This document discusses nursing philosophy and theory. It begins by introducing Virginia Henderson's nursing philosophy and conceptualization of 14 basic human needs that nursing aims to help patients meet. Henderson defined nursing as assisting patients with activities contributing to health that they would do for themselves if able. The document then discusses Florence Nightingale's early philosophy of nursing, which emphasized the relationship between a patient's environment and their health. Nightingale believed nurses should manage patients' surroundings to protect their health. Both Henderson and Nightingale helped define nursing's focus on the person, health, environment, and nursing itself.

1. NUR 3846 Broward Community College Nursing Philosophy Discussion
NUR 3846 Broward Community College Nursing Philosophy Discussion ON NUR 3846
Broward Community College Nursing Philosophy DiscussionConsider one of the nursing
theories, conceptual frameworks, or mid-range theories presented in the textbook and
class.Which philosophy/conceptual framework/theory/middle-range theory describes
nursing the way you think about it?What is your rationale for selecting this
theory/framework?Discuss how you could utilize the philosophy/conceptual
framework/theory/middle-range theory to organize your thoughts for critical thinking and
decision making in nursing practice.i attached a file below. please read it and answer the
questionsplagiarism freereferences NUR 3846 Broward Community College Nursing
Philosophy Discussionattachment_1Unformatted Attachment PreviewNursing Theory The
Basis for Professional Nursing LEARNING OUTCOMES After studying this chapter, students
will be able to: • Define philosophy, conceptual frameworks, theory, and middle-range
theory. • Consider how selected nursing theoretical works guide the practice of nursing. •
Understand how nursing philosophy or theory shapes the curriculum in schools of nursing.
• Delineate the role of nursing theory for different levels of nursing education. • Describe
the function of nursing theory in research and practice. To enhance your understanding of
this chapter, try the Student Exercises on the Evolve site at
http://evolve.elsevier.com/Black/professional. Chapter opening photo used with
permission from Photos.com. “Theory” is a word that is used often in daily language, such as
“I have a theory about that” or “In theory, this should work.” The word “theory” in this
context means that the person has some idea about a phenomenon and the way this
phenomenon works in the world. When people say, “I have a theory…” about a certain
phenomenon or situation, they are demonstrating something about their own distinct
orientation or way of seeing the world. “Theory” comes from the Latin and Greek word for
“a viewing” or “contemplating.” Nursing as a profession has a distinct theoretical orientation
to practice. This means that the practice of nursing is based on a specific body of knowledge
that is built on theory. This body of knowledge shapes and is shaped by how nurses see the
world. Parsons (1949) described theory as important because it makes a distinction
between what we know and what we need to know. The word theory has many definitions,
but generally it refers to a group of related concepts, definitions, and statements that
describe a certain view of nursing phenomena (observable occurrences) from which to
describe, explain, or predict outcomes (Chinn and Kramer, 1998). Theories represent
abstract ideas rather than concrete facts. New theories are always being generated,

2. although some theories are useful for many years. NUR 3846 Broward Community College
Nursing Philosophy DiscussionWhen new knowledge becomes available, theories that are
no longer useful are modified or discarded. You will be reading about Sister Callista Roy’s
adaptation model, one that has “stood the test of time” since the 1970s; its use expanded
from its origins as a curriculum framework for bachelor of science in nursing (BSN)
education to its current use as an organizing framework for nurses (Alligood, 2011). So why
is theory important? First, nursing as a profession is strengthened when nursing knowledge
is built on sound theory. As seen in Chapter 3, one criterion for a profession is a distinct
body of knowledge as the basis for practice. Nursing began its transition from a vocation to
a profession and academic discipline in the 1950s (Bond, Eshah, Bani-Kaled, et al., 2011).
