1. Nursing Theories in Implementing Theoretical Courses in Nursing
Hesook Suzie Kim, PhD, RN
Professor, College of Nursing
University of Rhode Island

2. Types of Theoretical Courses in Nursing
Health, health care, health care systems, & related ecosystem and cultural issues
The profession of nursing
Methods of inquiry and research
Theoretical courses with clinical contents for different population groups
Nursing practice
Nursing interaction

3. Variations in the Modes of Incorporating Nursing Theories in the Courses
Conceptual framework or grand theory as the schema for organizing curricular contents
Conceptual framework or grand theory as the schema for systematizing nursing process
Eclectic selection and teaching of nursing theories

4. As the Schema for Organizing Curricular Content
Holism as the organizing framework
Systems perspective as the organizing framework
Adaptation perspective as the organizing framework
Needs perspective as the organizing framework
Self-care perspective as the organizing framework
Caring perspective as the organizing framework

5. As the Schema for Systematizing Nursing Process
Major conceptual categories regarding persons as the basis for organizing assessment data
Explanatory ideas as the basis for making inferences about patients’ status
Explanatory ideas as the basis for selecting patient-care approaches

6. Eclectic selection and teaching of nursing theories
No specific commitment to a specific grand theory or conceptual framework
The major impetus for bringing in nursing theories – Heuristic value
Commitment to Pluralism in nursing knowledge development and applicability
Can be opportunistic, biased, or haphazardly selected

7. Eclectic selection and teaching of nursing theories
Guidelines for this approach
Establishment of Ontological Commitments regarding Humans, Human Living, and Practice
Epistemological understanding regarding the Nature of Nursing Knowledge
Formalization of A Model of Nursing Practice

8. Ontological Commitments
Ontology of Humans & Human Living
Biophysical entity
Self & individuality
Social, cultural, & historical embeddedness
Boundedness & determinism
Language, intentionality, self-determination, and consciousness
Ontology of Practice
Human to human engagement
Helping as the normative focus
Responsibility in one’s own action
Practice as situation-bound

9. The Nature of Nursing Knowledge
Client phenomena of interest to nursing – Nursing’s epistemic concerns regarding humans as clients of nursing
Types of Knowledge needed for practice
Enlightenment & Understanding
Explanation & Prediction
Control & Manipulation
Multiple routes to nursing knowledge development

10. Formalization of a Model of Nursing Practice
An example from AACN
Practice in providing care
Holistic base by incorporating bio-psycho-social & spiritual aspects
Advocacy and Education
Clinical judgment & decision-making
Clients with diverse background
Engagement in diverse environment
Practice in designing, managing, & coordinating care
Coordination in a health-care team
Information management
Practice as a member of the nursing profession

11. A Model of Nursing Practice
Two Philosophical Orientations
Philosophy of Care
Philosophy of Therapy
Three Dimensions of Practice
Scientific Dimension
Ethical Dimension
Aesthetic Dimension
Two Interacting Phases of Practice
Deliberation
Enactment

12. A Model of Nursing Practice
Ethical Dimension
Philosophy of Therapy
Scientific Dimension
Philosophy of Care
Deliberation
Enactment
Aesthetic Dimension

13. Nursing Epistemology
Four Types of Cognitive Needs in Nursing and Four Spheres of Knowledge
Inferential Needs – Generalized Knowledge Sphere
Referential Needs – Situated Hermeneutic Knowledge Sphere
Transformative Needs – Critical Hermeneutic Knowledge Sphere
Desiderative Needs – Ethical/Aesthetic Knowledge Sphere

14. Nursing Epistemology GENERALIZED KNOWLEDGE SPHERE SITUATED HERMENEUTIC
CRITICAL HERMENEUTIC
KNOWLEDGE SPHERE
INFERENTIAL
FOCUS
TRANSFORMATIVE
FOCUS
REFERENTIAL
FOCUS
SYNTHESIS
DISIDERATIVE
FOCUS
ETHICAL/AESTHETIC
KNOWLEDGE SPHERE

15. Theories in Different Knowledge Spheres
Generalized Knowledge Sphere – Inferential theories (Descriptive, Explanatory, & Prescriptive)
Situated Hermeneutic Knowledge Sphere – Referential theories (Descriptive)
Critical Hermeneutic Knowledge Sphere – Transformative theories (Descriptive, Explanatory, & Prescriptive-transformative)
Ethical/Aesthetic Knowledge Sphere – Normative theories

16. Selection & Incorporation of Nursing Theories
Selection of the Subject Matter or Topics in Courses (Based on some other organizing theory or framework)
Survey of nursing theories in the literature related to the subject matter
Selection of nursing theories in relation to four cognitive needs
Incorporation into teaching

17. Incorporation of Nursing Theories into Teaching
Understanding the phenomena
Finding nursing approaches related to the phenomena
Theories for Inferential Purpose
Theories for Referential Purpose
Theories for Transformative Purpose
Theories for Desiderative Purpose

18. An Example: Pain Inferential Focus Referential Focus
Transformative Focus
Desiderative Focus
Understanding the Phenomena
Biochemistry of pain
Gate control theory of pain
Psychological theory of pain expression
Pain experience trajectory
Embodied experience of pain
Suffering
Meaning theory of pain
Meta-narratives of pain
Stigma of pain
Transcultural theory of pain
Nursing approaches re: the phenomena
Theories of pain assessment
Theories of pain management
Clinical assessment of pain
Phenomenology of pain management
Theories of client-nurse collaboration
Theories of emancipation & empowerment
Ethical theory of pain management
Normative theory of pain management

19. A Proposal
Knowledge of key nursing theories which are well established and have disciplinary respect
Determination of general nursing theories applicable to many (or across) nursing phenomena
Selection of nursing theories specific to given nursing phenomena
Focus on establishing the nursing practice perspective

20. Types of Theoretical Courses in Nursing
Health, health care, health care systems, & related ecosystem and cultural issues
The profession of nursing
Methods of inquiry and research
Theoretical courses with clinical contents for different population groups
Nursing practice
Nursing interaction