21 Nursing Theories to Know
Written by:
University of Tulsa
• Jan 6, 2025
21 Nursing Theories to Know
Nursing is a complex, dynamic, and evolving field that relies on theoretical models to help shape research and practice. A theory can be defined as a system of explanations that combines facts and predictions, and nursing theories are sets of principles upon which the practice of nursing is based.
Nurse researchers and scholars have been instrumental in the development of nursing theories that have shaped the practice from the beginning. A Master of Science in Nursing (MSN) degree can prepare nurses for fulfilling, exciting careers as researchers, giving them the opportunity to change the future of medicine.
What Are Nursing Theories?
Nursing theories are systematic views providing a set of blueprints that help nurses understand and guide their practice. At their very core, they combine philosophy, ethics, practice, and science, which helps nurses better understand the what and why associated with patient care. Though theoretical, these approaches offer valuable insights into the field, allowing nurses to improve their professional critical thinking and decision-making skills.
It is important to remember that nursing theories can never be proven, but they can be tested and researched for the purpose of refuting or strengthening the theory, thereby furthering the nursing profession.
How Nursing Theory Benefits Practicing, Caring Nurses
Nursing theory is more than a simple framework guiding the practice and profession. It also gives hardworking, empathetic nurses the tools they need to describe what they do for patients — and the reasons why they do it.
A review published in the Scandinavian Journal of Caring Sciences looked at 35 studies from various parts of the world, ultimately finding that theory-guided intervention had a measurable and impactful effect on patients with a variety of acute, chronic, and psychological conditions. Applying theory led to better quality of life and self-care, and it reduced stress in most patients, thereby improving the overall efficacy of evidence-based care.
Nursing Theories in Practice
Nursing theory and nursing practice inform and influence each other in ways that shape the profession for the future. Scientific research and nursing experience lead to new theories, influencing the policies and procedures nurses follow. Almost every interaction a nurse has with a patient has been shaped by theory in some way, from providing culturally or spiritually competent care to communicating important information with loved ones.
The more nurses learn to apply theory in their everyday practice, the more they develop the skills, knowledge, and understanding that lead to quality, evidence-based care. In turn, evidence-based care and excellent patient outcomes influence new theories in a positive cycle that changes the profession for the better.
Understanding Nursing Theories: 4 Metaparadigms
Nursing metaparadigms are the concepts that drive the phenomenon with which nursing theories are concerned. In nursing, there are four primary metaparadigms: the person, health, environment, and nursing.
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Person: The individual receiving care is one of the four metaparadigms of nursing. In this context, a nurse must consider the individual’s spiritual, cognitive, biological, and psychosocial traits. In nursing, the person has worth and dignity, and each person has a unique experience related to health, illness, and treatment.
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Health: Health is defined differently in unique theories, but in general, it can be defined as a person’s overall physical, mental, and social wellness. It is important to remember that nursing theory does not define health as the absence of illness. Instead, it is an ever-changing and fluctuating state of wellness.
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Environment: Environment describes the context where nursing care takes place. It usually includes factors that can influence the person’s health, such as hygiene, climate, family network, or health care laws.
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Nursing: Finally, nursing encompasses the nursing practice. This metaparadigm explains what nurses do, their contextual roles, and their interactions with patients. Nursing and the associated provision of care promotes good health, prevents illness, and promotes healing. It also helps patients cope with terminal illnesses or drastic, long-term changes to their health or wellbeing.
21 Nursing Theories by Tier
Nursing theories can be broken down into three general tiers: grand theories, middle-range theories, and practice-level theories. This framework allows students and researchers to better identify or develop theories unique to their own ethics, philosophies, and research.
Grand Theories
Grand nursing theories offer broad perspectives, usually as they relate to abstract concepts based on one nurse’s (or a group of nurses’) philosophies. They encourage nurses to explore these philosophical concepts further, allowing them to guide their research and practice accordingly. Grand theories abound, and they include the following:
1. Modeling and Role-Modeling
Modeling and role-modeling asserts that nursing care must be based on each individual’s uniqueness. Nurses should observe their patients closely and model (or role-model) behaviors that resonate with their patients in order to promote trust, respect, and, ultimately, positive health outcomes.
This theory assumes the patient is the expert in their own care, ultimately defining what nurses should provide. Nurses who listen to their patients’ views of the world are far better equipped to provide high-quality, personalized care.
2. Transcultural Nursing
Transcultural nursing is all about understanding the way culture impacts the relationships between nurses and their patients. This nursing theory posits that culturally respectful care is essential to developing positive relationships that lead to better outcomes.
