NURSING theory and science are open, dynamic systems. The inherent but often overlooked attribute of nursing theory and science is change. The expansion of nursing's disciplinary knowledge is dependent upon an evolution in nursing theory that in turns influences the direction of scientific inquiry and empiric support for evidence-based nursing care. It is evident that nursing theory and science have significantly impacted the Nation's health. However, new questions challenge the directions of nursing theory and science, such as what are new philosophical orientations for the renovation of existing nursing theory; how relevant are grand, middle, and practice (situational) theory to contemporary research agendas; and how to conceptualize new theory across levels that meaningfully generate disciplinary and transdisciplinary knowledge. This commentary is a call for action to renovate or sunset existing nursing theories and spur the conceptualization of contemporary nursing theories that expand domain-specific knowledge while having a broad impact on the development of transdisciplinary science.

The advancement of nursing science is undergirded upon iterative development of contemporary and pragmatic theories. Modern nursing research is in urgent need of renovation of existing nursing theories as well as the generation of new theories across all levels of abstraction. As the discipline has matured, the sophistication of nursing research and scientific methodologies has been dramatically amplified. There has been a minimal renovation of existing nursing theory, which has led to the abandonment of higher-order theories such as metaparadigm and grand theories. Despite the increasing use of the theoretical underpinnings of grand theory to support the creation of middle-range theories, there has been a relative stall in the grand theory. The future of nursing research is dependent on the continued development of middle-range and practice theory. However, there is a pressing need to renovate existing grand theories and the construction of new theories that reflect phenomena relevant to the discipline and provide direction for future scientific inquiry and the generation of knowledge that informs nursing practice.

The path forward for nursing theory and research is the generation of knowledge that has relevance for nursing and influences scientific inquiry across disciplines. It is evident that nursing theory and research have generated evidence relevant to the discipline. To some extent, the disciplinary knowledge of nursing has begun to influence scientific inquiry across disciplines. The future of nursing theory and research in the 21st century and beyond should not solely focus on the expansion of disciplinary knowledge but also focus on the generation of new knowledge that transects disciplinary boundaries. As suggested in this commentary, the way forward requires a paradigmatic shift in our philosophical orientation, the critical appraisal of existing theories and fruition of new theories, and the conduct of research that leads to the development of knowledge that has applicability to practice and transdisciplinary relevance.