NR 501 Discussion Week 1, Importance of Theory in Nursing (TWO VERSIONS)

NR 501 Discussion Week 1, Importance of Theory in Nursing (TWO VERSIONS)  Is nursing theory important to the nursing profession? Is it important for nurse practitioners? Does theory inform nurse practitioner practice? If you believe that it is important, explain why it is useful. Prior to this class nursing theory has not been at the forefront of my thinking or practice. I am not familiar with any of the theories other than Nightingale’s. I took interest in her because she is the pioneer of nursing. I use her “do no harm” often in education on preventing hospital acquired pressure injuries. Does knowing or not knowing much about nursing theory matter in nursing practice? Before this lesson and literature review, I would have answered no it does not. But after reading this week, nursing theories help shape the nursing profession and care provided through evidence-based practice. Theory, research and practice should be connected and are cyclical (Saleh, 2018). Whether we realize it or not, nursing uses theory in their daily care. We have ideas or concerns about a problem, or we ask questions about practice and look for information to support the practice or fix the problem. We begin to research to find answers. Theory guides research and research generates knowledge to support theories, or it doesn’t, and we make changes accordingly (Saleh, 2018). I believe that using concepts of theory as nurse practitioners (NPs) is important and useful, as many of the theories focus on patient-centered care, which is one of the core values of nurse practitioners. However, theory-based practice is not a core competency for advanced practice nurses according to the Nurse Practitioner Core Competencies (NONPF) which begs the question of theory as important and useful for nurse practitioner practice. In reading NONPF, theory is not mentioned under competencies, but is mentioned vaguely under suggested curriculum. There needs to be clarity and standardization of nursing theories going forward. Theory-based nursing practice is useful because it increases professional power and growth. There is a place in daily practice for theory-based care to develop nurse-patient relationships which is shown to improve patient outcomes (Younas and Sommer, 2015). Nurses who are aware of or using Watson’s Theory of Caring have higher perceived caring behaviors than nurses who are not according to a study of 242 nurses (Kornusky & Karakashian, 2018). Theory-based practice is derived from research and encouraged by graduate and post-graduate nursing education. Both enhance knowledge and help practitioners form a framework for their own practice which evolves with time and experience. From our reading, King’s theory makes sense for NP practice and can be used in any clinical setting. Goal attainment using interactions between the NP and patient starts with developing a relationship, identifies problems, negotiates a plan of care, and comes to an agreement of actions to achieve goals (de Leon-Demare et al., 2011). Using King’s theory as a framework fosters communication and a relationship between NP and patient to optimize patient-centered care and patient outcomes. Many of the theories are patient-centered/holistic and not focused on a diagnosis or lab which is the essence of advance nursing practice (Rosa, 2014). References De Leon-Demare, K., MacDonald, J, Gregory, D., Katz, A., and Halas, G. (2015). Articulating nurse practitioner practice using King’s theory of goal attainment. Journal of American Association of Nurse Practitioners, 27, 631-636. Doi: 10.1002/.12218 Kornusky, J. and Karakashian, A. (2018). Evidence Based Care Sheet. Watson’s Theory of Caring: Integration into practice. Cinahl Information systems, Glendale, CA. Retrieved from Rosa, W. (2014). Nursing is separate from medicine: Advanced practice nursing and a transpersonal plan of care. International Journal of Human Caring, 18(2), 76-82. doi:10.20467/.2.76 Saleh, U. (2018). Theory guided practice in nursing. Journal of Nursing Research and Practice, 2(1), 18. Retrieved from Younas, A and Sommer, J. (2015). Integrating nursing theory and process into practice; Virginia Henderson’s need theory. International Journal of Caring Sciences, 8(2), 443-450 Discussion response: Literature mentions over and over the inability of nursing to become an independent profession because of the struggle to define the profession through theory and a gap between nursing theory and practice. It is believed this gap is related to nursing theories being meant only for scholars and educators rather than bedside nurses (Rosa, 2014), theories are vague and hard to understand, lacking a firm definition and not being standardized; for these reasons, nursing has dismissed use of theory-based practice at the bedside ( , ). I asked some of the nurses I work with what nursing theory they believe works for their practice and not one could even tell me a theory. Most of the nurses in the hospital I work in are BSN prepared. I find that I understand and can apply some of the theories and concepts better than others. I see how nursing can become confused and frustrated and dismiss theory all together. Hello Bridget and class, I am on the same page with seeing nursing become task oriented instead of patient oriented. This leads to what you mentioned in not using theory in practice, and I add not using evidence-based practice in the daily care. I finished my BSN in 1996 so I know a lot has changed since then, but not to this extent?! I am a wound ostomy nurse and go to every unit most days. I see nurses not completing a head-to-toe physical assessment. When I ask what is going on with their skin I hear, “they told me in report…” or “they did not tell me that in report”. What has happened to change this practice so dramatically? Nurses are asking the aides what the skin looks like and then charting it. I mentioned that nursing has become so task oriented that we are losing our roots in patient-centered care, evidence-based practice and use of theory.