There are no ifs, ands, or buts about it: Nursing theories are really important to understand both in practice and during study for key nursing exams while enrolled in a school of nursing.
From what nursing is to what and why nurses do what they do, nursing theories serve as the foundation of clinical decision-making. And because nursing practices have evolved alongside nursing science, nursing theories continue to emerge to provide valuable insights into the needs of patients.
Each of the nursing theories organizes a particular philosophy and framework of nursing that helps identify what nurses should do and the purpose for their actions in treating patients. They can improve their professional nursing decision-making skills by following these system processes.
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We’ll walk you through what you need to know about these theories.
What are nursing theories?
Nursing theories are the cornerstone of quality nursing practice. They’ve been used for a long time — since Florence Nightingale introduced the first nursing theory back around 1860.
In short, a nursing theory outlines the needs of patients and explains how nurses should respond to different situations.
Over the years, different nursing theorists have created guidelines for understanding the nursing role, the relationship between a nurse and their patient, and the best treatment options for patients. These different theories reflect nursing research and work to improve the overall well-being of patients.
What is the nursing metaparadigm?
The nursing metaparadigm is the idea that there are four main components that interact and are generally interrelated when it comes to treating patients. The metaparadigm provides structure and key areas of focus that help define how nurses should evaluate a patient and their needs and then determine the appropriate nursing care.
The metaparadigm is reflected in the different nursing systems. When nurses use all four components when evaluating and treating patients, they provide holistic care. The major components of the metaparadigm look at the patient’s health from all angles.
Those interested in the nursing profession should make sure they understand the four components.
The 4 main concepts of nursing theory
The nursing metaparadigm identifies four main concepts of patient care — first named by Jacqueline Fawcett — that outline how nurses need to evaluate their patients and provide care.
We’ll walk you through these four main components so you can see how they interact to create the full picture of a patient’s health and needs.
In a nursing theory, the Person can also be referred to as a Client or Human Being. These terms all reference the patient or other people receiving care offered by the nurse.
For example, when caring for a patient in a hospital, the patient will have the title of Person. If the nurse offers HIV education programs in a community health center, on the other hand, the group would receive this classification.
When nurses work to define who the person is receiving their care, they should take a holistic look at the individual or the group. This means considering their social, spiritual, and physical needs.
The Environment can also be referred to as the Situation. You can define this classification by looking at all the different surroundings and conditions that impact the patient or people receiving care.
For example, the Environment includes the physical place where the person is and the people in their lives that impact their health. All of these environmental factors should be recognized in the conceptual framework of each nursing theory.
Health is used to describe the current physical health of the person receiving care. This classification looks at the overall wellness of the person or people in question. Looking at the overall health of the patient requires not only collecting vitals but also looking at their emotional health and even their social conditions.
The Nursing classification describes the actions taken by the nurse to provide care to the person or people in question. This might take the form of nursing care in a clinical setting, such as putting in an IV, or educational care that nurses provide to community members or family members of patients.
The most common nursing theories to know
There are a variety of nursing theories that nurses consult to help them better understand their patients and provide optimal care. Most theories fall under three main categories, though.
- Grand Nursing Theories describe abstract nursing theories that focus on providing frameworks for understanding nursing behavior and don’t have too many details.
- Middle-Range Nursing Theories are a little more specific than Grand Nursing Theories and provide more details about behavior and specific patient populations that each theory focuses on.
- Practice-Level Nursing Theories provide more minute details about specific types of patients and situations.
Let’s now explore some of the most common nursing theories you can expect to encounter as you begin your nursing career.
The Environmental Nursing Theory is the first framework developed by Florence Nightingale during the Crimean War. Nightingale discovered connections between the environment in which the patient was situated and their recovery and health.
Nightingale focused on the importance of providing patients with five key requirements:
- Pure water
- Fresh air
- Efficient drainage
- Sanitation or cleanliness
- Light or direct sunlight
Patient-Centered Approach to Nursing
The Patient-Centered Approach to Nursing theory was developed in the 1940s by Faye Abdellah. The goal of this approach lies in guiding the care that nurses provide in hospitals and clinical settings.
This approach walks nurses through 10 specific steps:
- Get to know the patient and their health problems and needs.
- Gather data and sort out the most relevant information.
