Nursing Theory: What to Know as a Student

Nursing theory is the foundation of nursing practice, guiding nurses in their daily tasks, patient care and leadership roles. But what exactly is nursing theory, and why is it so important to nursing students?

Read on to delve into the significance of nursing theories — such as middle-range theories and change theory — and how they influence nursing practice in hospitals, emergency rooms and leadership positions. Whether you’re pursuing your nursing degree or advancing your career, understanding these concepts is key to success.

What is Nursing Theory?

Nursing theory is defined by the American Nurses Association (ANA) as a theoretical model that can provide a foundation or framework for making clinical decisions. Nursing theories are commonly used to shape nursing research, allowing nurses and other healthcare professionals to develop an advanced understanding of how and why particular nurse-patient interactions are beneficial and successful.

The first nursing theory was developed in the 19th century. Florence Nightingale’s Environmental Theory proved that a patient’s environment — including the amount of sunlight and fresh air they receive — has a direct impact on the overall success of their recovery. Since that first nursing theory was developed, many more have come after to help bridge the gap that exists between nurse researchers and nurses working in a clinical setting.

Definition and Purpose

Nursing theories are organized and research-backed models that define nursing as a healthcare discipline. In general, nursing theories work to define what nursing is, how it should be done and why nurses choose to pursue this profession. On a daily basis, nurses rely on nursing theories to define their practice and sharpen their clinical decision-making.

The ANA notes that nursing theories can be divided into three categories: grand nursing, middle-range and practical-level theories. Within each theory, the nursing metaparadigm anchors the foundation. The nursing metaparadigm includes four core components:

• The patient
• The environment
• The patient’s health during treatment
• The nurse’s approach to care

Impact on Patient Care

Nursing theories support evidence-based practices that elevate patient outcomes, ultimately increasing the safety and quality of care that is provided to each patient. They have a direct impact on patient care by:

• Defining what nursing practice is and what the scope of nursing should be so that nurses have a foundation to lean on as they make clinical decisions each day.
• Providing both rational and scientific reasons for specific nursing interventions; this helps ensure that patients receive the personalized care that they need to have the best possible outcomes.
• Generating additional knowledge for nurses, ensuring that they have access to the latest nursing research and findings, and enabling them to implement those findings in the clinical setting.
• Improving communication in the field of nursing by providing nurses with common terms to use when communicating with one another and with their patients.
• Directing nursing education and research, thus giving nurses the opportunity to continue their education and advance their nursing practice.

Change Theory in Nursing

Change theory of nursing is one of the most critical theories for nursing students to become familiar with. Simply put, change theory in nursing provides a framework for nurses to rely on when dealing with systematic change in the nursing profession, which is quite common in the era of advancing technology. By becoming familiar with change theory in nursing, aspiring nurses can enter the profession with confidence and agility — equipped with the skills required to navigate organizational, societal and systematic change.

What Is Change Theory?

According to SimpleNursing, change theory in nursing provides a framework for organizational change in nursing. It is a more concise theory that is largely based on the principles of Lewin’s Change Management Theory, and it allows nurses to become more comfortable and familiar with the ever-changing healthcare landscape. Change in nursing is inevitable, and nurses prepared to adapt to new technology, cultural shifts and organizational changes will be able to provide patients with better care over the course of their nursing careers.

Application of Change Theory in Nursing Practice

Change theory has numerous practical applications in nursing practice, enabling nurses to:

• Improve workflows in clinical facilities, in turn boosting efficiency while simultaneously enhancing patient care.
• Improve patient protocols that have a direct impact on the regular care provided.
• Enhance the patient experience so they feel more valued and appreciated during their stays, which can increase overall patient satisfaction ratings.

What Are Middle Range Theories in Nursing?

Middle-range nursing theories offer a broader scope than a specific, practical nursing theory yet a more focused scope than the larger grand nursing theories — which are designed to define nursing practice as a whole. According to the ANA, middle-range nursing theories are often used to explain clinical trends taking shape, but they also can be verified through additional nursing research.

Defining Middle-Range Theories

Middle-range nursing theories effectively bridge the gap between grand theories and specific nursing practices, providing nurses with a foundation on which to base various clinical decisions. Middle-range nursing theories are defined as those that:

• Offer a limited scope and are aimed at a specific phenomenon or trend that is occurring in the nursing field.
• Are based on the work of a grand theorist but also have been verified through research and nursing practice.

The concept of middle-range theories arose in the nursing profession as a way to address the fact that many grand theories could not be tested or proven. As a result, these nursing theories are more limited in scope — yet they still have a wide range of applications in nursing practice.

Examples of Middle-Range Theories

One of the most well-known middle-range nursing theories is Dorothea Orem’s Self-Care Deficit Nursing Theory. Orem developed this theory throughout the course of her decades-long nursing career, which spanned from the 1950s until the turn of the 21st century. This nursing theory provides nurses with a model for empowering patients to take as many actions on their own as possible, giving them confidence that they can become independent again. Within this model, nurses are asked to encourage patients to continue taking on more independent tasks as their recovery progresses.

The Role of Nursing Theory in Leadership and Nursing Practice

Nursing theories are more than just theoretical ideas that researchers ponder over throughout the course of their careers. These critical theories actually lay the foundation for nursing practice, and they play an active role in nursing leadership development. By understanding the relationship between nursing theories and their practical applications within the nursing field, nursing students can begin to rely on nursing theories in order to create a foundation for their own careers.

Nursing Theories and Leadership

Nursing theories promote effective, evidence-based decision-making among nurses and nurse leaders alike. Leaders who can effectively apply nursing theories within their clinical facilities will be able to make better decisions that improve outcomes for not only patients but also nursing staff members who report to them. Understanding and applying nursing theories is crucial for nurse leaders, such as shift supervisors or nurse managers, who are overseeing operations within an emergency room or a fast-paced hospital setting.

Leading With Theory

Nurses in leadership positions influence and guide their teams by applying nursing theories to practical challenges. Leading with theory, nurse managers and charge nurses can model the best ways to apply nursing theories in real-world settings and showcase the value of these theories within the profession.

Nursing Theories in Practice: Hospitals, Emergency Rooms, and Beyond

Nursing theories can be applied in any setting where a nurse works, but they are commonly relied upon by nurses who work in hospitals and emergency rooms. These settings are known for their fast-paced, high-stress environments — requiring nurses and all members of the care team to quickly assess, diagnose and treat patients who may be facing life-threatening situations.

Implementing Nursing Theories in Hospitals

In the hospital setting, nurses often turn to practice-level nursing theories, which directly address the specific goals of an individual patient. The scope of practice-level nursing theories is much smaller, allowing nurses an outline to refer to as they work directly with the patients who are in the hospital. A nurse may leverage nursing theories to lead with empathy and compassion in their interactions with a patient receiving care in their unit, which could ultimately even reduce the length of their hospital stay.

Using Nursing Theories in the Emergency Room

Within the high-stress context of an emergency room, nurses frequently work with patients who are faced with life-threatening conditions, meaning they must be able to swiftly apply nursing theories to make quick and optimal decisions. Many emergency room nurses use well-applied nursing theories to effectively assess and prioritize patients in the emergency room.

Learn More About Nursing Theories at Bryant & Stratton College

Beyond merely a set of concepts to learn, nursing theory is a practical guide to enhancing patient care, advancing nursing leadership and improving healthcare systems. As a nursing student, understanding models like change theory and middle-range theories is vital for your academic and professional growth. Ready to expand your nursing education and career skill set? Explore Bryant & Stratton College’s nursing degree programs to take the next step, or request more information today.