Theories and models of nursing and the nursing process

In summary, nursing models can be evaluated by carefully considering how human beings are conceptualised within a model, how adequately the model guides nurses in the decision-making associated with all stages of the nursing process and how appropriate is the expected role of the nurse. Reference to the criteria for evaluating nursing theory (Fig. 1) demonstrates that not only can nursing models be regarded as the precursors of nursing theory but some evaluative criteria for nursing theory develop from ways of evaluating nursing models (Fig. 2). The essence of this paper has been to consider nursing theory and its place in the current climate of concern both about nursing's professional status and about standards of patient care. The difficulty in defining theory has been briefly explored and suggestions have been made of possible ways of evaluating nursing theory. A distinction has been drawn between nursing models and nursing theory with a rationale for considering nursing models as precursors of nursing theory especially as there are similarities in the criteria used to evaluate them both. The nursing process has been described as a systematic, problem-solving approach to care. It is neither a nursing model nor a theory but rather one way of organising nursing activities. A major dilemma has been omitted from this paper, however, which nonetheless deserves mention here. This dilemma is identified and summarised by Jacox (1974) among others. The question posed is: Can and should we develop nursing theories?' (Jacox's emphasis). The main competing arguments put forward by Jacox are on the one hand that there are no phenomena or activities peculiar to nursing around which nursing theory can develop, and on the other hand that there is a need for a specified body of knowledge to inform nursing practice. Efforts to establish a firmer body of knowledge on which to base nursing practice may help to identify the unique function of the nurse. This will only be achieved if practising nurses take a keen interest in developing rigorous approaches to the evaluation of nursing models and theories. Craig (1980) has linked theory development and its integration with nursing practice to professional survival. If nurses cannot identify phenomena and activities that are peculiar to nursing and if they are not prepared to safeguard these areas of practice, then the future of nursing looks bleak. Project 2000 (UKCC 1986) offers an opportunity for nurses to be more willing and able to critically consider nursing's unique contribution to health care.