A "nursing theory" is a description or explanation of an area of professional nursing. This description or explanation is proposed in a systematic way in order to provide the broadest and most practical information for use in nursing practice and research. However, there is no one "universal" nursing theory. There are three major types of nursing theories, dealing with general concepts and models for everyday experiences. The greatest barrier to effective application of any nursing theory is trying to employ the wrong type of theory, or model, in a particular nursing situation.
Misapplication of General Theories
Nursing "grand theories" are general concepts that pertain to the overall nature and goals of professional nursing. A grand theory, and there are many, is a synthesis of scholarly research, professional experience and insights from theoretical pioneers (such as Florence Nightingale). While there are many benefits to knowing and understanding grand theories, these constructions are often abstract and do not lend themselves to empirical testing or problems in specific nurse settings. Therefore it would be a mistake, or a barrier to effective application, if a nurse were to employ a grand theory when encountering a unique patient situation or problem.
Limitations of Middle-range Theories
Middle-range nursing theories are models that can be applied to professional practice. They also serve as frameworks for research. Middle-range theories include specific concepts and provide strategies for delivering quality patient care. While middle-range theories are much less abstract than grand theories, the biggest problem in effective implementation of middle-range theories is that they do not deal with specific populations of patients and any specific problems. Therefore, while these theories will offer valuable guidelines for nurses, they cannot be applied to unique or particular health care issues.
Expecting Too Much From Practical Theories
Nurse practice theories are constructions that deal with questions that pertain to particular and specific issues, settings and populations. They are very valuable for day-to-day experiences. However, their limitation is that they have little connection to foundational nursing theories and research. Problems are often solved with new or improvised methods. While these methods may prove effective, much time can be lost with such improvisation. Often patients in emergency situations do not have time to lose.
Lack of a Complementary Philosophy
Professional nurses, in all fields and levels of leadership, must adopt a complementary approach to patient care. One type of theory cannot be applied to all types of patient conditions. Unfortunately, many nurses do not have an adequate enough understanding of the types of nursing theories to employ them effectively. This lack of understanding may point to an inadequate educational background and lead to unsatisfactory patient care.