 Began during mid 20th century, more

NURSING THEORISTS AND THEIR nurse leaders embraced higher

WORK education and came to an
UNIT 1 Evolution of Nursing Theorists understanding of the scientific age
Christine Erica C. Nafarrete UP-FB1-BSN1-03 and the research path to new nursing
knowledge.
Major Questions: What is the focus for
Table of Contents nursing research?
1. CHAPTER 1 Introduction to Nursing Theory: Its Emphasis: Role of nurses and what to
History and Significance research
2. CHAPTER 2 Nursing Theorists of Historical Outcomes:Problem studies and studies of
Significance nurses.
3. CHAPTER 3 History of Nursing Science Emerging Goal:Isolated studies to not yield
unified
4. CHAPTER 4 Theory of Development Process knowledge.

5. CHAPTER 5 The Structure and Analysis of  The Research Era and Graduate Era
Specialized Nursing Developed in Tandem

CHAPTER 1 Introduction of Nursing GRADUATE EDUCATION ERA ( 1950-

Theory: 1970s)
Its History ans Significance  Nursing master’s programs began to
include courses in concept
History of Nursing Theory development and nursing models ,
 Nursing theory is considered from two introducing students to early nursing
important perspective; HISTORY and theorists and knowledge development
SIGNIFANCE. processes.
 Florence Nightingale assume the great  1970s transition from vacation to
significance of providing a clean and profession as a nurse leaders.
healthy environment to achieve recovery Major Questions:What knowledge is need
of patients until in present. for the practice of nursing?
 She also envisioned nurses as a body of Emphasis:Carving out an advanced role and
educated women who organized service basis for nursing practice.
and caring for wounded in wartime Outcomes:Nurses have an important role in
(Crimean war) and establishment of health care.
Nursing school in London ( St. Thomas Emerging Goal: Focus graduate education
Hospital) pioneering activities in nursing on knowledge development.
practice and education.
 Nursing evolved through different eras. THEORY ERA (1980-1990s)
Profession did not start as what its  A natural outgrowth of the research
seemed to be. It started as a vocational and graduate education eras.
course offering only skills during their  Major developments in nursing
time. characterized as a transition from a
preparadigm to the paradigm period
Historical Eras of Nursing’s Search for in nursing.
Specialized Knowledge Major Questions:How do these framework
guide research and practice?
CURRICULUM ERA (1900-1940s) Emphasis:There are many ways to think
 The idea of moving nursing education about nursing
from hospital based diploma Outcomes:Nursing theoretical works shift
programs into colleges and the focus to the patient.
universities began to emerge in this Emerging Goal: Theorists guide nursing
era. research and practice.
Major Questions: What curriculum content
should student nurses study to be nurse? THEORY UTILIZATION ERA ( 21ST
Emphasis: Course selection and content for CENTURY)
nursing program  Gave way to new levels of
Outcomes: Standardized curricula for development and use of nursing
diploma programs. theory for evidence-based
Emerging Goal: Develop specialized professional practice.
knowledge and higher education.  Theory is relevant in the history of
nursing’s progress toward specialized
RESEARCH ERA ( 1950- 1970s) nursing knowledge, and that
knowledge contributes to recognition
Christine Erica Nafarrete UP-FB1-BSN1-03
 and appreciation of significance of community with
nursing as a Profession and which he/she will
Discipline. practice.

