Nursing TheoryTonia L. RossanoIndian River StateCollege       The development ofnursing theory is something that began many years ago, has evolved greatly, andstill has much room to grow.  There aremany types of theories, such as, grand nursing theories, middle range theories,and practice theories; each theory is beneficial in different ways.  The development of nursing has beenprogressive over time, with a multitude of contributors and shifting focus.  This paper will discuss the evolution ofnursing theory, different types of theory used in nursing, and how theory isbeneficial to the nursing practice.Evolutionof NursingThe stages ofnursing theory development are the silent stage, received knowledge, subjectiveknowledge, procedural knowledge, constructed knowledge, and currentlyintegrated knowledge (McEwen & Wills, 2014).

  Theory in nursing dates to as early as the1850s with Florence Nightingale; a time when nursing was first becoming aprofession with standards and educational criteria to be met.  The time of Nightingale is in the silent stage,a time where nursing education included scant theory (McEwen & Wills, 2014).  During the received knowledge stage of theorydevelopment, university education was growing as opposed to the previoushospital apprenticeship training for nurses; “Books on research methods andexplicit theories of nursing began to appear” (McEwen & Wills, 2014, p30).  The subjective knowledge stage wasa time when leaders in nursing made efforts to define the purpose ofnursing.  During the procedural knowledgestage, conceptual models for nursing were developed with dispute of having onlyone model for the entirety of nursing; requirement for curricula to be based onconceptual frameworks became mandated by the National League for Nursing(McEwen & Wills, 2014).  In theconstructed knowledge stage, Evidence Based Practice (EBP) was introduced andserved to bridge the gap between research and practice “.

. . scholars began tofocus on theories that provide meaningful foundation for nursing practice”(McEwen & Wills, 2014, p 31).  Ourcurrent stage of integrated knowledge has emphasis on the use of EBP andapplication of research to practice with the use of transitional research.  Also, the doctor of nursing practice (DNP)programs are growing and have gained more acceptance (McEwen & Wills, 2014).  NursingTheoriesThree main typesof theory used and applied in nursing include: grand nursing theory, middle rangetheories, and practice theories.  “Grandtheories give a broad perspective for the purpose and structure of nursingpractice” (Matney, Avant, & Staggers, 2016, “Nursing Theories” para.

2).  A major contribution of grand theoryis the explanation of the differences between nursing and medical practice(Matney, Avant, & Staggers, 2016). Grand theories are comprehensive and nonspecific, with abstractconcepts, and are generally not testable (McEwen & Wills, 2014).  “The grand nursing theories guide researchand assist scholars to integrate the results of numerous diverse investigationsso that the findings may be applied to education, practice, further research,and administration” (McEwen & Wills, 2014, p 117).  “Middle range theories have a more limitedview of circumscribed phenomena than do grand theories” (Smith & Liehr,2014, p. 35).

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  Middle range theories mayor may not be directly related to a grand theory, phenomena researched hasorganized frameworks with these theories. Practice guidelines are often developed from middle range theories. (Smith& Liehr, 2014).  Practice theoriesare grown from grand theories, middle range theories, or practice.

  Practice theories are focused and specific,with concrete concepts and have defined propositions.  Practice theories have testable goals oroutcomes (McEwen & Wills, 2014) Benefitsof Nursing TheoryThe use of nursing theories can help to create a healthyprofessional environment for patients and health care practitioners by helpingto guide our practice.  Theory promotesresearch and information that may translate and apply to better patient outcomes. Theory helps to enhance nurse’s knowledge andsupports the practice of nursing.  Havingconsistent, structured decision-making processes in place benefits nurses andpatients alike (Matney et al., 2016).  “Theory-guidedpractice elevates the work of nurses leading to fulfillment, satisfaction, anda professional model of practice” (Smith & Liehr, 2014, p. 15).

Nursing theory and application hasevolved over time helping to create a better nursing practice and profession. Theevolution of theory in nursing is continuing; theory in nursing has beencrucial to progress in the profession and will continue to be.  Each type of theory has benefits foracquiring and applying knowledge to the nursing practice.  Both nurses and patients benefit fromapplication of theory in practice.      ReferencesMatney, S.

, Avant, K., Staggers, N.,(October 30, 2015) “Toward an Understanding of Wisdom inNursing” OJIN: The Online Journal of Issues in Nursing Vol.21 No. 2. DOI: 10.

3912/OJIN.Vol21No01PPT02McEwen, M., Wills,E. (2014). Theoretical basis for nursing.(4th ed.

). Philadelphia, PA. Wolters Kluwer Health/Lippincott Williams & Wilkins.Smith, M.

, Liehr,P. (2014). Middle range theory fornursing. (3rd ed.).

New York, NY. Springer Publishing Company,LLC. Retrieved from: https://books.google.com/books?hl=en==7iFW6dUS3jMC=fnd=PP1=middle+range+theory+for+nursing+third+edition=CA5NMuelrX=jwQwvMv3L-1gZZzQgEn_h8UpAIg#v=onepage=middle%20range%20theory%20for%20nursing%20third%20edition=false