3. Environmental Theory
Environmental theory was originally developed by Florence Nightingale, who explained the importance of providing an environment conducive to healing. It proposes that factors like fresh air, temperature, quiet, cleanliness, diet, and light all influence health outcomes.
4. Humanistic Nursing
Humanistic nursing is one of a few nursing theories that factor in the combined experiences of the patient and the nurse. The idea is that both caregiver and patient grow through the experience using relational conversation. Humanistic nursing takes the holistic approach that wellness depends on not only the mind, body, and spirit, but also the patient’s social conditions and environment.
5. Emancipated Decision-Making in Health Care
The theory of emancipated decision-making in health care is thought to empower nurses to collaborate with their patients by providing valuable insight into their treatment options. The emphasized autonomy promotes better healing by allowing patients to maintain more of their dignity. Emancipated decision-making puts some of that power into the patients’ hands.
6. Theory of Human Becoming
The theory of human becoming focuses on humanity’s ability to exercise free will and choose their own fates. As individuals learn to accept their own definitions and interpretations of life events, they focus less on the events themselves, leading to profound personal discoveries. The theory is based on the following four concepts:
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Phenomenology: Phenomenology looks at human experiences and the meaning that we apply to them.
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Subject-Subject Interaction: This concept focuses on the relationships between nurses and patients, both acting as critical participants in the provision of care.
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Spirit, Caritas, and Transcendence: This concept acknowledges that patients have spiritual sides and acknowledges the importance of accepting and incorporating spirituality into holistic care.
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Pattern, Process, and Rhythm: This concept asserts that human existence is cyclical and ever-changing, emphasizing the need to accept patterns, processes, and rhythms to provide patient-centered, evidence-based care.
7. Nursing Process
The nursing process theory is perhaps one of the most important grand nursing theories. This theory is concerned with the interactions between patients and nurses and focuses on nurses taking action based on what they observe. At its heart, the theory centers on using the nurse-patient interaction to determine the most immediate need. It encompasses many of the factors introduced by Watson’s theory of human caring , such as identifying and treating patients based on an established hierarchy of needs.
Middle-Range Theories
Middle-range nursing theories are slightly narrower than grand theories, but not focused on minutiae in the same way as practice-level theories. They are driven by experience, particularly as it applies to specific phenomena, and they often attempt to explain outcomes or predict trends in clinical settings. One of the most well-known middle-range theories is change theory , which seeks to reduce the impact that change has on the delivery of health care by keeping it consistent and avoiding disruption.
Middle-range theories are descriptive, explanatory, predictive, or prescriptive, and many are a combination of these. Some of the most important middle-range theories include the following:
8. The Framework of Systemic Organization
This is one of many middle-range nursing theories that see individuals as organized systems. The idea is that people adapt to their environments, and patients can only fully realize their wellbeing when their personal needs and lifestyle are in a state of equilibrium with the environment.
9. Theory of Comfort
This theory posits that addressing the underlying human needs for comfort, ease, and transcendence promotes better health and wellbeing. This theory applies in physical, psychospiritual, environmental, and sociocultural contexts.
Nurses who prioritize comfort in the care they provide are better equipped to help their patients engage in behaviors and thought patterns that are conducive to better overall health.
10. Synergy Model
The synergy model was developed by the American Association of Critical Care Nurses (AACCN) and suggests that synergizing nursing competencies with individual patient needs across all levels of care results in better patient outcomes across the board.
More specifically, the model suggests that when nurses are receptive to patient needs, and when those needs serve as the underlying driver of nursing care, they provide better care to the whole person.
11. Quality of Nursing Care Theory
The evidence-based quality of nursing care theory calls for continually measuring outcomes against currently accepted standards to improve patient care while gaining access to health care insights at the individual, team, and organizational levels.
12. Theory of Uncertainty in Illness
This nursing theory explores the role uncertainty plays in patients with cancer or other long-term or terminal illnesses. The theory posits that the stress of uncertainty can be managed by seeking relevant and timely information, finding meaning in life, and maintaining hope for a brighter future.
The theory also posits that gaps in patients’ understanding of their illnesses can cause prolonged uncertainty that leads to further negative health effects and may prevent healing.
13. Theory of Group Power within Organizations
Health care providers — nurses, especially — have dynamic power they can use to influence decisions at the organizational level. Nurses who focus on enhancing this power collectively can contribute to better decisions and outcomes.
