The theory-practice relationship in nursing: an exploration of contemporary discourse

The nature of nursing practice, the nature and origins of nursing theory and the issue of the relationship between theory and practice are matters which have and continue to generate extensive philosophical discourse within nursing. Despite the abundance of literature on these matters, to date there have been few attempts to bring together, to summarise and to characterise the various ways in which the theory-practice relationship is understood within nursing. This paper offers a description of the principal ways in which the theory-practice relationship is commonly understood within contemporary philosophical discourse. An exploration of contemporary, scholarly discourse within the nursing literature, using Carr's typology of theories of theory and practice, as a framework for analysis, points to evidence that the theory-practice relationship is understood in a number of different ways. Foremost among these is the tendency to think of nursing as an applied-science and there is a tendency to think of theory and practice as separate endeavours. The content of the discourse also points to a tendency to view the relationship as one in which the basis for practice lies in the collective 'common-sense' understandings of practitioners engaged in practice. The relationship is also understood in terms of nursing being an 'ethical' activity in which practical wisdom, deliberation, judgements and choices are required for the conduct of practice. There is, in more recent discourse, evidence of views which attempt to contextualise nursing within its social reality and thus to conceive of the theory-practice relationship in ways congruent with the recognition that nursing practice is a human and a social enterprise that is inherently 'problematic'. These contemporary conceptualizations of the theory-practice relationship would appear to have evolved through a process in which each new conception has been accommodated with and assimilated into the already existing understandings. Ways of viewing the theory-practice relationship are expressed either explicitly or, in many instances, are implicit in and recoverable from expressions of views, beliefs and assumptions. It would appear that the current state of thinking with respect to the theory-practice relationship is one of eclecticism and pluralism and there is a general openness to the contribution of different paradigms of knowing to epistemological development.