Nursing Theory and Research
Role of Nursing Theory and Research in Nursing Practice
The development of nursing theory and nursing research [i]are closely aligned; both are part of the movement toward professional practice. Both have the same goal: to improve the quality of nursing care the client receives.[ii] Alligood states “Although some nursing leaders aspired for nursing to be recognized as a profession and become an academic discipline, nursing practice continued to reflect its vocational heritage more than a professional vision. The transition from vocation to profession included successive eras of history as nurses began to develop a body of specialized knowledge on which to base nursing practice. Nursing had begun with a strong emphasis on practice, and nurses worked throughout the century toward the development of nursing as a profession.”[ii]
[i] Fitzpatrick M. Louise.1983. Prologue to Professionalism. .Brady Communication Company, Inc. p..85
[ii] Alligood, M.T. 2014.Nursing Theory: Utilization & Application. Mosby-Elsevier. P.3.
Research has been described as a scientific method of collecting and interpreting data to gain new knowledge.[iii]
Historically, nursing knowledge was acquired in three ways: tradition, authority and trial and error.[i] Nursing care was based on tradition and ‘handed down from experienced nurse- authority - to students or new nurses – “we’ve always done (procedure or task) this way at this hospital”. Or, a nurse, confronted with a ‘new’ problem, solves it by trial and error which is counter to providing effective, safe patient care. Fitzgerald points out that if nursing is considered to be a profession, nursing actions must be chosen on a scientific basis. Mary Marvin explored this subject in the May, 1927 issue of the American Journal of Nursing article “Research in Nursing: Experimentation in Improving the Nursing Care of the Patient.” In her article Marvin provided numerous examples of common procedures that need study and provides pertinent questions that need to be asked.
One of the most important goals of the nursing profession is the production of a research-based body of literature.[ii]. While historically the occupation of nursing is considered to be “virtually as old as humanity”, nursing literature is relatively new. In the beginning, nursing was based folklore, trial and error and ‘common sense passed on from one generation to another. In the late nineteenth century, when Nightingale model nurse training schools began the hospital diploma schools expected students to learn by ‘doing. Students were often required to either memorize procedures or write these down in ‘students notebooks which were checked by instructors.
Textbooks were gradually introduced into nursing education. Isabel Hampton Robb, 1892 graduate of Bellevue Hospital School of Nursing and the first superintendent at Johns Hopkins, 1889-1894: was an early contributor to nursing literature. She was one of the founders of the American Journal of Nursing and wrote several books for students, instructors and practitioners including:
· Nursing: Its Principles and Practices (1894)
· Nursing Ethics (1900)
· Educational Standards for Nurses (1907)
Nursing Theory provides a systematic approach to practicing nursing as it describes the characteristics of the relationship between the nurse and a client. This relationship determines the nurse's actions in al nurse-client situations.(Fitzpatrick, p.89) Theory assists in:
· Identification of recipients of nursing care and the settings and situations in which practice should occur
· Defining what data to collect, classification of date
· Identification of actual and potential problems to be considered
· Understanding, analyzing and interpreting health situations
· Describes, explains and sometimes predicts client’s responses
· Clarification of objectives and establishes expected outcomes
· Determination of actions of interventions to be provided
· Determination of standards for practice
· Identification of areas for research[i]
Alejandro believes “In today's healthcare landscape, a demand for excellence influences Magnet® recognized hospitals to use nursing theories to achieve positive patient outcomes.2 There's a place for nursing theories in daily practice, whether at the patient's bedside or in community health nursing. Nurses should revisit the nursing theories they learned about in school and apply them to patient care.” [iv]
In Rochester, NY Highland Hospital’s Department of Nursing, nursing practice is guided by Dr. Jean Watson’s Human Caring Theory evidenced through Patient-Centered Care and Patricia Benner’s Model of Novice to Expert. To read more go to https://www.urmc.rochester.edu/highland/departments-centers/nursing/nursing-philosophy/model-of-care.aspx
[i] McEwen, Melanie and Evelyn Wills, 2014, Theoretical Basis For Nursing, 4th Edition. Wolters Kluwer Health/ Lippincott Williams and Wilkins.
[ii] Sarkis, Jeanne M. and Veronica Conners, 1986.Nursing Research: Historical Background and Teaching Information Strategies, Bull. Med. Libr. Assoc. 74(2) . April 1986. P.121.
[ii] Fitzpatrick M. Louise.1983. Prologue to Professionalism. .Brady Communication Company, Inc. p..85
[iii] Ibid p.85
[iv] [iii] Alejandro, Josefina I., DNP, RN 2017. Lessons learned through nursing theory. Nursing2018: February 2017 - Volume 47 - Issue 2 - p 41–42. doi: 10.1097/01.NURSE.0000511808.68087.e3