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A nursing theory is a set of concepts, definitions, relationships, and assumptions derived from nursing models for the purposes of explaining and predicting an event. Most nursing students have been stigmatized with the label of not being knowledgeable and being dullard by the clinical professionals and thereby resulting in reluctantcy to teach the upcoming nurses. The purpose is to explain application of theories to practice and to determine the problems encountered in applying nursing theories. Conclusively, application of theory to practice is important as it enhance and facilitates patients care. It is recommended that theories should be introduced to the application of theories in educational setting and a good interpersonal relationship should be encouraged between the clinical nurses, nursing educators and student nurses.
A nursing theory can be defined as a set of concepts, definitions and assumptions or propositions derived from nursing models or from other disciplines and project. It is also referred to as a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining and predicting events by specifying relations among variables (George, 2012).
Nursing science is an identifiable discrete body of knowledge comprising paradigms, frameworks and theories. The integration of nursing theories into practice demonstrates an evolutionary pathway for introducing a paradigm shift in the essence of the science of nursing. Nursing theory influences the practice of nursing in a multitude of ways that can have a profound impact. Theory provides a framework to support and define nursing practice, support quality of patient care, and can be implemented in practice situations to provide solution to nursing practice problems. In clinical settings, it has been discovered that the application of theory to practice is quite challenging for nursing student and nursing education has been confirmed to contain both theory and practice, in which practice serve as a basis for the development of nursing theory where as nursing theory must be validated in practice.
It has been discovered that nursing students were thought the ideal thing for clinical settings but due to excessive improvisation in nursing, they have not been able to put into practice what they have been thought, thereby contributing to degradation of knowledge, most students suffer from inferiority complex when they enter the clinical setting because lack of knowledge and experience and they have been stigmatized with the label of not being knowledgeable and be ing dullard by the clinical professionals thereby resulting in reluctancy to teach upcoming nurses. Due to lack of essential knowledge, inexperience and confidence, nursing students are always anxious because of the fear of implementing the wrong procedures and practice.
It is important to solve this problem because theory is like the mother of practice and theories application serves as a basis or guide to practice, theoretical knowledge and it also embodies the applied elements of logical reasoning and it is a background of practice which enriches one’s general thinking and skills that serve as a foundational background to human survival. It is also important to solve this problem because nursing students are the future nurses and if they lack the knowledge, information and experience to work then it will hinder the care rendered to patient and implementation of wrong procedures thereby leading to increased mortality in the clinical settings.
- Theory: This can be defined as a group of related conceptthat propose action that guide practice, it is also asset of concept, relationships, assumptions or proposition derived from nursing models or from other disciplines for the purpose of explaining and describing.
- Practice: This is underpinned by values that guide the way in which nursing care is provided.
- Nursing student: This is a student in a post-secondary educational program that leads to certification and licensing to practice nursing, usually as a part of program administered by a nursing schools and universities.
- Knowledge: This is can be defined as the information, skills and understanding that has been gained through learning or experience.
The objectives are as follows:
- To discuss the application of theories and clinicalpractice
- To discuss nursing studentsand theory application
- To determine the application of theoretical knowledge into clinical practice by nursing students
- To discuss the application of theory into clinical practice
- To discuss the importance of theory and the problems associated with applying nursing theories
3.0 MAIN CONTENT
3.1 APPLICATION OF THEORY TO PRACTICE
Application of Watson theory of human caring in care settings is called the carative or caritas process. A willingness to learn for the caring experience, being able to engage in a teaching-learning experience that is genuine, enabling and creating environment that are healing, caring for basic needs in both spiritual and physical way and being open to spirituality (Watson, 2017). In practice, this thereby means that a nurse practitioner engages their emotions in the caring relationship, not being close to any new spiritual and emotional experiences while looking after the physical and health needs of a patient.
Orem states that nursing is a service of deliberately selected actions to assist individuals to maintain their self-care. She describes three types of nursing systems according to the extent of contribution of nursing, the whollycompensatory, the partly compensatory bant the supportive-educative nursing system (Ekaterini, 2010). Although she perceives the individual as an integrated whole, she makes the assumption that each person is continuously engaged in activities in order to maintain self-care. Orem’s system of nursing clearly defined when the contribution of nursing is considered essential, taking into thought the self care deficits of each individual patient. Orem’s model for Coldwell-Foster and Bennett18 has the major strength that is applicable for nursing practice by both the beginner as well as the advance practitioner.
Nursing theories provide a foundation for nurses to professionally base their judgement of care. Theories are incorporated into nursing students’ education to influence students’ decision regarding patient’s health. Nursing theories remain an important foundation for both nurses and nursing students (Alligood, 2010).Nursing theories guiding structures for reasoning and decision making about the person, as well as about the nursing action indicated. Practice-based theories are based directly on the practice and outcome during patient care.
3.2 THEORIES AND CLINICAL PRACTICE
Spence et al (2010), proposed a model of nurse/patient empowerment derived from kanter’s theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use if patient empowerment strategies by nurses and ultimately greater patient empowerment and better health outcomes. The constructs described in kanter’s (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurse’s interactions.
