Nursing Theory Discussion

Discussion  1 There are challenges that face theory development within nursing.  What do you identify as the biggest challenge?   As an applied science, nursing knowledge is both theoretical and contextual (Anderson & Silver, 2019). Nurse leaders began to realize in the 1960s, that in order for nursing to be its own profession that nursing needed to delineate the role of nursing as a distinct body of nursing knowledge (Morse, 2017). In order to do so, nursing needed its own nursing theories (Morse, 2017). Nurse leaders knew they needed nurse theorist to create the nursing theory, nurse scientists to test theory, journals to communicate the theory, nurse educators to teach the theory, and nurses to use the theory when caring for patients (Morse, 2017). We can begin to see where the challenge starts when discussing nursing theory. How to get five different fields of nursing to work together in making nursing theory a reality in nursing. Current debates in nursing research focus on meeting the needs of the nursing discipline in an environment that is rapidly evolving and becoming increasingly complex in relation to healthcare (Anderson & Silver, 2019).  Biggest Challenge There are numerous challenges to the use of nursing theory. One is the use of nursing theory in nursing academia. One is the accreditation criteria requiring conceptual frameworks for the organization of nursing curricula (Roy, 2018). There is a heightened awareness of theory significance in nursing academia (Roy, 2018). There has been more attention given to nursing theories that were available (Roy, 2018). Some theory-based curricula could overwhelm students that were not able to apply in practice (Roy, 2018). Also, by diverting emphasis on nursing curriculum with a nursing conceptual framework attention has been diverted away from developing theories for practice (Roy, 2018).  Christian Worldview impact on nursing theory So when I think of a Christian worldview and nursing theory I think of the concept and nurse theory of caring. Caring has been defined as the “watchful attention to and meeting the needs of another person” (Rieg et al., 2018)). It is the essence of nursing and has been studied by varied philosophical viewpoints (Rieg et al., 2018)). Christian caring has been described as “caring for others is not intrinsic to human nature especially caring for a stranger” (Rieg et al., 2018)). They propose that because of our response, gratitude, and acceptance of God’s grace and care, Christian nurses are able to “see patients with great value, dignity and worth,” rendering the ability to minister to the whole person with compassionate care (Rieg et al., 2018). This is a trait that not every student who wants to be a nurse possesses. I believe that in order to be a nurse you have to be able to put the needs of the patient first and be willing to not only care for the physical being but also the spiritual being.  ***At least 3 scholarly reference reference not more than 5 years      Discussion 2 There are challenges that face theory development within nursing.  What do you identify as the biggest challenge?             I believe the biggest challenge to nursing theory development today is the educational approach on nursing theory.   Meleis (2018) expressed her deep concerns about the future of nursing theory development and under what parameter future generations of nurses will handle the conversation.  She was particularly concerned about how students see theory as something that academics and scholars do, or something that’s beyond their ken, and a compulsory exercise in nursing school.  Similar to this, I believe the biggest challenge in nursing theory development today is its decreasing value in professional ownership dating back to nursing theory education and developing an appreciating for theory as part of nursing.   There are two main reasons for the asynchrony of nursing theory in nursing.              First, Morse (2017) posited that the underutilization of nursing theory is the result of lack of cohesion about how nursing theory is taught and how to apply theory in nursing practice.    One school may be Orem oriented while another uses Roy.   The author also illustrated that many theory texts are written with much focus on the theorists but with reduced levels of inquiry on the theories themselves (Morse, 2017).   If nursing theory development is a listing ship, one way to rectify it is by going back to the pedagogy of theory in general, and in nursing theory to establish uniformity.   What my school teaches on theory is not the same as all other nursing curriculum.   Further, theory should add contextual meaning to all practice regardless of the specialty the professional is doing.   This begins with clinical instructors extending theory education by asking the question: “what nursing theory does this patient situation remind you?” In other words, add meaning to the discussion by incorporating theoretical underpinnings for care outcomes.               While it is important to recognize these great works of theorists, it is their theories that should take the central focus in the classroom but formalized across the spectrum of nursing education for or refreshed disciplinary perspective.   Roy (2018) attempted a study to compare three major theoretical approaches and found it near impossible to do because of the divide in theoretical perspectives and this may reflect in the classroom as multiple perspective from multiple philosophies can create a too fluid curriculum on theory.   Another solution may lay on a full curriculum overhaul towards the integration of theory throughout the educational and professional span of the student.  Beginning with theory introduction with the baccalaureate learner followed by further in-depth work at the graduate and doctoral level where the circular process continues with professors educating nurses on theoretical application and researchers focusing on discoveries of new knowledge.                Theory development is needed for the growth of the discipline and to explain phenomena in our environment, to intervene, and to predict certain outcomes (Meleis 2018).  Regardless of how nursing theory is incorporated in the nursing curriculum, its use should be a constant throughout one’s career and utilized because they are important.  Roy (2018) alluded to the need to focus on the curriculum and teaching theory.  The author reflected about the need for coherence in the quest to gather new knowledge, mainly because of a rapidly changing world and healthcare needs.   Roy argued that nursing knowledge can be derived from other disciplines and accommodated to nursing practice, for example, from the life sciences we have genomics, and theories and knowledge from the sociological and behavioral sciences can be integrated into nursing practice.   Roy also encourages the discipline to take heed and proceed in developing theories in phenomena observed and continue to develop theories for the future of nursing.  Without a profound change in attitude by the discipline in support of theory as its foundation, the forward movement int the future will stagger.               Secondly, as discussed in our previous forum, Hickman (2019) proposed a review of grand theories and the further development of middle-range theories to continuing advancing nursing science and be more reflective of current times.  The question remains on how to actualize this process through consensus within the discipline.   Since the conversation is needed, the conversation should take place in a larger platform for decisive activities.  We have the American Association of Colleges of Nursing (AACN) as the national voice for academic nursing.  The AACN (2020a) position statement on nursing research was last revised in 2006.  In that statement the word ‘nursing theory’ is not mentioned.   If nursing theory is critical to nursing research, why the omission.   The only reference found about nursing theory at AACN (2020b) is the Synergy model developed in 2016 as a new conceptual framework that brings into line patient needs with nurse competencies.  This glaring discord needs to be addressed as well as the re-alignment of nursing theory across all levels in order to give it its due in the discipline.  I believe until these questions are answered, we will always have a repetitive inquiry about the asynchronous relationship between nursing theory and its place in nursing education and practice.                 How does your Christian worldview impact theory development?             When I think of the relatedness of this topic to my Christian faith, I think of stewardship.   Stewardship in the Bible means that our lives are not our own and that we are entrusted with life that belongs to God who calls upon us to steward everything in life in glory to Him and for the good of others.   1 Peter 4:10 KJV “As every man hath received the gift, even so minister the same one to another, as good stewards of the manifold grace of God.”  We nurses are the stewards of Nursing and no one else.  We have ownership and stewardship of the discipline as nurses of the past, today, and the future.  We’ve been entrusted with it for 50 to 60 years or however long and are called upon to care and nurture the discipline so we can care for the person, therefore, it’s our duty to take responsibility and keep the faith until the new generation takes over to continue the work.   No other discipline has dominion over the nursing discipline; therefore, we have the accountability to preserve its principles and teach it to the future generation because it’s a worthy endeavor.  ***At least 3 scholarly reference reference not more than 5 years