Major Questions:What new theories are CRITERIA FOR DEVELOPMENT OF THE

needed to produced evidence for quality care? PROFESSIONAL STATUS OF NURSING
Emphasis:Nursing theory guides research,
practice, education, and administration. 1. Utilizes in its practice a well-defined and
Outcomes:Middle-range theory may be from well organized body of specialized
quantitative or qualitative approaches. knowledge.
Emerging Goal:Nursing frameworks 2. Constantly enlarges the knowledge it uses
produce knowledge (evidence) for quality and improves its techniques of education
care. and service through scientific method.
3. Entrusts the education of its practitioners
FAWSETT classified nursing models as to universities/colleges.
paradigms within a more organized/ 4. Applies knowledge in practical services
specialized meta-paradigm of: important to community welfare.
 PERSON 5. Functions autonomously in developing
 ENVIRONMENT professional policy.
 HEALTH 6. Attracts individuals with intellectual and
 NURSING CONCEPT personal qualities of intensifying service.
7. Strives to compensate nurses by
Significance of Nursing Theory providing freedom of action, opportunity
for continuous professional growth and
~ At the beginning of 20th century, nursing economic
was not recognized as an academic discipline
or a profession. The terms discipline and CHAPTER 2 Nursing Theorists of
profession are interrelated and some may Historical Significance
even use them interchangeably;however are
not the Historical Views of the Nature of Science
same.  Two competing European
philosophical perspective used in
science are Rationalism and
DISCIPLINE PROFESSION Empiricism.
EPISTEMOLOGY (episteme-knowledge;
-A discipline is - a profession refers logos-study of)
specific to academia to a specialized field -meaning knowledge, understanding
and refers to a of practice, founded - concerned with the theory of
branch of education, on the theoretical knowledge in philosophical inquiry or how
a department of structure of the knowledge came to be.
learning , or a domain science or knowledge - what is real is also considered
of knowledge of that discipline and knowledge
accompanying -it is the study of knowledge & justifies
-Function focus practice abilities. beliefs.
(WHAT NURSES DO)- - it questions what knowledge is and
knowledge focus ow -knowledge of that how it can be acquired.
what nurses know discipline and -this aims to discover the meaning of
and how they use accompanying knowledge and called it the true
them for thinking and practice abilities beginning of philosophy.
decision making while
taking care of patient - Recognition and Philosophical Foundation of Science
respect for their RATIONALISM
- knowledge of a scholarly disciplined  Rationalist epistemology ( scope of
person , health and contribution to the knowledge) emphasizes the importance of
environment forms health society. a prior reasoning that utilizes deductive
the basis for nursing logic by reasoning from cause and effect
as a discipline or from general to particular.
 Uses rational senses in ensuring the
- Kuhn- stated, “the truthfulness of a phenomenon
study of paradigm is  Reynolds (1971)labeled this approach the
what mainly prepares theory-then-research strategy. Any
the student for view of appealing to reason as a source
membership in a and test of knowledge.
particular scientific
Christine Erica Nafarrete UP-FB1-BSN1-03
 Criterion of truth is not sensory but offering the basis for a new
intellectusl and deductive ( general to perspective in science.
specific) - Empiricists view phenomena
 Ex. Lack of social support will lead to objectively, collect data and analyze it to
hopital readmission, “not all” inductively propose theory.

EMPIRICISM Science as a Social Enterprise

 Way of looking at reality using five  “Human beings do science” - Gale. It
senses. might be anticipated that social,
 An object is real in so far as seen, felt, economic, or political factors may
smelled, tasted, heard influence scientific enterprise. It depends
 A theory which states that knowledge on the funds, popularity of certain
comes only or primarily from sensory ideologies.
experiences.  Science progresses by the diversity of
 Fundamental part of scientific method dialogue within the discipline of nursing.
( experimentations) The creation of a merged paradigms is
 Reynolds (1971) called it , the research- debated in relationship to the
then-theory strategy. advancement of nursing.
 It is inductive (specific to general)
 Ex. Collect data->diagnosed CHAPTER 4 Theory Development Process

