Nursing Theorists and Their Theories

Introduction

Theories have been formulated ever since the inception of the nursing vocation, significantly stimulating maturity of the profession. They present comprehension on the methodologies applicable in healing and its apprehension as a discipline requiring substantive research (Browne, Bryant-Lukosius, DiCenso & Pinelli, 2004). The variation between the applied treatment by physicians and the definite understanding of the setting of patients and their interrelations with the environment are contrasted to signify the value of nursing. Previously, before the materialization of nursing as a science, it was based on traditions and values passed in manuals predisposed by experience. The theories evolved from private efforts of some nursing principals who contributed to the systematic diffusion of facts which characterizes the present practice. Prior studies have helped breed the present theories which subsequently establish previously held premises and expand to other areas such as human sciences (Alligood & Marriner-Tomey, 2010). Some of the theories were more pertinent to the nursing practice compared to others; however, they both chart channels to support innovations in the nursing vocation.

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Faye Glenn Abdellah

Faye was among the most eminent nursing theorist and public health scientist who immensely dedicated her lifetime to progress the nursing vocation. She developed enthusiasm for caring after watching unaided victims from an explosion suffering. Her edification experience qualified her to be a doctor, but she preferred nursing, which offered her with the prospect to participate in a caring occupation (Alligood & Marriner-Tomey, 2010).

She later became a nursing instructor and examiner who participated in the alteration of the focus of the vocation from dealing with diseases to a wider-reaching comprehension with patients. The liability of nurses was thus expanded to the care of the aged and broader family structures. She developed a framework for progressive patient care whereby significantly ill patients progressively received intensive, immediate and finally home care.

She discredited nursing without scientific basis, for example, the burning of literature which guided her teaching in Yale. The frustration she felt on the unavailability of substantial data charted her pursuit for the methodical explanations which are basic for the strategic formulation of theories (Houser & Player, 2004). She also developed an arrangement of standards which appraised the relative reputation of personal healthcare facilities. Faye pioneered the development of an organization system for keeping records of patients.

In her hypothesis, she views individuals as possessing physical, psychological and sociological requirements which may either be misunderstood or missed. Importance in the healing process must be placed on deterrence and analysis with comprehensive well being lasting over a lifetime, hence the need for a holistic approach.

She proposed a classificatory structure which identifies nursing problems, based on her proposition that nursing intends to meet the overall health requisites of a patient. Thus, the image of a nurse is portrayed as not just being considerate and compassionate, but also displaying competency, brainpower and technical expertise to assist patients. Her suggestions of 21 nursing problems, for example, provides a comprehensive guideline which clarifies the physical, psychological and social needs in the environs of patients, the nurse-patient interrelations, and the wide-ranging elements of patient care.

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Her hypothesis is relevant as it instructs us on the significance of edification which empowers the nurse to be more proficient in the nursing practice (Alligood & Marriner-Tomey, 2010). Nursing problems are thus personalized for the needs of particular individuals, and the necessity of formulating goals which chart the overall healing process in a scientific channel. Through the investigation of the 21 problems, a patient has a higher probability of receiving comprehensive analysis, while the nurse would be better placed to chart constructive strategies to provide apt treatment based on scientific postulations. Personal critical thinking is thus emphasized to improve augmented job contentment and more productive nurse-patient interrelations.

Dorothy Johnson

Dorothy was born in the early 90s and incepted her professional nursing vocation 20 years later after graduating form nursing school. She served the position of a trainer, assistant and associate professor over the years, and developed her esteem in the nursing field through some nursing publications. All through her vocation she stressed the value of expertise founded on explorations on the impact of nursing care on victims.

She was an early believer of nursing as a both a science and an art (Alligood & Marriner-Tomey, 2010), arguing that the vocation had a body of familiarity on science as well as art. Prior to her research, she proposed that the comprehension of the discipline of nursing care included an amalgamation of conceptions drawn from basic sciences. Nursing care eased the patient’s upholding of a state of stability arising from internal and external pressures. The disturbances caused by the stimulus resulted in the instability which alters the equilibrium state. Based on this, Dorothy formulated the area nursing care should concentrate on in order to guarantee the stability of the patient. A nurse may either lessen the traumatic stimuli or sustain natural and adaptive procedures for healing. Her theory arises from the attitudes of Florence Nightingale postulations that the intent of nursing is to back the populace to deter or recover from impairment. Nursing as a science and an art should thus highlight on the person and not the ailment (Meleis, 2007). She employed the work of behavioral scientists in sociological aspects to further her hypothesis. Her model involves systems of interconnected parts which commonly harmonize to represent the whole process.

