Nursing has its beginning as a domestic service provided by religious institutions and a trade based on individual skill. A major development in the history of nursing is credited to Florence Nightingale, who helped transform nursing from a trade to vocation. Being a member of the upper class, she had access to education and training, which allowed her to develop an environmental theory of nursing and advance her ideas of a nursing vocation. She has set nursing’s evolution into a science and profession founded on the unique theory to nursing.
Florence Nightingale’s Nursing Theory
In the early 19th century, hundreds of hospitals or hospital-affiliated nursing, training programs were set up, most of them followed the Nightingale’s model. There were little academic instructions considering the training of students to perform nursing. Different nursing organizations, such as the American Nurses Association, were instrumental in the transformation of nursing into a profession. These organizations worked for the regulation of nursing through licensure. State boards standardized nursing training by decreasing the focus on skills and increasing theoretical instruction.
In 1910, standard requirements of a health care profession were advocated by Abraham Flexner. His contribution led to the emerging of higher-learning preparation in nursing, the stimulus to develop a body of knowledge unique to nursing, the organization of nurses, and the establishment of nursing ethics. Nursing as a profession was developing with startlingly rapid progress. Columbia University was the first to offer a postgraduate nursing program, in the 1950s, whose graduates became pioneers in nursing theory. Hildegard Peplau published the first work considering the theory of nursing.
The focus of theory’s construction at this early stage of the nursing profession was to define what nurses did. The most accessible framework was the traditional, biomedical model with a focus on diagnosis and cure. Similarly, nursing theorists put emphasis on the problems and needs of patients. Peplau developed the interpersonal relations theory, in 1952, introducing a therapeutic relationship, which facilitated the resolution of patients’ problems. In 1955, Henderson presented 14 patients’ needs that were met independently through nursing assistance. Abdellah espoused a patient-centered nursing care, in 1960, which aimed at identifying patients’ needs and providing comprehensive care.
In the 1970s, graduates of Columbia University had an opportunity to continue their studying at the school of nursing in Yale. Nursing theorists moved on to explore not only the functions of a nurse but also the nurse-patient relationship. Nursing was established as a scientific way of providing patients’ needs, an art, and a caring profession as exemplified by the works of Joyce Travelbee, in 1966, and Wiedenbach, in 1964. Earlier theories were continuously enriched and revised with numerous practice and doctorates’ studies. New ones were added to broaden the scope of the theory further.
The Influence of Globalization on Nursing Theory
In 1984, Patricia Benner characterized professional development in nursing from novice to expert. Leininger promoted transcultural nursing, in 1980. In 1986, Meleis theorized different categories of transitions, which nurses must consider when providing care. The following decade, the evidence-based theoretical movement that swept the medical profession influenced nursing and resulted in the emergence of more extensive researches. This shifted efforts from grand theory’s construction of what nursing is and how nursing care should be provided to theories with a narrower, more particular focus, which can be used to guide specific practice. Moreover, globalization encouraged international interaction contributing to the diversity of nursing theory.
Theorists in the sphere of nursing are influenced by other disciplines. This is unavoidable since health, education, management, informatics and many other aspects of nursing are not unique to the profession. Nurses utilize knowledge in biology to understand, explain, and predict physiologic responses. Educators in the field of nursing apply to theories of learning to teach their students. However, borrowed theories are not sufficient in explaining nursing phenomena. Thus, they are adapted to suit the nursing context to provide various perspectives of knowledge and practice specific to nursing. In this manner, nursing remains a science which shares theories with other disciplines.
The establishment of nursing as a profession allowed nurses to create and shape a body of knowledge unique to them. It is an ongoing process. Further researching of key nursing concepts, peculiarities of provided nursing care, various facets of nursing practice have been enhancing the theory. In the process, nursing science provides the basis for nursing advancement and developments, while the practice of professional nursing propels nursing science.
In conclusion, the roles of nurses continue to evolve and broaden considering their skills and responsibilities that have similarly become more complex. Theory will also be tested and improved on the base of continuously broadening nursing practice. Nursing will also continue to use theories from an increasing number of other disciplines. Nursing could not have transcended its status as a vocation without theory building and face the challenges of being a profession.