Nursing theories play a significant role in nursing education, practice and patient interaction. Developed over hundreds of years, nursing theories have evolved to inform the nursing field today.

This guide explains what nursing theory is and who practices it, the various levels and concepts of nursing theory, and notable nurse theories and theorists who have influenced nursing in the present day.

Many who work in the nursing profession use nursing theories at some point in their practice. Nurses learn these theories in their formal education and may apply them during their careers.

Nurse researchers and nurse educators also rely heavily on nursing theories. For example, many university nursing programs will have courses dedicated to nursing theory or will integrate nursing theories in the curriculum.

A master’s of science in nursing program might have a class like theoretical practice, which focuses on how nursing healthcare has developed due to historical, social and political factors. A class on family development and functioning may cover nursing theories relevant to family-centered nursing care.

In research, nursing theories may be tested and evaluated so researchers can make conclusions about their efficacy and make recommendations on how they can be more successful in practice. Nursing researchers may also use nursing theories as background for new trends in nursing, to compare past results and current developments in nursing healthcare.

There are generally three levels of nursing theory, which begin with abstract ideas and become more specific according to each level. The three main categories of nursing theories are grand nursing theories, middle-range nursing theories and practice-level nursing theories. Different levels of nursing theories may influence others. The following details each type.

Most nursing theories focus on four main concepts or metaparadigmsExternal link:open_in_new, according to the College of New Jersey. A nursing metaparadigm definition is that it’s a set of propositions or concepts that serve as a framework from which conceptual models develop. Nursing theories tend to consider each nursing metaparadigm to apply how the principles in each theory relate to them.

In nursing, the four main metaparadigms, according to the Journal of Medical Ethics and History of MedicineExternal link:open_in_new, are person, environment, health and nursing. These four frameworks inform grand nursing theories, middle-range nursing theories and practice-level nursing theories.

The person is at the center of the four key concepts of nursing theory, because the person refers to the patient who is being cared for. The person may also be referred to as “client” and represent a group of individuals, families or communities.

Since every human being is different and has unique experiences, it’s important for nurses to take into account individual characteristics when making healthcare recommendations. Also, it’s beneficial for nurses to apply a human-focused strategy to care, involving emotional care components like empathy and compassionate communication.

Humans are constantly changing in reaction to factors like their environment. This framework takes into account biological, intellectual, psychological and sociocultural dimensions of the human patient.

A nursing environment is the setting in which nursing healthcare is provided. It affects both the patient and their ability to heal, as well as the nursing team due to factors like nursing unit morale. A nursing environment can be affected by issues such as noise levels, lighting, scent, the amount of space in rooms and access to nature.

In nursing, the environment also extends beyond the healthcare setting. It relates to the patient’s everyday life and social experience. The environment metaparadigm in nursing includes personal, social, national and global aspects, as well as societal beliefs and customs.

Health in nursing relates to both improving a patient’s immediate healthcare state and helping them maintain their overall health and well-being. Certain factors in a nursing environment can improve a patient’s health, including cleanliness, preparedness and a sense of caring. Basic medical needs like food and clean water can also impact a person’s health.

Health impacts the entire lifespan. This metaparadigm looks at the overall life of a client, including physical as well as social, moral and aesthetic areas. Health is contextual, relating to a human’s current state in their environment.

For example, how health is characterized in a theory related to senior care will look different to how health is characterized in a theory related to newborn babies.

Finally, the nursing practice metaparadigm refers to nursing as a practice profession and as an academic discipline. At its core, nursing is a practice that promotes health and advocates for patients. It’s a professional calling that requires training and education to provide optimal direct patient care. Nurses use nursing theory to inform their decisions and to think critically to determine the best treatment in any situation.

Nursing is based on scientific theory, but it also takes into account the human element to apply the best evidence-based care in diverse settings. Nurses use logical analysis, research and nursing theories to provide care that also factors in human choice and responsibility.

For example, a nurse whose patient is a smoker may recommend one form of smoking cessation over another, due to the patient’s overall health and decision-making patterns.

Nursing theory is based on centuries of nursing practice and research. Nursing theories have been tested and evaluated over time, providing modern-day nurses, nurse educators and nurse researchers with more insights to inform their practices. Nursing theories help to contextualize nursing practice and provide examples of how different types of care can affect patients in diverse populations.

Using nursing theories can also help improve patient outcomes. The Nordic College of Caring Science’s review of 35 nursing theory studiesExternal link:open_in_new found theory-guided interventions improved all of the studied outcomes in 26 studies and at least one outcome in the remaining nine studies. No studies reported that nursing theory-guided interventions weren’t useful. The study review recommends nurses continue to use nursing theories to guide their practice.