Nursing has knowledge that is distinct from, although related to, other disciplines such as
medicine, social work, sociology, and physiology, among others. The development of
nursing knowledge is the work of nurse researchers and scholars. The evolution of the
profession of nursing 177depends on continued recognition of nursing as a scholarly
academic discipline that contributes to society. In today’s research environment where
theory is developed and tested, interdisciplinary collaboration is now considered to be a
critical approach to the development of knowledge. Use of nursing theory in other
disciplines is not yet common, however (March and McCormack, 2009). Even in our own
discipline, unfortunately, nursing theory is underused in ing research. A recent study
demonstrated that nursing theory was used infrequently in research published in nursing
journals between 2002 and 2006: only 460 of 2184 (21%) research articles published in
seven top nursing research journals used nursing theory (Bond et al., 2011). Second, theory
is a useful tool for reasoning, critical thinking, and decision making (Tomey and Alligood,
2010). The ultimate goal of nursing theory is to excellence in practice. Nursing practice
settings are complex, and a large amount of information (data) about each patient is
available to nurses. Nurses must analyze this information to make sound clinical judgments
and to generate effective interventions. From organization of patient data to the
development and evaluation of interventions, theory provides a guide for nurses in
developing effective care. Box 9-1 shows how theory guides nursing practice. Several words
are used to describe abstract thoughts and their linkages. From the most to least abstract,
these include metaparadigm, philosophy, conceptual model or framework, and theory.
Metaparadigm refers to the most abstract aspect of the structure of nursing knowledge
(March and McCormack, 2009). The metaparadigm of nursing consists of the major
concepts of the discipline—person, environment, health, and nursing—that were discussed
in Chapter 8 and will be addressed again in Chapter 11. In the past two decades, caring has
been added as a major concept of the discipline central to nursing knowledge development
and practice. Simply stated, these five concepts comprise the metaparadigm of nursing; that
is, these are the concepts (abstract notions or ideas) of most importance to nursing practice
and research. Nursing philosophies, models, and theories contain most or all of these
concepts. BOX 9-1 Nursing Theory and the Professional Nurse Theory guides the
professional nurse in: 1. Making sound clinical judgments based on evidence by a.
Determining which data are important b. Organizing, analyzing, and understanding
connections in patient data 2. Planning appropriate nursing interventions 3. Evaluating

3. outcomes of interventions A philosophy is a set of beliefs about the nature of how the world
works. A nursing philosophy begins to put together some or all concepts of the
metaparadigm. For instance, Florence Nightingale, whose work will be considered in more
detail later in this chapter, wrote Notes on Nursing: NUR 3846 Broward Community College
Nursing Philosophy DiscussionWhat It Is and What It Is Not, in which her basic philosophy
of nursing is described in detail. A conceptual model or framework is a more specific
organization of nursing phenomena than philosophies. As the words “model” or
“framework” imply, models provide an organizational structure that makes clearer
connections between concepts. Theories are more concrete descriptions of concepts that
are embedded in propositions. Propositions are statements that describe linkages between
concepts and are more prescriptive; that is, they propose an outcome that is testable in
practice and research. For example, Peplau’s (1952/1988) book Interpersonal Relations in
Nursing contains a theory that describes very specific elements of effective interaction
between the nurse and patient. Using concepts from nursing’s metaparadigm, Peplau
created a theory delineating elements of excellent and effective practice in psychiatric
nursing. She linked abstract concepts such as health and nursing to create a concrete, useful
theory for practice. Peplau’s theory will be described later in this chapter. The primary
source—the original writings of the theorist—is the best source for in-depth understanding
of the theory. In the original writings, the theorist will describe exactly what he or she is
thinking and how the concepts go together. Articles written by other scholars can be helpful
in explaining and interpreting primary sources. Explanatory or interpretive articles
introduce students to the historical development of the philosophy, model, or theory and
specify criteria (standards) by which to analyze, critique, and evaluate them. Articles such
as these were first published in the early 1980s with a completely different purpose than
the theorists’ original articles. Explanatory or interpretive articles are written to contribute
to the general understanding of nursing theory and theoretical developments in nursing in a
unique but complementary way. Undergraduate and graduate students, faculty, and
practicing nurses have found that these explanatory and interpretive articles on nursing
theory make a significant contribution to their knowledge and understanding of nursing
science in its own right. Many of the articles and books cited in this chapter were texts
written to clarify, describe, and interpret theorists’ work. In this chapter, four types of
nursing theoretical works will be presented: philosophies, conceptual models, 178theories,
and middle-range theories. Selected works from each of these four types provide a broad
overview of theory within the discipline of nursing. This introduction is designed to help
you develop a beginning understanding of nursing theory on which to build as you pursue
your nursing education and career in the profession of nursing. Philosophies of Nursing
Chapter 8 introduced nursing philosophy and discussed its function in nursing practice and
educational institutions. A philosophy provides a broad, general view of nursing that
clarifies values and answers broad disciplinary questions such as the following: “What is
nursing?” “What is the profession of nursing?” “What do nurses do?” “What is the nature of
human caring?” “What is the nature of nursing practice and the development of practice
expertise?” Three philosophies representing different positions in the development of
nursing theory are presented here. NUR 3846 Broward Community College Nursing

4. Philosophy DiscussionTable 9-1 contains questions that represent the different views of the
same patient situation among nurses who subscribe to the philosophies of Florence
Nightingale, Virginia Henderson, and Jean Watson, whose work is presented here.
