Essay on Theoretical Basis of Advanced Nursing Practice

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Table of Contents
1. Introduction 2
2. Phenomenon of Interest 3
3. Nursing Meta- paradigm 4
3.1. Person (Human being): 5
3.2. Environment: 5
3.3. Health: 5
3.4. Nursing: 5
4. Grand Nursing theory 6
5. Middle Range Nursing theory 7
6. Complexity Science 7
7. Conclusion 9
8. References 10

With the tremendous development of science and technology in the last few decades, there has been a great boost in the medical field and its requirements. Due to the unhealthy lifestyles and improper eating habits, increasing number of people are getting prone to number of diseases and illnesses. Thus, during such times, along with the advancement in the medicines and treatment provided by the Doctors, there has to be up gradation in the Nursing practice. Nursing practice has been observed since ancient times. But, however, their roles and responsibilities are changing along with changing times. Nowadays, a nurse has to have an overall understanding of the medical illnesses faced by the patient as well as have excellent grooming and communication skills that would help in developing positive atmosphere for the patient and this would help them in recovering much faster from their illness or disease (Jones and Bartlett Learning, 2015).
There have been many theories which are developed on the scopes and potential of the nursing practice. These theories have provided the ideal behavior and frame work for the nursing practice. It is found that there are various critical situations that have to be faced by the nurses during their practice. These difficulties are evaluated and the scope of nursing practice based on two theories namely, Grand Nursing theory and Middle range nursing theory have been developed after analyzing them. A nursing paradigm is going to be obtained which has also been developed in the earlier paper regarding the Best Practices for Psychiatric Medication Adherence. There has to be special focus laid on the quality of nursing practice that is followed. The need of providing advance education to the nurses have been discussed in the paper which serves to be the phenomenon of interest for the paper.
Phenomenon of Interest
The phenomenon of interest of the paper serves to be maintaining the high quality of nursing practice for sustaining best practices of health care and post operation practices across the globe. There has been extensive studies developed on the quality of nursing practices adopted. There has been considerable increase in the number of patients, especially those with mental illness and disorders. Hence, during such times, handling of the patients and providing them with a supportive atmosphere has to be taken care of. It should be observed that the nursing practices followed are such that helps in the treatment of the disease complementing the medication provided by the doctors in the hospitals. Hence, the understanding of the measures after operation that is post operation have to be considered and executed with extreme care and high efficiency.
The issues of negligence and ignorance of the nurses have been witnessed many times where it has extremely dangerous consequences on the health of the patients and sometimes, it has even led to their death. Thus, it should be evaluated that the virtues of being active, alert and cautious should be observed among the nurses in their practice (Jones and Bartlett Learning, 2015).
The advanced education for nursing practice would be a very good alternate solution to the above problem where effective training and practice would help the nurses to establish high quality in their work. It should be observed that providing these quality education should be taken as a priority in cases where nurses handle critical situations like in the burnt cases, accident cases, very intensive condition cases. In these cases, there has to be special training and practice offered to the nurses so that they do not get dumbstruck by the situation and instead of getting confused, they handle the situation effectively. This has to be obtained through a meta-paradigm of the above mentioned phenomenon of interest for the advanced education and training of the nurses.
Nursing Meta- paradigm
A Meta- Paradigm refers to development of a framework which provides the set of values and research that is carried out on a particular mode of discipline. There are various structure s developed that would help in effective working and following of the framework provided. A very well-known researcher of medical field, Fawcett, in 1984. This kind of framework not only helps in providing standard set of virtues but also provides the basis for a meta-paradigm theory. He identified the global concepts that has to be obtained in the concepts from the global perspectives for a specific discipline (Fawcett J. , 1984). An extensive method to follow them and establish them in practice. Here, we are going to consider the nursing meta-paradigm which would help in developing a framework for the ideal practices and behavior that has to be inculcated in the nursing practices (Masters, 2010).
It can be seen that the nursing meta-paradigm has few disciplines which have to be accomplished and taken care of. These disciplines were established by many researchers for nursing meta-paradigm and all of them mostly came up with four components which are (Fawcett J. , 1984):
Person (Human being):
It refers to the person who are involved in nursing. These are the people who participate in the nursing practice. It can be a person, group of person or community that are affected by the nursing practice.
These refers to the situations and condition that are faced by human beings and affect their health. This include the social, economic, physical, psychological, local, cultural, global phenomena which are witnessed by human beings. It plays a pivotal role in development of any healthcare issues in the individuals.
It is the component which refers to the life and death phenomena of human race. It is the element which is critical in developing of researches and theories on human life.
It is the practice which is followed by the nurses, that is, the processes that are carried by them considering the health of the patients. It involves practices that are ethical, polite and caring form the global point of view for the health of the patients.
These are the four main components of the nursing meta-paradigm as provided by Fawcett and other researchers. There are various theories developed on the concept of nursing practices and two of them are going to be discussed in the section below.
Grand Nursing theory
Grand Nursing theory refers to the type of nursing practice that has the highest scope and has very broad approach. The theories developed in this are very descriptive and have extensive analysis of the content related to the practice in nursing. They considerably evaluate each and every element that can be used in developing the behavior and attitude as well as other virtues in nurse practices.
However, they are not capable of undergoing testing due to lack of the presence of the quantitative measures that would be required in measuring and developing ideal practices to be inculcated in nursing.
This kind of theory in nursing would help in establishing the paradigm of effective nursing practices. This theory can be used for developing the elements that tare critical in understanding of good health care practices by the nurses. The level of advanced education that is to be provided to the nurses can be determined on the basis of this theory. The factors identified by this theory have huge scope as they are evaluated minutely. There are steps which are to be followed after the identification of the elements and this is not provided by this theory (Kim H. S., 1988).
The health and environment component of nursing meta-paradigm can be very well described through this theory. The nursing component requires a specific goal oriented approach for the nurses that would help them in better understanding of their tasks and responsibilities. This is not provided through this theory and this serves to be the most significant limitation of this theory (Rolfe, 1996).
Middle Range Nursing theory
Middle range nursing theory are very specific and they have an approach that helps in establishing the relation between the theories involved in nursing and the practices that are to be followed in nursing. This theory has focused on specific goal oriented measures to be developed and has specialized the scope by narrowing its reach and specifically mentioning of the elements involved. It is very promising theory of Nursing where it provides the advantages of the Grand nursing theory and connects them directly to the practices that are to be adopted in nursing.
The Mid- range theory has various advantages for application on the nursing practices and it helps in determining the factors and measures that were required for specific goal oriented working of the nurses. The approach that is developed in this theory provides an evaluation and analysis of the steps resulting in effective working of nurses. Middle range theories helps in overcoming the flaws of the grand nursing theory where it provides particular and specific tasks which are to be followed for observing good healthcare practices among the nurses (Lenz & Pugh, 1995).
The health care practices that would be adopted through critical evaluation in this theory would help in developing efficiency in Person and Nursing components of the nursing meta-paradigm mentioned in the above section. These components would be accurately determined and quantified for appropriate nurse practicing (George, 1990).
Complexity Science
Complexity Science can be termed as the aspects of scientific fields which are complex in their structure, process and practice. It involves considering the critical elements which are neglected in the traditional approaches and theories by the researchers and scholars. It helps in establishing a link between the various elements that are involved in the process and then provides solution for each one of them. This can be applied on the field of nursing where it would help in obtaining the measures that are required for effective health care practices by nurses (Plsek & Greenhalgh, 2001).

