An Overview of Nursing Theories

Nursing theories were created out of the necessity to define what nursing is all about. As the nursing profession grew, so did its knowledge base expanded from its humble beginnings in the work of Florence Nightingale to its still-evolving scope today. Nursing theories aim to structure professional nursing education, practice and research. They attempt to explain what makes nursing distinct from all other professions. Since the days of Nightingale, many nurse leaders have brought forth their own theories to conceptualize the nature of nursing.

Foremost among these theorists is the founder of modern nursing — Florence Nightingale. She viewed nursing as a calling for women who uses nature’s laws to serve others. For her the purpose of nursing is to place the patient in the best condition so that nature can restore the person back to health. She focused on the environment, emphasizing basic needs such as ventilation, warmth and comfort, diet and cleanliness. These concepts remain essential components of nursing care today.

Virgina Henderson put forth the unique definition of nursing as “a profession that assists the individual, sick or well, in activities contributing to health or recovery”. This landmark statement represents a distinction of nursing from medicine. She identifies 14 components of nursing care which the nurse helps the patient achieve independently. She describes both the independent function of nurses as well as their role as collaborators with the patient and other health care professions.

Dorothy Orem’s self-care deficit theory says that individuals benefit from nursing because they tend to develop a weakness or limitation in maintaining optimal health. The role of the nurse is to help these individuals regain their self-care capabilities. She identifies wholly compensatory, partially compensatory, and supportive-educative systems for nurses to implement to meet health goals.

Sister Callista Roy developed a systems theory for nursing. She describes the person as an open, biopsychosocial system which constantly interacts with the environment through constant stimuli. Individuals who adapt to stimuli maintain good health, while those who adapt poorly can develop illness. The function of the nurse is to manipulate stimuli in such a way that the patient moves toward better health.

Imogene King describes nursing as “a human interaction between nurse and client”. She emphasizes communication between the nurse and the patient to achieve mutually set goals. King also views the person as an open system subject to stressors from the environment. The nurse strives to help the individual adjust to these stressors and make use of available resources to maintain health. King focused on the participation of all parties involved in attaining goals pertaining to the patient’s health.

Among nursing theories, one of the most complex is the one presented by Martha Rogers which defines the person as an “irreducible, four-dimensional energy field” that interacts with the environment. Many nurses find it difficult to grasp Rogers’ ideas. But they can be best illustrated with the example regarding therapeutic touch. Nurses often make use of this technique to convey empathy, provide reassurance, and help the client manage pain when their “fields” overlap when touching hands or when they are just in close proximity with each other.

Hildegard Peplau views the nurse-patient relationship as an interpersonal or psychodynamic experience. She identifies four stages in the nurse-patient relationship: orientation, identification, exploitation and resolution. Peplau described nursing as a “maturing force” which helps the patient to achieve health goals.

Madeleine Leininger assumes that culture and caring are always linked. She defines transcultural nursing as focusing on cultures and the caring behavior, health beliefs, and nursing care expressed within these cultures. She views the goal of nursing as developing “culture-specific” and “culture-universal” practices. Leinenger also considers caring as the essence of nursing and its distinctive, unifying feature. In today’s multi-cultural health care environment, Leininger’s theory has become an important nursing theory guiding nurses.

There are many other nursing theories, each presenting a unique view of nursing. All of them have contributed to nursing knowledge and made nursing a distinct and respected profession that it is today. As nursing practice and the health care environment continue to evolve, nurses can rely on these ideas or possibly formulate other novel nursing theories.

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