Nightingale’s Philosophy Florence Nightingale was born in 1820, in Florence, Italy. She was
the daughter of a wealthy English landowner and his wife, Fanny, whose goal in life was to
find suitable husbands for her daughters. Florence was very close to her father, and he
undertook the responsibility for her education, teaching her a classical curriculum of Greek,
Latin, French, German, Italian, history, philosophy, and mathematics. At 25 years of age,
after deciding to remain unmarried, Florence announced her decision to go to Kaiserswerth,
Germany, to study nursing, over the strong objections of her parents. At that time, nursing
was considered the pursuit of working-class women. Her persistence in the face of her
parents’ opposition proved to be a sustained characteristic over the course of her life. This
trait enabled her to accomplish work that most women of the time would not have had the
education or willingness to achieve. TABLE 9-1 Three Philosophies of Nursing: Three
Different Responses to the Same Patient Situation Florence Nightingale What needs to be
adjusted in this environment to protect the patient? Virginia Henderson What can I help this
patient do that he would do for himself if he could? Jean Watson How can I create an
environment of trust, understanding, and openness so that the patient and I can work
together in meeting his or her needs? Nightingale’s work represents the beginning of
professional nursing as we know it today. In Notes on Nursing: What It Is and What It Is Not
(1969; originally published in 1859), Nightingale explained her philosophy of health, illness,
and the nurse’s role in caring for patients. Importantly, she made a distinction between the
work of nursing and the work of physicians by identifying health rather than illness as the
major concern of nursing. Her writing about nursing reflected the sociohistorical context in
which she lived, making a distinction between the work of nursing and the work of
household servants, who were common in her day and often cared for the sick. Nightingale’s
unique perspective on nursing practice focused on the relationship of patients to their
surroundings. She set forth principles that were foundational to nursing and remain
relevant to nursing practice today. For example, her description of the importance of
observing the patient and accurately recording information and her principles of cleanliness
still shape hospital-based nursing practice today. Nightingale focused the profession on
what has become known as the metaparadigm of nursing: person (patient), health (as
opposed to illness), environment (how the environment affects health and recovery from
illness), and nursing (as opposed to medicine). Using Nightingale’s Philosophy in Practice
Nightingale believed that the health of patients was related to their environment. She
recognized the importance of clean air and water and of adequate ventilation and sunlight
and encouraged the arrangement of patients’ beds so that they were in direct sunlight. In
her writing, she described both the necessity of a balanced diet and the nurse’s
responsibility to observe and record what was eaten. Cleanliness of the patient, the bed
linens, and the room itself were essential. Nightingale recognized the problem of noise in
hospital rooms and halls, which foreshadowed the attention given to excess noise in
inpatient settings in recent years. Rest is important in the restoration of health; Nightingale
believed that sudden disruption of sleep was a serious problem. The relationship of health

5. to the environment seems obvious today, but for nursing in the second half of the 19th
century, Nightingale’s work was radically different. Nightingale recognized nursing’s role in
protecting patients. Nurses were newly responsible for shielding patients from possible
harm by well-meaning visitors 179who may provide false hope, discuss upsetting news, or
tire the patient with social conversation. NUR 3846 Broward Community College Nursing
Philosophy DiscussionNightingale even suggested that the nurse’s responsibility for
patients did not end when the nurse was off duty. This view underpins the system of
primary nursing found in some settings today. Interestingly, Nightingale suggested that
patients might benefit from visits by small pets, an idea that has been incorporated in both
long-term and some acute care settings. The nurse whose practice is guided by Nightingale’s
philosophy is sensitive to the effect of the environment on the patient’s health or recovery
from illness. This philosophy provided the foundational work for theory development that
proposed changing patients’ environments to effect positive changes in their health.
