A Comparison of Grand Theorists
Nursing theory has been evaluated and reviewed over time to determine if theories develop framework to develop best practices. In this paper, we will review four grand theorists and compare their theories. After evaluating each theory, as the reviewer, I will infer which theory I most align my personal practice and why.
The first of the grand theorists for review is Virginia Henderson, a needs therapist and her theory of Activities of Living. Her theory identified 14 components that are needed in daily life to assure health and the possibility to regain health and/or independence (Nursing, 2019). She identified normal activities such as breathing, moving, elimination, communication, spirituality, and abilities such as learning and discovering. Henderson felt is it necessary to educate patients for independence. She felt that a patient must be able to care for themselves to preserve their health. Virginia Henderson succeeded with an educational pathway up to her Masters degree (Nursing, 2019).
The next theorist is Hildegard Peplau. Peplau is an interaction theorist that developed the Theory of nurse-patient relationship. This theory developed roles that included, the stranger role, resource role, teaching role, counseling role, surrogate role, active leadership role and technical expert role (Nursing, 2019). With each of these roles, the nurse takes each role and implements interventions to educate the patient and problem solve for goal setting. As an interaction theorist, she used roles to meet goals (Meleis, 2018). Peplau’s education was finalized with her Doctoral degree.
For the outcomes theorist, I chose Martha Rogers and her theory of Science of unitary human beings. Rogers chose to build on human nature and created this theory to collapse nursing science and artfulness to meet demands of the patient. When rehabilitation a patient, Rogers chose pain management and psychotherapy as her focus. Non-invasive interventions were used. Rogers’ proven education was completed in 1954 with her Doctorate degree.
Last, for the caring/human becoming theorist, Jean Watson developed the philosophy of science and caring. This theory developed 10 carative identifiers in which three developed a philosophical foundation with the remaining seven part of the major concepts (Nursing, 2019). Her theory used a holistic style wherein she wanted patients to feel cared for. She felt the nurse should oblige the patient through interpersonal relationships. Watson completed her Bachelors of Nursing, then specialized in mental health nursing and psych and then finished her education and earned her PhD in psychology and counseling.
Of the 4 theorists discussed, as a home health nurse, I align with Hildegard Peplau. Of the 7 roles she developed, in home health nursing, you serve each of these. Many patients do not welcome home health initially and usually do so to appease their family or physician. If we home health nurses align with the stranger role, we are able to start the relationship and then build on the next role. The primary feedback we receive from patients is how they appreciate us taking the time with them. A benefit to home care is not feeling rushed by a waiting room full of patients. It is easy to find ourselves in each of Peplau’s role when doing our job correctly and completely. We provide resources, we educate, we counsel, we advocate, we hold patient’s accountable for self-improvement and goal meeting and lastly, as nurses we all prepare for the role of nursing, the actual physical care.
|Needs theorist – Virginia HendersonTheory of Activities of living||Interaction Theorist Hildegard Peplau nurse-patient relationships||Outcomes Theorist Martha Rogers||Caring/Human Becoming theorists Jean Watson|
|Educational Background||1921 Army School of Nursing, walter Reed Hospital in DC, 1932 Bachelors Degree and in 1934 Masters Degree in Nursing Education||1931 Pottstown Penn School of Nursing, worked as a staff nurse. 1943 Bachelors degree in interpersonal psychology. Then earned her Masters and Doctoral degrees from Teacher’s college, columbia University and was certified in psychoanalysis at the William Alanson White Institution of NYC||Nursing diploma received from Knoxville General hospital school of nursing 1936; Public health nursing degree from George Peabody Collenge in 1937; Masters degree from Columbia University in 1945; Doctorate in Nursing from Johns Hopkins University 1954.||1961 Lewis Gale School of Nursing, 1964 Bachelors at University of Colorado and 1966 Masters in psych and mental health nursing. 1973 Ph.D. in educational psychology and counseling.|
|Philosophy of Nursing||While a nurse’s job is to care for patients, it is also to help patients be able to care for themselves when they leave the healthcare facility.||Theory of interpersonal relations nursing should be therapeutic, nursing is an interpersonal process because it is an interaction of 2 people that act for the common good of the patient||A patients environment is a large part of their ability to maintain or improve health. Theorist believed a patient’s environment must be considered when addressing health and need for treatment||Nursing is science that includes philosophy, values, thought and knowledge, commitment and action through interpersonal caring relationships. The role of the nurse is to oblige the patient through interpersonal relationships|
|Definition of Nursing||The nurse is to help the patient perform activities that he normally would to aide in the recovery or possibly death. These are activities that the patient would need to do without assistance that would provide for independence and health.||Peplau believed that the nurse and patient should develop common goals and implement agreed upon actions for the good of the patient||Rogers believed that nursing is a commonality of science and art that is humanistic and humanitarian. One should consider human nature and that nurses should participate in the process of healing.||How nurses express care to their patients which caring promotes better health.Holistic approach of caring is priority in the theory.|
|Goal / purpose of theory||The theory identified 14 daily physical requirement to assess for ability to regain health and independence.||to foster therapeutic relationships to develop mutual goals and problem solving through interpersonal process (educational, therapeutic and collaborative)||Science of Unitary Human Beings theory||Watson felt that caring should be central to the nursing practice. With caring we promote healing and health better than a simple medical cure with a holistic approach. Nursing culture should include caring.|
- Meleis, A. I. (2018). Theoretical nursing: development and progress (6th ed.). Philadelphia Wolters Kluwer. ISBN: 978-0-06-000042-4
- Nursing Theorists. (n.d.). Retrieved January 30, 2019, from http://nursing-theory.org/nursing-theorists/