Theory of Development Process

Theory
 An idea that is suggested or presented as
possibly true but that is not known or
proven to be true.
CHAPTER 3 History of Nursing Science  A set of statements that tentatively
describe, explain, or predict relationship
History of Nursing Science among concepts that have been
Early 20th century views systematically selected and organized as
 Positivism emerged as the dominant view an abstract representation of some
of modern science. phenomenon (Powers and Knapp)
 Modern logical positivists believed that  An internally consistent group of relation
empirical research and logical analysis statements ( concept, definitions, and
were two approaches that would produce propositions) that is represent a
scientific knowledge. systematic view about a phenomenon and
- Philosopher focused on the analysis which is useful for description,
of theory structure. explanation, prediction and control (Bodie
-Scientists focused on empirical & Chitty)
research.  We apply theory to describe, explain,
-Increasing use of computers which predict, or prescribe nursing practice.
permits the analysis of large data.
Categories of Theory Components
Interdependence of Theory and Research Concepts
 In constructing theory, theorists must be  Are words or phrases that are used to
knowledgeable about available empirical represent the phenomenon observed
findings and able to take these into  Are the building blocks of theories,
account, because theory is concerned “ideas”
with organizing and formalizing available  Describe and classify the phenomena
knowledge of a given phenomena
 The theory is subject to revision or maybe Type Meaning Example
abandoned in favor of an alternative
explanation for new information. Abstract Independent CHS
of a certain
Emergent of Science and Theory in the time and
late 20th Century place
 Phenomenological Approach reduces Concrete More specific Nursing,
observations or text to the meanings of time or place Pharmacy
phenomena independent of their Discrete Then may or Patients,
particular context. This approach focuses may not nurses,
on the lived meaning of experiences. belong to a environment
- several authors presented analysis particular
challenging the positivist position, thus category or
class or

Christine Erica Nafarrete UP-FB1-BSN1-03

 phenomena
Continuous Concepts - Pain, health- 10 Phases of concept Building Process
classifications illness 1. Write a meaning practice story.
of dimensions continuum 2. Name the central phenomenon in the
or gradations practice story.
of a 3. Identify a theoretical lens for viewing the
phenomenon phenomenon.
across a 4. Link the phenomenon to existing
continuum literature,
Theoretical Establish Dictionary 5. Gather a story from someone who has
Definitions meaning meaning lived the phenomenon.
(dictionary) 6. Reconstruct the shared story and create a
Operational How these Provide mini-saga that captures its message
Definitions concepts are measurement 7. Identify the core qualities of the
used or will phenomenon
be used 8. Use the core qualities of the phenomenon
within the 9. Create a model of the phenomenon
context of the 10. Write a mini synthesis that integrates the
phenomenon phenomenon with a population to suggest
research direction.

Relational Statements
-statements in a theory may state
definitions or relations among concepts.
Theoretical Statements
-relate concepts to one another; permit
analysis
Operational Statements
-relate concepts to measurements

Linkages and Ordering

Scientific Law Vs. Theory

Scientific Law Theory

 Statements of fact  More complex and

that aims to explain, dynamic; maybe
in brief simple replaced
terms, an action or  Explains an entire
set of actions group
 Generally accepted  Can be changed or
to be true and improved without
universal and can of changing the overall
occasional be truth
expressed in terms  ACCEPTED AS
of a single TRUE AND
mathematical PROVEN
equation
Linkages
SIMPLE, of TRUE, Provide rationale of
UNIVERSAL,
theoretical AND why theoretical
ABSOLUTE
statements statements are
 Governs a single linked; add
action, foundations plausibility
for all of
Linkages science Provides rationale for
operational
Statements based how measurement
on repeated
statements variables are linked;
experimental permit testability
observation
Organization ofthat Eliminates overlap
describes
concepts and some ( tautology)
aspects into
definitions of the
universe
primitive and derived
terms
Always applies
under the same
Organization of Eliminates
conditions, and
statements and inconsistency
implies that there is
linkages into Christine Erica Nafarrete UP-FB1-BSN1-03
a casual relationship
premises and derived
involving its
hypotheses and
elements
equations
 HYPHOTHESIS
 An educated guess based upon
observation
 Can be supported or proven but leads to
further study or discussion
 An assumption made for the sake of
arguments
 HAS NOT BEEN PROVEN
 Ex. Watching excessive amounts of TV