Nightingale promoted the view that nurses’ primary responsibility was to protect patients
by careful management of their surroundings. Henderson’s Philosophy Virginia Henderson,
whose photo is featured on the title page of this chapter, was born in 1897 in Kansas City,
Missouri, and was named for her mother’s home state to which her family returned when
Henderson was 4 years old. Although she received an excellent education from a family
friend who was a schoolmaster and from her father who was a former teacher, Henderson
did not receive a traditional education that awarded a diploma, which delayed her entry
into nursing school. During World War II, she studied under Annie Goodrich at Teachers
College, Columbia University, where, after numerous interruptions, she received her
bachelor’s and master’s degrees. By the time she died in 1996, Virginia Henderson was
internationally known and regarded by many as “the Florence Nightingale of the 20th
century.” One hundred years after Nightingale, Virginia Henderson’s work first was
published, emerging at a time when efforts to clarify nursing as a profession emphasized the
need to define nursing. Henderson’s philosophical approach to nursing is contained in her
comprehensive definition: the “unique function of the nurse … is to assist the individual,
sick or well, in the performance of those activities contributing to health or its recovery (or
a peaceful death) that he would perform unaided if he had the necessary strength, will or
knowledge” (Henderson, 1966, p. 15). Although Henderson was recognized for many
contributions to nursing throughout her long career, her early work remains particularly
noteworthy and relevant, defining nursing and specifying the role of the nurse in relation to
the patient. Henderson’s relationship with one of her former students, who recognizes the
ongoing contributions of Henderson’s work to nursing, is described in Professional Profile
Box 9-1. Henderson’s philosophy linked her definition of nursing that emphasized the
functions of the nurse with a list of basic patient needs that are the focus of nursing care.
She proposed an answer to questions similar to those addressed by Nightingale a century
earlier: “What is the nursing profession?” and “What do nurses do?” Henderson described
the nurse’s role as that of a substitute for the patient, a helper to the patient, or a partner
with the patient. Henderson identified 14 basic needs (Box 9-2) as a general focus for
patient care. She proposed that these needs shaped the fundamental elements of nursing
care. The function of nurses was to assist patients if they were unable to perform any of

6. these 14 functions themselves. Although these needs can be categorized as physical,
psychological, emotional, sociologic, spiritual, or developmental, thoughtful analysis reveals
a holistic view of human development and health. The first nine needs emphasize the
importance of care of the physical body: breathing, eating and drinking, elimination,
movement and positioning, sleep and rest, suitable clothing, maintenance of suitable
environment for the body temperature, cleanliness, and avoidance of danger or harm. Next
she included psychosocial needs such as communication and spirituality, including worship
and faith. NUR 3846 Broward Community College Nursing Philosophy DiscussionShe
concluded with three developmental needs: the need for work and the sense of
accomplishment; the need for play and recreation; and the need to learn, discover, and
satisfy curiosity. Henderson believed that all 14 basic needs are amenable to nursing care.
They continue to be used today in philosophical statements of schools and departments of
nursing. Using Henderson’s Philosophy in Practice Nurses whose practice is consistent with
Henderson’s philosophy adopt an orientation to care from the perspective of the 14 basic
needs. Henderson’s clarity about the role and function of the nurse is a strength of her work.
This philosophy is easily applied to a variety of patient care settings, from brief outpatient
encounters in which a limited number of needs are addressed to a complex setting such as
intensive care where patients are extremely vulnerable. Henderson used her definition of
nursing and the basic needs approach in her well-known case study of a young patient who
had undergone a leg amputation. Using this case, Henderson (1966) demonstrated how the
nurse’s role changes on a day-to-day, week-to-week, and month-tomonth basis in relation to
the patient’s changing needs and the contributions of other health care providers.
PROFESSIONAL PROFILE BOX 9 -1 Edward J. Halloran, PhD, RN, FAAN Remembering
Virginia Henderson Although I had known Virginia Henderson from the time I was a
graduate student at Yale, geography later brought us more closely together. Knowing her
family lived in Virginia (mine was in Connecticut), whenever I traveled by car from North
Carolina to Connecticut I called and asked if she wanted a ride back home with me, because
I could drop her off in Virginia en route to North Carolina. Six times we made the 8-hour
ride together. Our conversations were wide-ranging because we were both world travelers.
We talked much about politics; most about nurses—“see a nurse before you go to a doctor”
as a solution to health care cost, quality, and access problems; some about patients—“give
them their records” as a most important patient education tool; and some about our large
extended families. I was introduced to two of Virginia Henderson’s sisters when they were
…NUR 3846 Broward Community College Nursing Philosophy Discussion