Johnson based her hypothesis on the behavioral system model believing that recurring and purposeful ways of behaving characterize the life of individuals, which constitute the overall holistic process. Through the categorization of these behaviors, it is possible to envisage and order the demeanor that would be portrayed. She split general human behavior into seven compartments, each comprising of a pattern of behavioral responses which emphasized on a common objective. The responses usually occur from edification and familiarity predisposed by both physical and social factors.

There are assumptions, for example, the form that the behavior follows and its significance can identify the goal being sought. Individuals may opt for their own behavior rather than the expected ways. The subsystems have their own courses of action; hence the presence of observable outcome signifies the individual’s character.

Her postulation generally signifies the applicability of nursing as a force which influences the organization of victim’s behavior when under stress by imposing dogmatic mechanisms. It symbolizes its artistic and scientific nature through the deterrence nature in the maintenance of balance. Nursing activities thus do not depend on medicine, but rather acts complementarily (Alligood & Marriner-Tomey, 2010).

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Dorothy theory’s relevance is evidenced in its ability to guide future hypotheses, edification and research studies. Nurses thus can distinguish nursing from medicine through the focus on behavior rather than examining biological aspects. The grouping of the behavior and biological process to constitute health provides an abstract framework functional in formulating other theories.

Virginia Henderson

Virginia was a nurse, examiner, logician and author who visualized nursing as a process of helping people become autonomous in relation to the operation of activities which influence their overall health and recuperation. Born in1887, she received nursing education before edifying others on her experiences (Alligood & Marriner-Tomey, 2010).

Nursing activities are based on 14 components, which exemplify human requirements. When a patient has been guided to manage efficiently the processes, then they are deemed to be independent and in no need of a nurse. She envisioned the role of a nurse as being substitutive, auxiliary or complementary. The nurse may either choose to presuppose the role of the patients, provide control on how they can improve their health, or practically work with the patient to guarantee they realize their self-determination (Eichelberger & Sitzman, 2010).

Her designation of nursing plainly delineated it from medicine, stating that the nurse is liable to aid both the impaired and the healthy individuals to organize events which cultivate health or hasten recovery while equipping them with the necessary knowledge for assistance. Thus, nursing does not purely mean the appliance of the existing orders from physicians.

Virginia also believed that any associations of nursing should be related to apt scientific research, which is indispensable in civilizing the practice of nursing. For example, she demanded that al nurses must have existing literature on current researches to upgrade their practice. Her published literature which summarizes her classification of nursing has been applied worldwide evidenced by its rendition to other languages. She believed that guaranteeing the self-rule of patients to better their health was the sole duty of the nurse, who is not supposed to be involved in other analytic procedures.

Katherine Kolcaba: theory of comfort

Traditionally, comfort constituted the essential intent of medicine and nursing, and was typically the first thoughtfulness of the nurse. A nurse, who makes patients comfortable, through the modification of the patient’s environment, is thus seen to be proficient. Her theories hinged on the hypothesis of prior theorists including Nightingale and Henderson (Alligood & Marriner-Tomey, 2010). The theory was thus developed from the experience and training, logic, and retroaction of the previous conceptions.

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Her theory is seen as being more interdisciplinary rather than offering much relevance on the nursing profession. However, the hypothetical structure of the theory offers plans for healthcare providers within institutions. Historically, it was believed that comfort leads to recuperation, but lately it has gained insignificant focus (March & McCormack, 2009), and is reserved for patients who cannot be presented with other medical options. Her concept, which was analyzed from sections such as psychiatry and English, signifies its association to activities that strengthen patients.

In nursing records, theories have habitually been borrowed from other disciplines. Regrettably this has not been reciprocated in the nursing practice. The diffusion of comprehension across disciplines is habitually beneficial; however they require proper assessment before being incepted in the nursing discipline. The model is relevant to improve conscription and retention of skilled nurses in an organization (Kolcaba, 2003).

Patricia Benner

Patricia was more concerned with how nurses study to do nursing rather than the concrete practice of nursing. She began her vocation in ICU before moving into research where she expounded on how nurses gained expertise and the functioning of the nursing practice (Benner, Chesla & Tanner, 2010). She concluded that the expertise constituting the practical world is indispensable for the advancement of the proficiency of the nurse and the ability to offer attention.

