This paper addresses fourteen questions spanning core concepts in nursing theory and professional practice. Topics include professional communication in healthcare, the ethical responsibilities of advanced practice nurses, the value of nursing theory, and comparisons between baccalaureate and master's-level nursing education. The paper also examines three nursing paradigms (human needs, interactive, and unitary process), selected grand and middle-range theories such as self-care theory and the theory of caring, health promotion theory, interpersonal relations theory, and Benner's novice-to-expert framework. Social exchange theory is considered in relation to nurse-patient relationships, and the paper concludes with brief commentary on collaborative learning team reports.
Communication is the reciprocal process by which messages are sent and received between two or more individuals. It involves the exchange of ideas or opinions, which may take oral or written form. Communication also encompasses information that people send or receive through the senses — touch, sight, and hearing. Professional communication is a foundational tool in professional practice: it is a formal mode of interaction that must follow certain rules and norms in order to be clear and credible to others. The quality of communication is critical in enhancing clarity and accuracy. While professional communication is shaped by organizational culture and ethics, its content must be simple, clear, and written in formal language.
Professional communication is especially important in healthcare because it supports safe and effective care delivery. Communication failures can lead to disastrous outcomes between nurses and patients. Personal appearance is one dimension of professional communication and includes attire, facial expression and eye contact, movement and gestures, grooming, pace of walking, physical characteristics, posture, and sounds. Personal appearance should complement pace of speaking, tone of voice, and other nonverbal elements.
The key components of professional communication include use of proper grammar, speaking with a clear tone and voice, careful listening, and preparing with pertinent information (AMN Healthcare Education, 2012).
Historically, ethics have been a primary focus of the nursing profession. Because new nurses are required to follow ethical guidelines, advanced professional nurses play critical roles in fostering ethical practice in professional settings. At the clinical boundary, the roles of the advanced professional nurse include: respecting the dignity of patients; delivering innovation and excellence in patient care; delegating tasks appropriately; practicing good judgment; alleviating suffering; being attentive to patients' interests; and working collaboratively to enhance nursing practice and standards.
At the professional practice boundary, advanced professional nurses are responsible for maintaining authenticity in nurse-to-nurse and nurse-physician relationships, and for evaluating and addressing issues such as impaired practice and a nurse's acceptance of inappropriate gifts from patients.
At the self-development and self-care boundary, an advanced professional nurse should participate in self-care activities to maintain moral self-respect, competence, and professional growth; advance knowledge through practice, research, and education; and promote healthy practice by participating in professional organizations that address ethical and unsafe issues in the community. Advanced professional nurses must also maintain confidentiality regarding patient and family information (Butts, 2008).
Nursing theory is a set of interrelated definitions, statements, and concepts that are predictive and explanatory in nature, proposed to describe nursing phenomena and assist in explaining or predicting outcomes. Nursing theory guides professional conduct. It assists nursing professionals in understanding patient symptoms and care, and nursing practice is strengthened when it is built on a sound theoretical foundation. Theory helps nurses analyze and organize patient data and understand the connections between data points. It also supports sound clinical judgment and enhances planning in professional practice. A major benefit of nursing theory is that it assists in measuring quality of care, and it helps build common terminology for communicating with other health professionals.
Alligood and Tomey (2002) argue that nursing theory provides a solid foundation for patient diagnosis, assessment, and intervention. Nursing theory also provides a common ground for communication between nursing practitioners and other healthcare professionals with respect to patient care. It solidifies nursing professionals as viable team members capable of delivering high-quality healthcare, and it allows healthcare providers to contribute valuable input in carrying out patient treatment.
"Comparing competencies across nursing degree levels"
"Three paradigms and their philosophical differences"
"Self-care, caring, interpersonal, and developmental theories"
"Health promotion, Benner's stages, and social exchange"
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