University of San Agustin

General Luna St., 5000 Iloilo City, Philippines

www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

1) What are the significant events that highlights in the history of nursing theory?
a. Florence Nightingale
• Nightingale's "Notes on Nursing," in 1859/1992, is the first nursing theory that
focuses on the manipulation of the environment for the benefit of the patient.
Although Nightingale's work was not presented as a "nursing theory," it has guided
nursing practice for almost 140 years - a lasting legacy for the nursing profession.

b. The Columbia School (1950's)

• The necessity for graduate-level nursing education for administrative and faculty
positions was recognized in the 1950s.
• Columbia School theorists followed a biomedical model that was largely concerned
with what nurses do or their functional roles. They considered patient problems and
needs to be the practice focus.
• Johnson (at the University of California, Los Angeles), independent of the
Columbia theorists, proposed that nursing knowledge is founded on a nursing
diagnostic theory distinct from medical diagnosis (Meleis, 1997).

c. The Yale School (1960's)

• In the 1960s, the focus of theoretical thinking in nursing shifted from problem/need
and functional role to the nurse-patient connection.
• Nursing, according to Yale School theorists, is a process rather than an end in itself.
Their theories investigate how nurses do their duties and how patients view their
circumstances.
• It is important to note that federal funds were made available for doctoral studies
for nurse educators during the 1960s. The individuals who graduated with a
doctorate became the next generation of nursing theorists.

d. The 1970's
• Many nursing theories were initially presented during this decade. Since their first
introduction, the majority of these theories have been revised.

e. 1980's
• Many nursing theories were revised in the 1980s in response to research discoveries
that broadened them. Dorothy Johnson's, Rosemarie Rizzo Parse's, Madeleine
Leininger's, and Erickson Tomlin and Swain's works were also added to the body
of theoretical thought in nursing.

f. 1990's
• Parse modified the name of her theory from Man-Living-Health to Theory of
Human Becoming in 1992. She explained that the reason for the change is that

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

contemporary dictionary definitions of "man" are gender-based rather than
signifying "humanity."
• Boykin and Schoenhofer published their "Nursing as Caring" idea in 1993,
presenting it as a broad theory with caring as a moral imperative for nursing.
• Research projects that evaluated and expanded nursing theory were conducted in
the 1990s numerous.

2) What were the highlights in the following Eras of Nursing Knowledge?

a. Curriculum Era
• An emphasis on curricular content and the trend toward the objective of uniform
curricula are evidence of efforts to understand the nature of the information
required for nursing practice in the curriculum period.
• This emphasis on what nurses needed to know to practice nursing resulted in
curricula expanding beyond physiological and pathophysiological understanding to
include social sciences, pharmacology, and nursing practices. The fact that this
content was taught in classes named "fundamentals," which translates as
"essentials," demonstrates an early value placed on nursing content that was unique
to nursing activity and went beyond understanding of the patient's ailment.
• As Nightingale emphasized (Nightingale, 1996), the differences between a medical
view of the patient and a nurse's view are visible in these early developments.
Nursing began to embrace science in the curricula of this early era.

b. Research Era
• The incorporation of nursing into higher education institutions resulted in a
fundamental shift in the search for a meaningful body of knowledge. When nurses
were introduced to research, they saw the necessity for nursing research, which
ushered in the research age.
• This epoch stressed scholarship and the importance of disseminating scientific
discoveries through scholarly publications.
• These early research endeavors influenced nursing, and as more nurse educators
were exposed to research, a new emphasis on graduate education that incorporated
nursing research emerged by the 1960s and 1970s.

c. Graduate Education Era

• The curriculum for master's level preparation includes courses in nursing research,
clinical specialty practice, and leadership throughout the graduate education era of
the 1960s and 1970s. Many institutions also began to incorporate a core course in
nursing theory or nursing models in a core curriculum that was built around a
nursing philosophy and a conceptual or organizational framework.
• During this time, a series of conferences brought nurses together to discuss ideas
and examine what they had learned in their Ph.D. degrees in domains other than
nursing that could solve nursing's knowledge-building goals.

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

• It is worth noting that the nature of the body of nursing knowledge was addressed
in these conferences, namely whether nursing will be other discipline -based or
nursing-based. Considering this topic was a watershed moment in nursing history
in terms of structuring graduate nursing education and comprehending the nature
of the body of knowledge required for nursing practice.
• Doctoral education became popular. The driving force was the necessity to build a
specific body of knowledge and the conclusion that the information should be
developed by nurses who have been trained in the nursing discipline. Rogers
(1970) argued that nurses required a framework.
• Batey (1977) recognized conceptualization as the most significant restriction of
publishing nursing research during this time. She stressed the significance of the
conceptual phase of research in developing nursing science by providing a content
basis as well as a relationship with other studies.

d. Theory Era
• Nursing theory development generated spectacular growth in only one decade -
from 1980 to 1990 - and has been recognized as the cornerstone of the development
of the nursing discipline (Meleis, 1983).
• Growth in this age is evidenced by the development of nursing literature and new
nursing journals, national and international nursing conferences, and the
establishment of a new nursing doctoral program.
• Fawcett (1984, 1989) presented a meta paradigm concept of nursing knowledge
for the discipline of nursing based on Kuhn's (1970) ideas, proposing the
boundaries of nursing knowledge to be person, environment, health, and nursing.
Her work helped to clarify middle-range or practical theory for the theory use phase
of the theory era. Furthermore, her work reveals how nursing theory is linked to or
generated from nursing models.

e. Theory Utilization Era

• Nursing has entered a new phase of using philosophies, models, or the ories in
practice, which is known as theory-based nursing practice.
• The transition from theory development to theory application and use
acknowledges the value of a framework for critical thinking and decision -making
in professional nursing practice.
• The "intellectually disciplined process of actively and skillfully conceptualizing,
applying, analyzing, synthesizing, and/or evaluating information gathered from, or
generated by, observation, experience, reflection, reasoning, or communication, as
a guide to belief and action" is referred to as critical thinking (Scriven and Paul,
2004, p.1)

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403