NR 501 Week 4: Connection Between Theory and Advanced Clinical Practice

Week 4: Connection Between Theory and Advanced Clinical Practice 

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While the focus of this course is nursing theory, some nurses say that theory has no role in clinical practice.  What are your thoughts? Does nursing theory have a role in clinical practice? How would you use nursing theory to improve or evaluate the quality of clinical practice?  Be sure to include an example that demonstrates your thoughts.  Don’t forget to include a scholarly reference! 

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Collapse SubdiscussionMegan Edwards 

Megan Edwards 

Jan 17, 2018Jan 17 at 1:06pm 

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Connection Between Theory and Advanced Clinical Practice 

        Nursing theory has an important role in clinical practice. Theory has been recognized as the tool to making our practice a “rational knowledge based science” (Mao, 2015, p. 13). I feel that many people feel that theory has no place in clinical practice because of the abstract ideas and terminology that is involved. Mao (2015) gives the example of the nurse practitioner who’s main focus is curing rather than caring, while most theory is centered in caring as the primary nursing goal. “Currently, there is an explosion on the number of nursing theories, but not the usage of nursing theory” (Mao, 2015, p. 13). 

        However, I feel that theory is at the base of clinical practice. Every intervention that we perform as nurses is based in theory. You may not actively think to yourself, “today I am applying Orem’s theory of Self Care to my practice,” but you are still educating your new onset diabetic patient on insulin administration. I think that taking time to understand and simplify theory would make it easier to use it to improve clinical practice. For example, Martha Rogers’ theory the Science of Unitary Human Beings sounds pretty abstract when you read about it. It talks about energy fields and uses big words like resonance and helicy (Rahim, 2016). However, at its core the theory is just talking about the patient and their relationship to their environment. The patient and their environment are two things that are constantly interacting with one another and affecting one another (Rahim, 2016). We apply this idea to nursing all of the time. We are taught in nursing school to look at our patients holistically and assess all of the factors that could be affecting their health.  When I receive a patient I am constantly assessing their family dynamic. I am thinking about what their home situation is like and what help they will need at discharge. I am taking into account the hospital environment and its affect on them. Finally, I am taking into account their illness and how it is affecting their reaction to the hospital environment. At no point in my day am I going to think to myself that I am applying Mary Rogers’ theory, but I am applying it because my training as a nurse was based upon it. I think that the argument that theory does not apply to real life practice exists just because there needs to be an effort to simplify it and realize that it is already occurring in our everyday practice.  

References 

Mao, A. (2015). The gap of nursing theory and nursing practice: is it too wide to bridge? Macau Journal of Nursing, 14(1), 13-20. Retrieved from http://web.b.ebscohost.com.chamberlainuniversity.idm.oclc.org/ehost/detail/detail?vid=31&sid=fd5498a1-42f5-4660-88a2-6b5fee7ebaaf%40sessionmgr120&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=ccm&AN=113930388 (Links to an external site.) 

Rahim, L. (2016). Comparison between two nursing theories: Rogers and Leddy. Journal on Nursing, 6(1), 1-5. Retrieved from http://web.a.ebscohost.com.chamberlainuniversity.idm.oclc.org/ehost/detail/detail?vid=3&sid=472994c4-62a3-42ca-94e5-95386a361761%40sessionmgr4006&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=116359098&db=ccm 

 

 

Brenda Talley 

Brenda Talley 

Jan 22, 2018Jan 22 at 4:10pm 

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Megan, outstanding contribution on the connection of theory to advanced clinical practice! 

I understand what you mean by not consciously applying the theory in a given encounter.  Once we are educated in nursing theories and we resonate with some in particular, the philosophy, viewpoint, actions, relationships described in the theories becomes integral with who we are and how we see the world and others in it. 

Great beginning to the week! 

 

 

Collapse SubdiscussionAdelaida Larduet Mayeta-Peart 

Adelaida Larduet Mayeta-Peart 

Jan 22, 2018Jan 22 at 5:16pm 

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Hi Megan, Professor Talley and colleagues, 

I agree with your perspective and discussion, theory is applied daily to every nursing action and procedure. We as nurses carry out nursing actions and procedures with the purpose of assisting patients in the recovery of health and or maintain a good health status with these theories as foundation. As you well explained we do not stop to think which theory we are applying, we just use then routinely and apply them as evidence base practice. Now to have current information on evidence based information we need to keep up to date with current and recent clinical practice research, one of the ways to do so, is by participating in clinical research or continuing education workshops. 

Evidence based practice is the current development in nursing practice that dictates excellence when carrying out a specific nursing action and or procedure, that promises assurance of optimal patient healthcare outcomes. A study undertaken by McKeon and McKeon (2015), define evidence based practice as the process in which clinical practice and nursing data are standardized into clinical decision-making. Once the application and utilization of clinical experience are used jointly with the most up to date information and best evidence available, nurses are able to provide and enhanced care for their patients and families. 

We can relate to Dorothea Orem’s self-care nursing theory, which is one of the grand nursing theories. This theory has emphasized that the client’s capacity to accomplish life-sustaining activities are indispensable to the patient’s well-being (Wong, Ip, Chio & Lam, 2015). 

