Nursing Science is an identifiable discrete body of knowledge comprising paradigms, frameworks and theories. The integration of nursing theories into practice demonstrates an evolutionary pathway for introducing a paradigm shift in the essence of the science of nursing. Patient safety and quality initiatives as well as magnet status continue to mandate that nurses practice from a framework of professionalism. A sound evidence based practice advances the overall nursing administration too. Nurse leaders guided by a conceptualized practice have an opportunity to transform health care.
Theories have been developed in nursing to explain the phenomenon importance to clinical practice.
For example, we have a theory of health promotion behavior (Pender & Pender, 1996 ) and a theory of mother infant attachment (Walker, 1992 ). Although we use these theories to guide our practice, in many cases we have not tested them to determine whether or not the nursing actions proposed actually have the effects claimed. If nursing is truly to be a professional practice, an environment supporting professional practice must be created. Given the anticipated shortage as well as the increased demand for nursing, ANA (American Nurses Association ) notes work environment that supports professional practice to enhance positive staff and patient outcome.
There are many conceptual models and the nursing theories that provides the basis for clinical practices, among them few are as follows –
- Johnson’s Behavioural system model
- Neuman’s systems model
- Orem’s self care framework
- Imogene King’s theory
- Roy’s adaptation model
- Peplau’s theory of interpersonal relations
- Watson’s theory of human caring
- Orlando’s theory of the deliberate nursing process
………. and so forth.
N.K. – Nursing Knowledge
N.P. – Nursing Practice
I – Integration and Synthesis of Nursing Knowledge through Cognitive, Psychomotor and Affective Domain.
Why We Need To Apply Nursing Theories???
Using Nursing Theories helps to guide nursing practice. It-
- helps to guide organize data,
- understand and analyze patient data, and
- make appropriate decisions related to nursing interventions.
Application of Imogene King’s Theory Into Nursing Practice Using Case Study:
For example: A Nurse is meeting Mrs. X for the first time in Antenatal OPD.
Nurse perception: Mrs. X is well groomed pregnant female who appears to be comfortable in the examination room and makes an eye contact with the nurse. As they interact, nurse finds that she is 25 years old, married, 6 months pregnant and gained 4 Kg of weight so far, and has moved to a new locality.
Mrs. X perception: Views herself as healthy, recently moved to new area, works as a teacher, plans to continue after baby. She asks questions about labour process. She reports her nausea is subsided and feels that her pregnancy is progressing normally.
- Nursing Diagnosis:
Knowledge deficit about health care resources, child birth related to recent move to a new locality.
- Mutual Goal Setting:
To be a healthy mother and to have a successful pregnancy and delivery of healthy baby.
Establishing and keeping a schedule of regular prenatal visits.
Verbalization of understanding the availability of resources and labour process.
According to a Research article, Theory provides nurses with a perspective to view client situations, a way to organize the hundreds of data bits encountered in the day-to-day care of clients, and a way to analyse and interpret the information. A theoretical perspective allows the nurse to plan and implement care purposefully and proactively. When nurses practice purposefully and systematically, they are more efficient, have better control over the outcomes of their care, and are better able to communicate with others.
Health care agencies can designate a specific nursing theory to guide the nursing practice within the entire organization. The critical component in choosing a nursing theory for an organization is the ‘fit’ between the philosophical assumptions of the organization and the theory. Modelling and role-modelling, a theory and paradigm for nursing, can be implemented in any setting.
According to another Research study, Patients with end stage kidney disease require complex care regardless of where they are within the disease continuum. Although not often recognized by clinical nurses, the incorporation of nursing theory into the clinical care of patients with end stage kidney disease can enhance the overall care that is administered. This paper will endeavor to demonstrate how the three nursing models/theories of Orem, Neuman and Peplau can assist renal nurses to articulate their practice and to incorporate these theories into the nursing practice required to care for patients with end stage kidney disease.
We have seen that these models continue to use the nursing process as the core for decision making in determining if nursing care to clients is meeting the expected outcomes as established by the clinical pathways. Applying these theorists views is a challenge and it provides opportunity for meaningful nursing practice.