Academic level – Undergrad. 1-2
Type of paper – Critical thinking
Topic Title – Development of Nursing knowledge
The development of nursing knowledge is an ongoing process. Discuss the case for the ongoing development and use of nursing grand theories and conversely, make a case for the obsolescence of nursing grand theories for today’s practice and research.
Theme: The Nature of Nursing knowledge
Introduction to the Nature of Nursing
– Theory: General Issues
-Middle Range Theory
– Practice Theory/Micro
Article to be used:
Sandra J. Peterson, PhD, RN & Timothy
S. Bredow, PhD, RN, NP-C.Middle Range Theories: Application to Nursing Research and Practice (4th Ed). (2020). ISBN: 978-0-06-000044-8 Chapter 1, pp. 1-35
Nursing knowledge continually evolves to adapt to the changing healthcare landscape and improve patient outcomes. Nursing grand theories have played a crucial role in shaping education and practice with a broad framework, but they may no longer be relevant. While these theories still contain valuable insights, they need further support to ensure their applicability in the context of modern challenges and different specializations.
Grand theories have been instrumental in helping nurses develop a broad understanding of different concepts and relationships within practice and patient care. For instance, Orem’s theory of self-care deficit informs how nurses can empower patients to manage their conditions and take control of their well-being (Peterson & Bredow, 2020). This knowledge is important for productive nurse-patient relationships, chronic disease management, and patient education. Grand theories can also identify critical nursing areas for further investigation and intervention, guiding researchers and practitioners toward evidence-based approaches. Watson’s theory of human caring is a prominent example because it encourages nurses to explore the emotional, spiritual, and interpersonal dimensions of care (Peterson & Bredow, 2020). As a result, these theories offer a comprehensive framework for nursing education, helping to shape curricula and guide future practitioners. They can foster a deeper understanding of the holistic nature of care and promote a patient-centered approach. This evidence supports the need to use grand theories as a theoretical foundation that has shaped decades of healthcare.
Historical context and broad scope are the most significant limitations of grand theories that decrease their relevance for continuously evolving nursing knowledge. Many of these theories emerged decades ago, so they may not properly account for recent changes in healthcare practices and technology. The dynamic nature of healthcare has introduced new challenges, such as greater administrative responsibilities, limited face-to-face time with patients due to technology adoption, and the growing popularity of digital health platforms (Fawaz et al., 2018). Grand theories may not directly address these contemporary factors, forcing nurses to seek alternative theoretical perspectives. Additionally, the complexity of modern healthcare systems creates the need for more specialized and context-specific approaches to patient care. Although grand theories are valuable because they are generally applicable, they are too broad to address unique challenges in specific healthcare settings. If nurses follow these theories rigidly, they may be unable to adapt to diverse patient needs and healthcare environments.
The need for ongoing development of nursing knowledge and the limitations of grand theories create the need for additional support. Peterson and Bredow (2020) present evidence that middle-range theories can be an advantageous alternative because they are more focused. While grand theories encompass broad aspects of nursing, middle-range theories address specific phenomena and provide practical guidance in contemporary healthcare settings. In turn, these characteristics help to bridge the gap between theoretical concepts and practical applications. Middle-range theories can better accommodate the evolving healthcare landscape, incorporating recent changes and emerging challenges. Nurses can still learn from grand theories if they also include middle-range frameworks to improve their ability to adapt to dynamic healthcare environments. This balanced approach is key to tailoring practice to patient-specific and evidence-based requirements.
In conclusion, the ongoing development of nursing knowledge is necessary to meet the ever-changing demands of modern healthcare. While nursing grand theories have significantly contributed to this knowledge, their historical context and broad scope make them less applicable for modern nurses. Striking a balance between grand and middle-range theories can lead to a more practical and focused approach with a solid theoretical foundation.
Fawaz, M. A., Hamdan-Mansour, A. M., & Tassi, A. (2018). Challenges facing nursing education in the advanced healthcare environment. International Journal of Africa Nursing Sciences, 9, 105–110. https://doi.org/10.1016/j.ijans.2018.10.005
Peterson, S. J., & Bredow, T. S. (2020). Middle range theories: Application to nursing research and practice (4th ed.).