Table of Contents
6. CHAPTER 6 Florence Nightingale: Modern
Nursing
7. CHAPTER 7 Jean Watson: Warson’s Philosophy
and Theory of Transpersonal Caring
8. CHAPTER 8 Marilyn Anne Ray: Theory of
Bureauratic Caring
9. CHAPTER 9 Patricia Benner: Caring, Clinical
Wisdom, and Ethics in NUrsing Practice
NURSING THEORISTS AND THEIR
10. CHAPTER 10 Kari Martinsen: philosophy of WORK
Caring UNIT II Nursing Philosophies
11. Katie Eriksson: Theory of Caritative Caring Christine Erica C. Nafarrete UP-FB1-BSN1-03

reduces a person’s ability to concentrate;

smoking leads to lung cancer. CHAPTER 6 Florence Nightingale:
Modern Nursing
Contemporary Issues in Nursing Theory
Development Florence Nightingale
 Theoretical Boundaries and Levels to  Nightingale’s (1856-1992) NOTES ON
Advanced Nursing Science NURSING presents the nursing theory
-proposed framework now used that focuses on the manipulation of the
without reference to the author for the environment for the benefits of the
development of nursing science. patient.
 Nursing Theory, Practice, and Research  She is known as the MOTHER OF
-theory-testing research may lead one MODERN NURSING
nursing theory to fall aside as a new  Born on May 12, 1820, in Florence Italy.
theory is developed that explains nursing She was named after her birthplace
phenomena more adequately; must continue
to advance the discipline. Crimean War
 March 1853, Crimean war broke out
between Russia and Turkey. Florence
volunteered her services in the war.
 She founded out that: soldiers lay in filth
and in crowded hallways, there rats and
insects, they lack basic supplies ,
inadequate water supply, wounded wears
unwashed clothes and the primary
because of deaths are infections
 At night, she carried lamp through
corridors stopping to help soldiers
therefore she is nicknamed “THE LADY
WITH THE LAMP”

Post- War Contributions

 Nightingale returned to England as a
national heroine in 1856
 She published two books: Notes on
Hospital (1859) and Notes on Nursing
(1859)
 She raised enough funds and used this to
established the Nightingale school and
Home for Nurses at St. Tomas Hospital