The various issues that are to be considered in nursing practice are to be evaluated. In nursing practices, the complexity science that is involved, considers the steps that are to be taken by the nurses after the operation. The situation after any kind of operation is critical and it requires special care and handling from the nurses to ensure that the patients are recovering well after the operation (Kim H. , 1989).
At the same time, there are many approaches which are to be observed in maintaining the complex nature of nursing practices. The complexities range from understanding the cases of the patients which are very different from each other and hence cannot be generalized. It requires proper understanding of each and every individual case that is being operated. It helps in providing special care and practices that would help in easy and fast recovery of the patients and would not complicate their condition through any negligence or ignorance (Fawcett J. D.-M., 2012).
Having a proper and advanced education of nursing would help the nurses in establishing high standards of quality in their practices and also set the mas a benchmark for the other nurses in the hospital and would also help in establishing of firm disciplines among the nurses. The complex nature of treating the patients especially, after the operation has to be understood by the nurses and hence, having an in depth knowledge and understanding of each and every case would help in developing appropriate measures and behavior that would help in developing a positive atmosphere in the treatment of the patients.
The complexities involved in each and every case differs and hence, it requires an extensive effort from the nurses to understand and develop extensive knowledge and assistance for the cases especially after the operation.
Thus, the four components of meta- paradigm are very well established through the two theories of nursing. The phenomenon of interest regarding the quality of the nursing practices after operation that is, post-operative has been established and discussed through development of steps that would help in obtaining excellent nursing practice.
Thus, the complexities involved in nursing and healthcare practices can be established by evaluating them through the grand nursing theory and providing a quantitative approach and solution for the complexities through Middle range nursing theory.

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements Image. The journal of nursing scholarship, 84 – 87.
Fawcett, J. D.-M. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. . FA Davis.
George, J. B. (1990). Nursing Theories: The Base for Professional Nursing Practice. Pearson Education.
Jones and Bartlett Learning. (2015). INTRODUCTION TO THEORETICAL NURSING KNOWLEDGE. Retrieved from
Kim, H. (1989). Theoretical thinking in nursing: problems and prospects. Recent Advances in Nursing, 106-122.
Kim, H. S. (1988). Theoretical thinking in nursing: problems and prospects. . Recent advances in nursing, 106-122.
Lenz, E. R., & Pugh, L. C. (1995). Collaborative development of middle-range nursing theories: Toward a theory of unpleasant symptoms. Advances in Nursing Science, 255- 280.
Masters, K. (2010). Framework for Professional Nursing Practice. Jones and Bartlett Learning.
Plsek, P. E., & Greenhalgh, T. (2001). Complexity science: The challenge of complexity in health care. BMJ: British Medical Journal, 625 – 630.
Rolfe, G. (1996). Closing the Theory-Practice Gap a New Paradigm for Nursing.


Posted on

March 9, 2018

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