IMPORTANCE OF NURSING THEORIES

By: HOMAIDI L. ABDUL HAMID, RN

Midterm

Importance Of Nursing Theories

● Aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs
1978).
● Provides the foundations of nursing practice, help to generate further knowledge and
indicate in which direction nursing should develop in the future (Brown 1964).
● Help us to decide what we know and what we need to know (Parsons 1949).
● Helps to distinguish what should form the basis of practice by explicitly describing
nursing
● The benefits of having a defined body of theory in nursing include better patient care,
enhanced professional status for nurses, improved communication between nurses, and
guidance for research and education (Nolan 1996).
● The main exponent of nursing- caring – cannot be measured, it is vital to have the theory
to analyze and explain what nurses do.

NURSING THEORISTS AND THEIR WORKS

Nursing Theory:
EXPLAINS, DESCRIBES, PREDICTS, PRESCRIBES → NURSING CARE
Modern Nursing and Environmental Theory

FLORENCE NIGHTINGALE
● Nursing “is an act of utilizing the environment of the patient to assist him in his recovery”.
● She tended to wounded soldiers during the Crimean War.
● She became known as the “Lady with the Lamp” because of her night rounds.
● Immortalized in the poem “Santa Filomena” by Henry Wadsworth Longfellow.
● After the Crimean War, she established a nursing school at St. Thomas Hospital and
King’s College in London in 1860.
● Nightingale wrote Notes on Nursing (1859), which was the foundation of the curriculum
for her nursing school and other nursing schools.
○ Notes on Matters Affecting the Health, Efficiency and Hospital Administration of
the British Army.
○ Notes on Hospitals
○ Report on Measures Adopted for Sanitary Improvements in India from June 1869
to June 1870.
● She was able to work into her eighties and died in her sleep on August 13, 1910 at the
age of 90.
● International Nurses Day is celebrated on her birthday.
Environmental Theory

Nightingale’s Major Concepts

1. PERSON
● A patient who is acted on by nurse
● Emphasized that the Nurse has in control of the patient’s environment.
● Affected by environment
● Passive yet has reparative powers.
2. ENVIRONMENT
● Foundation of the theory
● Included everything, physical, psychological, and social.
● Nurses are instruments to change the social status of the poor by improving their
● living conditions.
3. HEALTH
● “We know nothing of health, the positive of which pathology is the negative,
except from observation and experience”.
● Given her definition that the art of nursing is to “unmake what God had made
disease”, then the goal of all nursing activities should be client health.
● Nursing should provide care to the healthy as well as the ill and discussed health
promotion as an activity in which nurses should engage.
● Envisioned maintenance of health through prevention of disease via
environmental control.
4. NURSING
● “What nursing has to do.. Is to put the patient in the best condition for nature to
act upon him” (Nightingale, 1859-1992)
● Nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness,
quite and the proper selection and administration of diet– all at the least expense
of vital power to the patient”.
● Nursing is having the responsibility for someone else’s health.
● She wrote her Notes on Nursing to provide women how to “Think like a Nurse”.
Ventilation and Warming
Light and noise
Health of houses
Bed and beddings
Personal cleanliness
Variety
Chattering hopes and advices food

○ “Keep the air he breathes as pure as the external air, without chilling him”.
○ Recognized this environmental component as a source of disease and recovery.
○ Provide description for measuring the patient’s body temperature through
palpation of extremities.
 ○ Nurses were instructed to manipulate the environment to maintain both
ventilation and patient warmth by good fire, opening windows and properly
positioning the patient in the room.
Light
● “Light has quite as real and tangible effects upon the human body… who has not
observed the purifying effect of light, and especially of direct sunlight, upon the air of the
room?”
Noise
● Noises created by physical activities in the environment (room) was to be avoided by the
nurse.
Cleanliness
● Bathing of patients on a frequent , even daily , basis.
● Nurses should wash their hands regularly.
Bed and Beddings
● Noted that a dirty environment (floors, carpets, walls and bed linens) was a source of
infection through the organic matter it contained.
● The appropriate handling and disposal of bodily excretions and sewage was required to
prevent contamination of the environment.
Foods
● Instructed nurses to assess dietary intake, meal schedules and its effect on the patient.
Chattering of Hopes and Advices
● Protects patient from receiving upsetting news, seeing visitors who can affect the
patient’s recovery negatively and from suddenly receiving disruptions from sleep.
Assumptions
● Nightingale believed that five points were essentials in achieving a healthful house: “pure
air, pure water, efficient drainage, cleanliness and light.”
● A healthy environment is essential for healing. She stated that “nature alone cures.”
● Nurses must make accurate observations of their patients and be able to report the state
of the patient to the physician in an orderly manner.
● Nurses should use common sense, observation, perseverance and ingenuity.
● Believed that nurses should be Moral Agents
● Addressed Professional relationship with patients.
● Instructed nurses on principle of confidentiality and advocate care for the poor.
● Patient decision making – indecision or changing the mind is more harmful to the patient
than the patient having to make a decision.
● “The Nightingale of Modern Nursing”
● Others named her as the “First Lady of Nursing” and “Modern-Day Mother of Nursing”
VIRGINIA HENDERSON
● In 1918, she entered the Army School of Nursing in Washing, DC.
● In 1921, she was a staff nurse at Hendry Street Visiting Nurse Service in New York.
● She began her career as a nurse educator in 1924 at the Norfolk Protestant Hospital in
Virginia where she was the first and only teacher in the school of nursing
● Awarded in 1988 by the American Nurses Association for her lifelong contributions to
nursing research, education and professionalism.
● Henderson died in March of 1996 at the age of 98.
Henderson’s Major Concepts
1. Person/Individual
● Considers the biological, psychological , sociological and spiritual components.
● She defined the patient as someone who needs nursing care, but did not limit
nursing to illness care.
2. Society and Environment

● “The aggregate of all external conditions and influences affecting the life and
development of organism” Webster Dictionary .
● Maintaining a supportive environment is one of the elements of her 14 activities
● She sees individuals in relation to their families but minimally discusses the
impact of the community on the individual and family.
● She supports the tasks of private and public health agencies keeping people
healthy.
● She believes that society wants and expects the nurse’s service of acting for
individuals who are unable to function independently.
3. Health

● Equated health with independence.

● The quality of health rather than life itself, that margin of mental/ physical vigor
that allows a person to work most effectively and to reach his highest potential
level of satisfaction in life”.
4. Nursing
● The unique function of the nurse is to assist the individual, sick or well, in the
performance of those activities contributing to health or its recovery (or to
peaceful death) that he would perform unaided if he had the necessary strength,
will or knowledge. (Virginia Henderson)
14 Activities for Client Assistance
● Physiological
● Psychological Aspects of communicating and learning
● Spiritual and moral
● Sociologically Oriented to Occupation and recreation.

1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body wastes.
 4. Move and maintain desirable positions.
5. Sleep and rest.
6. Select suitable clothes- dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and
modifying the environment.
8. Keep the body clean and well groomed and protect the integument.
9. Avoid dangers in the environment and avoid injuring others.
10. Communicate with others in expressing emotions, needs, fears, or opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a way of accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover or satisfy the curiosity that leads to normal development and
health and use the available health facilities.
Assumptions

● “Nurses care for a patient until a patient can care for him or herself.”
● Nurses are willing to serve and that “nurses will devote themselves to the patient day
and night.”
● Nurses should be educated at the college level in both sciences and arts and should be
knowledgeable in both biological and social sciences.