Christine Erica Nafarrete UP-FB1-BSN1-03

 Nightingale’s work greatly influenced John 4. Warmth - Nightingale outlined a procedure
Stuart Mill’s book on women’s rights. for measuring the body’s temperature.
5. Quiet - unnecessary noise can actually be
harmful for patient.
Environmental Theory 6. Diet - nurse’s roles is to asses both the
“ Nursing is the art of utilizing the the patient's meal schedule and its effect on the
patient.
Nightingale view of nursing
7. Management - nurse is actually in control
was comparable to motherly
of the environment, physically, and
Nursing instincts. Her “Notes On
administratively.
Nursing”provided guidelines
to women who wanted to
“Nightingale believed that the nurse
become nurses and gave
continuously controlled the environment even
advice on how to think like a
if she is physically absent from caring for the
nurse. Nurse is also should be
patient because she is still responsible for
able to perform nursing
supervising the other members of the health
interventions that will allow
team who worked on her patient during
patients to heal and recover.
absence”
The person is the patient
himself. Passive patient,
Person patient who depends wholly
on the nurse. Nightingale
viewed patient as a person
who needed nursing care
regardless of the patient’s
social worth.
Nightingale viewed health as
being well. Health is also
Health living up to one’s fullest
potential. Disease and illness
are viewed as a reparative
processes that are instituted
by mother nature by mother
nature, when the person
didn’t attend to its concerns.
The environment was viewed
as “those elements external
Environment to and which affect the health
of the sick and healthy
person” and included “
everything from the patient’s
food and flowers to the
patient’s verbal and
nonverbal interactions.”
central to nightingale’s
theory is the concept of a
therapeutic environment that
will enhance the comfort and Theory in View of Metaparadigm:
recovery of patient.
environment for his or her recovery.”
CHAPTER 7 Jean Watson: Warson’s
Environment Philosophy and Theory of Transpersonal
-external conditions and influences affecting Caring
the life and development of an organism.
Jean Watson
Components of Environment:  Born and grew up in a small town of
1. Proper Ventilation - responsibility to keep Welch West Virginia; youngest of the
the air that patient breathe pure eight children began developing her
2. Adequate Light -Direct sunlight has a theory while she was assistant dean of the
quite as real and tangible effects on undergraduate program at University of
human. Colorado.
3. Cleanliness - she advocated taking bath  Worked from 11 curative factors to
daily and that nurses should also bathe formulate her 10 curative factors.
daily while keeping their duty uniforms  Modified 10 factors slightly over time and
clean. developed the caritas processes, which
Christine Erica Nafarrete UP-FB1-BSN1-03
 have a spiritual dimensions and use a
more fluid and evolutionary language. Transpersonal Caring Relationship
 authourized 11 books which reflect the Characterizes a special kind of human care
evolution of theory of caring. relationship that depends on:
-1st book: Nursing: The Philosophy and  The nurse’s moral commitment in
Science of Caring (1876) use 10 carative protecting and enhancing human dignity
factors but evolved to include “caritas” as well as the deeper/higher
(connection between caring and love.  The nurse’s caring consciousness
-2nd book: Nursing: Human Science
communicated to preserve and honor
and Human Care- A Theory of Nursing (1985),
the embodied spirit, therefore, not
addresses her conceptual and philosophical
problem in nursing.
reducing the person to the moral status
of an object.
Transpersonal Caring Relationship  The nurse’s caring consciousness and
 Foundational of her theory; it is a special connection having the potential to heal
kind of human care relationship. since experience, perception and
 A union with another person-high regard intentional connection are taking place.
for the whole person and their being in
the world The term “transpersonal” means to go
 “ Caritas” originates from the g beyond one’s ego and the here and now as
 reek vocabulary, meaning to cherish and it allows one touch to reach deeper spiritual
to give special loving attention connections.
 Watson usus the term “carative” instead
of curative A Caring Occasion is the moment when
the nurse and other person come together
10 Elements of Carative Factors
Carative Factors Clinical Process
Practice loving
Humanistic- kindness and
Altruistic System of equanimity (self-
Value control/composure)
10 Elements of Carative Factors
within context of
Carative Factors Clinical Process caring
Engaging in genuine consciousness.
Transpersonal teaching-learning Being authentically
Teaching -Learning experience that present, and
attends to unity of enabling and
being and meaning, Faith-Hope sustaining the deep
attempting to stay belief system and
within other’s frames subjective life world
. of self and one being
Supportive , Creating a healing cared for.
Protective , and/or environment at all Cultivation of ones
Corrective Mental, levels ( physical as own spiritual
Physical, Societal, well as non-physical). Sensitivity to self practices and
and Spiritual and others transpersonal self,
Environment going beyond ego
Assisting with basic self, opening to
needs, with an others with
intentional caring sensitivity and
consciousness, compassion.
Human Need administering Being presents to,
Assistance “human care and supportive of,
essentials”, which Expressing Positive the expression of
potentiate the unity and Negative positive and negative
of being all aspects Feelings feelings as a
body, mind and connection with a
spirit. deeper spirit of self
Opening and and the one being
attending to spiritual- cared of.
Existential- mysterious ans Creative use of self
Phenomenological- existential Creative Problem and all ways of
Spiritual Forces dimensions of one;s Solving Caring knowing as a part of
own life-death ; soul Process the caring process to
care for self and one- Christine Erica Nafarrete
engageUP-FB1-BSN1-03
in artistry of
being-cared-for. caring- healing
practices.
in such a ways that an occasion for human
caring is created.

Theory of Assertions
 The theory acknowledge the unity of the
person’s mind-body-spirit.
 The mind is the point of access to the
body and the spirit.
 The spirit relates to aperson’s soul, the
inner self. The essence of the person,
the spiritual self.
 It is the spirit that allows the person to
transcend the “here and now”
coexisting with past, present, and
future, all at once through creative
imagination.
 Watson ascertains that the care of the
soul remains the most powerful aspect
of the art of caring in nursing.

Major Assumptions
 Nurse’s ability to connect with another
at this transpersonal spirit to spirit
levels translated via means of
communication.
 Nurse’s own life history or previous life
experiences are valuable teachers for
this work.
 Continiuous growth for developing and
maturing within a transpersonal caring
model is on-going.

Christine Erica Nafarrete UP-FB1-BSN1-03