She proposes that one can gain comprehension and expertise without the actual understanding of the theory. Her postulations explained that for individuals to be deemed experts, they must have gained apt experience (Alligood & Marriner-Tomey, 2010). Nurses thus pass through levels of maturity in the practice, progressing from a novice, advanced beginner, competent, proficient and finally to an expert. As the nurse evolves in each level, they augment skills, as each step adds more wisdom on previous assumptions, thus, equipping the learner with more scientific know-how (Bryan-Brown & Dracup, 2004). The learner also alters conceptions of holistic situations to focus only on the pertinent parts.

Patricia’s theory thus changes the practice’s comprehension on the definition of an expert. For example, the nurse presenting superior care is thus considered as an expert, rather than the one receiving the uppermost pay. It thence recognizes that theories should not steer the profession; rather experience in the profession should guide the fabrication of hypothesis.

Despite its insignificance in the nursing vocation, it has furthered the formulation of practical expectations for newer nurses. Her works have influenced healthcare providers all-inclusively, for example, in the provision of basis for new legislation and methodologies for nursing practice and edification of the available theories.

Merle Mishel- uncertainty in illness model

Mishel has conducted all-inclusive research to empower cancer patients to advocate for their own rehabilitation. Her studies also survey how healthcare can be improved for patients without any augmentation of costs (Liehr & Smith, 2008). The indistinctness of an individual patient should be comprehended as a challenging attribute of the experience of the persistent nature of some ailments. Ill health uncertainty is evidenced in both acute and chronic ailments and is habitually depicted as a cognitive stressor, logic of lessening of control, and an imagined state of doubt that persistently changes. It is amplified by heightened feeling of pain and abridged forbearance of aching stimulus. There is therefore higher psychological stress and inferiority in the eminence of life (Afari, Wright & Zautra, 2010).

The theory explains positions where patients are not certain about an established illness, thus rendering the client incapable of knowing the undertone of the illness and the expected outcomes. For instance, it may occur when a patient misperceives an established ailment because of lack of appropriate information or a lack of the healthcare giver’s recognition of the client’s adaptability to the ailment. Her theory is defined by a four stratagems that further explains her premise to fabricate a framework that is valuable in the nursing practice. Nurses are thus urged to cooperate with clients in formulating intercessions that uphold positive results (Cherry & Jacob, 2005).

This is a mid range premise and thus can be effortlessly specialized for circumstances. Therefore, it may have limited use in other specializations, for example pediatrics, unless more research is undertaken. The advancement of the theory does not have existing scales to validate coping mechanisms in association to uncertainty. Its relevance in the practice is the insight that it affords healthcare givers on the patient’s viewpoint. It fabricates an outline to base meaningful analysis about presented uncertainties and formulate intervention strategies to direct the client on how to manage the uncertainty.

The nursing practice has undergone transformations based on distinct stages such as theorizing, development of concepts and debates on their effectiveness, factors which have shaped the professionalism of the discipline as an art and a science (Browne, Bryant-Lukosius, DiCenso & Pinelli, 2004). Further innovation in the nursing profession would be fueled by the growing population needs and the desire to fulfill the integrative character of the needs. The next direction of theories would rely on practice, assumptions, research and pertinent edification.

Nursing theories have established basis for fabricating structure and synchronization to what was before a collection of unfounded assumptions and experiences. They have charted channels to organize problems in nursing based on the client’s requisite, thus initiating a topology of new methodologies of treatment and other nursing demands. Nursing theory would institute channels where nurses will extend their verdicts beyond the usual directorial approach. This furthers the extensive contribution of nursing to the overall provision of healthcare guidance in both hospitals and community based therapy centers.

There should be a continuous leadership in all sectors of nursing to ensure that nursing theories and structures are integral to all characteristics of nursing service organization. A better integration of the theories would guarantee progressive integration in order to fabricate basic theories which may be universally applied. There are several demographic alterations, including changes in population and their outlooks on the healthcare services being availed. Therefore, there is the need to convey the significance of delineating the exceptional and distinctive care offered by nurses. This helps in the formulation of an interdisciplinary setting that makes certain that all nurses develop a mode that instructs on the running of nursing services in the practice.

Self care and dependency in care would be emphasized with the aim of providing clients with means of deterring illnesses (Browne, Bryant-Lukosius, DiCenso & Pinelli, 2004), which would free them from disease originating factors. This is part of the process of determining when nurses are essentially needed and their definite roles in determining the implementation of the hypotheses. The presence of nurse leaders to oversee and govern the whole process would be essential to offer directions in the attainment of the objectives of the premises.

