21st Century Nursing Theory Paper

For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)

The caring, supportive, sympathetic features of nursing, is immeasurable. Theories are essential to have. They provide a description of what nurses do and give meaning and purpose. When nursing theories are developed this new knowledge can greatly impact the future of nursing practice (McCrae, 2012).

The nursing profession has evolved dramatically since Florence Nightingale. Nursing is now the largest health care profession in the United States and comprises one of the largest workforces (Rosseter, 2011). Nursing has become an increasingly specialized field and using a theoretical basis that defines the person receiving care should be the goal for nursing interventions (Im, 2012). Nursing is more than cleaning and giving medications. Knowledgeable nurses have been improving health outcomes since 1990 because they are using research and evidence based practice that has proven to provide better care (Stevens, 2013). Nurses who combine clinically useful information with specifically defined theories also help to provide effective specialized health care (Im, 2012). I use situation-specific theories because they create frameworks that better defines patients and can correlate the integration of research and evidence based practice into my care.

The purpose of this paper is to compare and contrast nursing theorists from the four categories which are identified by Meleis as: Needs, Interaction, Outcome and Caring. (Meleis, 2012, Chapter 9) I have chosen Faye Abdellah, Imogene King, Myra Levine and Jean Watson as the grand theorists that I would like to explore for this study in contrast and comparison. This decision was made, in part, due to the fact that all of these theorists were born and educated in the twentieth century and I felt that their theories might be more applicable to my nursing practice. The information contained in the tables was obtained from several sources in an

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

The profession of nursing has, in recent years, been trying to further develop, test and use proposed nursing theory. To utilize theory appropriately, in all domains of practice, education and research, it is important to know how to describe, analyze and evaluate

The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way.

Grand theories are relatively abstract concepts and help to provide nursing knowledge in a general way. However, this theory is the most complex and widest in scope of the level of theory have been subdivided into Human needs, Interactive and Unitary process theories (McEwen, & Wills, 2014). For this reason, Nightingale’s Environmental theory is part of the grand theory because it encompasses different areas of nursing care. This theory incorporate knowledge made from observing the patient and critical thinking as contrast to empirical and medical care (McEwen, & Wills, 2014). Between these three subdivisions, Nightingale’s theory is also a Human Need Theory because she based her theory on how the environment cause changes in ill patients. Nightingale used inductive reasoning through observation and experiences to obtain laws of health, disease and nursing (pdf).

To this end, I believe middle-range theories are best suited to advance nursing knowledge and practice in the 21st century. “Middle-range theories are at those levels of conceptualization that could inform nursing practice and research, and thus continue the cycle of advancing foundational knowledge and enhancing quality care”, (Meleis, 2012). Middle-range theories were created to help the nursing profession realize its overall mission and goal, now and in the future; to alleviate pain, suffering and distress, as well as promote health-seeking behaviors which will lead to improved health outcomes and attainable goals. Because middle-range theories lie in the middle of grand theories and situation specific theories, they are directed more toward specific interventions that can be implemented at the ‘bedside’. As such, they are designed to provide frameworks to manage patients’ experiences with symptoms, as well as the ability to understand responses to health and illness phenomenon.

The importance of nursing theory to practice of nursing should not be overlooked or underrated. That is because, it’s understanding and application are essential in enhancing patient 's care, improving communication between nurses, providing education’ and guidance in research, (Robert T. Croyle (2005). It is equally important to know that currently, there are many theories that guide the practice of nursing. Two of the most prominent ones will be compared and will form the subject of this this discussion.

Meleis (2012) further classifies theories into distinct categories: grand theories, middle-range theories, and situation specific theories. Grand theories consist of the construction and synthesis of knowledge; which includes the mission of nursing, and the goals in nursing practice (Meleis, 2012). Grand theories are broad in range and consist of a framework for which to practice. Grand theories can be applied to all aspects of nursing and patient care. An example of a grand theory would be Dorothea Orem’s’ Self-Care Deficit Nursing Theory. The central aspect of this theory is that all humans want to thrive and care for themselves (Nursing theory.org n.d.). Middle-range theories have a more limited scope. The notable difference between grand theories and middle-range theories is that middle-range theories are based on scientific and empirical evidence (Meleis, 2012). An example of a middle-range theory is the theory or discussion of quality of life (Meleis, 2012). The final theory classification is

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed

Nursing theories can be categorized considering their levels of perception, and the literature mentions that there are two kinds of concepts: grand theories and middle-range theories. Whether concepts are grand or mid-range (MR), we establish corrective intellectual and influence practice and investigation. By description, grand concepts are theoretical, complex, and detached from practice. We are not destined to be simply grasped or experienced. Associated with grand theories, MR theories enclose less perception and interactions, are adjustable to an extensive range of practice and knowledge, can be made from numerous sources, and are solid enough to be experienced. For these reasons, MR principles are predominantly persuasive as nursing science statements the encounters of the 21st period.

Nursing theory is relatively new and as such, it continues to evolve as new knowledge is gained. There are numerous theories of nursing, each of which took years to develop and most of which continue to evolve and adapt. There are commonalities between and among the existing theories although each may focus more heavily on different aspects of responsibilities. It has to do with the philosophical foundations for each theory.

“Nursing theory aims to describe, predict and explain the phenomenon of nursing” (Colley, 2003, p. 33); therefore, nursing theory is the scaffolding on which nurses stand to build and remodel nursing practice. This is a symbiotic relationship because nursing theory builds the nursing practice and as practice expands the scaffolding must, in turn, grow as well. As such, the investigation into practice and research keep informing the practice and profession of nursing. Ultimately this leads to more effective patient care utilizing evidenced-based