Theory Choice And Rationale : Nightingale's Grand Theory

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)

Developing a personal philosophy of nursing and patient care is essential to the development of every nurse. The development of a personal philosophy begins in nursing school. Nurses incorporate our personal beliefs within our nursing practice and as we grow and mature as nurses and human beings our philosophy changes. Exposure to new beliefs, cultural differences, and researching the views of a variety of nursing theorists assist nurses in developing an expanding their own philosophy with the culture of care.

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

Nursing is a continually evolving discipline. Nursing theories and conceptual frameworks serve as basis for research, education, and standards of practice. Theory plays a vital role in every nurse’s practice as it aims to define, explain, and predict the phenomenon of nursing. It helps the nursing profession expand its practice, develop research studies, and enhance patient care. This paper will discusses two of the major nursing theorists and their respective works. The paper will focus on Dorothea Orem’s self-care theory and Madeleine Leininger’s theory of culture care diversity and universality. These famous nursing scholars have contributed immensely to the study of nursing and its practice.

Multiple Sclerosis known as MS is a disease that affects the brain and spinal cord this disease, unfortunately has no cure, and would cause a person’s life to progress to become more and more difficult each day. They begin to lose the ability to control their body movements and make it seem almost impossible to carry out simple, everyday function (Nordqvist, 2012). Patient’s that battle diseases such as this will no longer have the will to live because they know that there health will not get any better and they will soon die a

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).

Nursing was, for my sixteen year old self, taking care of the sick. Little did I know the complexities of that definition. Still, taking care of the sick was interesting enough to make nursing my major. I started practicing nursing years ago. However, I still struggle defining and explaining my profession to others. I usually start by differentiating nursing from medicine. Nurses see patients as humans rather than a disease that needs treatment (Zaccagnini & White, 2014, p. 15). However, as I advance my career, I must actively incorporate nursing theory into my practice. Nursing theory gives a foundation to understand patients and their health problems better. The use of nursing theory provides a framework to evaluate nurses’ interventions on a higher standard (Zaccagnini & White, 2014). Kenney described five steps to follow once the decision to include nursing theory has being made. This paper will explore the process of applying the Kenney’s five steps into my practice.

Florence Nightingale, or as soldiers on the battlefield would call her the “Lady with the Lamp”, was an inspirational women of the nineteenth century that had many aspirations and dreams concerning the care of others. Achieving these dreams by “facilitating the reparative processes of the body by manipulating the patient’s environment” (Potter & Perry 2009, p. 45); Nightingale laid the foundations of modern nursing and gave the country and many others a system that has stood the test and remains timeless. In this, Florence has become one of the most widely known nursing theorist to this day.

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Alice Petiprin, 2014). It involves the nurse’s initiative to make environmental settings appropriate to aid in the recovery of the patient’s health. According to Nightingale all external factors are somehow associated with the patient and affects their life physically, mentally, and socially (Alice Petiprin, 2014).

The two theories that have helped to form my personal perspective on nursing are Erickson; and Rogers. Helen Erickson’s model is based on caring for an individual patient based on their own unique needs and perspective (Nursing Theories and Models, 2017). Erickson’s model took concepts from several other theorists such as Maslow, Padget, Seyle, and Lazarus and combined them to create a nursing model that takes care of each individual patient based on their needs ( Reed, 2017). This theory helps me to be more cognizant of the individual needs of my patient, not all patients regardless of disease process are the same. Each patient may have different underlying factors or circumstances that affect their health and current situation. Rogers’ theory is broader, viewing nursing as both an art and science, promoting health and wellbeing to patients regardless of where they are (Nursing Theories and Models, 2017). The science of nursing involves the knowledge and research of nursing, and the art is applying that science for the betterment of the patient. This theory views an individual as part

Nursing theory is vital to the nursing profession because it provides a foundation and framework which is reflected in nurses’ caring ideals and practice (William, 2015). Theory provides an understanding of a nurse’s role within the healthcare system. The first nursing theory, formed by Nightingale, was observations of interventions that improved patient outcomes (Mackey & Bassendowski, 2016). Nurses can improve quality of care by implementing theory into their practice (Mackey & Bassendowski, 2016). This paper will discuss the importance of nursing theory, Florence Nightingale’s Notes on Nursing: What It Is and What It Is Not, and the application of this theory in the nurse

Developing a nursing philosophy is important to a nurse as it serves as a guide and is the foundation for personal nursing practice. Following a personal nursing philosophy can enhance your nursing career, make you a better nurse and improve patient outcomes. However, it is difficult to choose one nursing theorist, as there are viewpoints from several theorists that align with my personal theories. Choosing one theory is not only difficult, it is possible to change a theory during your nursing career or draw from various theories while working with patients and their families depending on the situation. Consequently, nurses are taught the foundation of multiple theorist and there does not seem to be one correct model. It is a matter of finding one that fits your

The concept of environment and its integral role in the delivery of nursing care was among the first identified and documented nursing concept since its early days. Florence Nightingale pioneered the profession of nursing and along with it, pioneered the concept of Nursing Theory. Her Environmental Theory was patient focused and incorporated five environmental components needed to promote health. Jarrin (2012) supported that the role of nursing is to promote the best possible environment for the patient to assist in their natural reparative process. It dates back from the time of ancient Greek philosophers and historians, including Plato, Hippocrates, and Aristotle, whose works are studied by Nightingale in her early years. According to Rahim (2013), as considered as the profession’s first nurse theorist, Florence Nightingale provided the essential foundation in environmental theory. She believed that some laws of nature, when applied and integrated into nursing care, can assist individuals in restoring their health during their illness, and, in those who are already healthy, promote health and prevent illness.

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 theory is foundational to nursing practice; however, there exists a reciprocal relationship between practice and theory. Through examining nursing theory, the nurse can make better-informed decisions about the patient’s care. In addition, the theory will influence the care for future patients as well. One theorist that changed the landscape of nursing is Madeleine Leininger. Her culture care theory changed the dialogue of healthcare regarding care. This paper will discuss the importance of theory in nursing theory. Next, a summary of Leininger’s theory will precede a discussion about how the theory will be applied in a nursing context. Finally, the correlation between Leininger’s theory and the practice of a nurse practitioner will ensue. Her culture care theory will inform the practice of a nurse practitioner and how culturally competent care will be given.