A system of categorizing patients according to the applicable nursing theories, rather than the generation of nursing activities based on administrative orders would support novelty in the profession. This would promote better handling of the individual, instead of dealing with particular diseases which may be recurring due to deficiency of apt nursing.

The institutionalization of nursing theories into human resource management will endorse cost effectiveness in the consumption of assets to complement specific needs of individuals and the general populace. Nurses with different skill levels would be better allocated responsibilities and apt recruitment strategies followed to ensure that the staff can aptly complement each other to satisfy both the success of the organization and the overall well being of the populace.

There are several other factors which need deliberation in the nursing field, though they may not be exclusively related to nursing. Incessant quality enhancement, premeditated scheduling and communication are among the stratagems which may certify the success of the nursing hypotheses. Healthcare services would thus be better designed, executed and monitored using the nursing theories (Allison & McLaughlin-Rendenning, 2000). Healthcare providers would need to have a wide hypothetical expertise of modern-day management theory and practice to make better use of the presented conceptions over wide-reaching practices.

The theories have advanced the appreciation of the value of research as an essential basis for the advancement of the nursing profession (Retsas, 2000). Evidence-based practice would be brought into detailed focus, and the factors which hinder the applicability of research in establishing guidelines be identified. Exceedingly intricate tasks require better management of assets and strengthened edification of issues affecting the practice and research methodologies.

Conclusion

The specialized power of a nurse is amplified with the appliance of theoretic comprehension which offers strategy on decisive judgment and formulating resolutions. Nursing outcomes can be easily predicted based on the advantages and shortcomings of the theories. Through the appliance of the hypothesis it is easier to determine the condition of the patient, apply pertinent nursing methodologies, and offer therapy wit premeditated and expected results (Alligood & Marriner-Tomey, 2010). It assists to direct research on newer methodologies to progress the access and discharge of care. Through the study of these hypotheses, one develops systematic skills and a wide-ranging capacity to formulate decisions and defend any assumptions in the profession. All the philosophies, models, and theories despite their relevance to the practice present a platform for further progression in the discipline in both administration and edification. Questioning of current practices would be easier and hence chart new nursing expertise and superior release of treatment and healthcare services (Browne, Bryant-Lukosius, DiCenso & Pinelli, 2004).

References

Afari, N., Wright, L. & Zautra, A. (2010). The illness uncertainty concept: a review. SpringerLink: current pain and headache reports, Vol 13, No. 2, pp.133-138.

Alligood, M. & Marriner-Tomey, A. (2010). Nursing theorists and their work. 7th ed. Missouri: Mosby Elsevier.

Allison, S. & McLaughlin-Rendenning, K. (2000). Nursing administration in the 21st century-a Self-care theory approach. Contemporary nurse. London: Sage publications.

Benner, P., Chesla, C. & Tanner, C. (2010). Expertise in nursing practice: caring, clinical judgment & ethics. New York: Springer publishing company.

Browne, G., Bryant-Lukosius, D., DiCenso, A. & Pinelli, J. (2004). Advanced practice nursing roles: development, implementation and evaluation. Journal of advanced nursing, Vol 48, Issue 5, pp. 519-529.

Bryan-Brown, C. & Dracup, K. (2004). From novice to expert to mentor: shaping the future. American journal of critical care pp 448-450.

Cherry, B. & Jacob, S. (2005). Contemporary nursing: issues, trends & management. Missouri: Elsevier health sciences.

Eichelberger, L. & Sitzman, K. (2010). Understanding the work of nurse theorists: a creative beginning. Massachusetts: Jones & Bartlett Learning.

Houser, B. & Player, K. (2004). Pivotal moments in nursing volume 1: leaders who changed the path of a profession. Indianapolis: Sigma Theta Tau.

Kolcaba, K. (2003). Comfort theory and practice: a vision for holistic health care and research. New York: Springer publishing company.

Liehr, P. & Smith, M. (2008). Middle range theory of nursing. New York: Springer Publishing Company.

March, A. & McCormack, D. (2009). Nursing Theory-Directed Healthcare: Modifying Kolcaba’s Comfort Theory as an Institution-Wide Approach. Lippincott’s nursing center.com: Holistic nursing practice-featured journal, Vol. 23, No. 2, pp. 75-80.

Meleis, A. (2007). Theoretical nursing: development and progress. Philadelphia: Lippincott Williams & Wilkins.

Retsas, A. (2000). Barriers to using research evidence in nursing practice. Journal of advanced nursing, Vol 31, issue 3, pp. 599-606.

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