The use of theory as a basis for practice is one of the characteristics of a profession. Therefore, the nursing theory is very important for the nursing discipline. It helps nurses define the body of knowledge and gives directions to nursing practice. In addition, the nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn & Jacobs, 1978). Many studies indicated that many perceived contributions from nursing theories such as assisting student learning, helping to structure patient assessment, improving problem-solving, guiding and justifying nursing actions, and providing others with rationale for nurses’ work (McKenna, 1997).
However, many nurses do not use nursing theories to guide their practice, including applying these theories to research. Fawcett (1992) states that most of the grand theories currently available in nursing are all-embracing, abstract, non-testable conceptual models. Therefore, in an attempt to be all-inclusive, nursing theories explain nothing. In addition, Meleis (1997) felt that theorists were becoming more competent in articulating what theory is rather than the substance of practice itself. It is argued that if we do not know what nursing is, how can we work within the real world of practice?
We need to underline that nursing theories have so many levels. Nursing theories vary according to typology, scope, generalizability, level, and abstraction role. The most abstract and universal is called meta-theory or philosophical inquiry. A theory that is broad in scope and highly abstract is conceptually referred to as a grand theory. In contrast, the theory with a narrow scope and is more concrete or practical is referred to as a middle-range theory. Last, micro-range/practice theory is the most restrictive regarding time and scope of application (Higgins & Shirley, 2000).
From these levels of theories, we may rethink which nursing theories we cannot apply to practice. Nurses may feel confused regarding nursing theories because they have just been taught about grand nursing theories only (according to my experiences in Diploma and Bachelor nursing programs). So, nurses may think it is difficult to be applied. However, if nurses think grand theories are too abstract, they might use middle-range or practice theories. But we need to consider that middle-range theory might not be able to cover all parts of nursing care holistically, in terms of bio, physics, psychology, social, and spiritual care. Therefore, nurses need to develop more middle-range theories. Otherwise, nurses use grand theories that comprehensively guide and direct nursing care.
Thus, it is still a challenge for nursing leaders today to guide clinical nurses to apply theories to practice. This phenomenon leads to the investigation further whether nurses understand or not nursing theories. In the end, nurses need to develop and bring theories into practice because no other profession can achieve a full professional status comparable with other disciplines by basing its practice on theories.
References
Chinn, P. L., & Jacobs, M. K. (1978). A model for theory development in nursing. Advances in Nursing Science, 1(1), 1-12.
Fawcett, J. (1992). Conceptual models and nursing practice: The reciprocal relationship. Journal of Advanced Nursing, 17(2), 224-228.
Higgins, P. A., & Shirley, M. M. (2000). Levels of theoretical thinking in nursing. Nursing Outlook, 48(4), 179-183.
McKenna, H. (1997). Nursing theories and models. Oxfordshire: Routledge.
Meleis, A. I. (1997). Theoretical nursing: Development and progress (3rd ed.). Philadelphia: Lippincott.
This article was originally published in Gunawan, J. (2015). Bringing Nursing Theories into practice: If not Nurses, Who else? International Journal of Health and Rehabilitation Sciences (IJHRS), 4(3), 201-202. [Free Download]
About Author
