Theory? Who Needs It?

Nursing theorists are important.

I’m ducking right now to avoid the rotten fruits and vegetables readers are throwing out through my laptop screen. This opinion is not popular. I know. I didn’t work up much excitement about them either when I was in nursing school. Indeed, I may or may not have gotten the stink eye for the costume I came up with to impersonate Martha Rogers in class for an assignment (I went to a rogerian school). As I recall, there was some suggestion on my part that the worthy lady had fallen under the influence of illegal substances when she came up with her theory. Yikes.

Nursing theorists have fallen from grace from what I can tell of tales I hear from nursing students in 2- and 4-year programs. Graduate students still take theory classes. I’m guessing most nursing students think this is good riddance, but I argue that nursing theorists belong in every nursing program and every nurses’ head—both in theory and in practice.

They allow a little abstract thinking, and, perhaps more importantly, they leave a little abstract map in your head. Abstract thinking is good for you on its own, but these little abstract cognitive maps help solve actual problems. When you are a practicing nurse, often the solution you need just isn’t there, or perhaps you have a few to choose from. What criteria will you use when concrete answers just don’t exist? You’ll naturally fall back to theory.

Related to the previous point: nursing theory provides structure to our profession. As I dimly recall, having our very own theories is one criterion for considering nursing its own profession to begin with; I think that’s pretty important. Don’t you? If you research, write, or both, you will find that working with a theorist in mind guides what you do and that providing this guide explicitly aids in structuring the research and writing. If you plan to leave school with the goal of never writing anything again, good luck with that.

The thing with theories is that even if they’re not “right” or “proven,” they give nurses a place to hang their caps. Think of how you may have tried to solve complicated physics problems or word problems that you had no idea where to even start. Assuming chucking the whole thing wasn’t an option, you had to sift through everything and pick somewhere to start. Once you chose a framework, you could hang numbers and information on the frame and move things around until they made more sense, and eventually the solution appeared. You used abstract ideas to solve a concrete problem.

It’s the same thing here. It is less important to remember the exact theory and the life story of the theorist (although they tend to be fairly interesting, especially the pioneers) than to remember the gist of the thing. Really, no matter what your own ideas, you can find a nursing theory that either supports and builds on what you already believe about what you are doing or changes your mind, and you’ll tend to remember either one because you had to think about it.

I suffer no delusion that readers will leap up, convinced, and start reading nursing theory for fun over dinner. However, consider what I’ve said; if you’re a student made to study theory, do it with a little more gusto. If you managed to get out of school without it, I’d say you’re lacking in professional preparation. Consider making a goal involving familiarizing yourself with a few important nursing theorists.

About Megen Duffy

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Megen Duffy, RN, BA, BSN, CEN, is a practicing nurse, blogger, and contributing editor for the American Journal of Nursing. Megen has practiced in a variety of settings from emergency rooms to prisons.