- Use past experiences and insights into the nursing profession to compare the patient with other patients who have presented similarly.
- Create a therapeutic plan to treat the patient.
- Create tests and run them to see how the patient compares and what new generalizations need to be made.
- Speak with the patient about what they view as their nursing problems.
- Observe the patient throughout the treatment period to see if there are any changes in their behavior.
- Observe how the patient and their loved ones react to the nursing treatment plan.
- Determine the nurse’s perceptions of the nursing problems facing the patient.
- Create a comprehensive nursing care plan based on the information gathered throughout this process.
Casey’s Model of Nursing
Anne Casey’s Model of Nursing emerged in the late 1980s and focuses on nursing as it pertains to children. It helps nurses connect with both the pediatric patient and their family to provide optimal care. At the core of this theory is the idea that children are cared for best by their family members while receiving help from health care professionals.
Theory of Comfort
The Theory of Comfort emerged in the 1990s by Katherine Kolcaba. With this theory, nurses focus on providing patients with comfort as their primary objective. The idea behind this focus is that if the basic needs of the patient are met, the patient will naturally experience some relief, which is the first step in the three stages of comfort.
After relief comes ease and then transcendence.
The Tidal Model also emerged in the 1990s. It was spearheaded by Phil Barker, who worked to combine nursing with psychiatry by helping people through experiences of distress. This model helps patients navigate these negative moments through the 10 Commitments of:
- Valuing the voice and experiences of the patient
- Respecting the language used by the patient
- Having a true curiosity about the patient and their experiences
- Having an outlook like an apprentice to learn
- Using the tools available to help the patient
- Helping the patient see the next step
- Helping the patient understand and experience the gift of time
- Using personal insights and wisdom
- Understanding that the only thing constant in life is change
- Being transparent throughout the process
Self-Care Deficit Theory
Dorothea Orem developed the Self-Care Deficit Nursing Theory over the course of her career from the early 1950s to 2001. Under this understanding of nursing, patients want to care for themselves but need assistance sometimes.
In the Theory of Self-Care Deficit, nurses can help patients by empowering them to do as much as they can independently. According to Orem’s self-care model, as the patient improves, the nurse encourages the transition for the patient to do even more by themselves.
Cultural Care Theory
The Cultural Care Theory, created by Madeleine Leininger, states that nursing care needs to align closely with the personal beliefs of the patient. In other words, the individual’s religious beliefs, cultural practices, and values should play an important role in the nursing interventions the patient receives.
This can be particularly important for those working in transcultural nursing and can help nurses put their nursing knowledge to use in a way that benefits the patient directly.
Theory of Interpersonal Relations
The Theory of Interpersonal Relations arose from the work of Hildegard Peplau. Peplau believed that nursing should revolve around the back and forth seen in the relationship between the patient and the nurse.
Instead of seeing the nurse as simply fulfilling the doctor’s orders and the patient simply receiving treatment, this modern nursing theory shifts the role of nurses by emphasizing the relationship between the nurse and the patient.
The Adaptation Theory was developed by Sister Callista Roy and focuses on the interconnected systems that a patient experiences as part of the nursing process. The interrelated systems of patients within their families and social groups, as well as various human life processes, form the focus of this theory of nursing.
In the adaptation model, nurses help patients navigate and maintain balance in spite of these different conditions.
Nursing Need Theory
The Nursing Need Theory emerged from works by Virginia Henderson. Henderson and the Need Theory worked to focus on the basic human needs of the patient and encouraged their independence throughout their time in the hospital.
The hope is that by following this model, patients don’t need to be hospitalized longer than necessary and that progress in the patient’s condition isn’t delayed.
Study smarter for nursing exams like the NCLEX
These nursing models will play an important role in your nursing education, so you’ll want to carefully review them when studying for exams.
Graduating from a nursing program — whether you’ve earned a BSN to become an RN or earned an MSN to become a nurse practitioner — is just one part of the process.
You’ll also need to pass tests for licensure. The good news is that SimpleNursing is here to simplify the process of helping nursing students prepare for major exams like the NCLEX with top-notch practice questions, video-based rationales, and comprehensive assessments.
Knowing how to study, identifying your weak points, and targeting the areas where you need the most review can help build your skills and prepare you for the rewarding and exciting field of nursing.