Further, it asserts that it is important to avoid patient coercion — even subconscious feelings of coercion — and for nurses to share their power with others within the organization to help patients feel more at ease.
14. Advancing Technology, Caring, and Nursing
This nursing theory is about integrating technology into the nursing profession in ways that improve patient care rather than depersonalize it or desensitize health care staff. The idea is that technology should never replace a nurse’s capability, but should instead complement and enhance it.
Practice-Level Theories
Practice-level nursing theories are the narrowest of all, and they offer care-related insight into a specific patient or patient type. These are the theories that guide specific actions among nurses, particularly as they relate to treating a health condition. Practice-level theories influence day-to-day care more than the other tiers because they apply to so many daily responsibilities. Some of the most influential practice-level nursing theories include the following:
15. Cognitive Behavioral Therapy (CBT)
CBT is a theoretical treatment program based on the idea that a patient’s thoughts, feelings, and behaviors are woven together to form the cloth of the whole person. CBT aims to create positive change in emotions and actions by changing negative thought processes and beliefs. The therapy grows more popular with each passing year, and digital options become more widely available.
16. Systems Theory
This nursing theory approaches individuals as they appear in their environments, which include their families, friends, social networks, and communities. The theory posits that a change in one area can influence changes in all others, demanding a holistic approach to nursing at the individual, family, and public health levels.
17. Humanistic Theory
Humanistic theory proposes that every individual has an inherent level of goodness and potential to grow personally. This theory says that when patients are treated positively and with unconditional empathy, therapeutic interventions at both the physical and mental levels can be more powerful, leading to better overall outcomes.
18. Psychodynamic Theory
Based on the collective works of Sigmund Freud, psychodynamic therapy nursing theory focuses on how unconscious motivators like desire drive human behavior and shape lives. Early childhood experiences are thought to have a tremendous impact on psychodynamics, and addressing these unresolved issues can help individuals achieve new levels of wellness.
19. Social Learning Theory
Social learning theory believes that observational learning can be a key to personal growth — or, perhaps, unwanted behaviors. Learning occurs through social interactions like imitation and modeling, and whether the outcomes are positive or negative depends on the individual’s social circles, particularly in early life.
20. Narrative Therapy
Narrative therapy separates individuals from their problems, giving them the opportunity to tell a story that completely rewrites their own. Through their own personal knowledge and the skills they develop over a lifetime, patients exposed to narrative therapy learn to see experiences more positively and manage their problems more constructively.
21. Solution-Focused Brief Therapy
This is one of a few nursing theories that hone in on solutions rather than the problems that necessitate them. It is forward-looking and goal-oriented, assuming that patients already have the resources they need to change their lives and using past successes as a sort of proof of concept.
What Does the Future of Nursing Theories Look Like?
According to a 2024 paper published in the Journal of Nursing Management, the number of professional publications focused on nursing theories rose sharply, from two publications in 1990 to an incredible 1,880 articles in 2022. Though most papers focused on generalized nursing, other hotspots included health care science, public and environmental health, and general internal medicine, just to name a few.
As more organizations, insurers, and communities discover the power of collective knowledge and learning, nursing theory will continue to be of the utmost importance.
Play a Role in the Future of Nursing Theories with a Graduate Degree from The University of Tulsa
As funding for the research of nursing theories continues to rise, the demand for nurse researchers and experienced nurses will grow. Nurse researchers often dedicate decades of their lives to studying or developing a single theory, forever changing the way nurses care for patients.
Graduate nursing degrees can provide you with the knowledge and passion you need to develop and implement some of the most powerful nursing theories in the profession. These programs teach you more about research, communication, and critical thinking as it applies to nursing, all while helping you understand the importance of self-care.
The University of Tulsa’s Master of Science in Nursing program offers three unique tracks that can take your nursing career to new heights, including Leadership and Innovation, Education and Elevation, and Public Health Global Vision. Discover how you can do your part to change the future of nursing theory with a specialized MSN.
Recommended Readings
What Is Health Promotion in Nursing Practice?
Nursing Professional Development: Graduate Opportunities
Is an MSN Worth It? Reasons to Pursue This Advanced Degree
Sources:
ANA Nursing Resources Hub, “What Is Nursing Theory?”
Cognitive Behavioral Therapy, “Advances in Digital CBT: Where Are We Now, and Where Next?”
Simple Nursing, The Most Common Nursing Theories
The Nerdy Nurse, 12 Vital Nursing Theories & Important Nursing Theorists
