Clinical Nursing

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

designed to guide the practice of nursing” (Medical Dictionary for the Health Professions and Nursing, 2012). Nursing theories can help patients, managers and other healthcare professionals to recognize what and how much that nurses do contribute to the healthcare field. I never did realize how important theories in nursing practice could be until I became a nursing student myself. Nurses use theories in their everyday practice, but never think about them as being

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

When reflecting on current trends of clinical practice, I feel that middle-range theories are more applicable. Middle-range theories are broad enough to incorporate in everyday clinical practice for the average floor nurse without being too narrow in scope as the situation-specific theories. Additionally, middle-range theories are less abstract than grand theories and are easier to relate to and put into practice (Liehr & Smith, 1999, p. 85).

Health promotion includes providing activities that improve a person’s health. These activities assist patients to “maintain or enhance their present levels of health. Health promotion activities motivate people to act positively to reach more stable levels of health” (Potter & Perry, 2005, p. 97). In order for nurses to assist patients in obtaining healthy lifestyles, they must first assess a patient’s perception of health. The World Health Organization defines health as a “state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity” (as cited in Potter & Perry, 2005, p. 91). There are many nursing theories that are based on an individual’s perception of health. This paper will

quality of patient care, and can be implemented in practice, to provide solutions to nursing

Middle range nursing theories are abstract, testable theories that contain a limited number of variables. According to Chinn and Kramer (2011), middle range nursing theories can lead to new practice approaches as well as examine factors that influence the desired outcomes in nursing practice. One beneficial and widely used middle range nursing theory is the theory of unpleasant symptoms, developed collaboratively by Lenz, Pugh, Milligan, Gift, and Suppe in 1995.

Over the past 30 years nursing has evolved from a task-oriented to a logical and systematic approach to care, using theories and models to guide practice. According to Jasper (2007, p117) theories of decision making in medicine tend to favour logical, precise analytical models which are held to be testable, unambiguous and repeatable, therefore satisfying scientific principles. These represent important ideas of certainty and rationality that are intended to provide a sense of security and reliability. When used correctly a nursing model should give direction to nurses working in a particular area, as it should help them understand more fully the logic behind their actions. It should also act as a guide in decision-making and so reduce conflict within the team of nurses as a whole. This in turn should lead to continuity and consistency of the nursing care received by patients according to Pearson et al (1999,p ).

For many years, health promotions and prevention has been the focus for healthcare providers, especially nurses. Health promotion seeks to improve a person or population’s health by teaching about and helps people become more aware of risky behaviors associated with different diseases. It encourages individuals to take preventative measures to prevent onset or worsening of a disease or illness. It encourages a healthier lifestyle (Edelman & Mandle, 2010). The strategy is to help people make health improvements or prevention before illness occurs.

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.

Theory has so far remained a strategic tool in advanced nursing practice. Firstly, nursing utilizes every feature of management science. Fortunately, the knowledge base of each and every management science takes theory into account. Theory includes methods, principles, and concepts. The principles are usually related, and can be observed and validated or verified when translated into the practice of management. Likewise, concepts are general notions, thoughts, and ideas that tend to form a basis of discussion or action. Therefore, theoretical principles guide clinical nurses to various

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.

Health promotion (HP) is a multi-dimensional and complex concept which the researcher is frequently used and defined in different ways. One of the nursing roles for nurses is the promoter of health; therefore it would be useful to attempt to clarify the concept. This article develops a concept analysis is to clarify the meaning of an existing concept of HP using the process developed by Pender, Murdaugh, and Parsons (2006). The method suggested by Walker and Avant guided this concept analysis. Attributes, model cases, antecedents and consequences, and empirical references are described. The implications for further research are also described.

While all types of nursing theories are applicable to nursing practice, I believe that middle range nursing theories are the most useful and applicable to practice in the 21st century. Grand theories of nursing are of the broadest range and situation specific theories focus on particular circumstance. Although these are both applicable to nursing practice and knowledge development, I feel that grand theories are too broad and abstract to easily apply to clinical practice and situation specific are too narrow in context of current nursing practice. In my experience as a clinical nurse, the majority of patients I have cared for have multiple medical, social and/or psychological issues. For this reason, I feel that middle range nursing theories are most applicable to current nursing practice. Middle range theories, as defined by Meleis (2018), “have more limited scope, have less abstraction, address specific phenomena or concepts, and reflect practice (administrative, clinical or teaching)”.

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