According to Wong, Ip, Chio & Lam (2015) an individual begins and does self-care to preserve life, healthy functioning, and well-being. This individual must achieve selfcare intervention which is influenced by basic predisposing factors such as age, sex, developmental state, environmental factors, family system factors, sociocultural factors, health state, pattern of living, healthcare system factors and availability of resources. The patient’s capability to achieve or involve in self-care may be affected by  the abovenamed predisposing factors and therefore these self-care activities might need to be modified by the type of activity or even the quantity of these self-care activities.   

References 

McKeon, P. O., & Medina McKeon, J. M. (2015). Evidence-based practice or practice-based evidence: what’s in a name?. International Journal of Athletic Therapy & Training, 20(4), 1-4. DOI: 1-4 http://dx.doi.org/10.1123/ijatt.2015-0055 (Links to an external site.) Retrieved from http://eds.a.ebscohost.com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=2cef8dbd-7ff5-4058-835a-c39989924269%40sessionmgr4006 (Links to an external site.) 

  

Wong, C. L., Ip, W. Y., Choi, K. C., & Lam, L. W. (2015). Examining self-care behaviors and their associated factors among adolescent girls with dysmenorrhea: an application of orem’s self-care deficit nursing theory. Journal Of Nursing Scholarship, 47(3), 219-227. doi:10.1111/jnu.12134 

Retrieved from https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/1678728778?accountid=147674 (Links to an external site.) 

 

 

Jamie Taylor 

Jamie Taylor 

Jan 28, 2018Jan 28 at 3:22pm 

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Adelaida, 

It is so true that we must practice theory daily. I found that Orem’s theory of self-care is vital to the future as a nurse practitioner. Understanding the basic concepts of the nurse-patient relationship and how that affects the overall well-being of the client is imperative to successful care outcomes. In order to competently care for the client, you must have a holistic understanding of the client. The environmental, socio-economic barriers, support system, and even the client’s definition of healthy play vital roles in the care that we can provide. If the client does not understand the concept of well-being and or has an alternative definition of health there is little benefit to providing healthcare solutions for problems the client does not feel are problems. 

Education is key when using Orem’s self-care theory. Understanding the client’s educational level will provide an idea of what clinical decisions can and must be made.  When considering health promotion it is important to treat each person as an individual and treat their needs based upon education and understanding. 

 

 

Collapse SubdiscussionHailey Whisenant 

Hailey Whisenant 

Jan 21, 2018Jan 21 at 8:19am 

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Nursing theory plays a huge role in our clinical practice. Nursing theories, I believe, are designed to provide suggestions on how to improve clinical practice. Nursing theories are ongoing and continue throughout the years and stimulate reflections and improvements that happen in the clinical practice. Nursing theories are models that act as the main foundation for our nursing practice. Nursing theories show the importance of caring behaviors, reflecting back all the way to the early 1800’s, and are significant to improving patient outcomes in our practice. 

They identify both the strengths of our practice, and also the weak areas that need development. Nursing theories raise awareness of faculty and our nurse leaders and theorists by going further in-depth with metaparadigms. I believe nursing theories overall improve the quality of our clinical practice by improving patient care in the past, present, and future. Nursing theories are our calls to actions to better ourselves, our profession, and our patients. (Duffy, 2009). 

Reference 

Duffy, J. R. (2009). Quality caring in nursing: applying theory to clinical practice, education andleadership. New York, NY: Springer 

 

 

Collapse SubdiscussionBrenda Talley 

Brenda Talley 

Jan 22, 2018Jan 22 at 4:14pm 

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Hailey, interesting idea that nursing theories can help us identify gaps in nursing practice.  Nursing theories tend to express the ideal in nursing. 

  

class,can you think of examples in advanced clinical practice when a nursing theory may help identify a gap or a problem in terms of how advance practice is approached? 

  

 

 

Collapse SubdiscussionHailey Whisenant 

Hailey Whisenant 

Jan 23, 2018Jan 23 at 6:04am 

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Professor Talley and class,  

An example in our advanced clinical practice when a nursing theory identifies a gap or a problem in terms of how advance practice is approached includes the gap between theory itself and putting it into practice. Often times healthcare personnel read about theories, they study them, know what they are about, but do not put them into practice. They have theories go in one ear and out the other.  

The term theory is defined as a set of principles or statements that are utilized to explain a group of facts, it is often tested and widely accepted in the nursing profession. The term practice is an act or process of completing a task or an action. These two terms often times appear to be opposite of each other, but in reality you must apply theories into practice in order to promote health and improve patient outcomes. Nursing is defined as caring for a person in a variety of health related scenarios (Ajani et al., 2011). 

This type of caring involves teaching and education in regards to preventing illness. With this type of caring, nurses play a key role in health promotion and utilization. If all nurses are placed with a competence in theory and utilize theories in their practice, they will then maintain a proper balance between theory and practice and promote an even higher standard of health. Unfortunately, not all nurses are placed with a competence in theory, and the ones that are placed with a competence, do not put theories in their practice. This is where the gap in advanced-practice nursing comes into effect (Ajani et al., 2011). 

Reference: 

Ajani, K., & Moez, S. (2011, June 10). Gap between knowledge and practice in nursing. Retrieved January 23, 2018, from https://www.sciencedirect.com/science/article/pii/S1877042811009426 

  

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