Orem used her theory to examine the self-care needs of persons and nurses role in assisting or supporting persons in meeting those needs. Orem saw that in order for a person in ill health, become healthy and well, certain self-care needs must be met. If a person is not capable of providing any self-care, the nurse would be responsible for providing most of the care. On the other hand, if the person is fully capable of providing basic self-care, the nurse would be the supporter/educator/facilitator of that self care. Orem’s self care theory examines how people or communities can achieve a healthy state through self care by themselves or with the help of the nurse (Orem1980).
3.3 NURSING STUDENTS AND APPLICATION OF THEORIES
Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. Paul’s Model of Critical Thinking is examined for its application to nursing education (Andrea, 2012)
Hatlevik (2011), indicates that student’s perception of coherence between theory and practice during initial nursing educationis directly influenced by reflective skills and theoretical knowledge. It also reveals that reflective skills have mediating effects and practical skills have a fully mediated influence on student’s perception of coherence and theoretical knowledge have a partially mediated influence on student’s perception of coherence.
There are a lot of theories in nursing but only few can be applied to clinical practice such as Virginia Henderson theory, callita Roy theory and Florence Nightingale theory among others on the criteria based on the four metaparadigms which are the environment, health, patient and nursing (Angelo, 2014). Henderson’s need theory can be applied to nursing practice so that nurses can set their goals on the theories 14 components and meeting up with the goals that can help to improve a students or nurse performance in nursing care, it is easier to apply this theory to practice bynursing students because it consists of the four metaparadigms.
3.4 IMPORTANCE OF THEORY
According to smith and parker (2015), nursing theories provide the nurse with guidance in many ways. Theories also enhance the nurse sense of belonging and identity when it comes to helping patients. In the health care society, the nursing theories can be used in showing the nurse their role and responsibility in this great career. Through the nursing theories, the nurses get in the position to identify the patient’s needs, enhance effective patient-nurse communication, effectively assess the condition of the patients and effectively design techniques to assist patients.
Nursing theories offer conceptual bases for nursing practice and utilize a logical structure of ideas, hypothesis and assumptions that can be applied to a variety of situations. As a body of knowledge, nursing theories provides a wide array of conceptual structures in which nurses or organizations can use as a scientific back up. (Keith, 2012)
3.5 PROBLEMS OF APPLYING NURSING THEORIES
It has been discovered that gap between knowledge and practice is also a major problem of applying nursing theory to practice because theory-practice gap is felt most acutely by nursing students due to the demands of their tutor and practicing nurses. They are faced with real clinical situations in which they are unable to generalize from what they’ve learned in theory. (Rolfe, 2003)
The inability of nurses to transfer to the clinical settings what they have learned in class may be because nurse educators do not use teaching strategies that promote transfer of learning. Unfortunately there is paucity of evidence as to which teaching strategies promote transfer of learning. Yvonne Botma (2014), revealed that simulation promotes theory-practice integration, builds confidence, makes students aware of the aspects of care that need to be improved through deliberate practice, increases the motivation to learn and transfer their knowledge.
4.0 IMPLICATIONTO NURSING EDUCATION AND NURSING PRACTICE
The issue of nurse staffing has been a devastating challenge to the nursing profession and when there is issue with the nurse staffing, then it will alter the implementation of patients therapeutic careand the outcome of patients care (Marialena, 2011), the Watson caring theory has been seen to be applicable to the problem of nurse staffing.
It is defined to promote better patients care, to enhance the image of nursing profession and to improve communication among nurses. Empowered nurses are more likely to empower their patients which results in better patients and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.
The advance and the use of nursing theory have been restrained by the approaches used in nursdong education. The isolation of theory in education is inappropriate and restriction of nursing theory to curriculum makes it difficult to focus on nursing theory. The application of Henderson’s nursing need theory with the curriculum can teach students nurse on how to establish the therapeutic plans for practical which complete or supplement a patient’s strength and allows the patient to provide adequate care for themselves (Angelo, 2014)
The self-care nursing theory teaches nurses to help patient’s so that their ability to engage in the self-care act will be improved and the implementation of the self-care theory can be productive in education when the interrelated theories is applied (Taylor, 2006)
Application of theory to practice enhances and facilitates patient care by involving the theory which meets the criteria of the four metaparadigms (patient, nurse, environment and health) in practice. Theory application is very efficient in nursing practice and it should be taught as one of the most essential factor in nursing education.
It is recommended that theories should be introduced early enough to the student nurses who are coming into the profession so that the implementation of theory into practice will be more effective and efficient. Regular and frequent check up and training should be conducted on nurses in clinical practice so as to be able to update them on new changes in theories and to enhance easy application of nursing theories. Collaboration should be encouraged between nurses in clinical and educationalsettings to enhance theory application (Ashaju-kayode, 2019).
Good interpersonal relationship should be encouraged among nurses, nursing student and nurses should be willing to teach and motivate upcoming nurses. Nurse Manager must be able to delegate duties and entrust duty rights with adequate authority to the nursing students for developmental purpose in theory application.
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- Yvonne Botma (2014): Nursing student’s perceptions on how immersive simulation promotes theory–practice integration; International Journal of Africa Nursing Sciences; Volume1, Pages1-5:https://doi.org/10.1016/j.ijans.2014.04.001
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