Nursing Theory

There is not a broad exposure to nursing theory within most nursing programs, limiting how nurses conceptualize and view theory as a vital component of practice. Instead students may be asked to choose a theory and write about a caring moment related to a particular nursing situation. Unfortunately, this does not adequately expose students to nursing theory, leaving them with no incentive to further pursue the study of nursing theory. By the addition of this assignment somehow there is the premise of “addressing nursing theory” without the necessary study of nursing theory. This exercise suggests a form of appeasement to those in the profession who place importance on nursing theory.

From the perspective of Paterson and Zderad’s (1976) humanistic nursing framework, Silva describes a caring interaction between nurse and patient. She defines this situation as a linear thought process however, as one reads the exemplar, one is drawn to the fact that this interaction is anything but linear. Is it a caring moment? Of course it is, but it is far from linear. Just as the nurse-patient relationship is forming so too are the competing priorities of the patient’s family, her impending death, and cherished possibilities. The only linear aspect of this situation is the timeframe the scenario falls within and even that is not linear as one is sensitive to all of the actual dimensions involved.

This work clearly notes that there has been only one perspective analyzed, hence, one sees a real deficit in terms of understanding theory, conceptual framework, and humanistic nursing. Herein, lies the real problem. During a master’s education there is a requirement to become familiar, alas, expert in the field studied. Since the education regarding theory, research, and practice is so perfunctory, it places today’s emerging nurse professionals at a distinct disadvantage.

Another example of lack of understanding is the between Silva writes about. The between represents the culmination of a caring moment when the nurse and patient humanize their interaction with each other. There are other theories that illuminate the connecting of a nurse and patient in situation with one another, but nurses would not be cognizant of these other theories since they are not been exposed to them. This lack of exposure is the direct result of eliminating the importance of nursing theory from nursing education programs.

Silva writes about the concept of authentic presence. Other theories articulate this concept but since there were no comparisons made, other perspectives of authentic presence are omitted from the reader’s knowledge. This is particularly troubling since the lack of exposure to other theories prevents nurses from fully comprehending why nursing theories are critical to understanding people and are important to practice.

Silva’s column points out some real concerns about nursing education. It is obvious that the students are not being called to a higher standard and that working on a master’s degree in nursing is simply an extension of their baccalaureate programs. There is no higher level requirement to complete, to study extensively to gain a perspective in nursing and higher education that fosters growth in the profession. The same is true of any higher degree in nursing. Pour the needed facts into students’ brains, ensure passage of the test or certification, and grant the degree. One wonders why the profession is not taken seriously by other professions. It is not about knowledge and professionalism and caring. It is all about rushing to increase the number of nurses needed to take care of the rising number of patients without regard for the higher level of education that needs to take place to ensure the safety of patients and quality of care. This requires more than a perfunctory glance at a single theorist, it requires more than is currently being taught. The quickest, fastest paced program does not win the race. Humanity is at stake and it is time that nurse leaders take a stand.