TODAY'S CLINICAL setting is filled with discussion and implementation of evidence-based practice, but this wasn't always the case.1 Theorists have elevated the science of nursing to its modern prominence with decades of research.
Now that I'm retired, I've come to realize that nursing theories were essential to my actions throughout my career. Nursing theories form the supportive framework on which our patient care relies. Dated and untested management strategies aren't useful and can even be an obstacle in the delivery of safe patient care.2 However, when supported by evidence, theories in practice are forever contemporary.
My introduction to theory
I was first introduced to nursing theory in 1974 when I began my Master of Arts in Nursing program. My first course was Theoretical Framework for Nursing Practice, which introduced my classmates and me to the philosophies of Martha Rogers and Sister Callista Roy. Rogers' Theory of Unitary Human Beings opened our eyes to the influence of a patient's home life on anticipated health outcomes.3 And The Roy Adaptation Model opened our minds to the interconnected nature of biological, psychological, and social systems affecting patients.4
Over the course of my education, not all historical nursing figures we studied were presented as theorists, but I later realized many of them were just that-Florence Nightingale and her work on infection control and environmental cleanliness, Faye Abdellah and her Twenty-One Nursing Problems Theory.5
Although it wasn't on my radar in 1974, nursing theorists, theories, and models were beginning to gain wider recognition. Research from the 1970s supported many of these concepts with solid evidence. It was in this decade that doctoral education in nursing increased with emphasis on theory development and testing.1 Fast forward to 2010 when I began my Doctor of Nursing Practice coursework, and more nursing theories and theorists were now studied in depth. Evidence-based practice is now emphasized in the field of nursing.
Knowledge comes full circle
During my career as adjunct faculty, I've frequently taught the theories I'd once studied to my students. Nightingale's Environmental Theory was essential in teaching nursing students proper hand hygiene, sterile technique, and use of personal protective equipment for infection control.6
I taught my nursing students to formulate a nursing plan, including attainable and measurable goals based on their assessment of patient and family needs-an application of Imogene King's Theory of Goal Attainment.7 Showing my students how to teach a patient with diabetes to self-manage his or her chronic disease put Dorothea Orem's Self-Care Deficit Nursing Theory into practice.5
Why we do what we do
Learning and applying nursing theories shouldn't be limited to the classroom. In today's healthcare landscape, a demand for excellence influences Magnet(R) recognized hospitals to use nursing theories to achieve positive patient outcomes.2 There's a place for nursing theories in daily practice, whether at the patient's bedside or in community health nursing. Nurses should revisit the nursing theories they learned about in school and apply them to patient care.
When our patients and their families, and even those in other healthcare professions ask why we do what we do, we can cite the nursing theories and theorists who guide us in our profession.
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