasing reliance on theory reflects fundamental changes in the practice of nursing. Nurses used to be involved simply in patient care at the time of an illness or injury. However, nurses have taken a much greater role in the practice of medicine, and are often involved in education and prevention efforts, which make their understanding of theory much more critical to their daily practice.

The Application of Theories to Clinical Settings