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Nursing Theory and its Application in Practice

  • What is Nursing Theory?

    • Nursing theory is defined as a group of related concepts, definitions, and statements about a particular subject, specifically nursing.
    • It provides a particular view of nursing, as each theorist possesses a slightly different perspective.
    • Theories describe nursing, explain its craft and science, and predict outcomes based on observation and accumulated knowledge.

  • Importance of Nursing Theory

    • The nursing profession is strengthened when built upon sound theory.
    • While theory provides a framework, real-world practice can be messier and requires fluidity within evidence-based, solid science boundaries.
    • Theory allows for the development of knowledge, providing a foundational starting point.
    • It supports excellence in practice, helping nurses develop effective caregiving.

  • Applying Theory in Nursing Practice

    • Even experienced healthcare professionals starting as nurses must begin their nursing practice anew, using theory as a foundation.
    • Nurses examine the body of knowledge and incorporate theories that resonate with them into their own practice.
    • It is acceptable not to rely on a particular theorist if their philosophy doesn't align with an individual nurse's approach.

  • Key Nursing Theorists and their Philosophies

    • Florence Nightingale ( 1800s - Crimean War - Environmental Theory)

      • Core Philosophy: Adjusting the patient's environment to promote health.
      • Considered a holistic nurse before the term was defined.
      • Observed the impact of dirty, unsanitary conditions (bloody dressings, high infection rates, poor food) on wounded soldiers.
      • Key Principles: Emphasized the importance of clean air, fresh water, adequate ventilation (e.g., opening windows), and sunlight.
      • Current Application: Observing and recording patient observations (as she advocated), applying principles of cleanliness (epidemiology, infection control), and providing comfort (palliative techniques).

    • Virginia Henderson (Need Theory - 14 Basic Needs)

      • Core Philosophy: Addressing the patient's needs, particularly focusing on assisting individuals (sick or well) to perform activities contributing to health, recovery, or a peaceful death, which they would otherwise perform unaided.
      • Goal: To help patients develop skills for maximum independent care.
      • Rationale: Allowing patients to perform self-care, even if slow, fosters independence, dignity, and better outcomes, preventing feelings of helplessness or dehumanization.
      • Example: Encouraging a patient to wash their own face, even if it takes a long time, rather than doing it for them.
      • Emphasis on Patient Resilience: Highlights the importance of a patient's stubbornness or determination (e.g., post-stroke recovery) to overcome predicted limitations.

    • Jean Watson (Theory of Caring)

      • Core Philosophy: Nursing is fundamentally about caring for people and building a trusting nurse-patient relationship.
      • Emphasizes the caring aspects of nursing practice.

    • Dorothea Orem (Self-Care Deficit Theory)

      • Core Philosophy: Identifying a patient's self-care deficits and assisting them in addressing those deficits.
      • Application: Helping patients deal with mobility problems (e.g., teaching use of a walker or cane) to prevent giving up and promote activity.

    • Imogene King (Interacting Systems Framework & Theory of Goal Attainment)

      • Core Philosophy: Setting realistic goals for and by the patient, involving the patient in all aspects of their care (patient-centered care).

    • Sister Callista Roy (Adaptation Model)

      • Core Philosophy: Modifying aspects to help the person adapt to their environment or altered circumstances.
      • Example: Assisting a patient with a below-the-knee amputation to adapt through a prosthesis, emphasizing that limitations are often self-imposed (e.g.,