evidence practice and multidisciplinary

D I S C U S S I O N P A P E R

Whither Nursing Models? The value of nursing theory in the context

of evidence-based practice and multidisciplinary health care

Niall McCrae

Accepted for publication 23 July 2011

Correspondence to N. McCrae:

e-mail: n.mccrae@kcl.ac.uk

Niall McCrae PhD RMN

Lecturer

Mental Health Nursing

Florence Nightingale School of Nursing &

Midwifery, King’s College London, UK

M C C R A E N . ( 2 0 1 2 )M C C R A E N . ( 2 0 1 2 ) Whither Nursing Models? The value of nursing theory in the

context of evidence-based practice and multidisciplinary health care. Journal of

Advanced Nursing 68(1), 222–229. DOI: 10.1111/j.1365-2648.2011.05821.x

Abstract Aim. This paper presents a discussion of the role of nursing models and theory in

the modern clinical environment.

Background. Models of nursing have had limited success in bridging the gap

between theory and practice.

Data sources. Literature on nursing models and theory since the 1950s, from health

and social care databases.

Discussion. Arguments against nursing theory are challenged. In the current context

of multidisciplinary services and the doctrine of evidence-based practice, a unique

theoretical standpoint comprising the art and science of nursing is more relevant

than ever.

Implications for nursing. A theoretical framework should reflect the eclectic,

the pragmatic practice of nursing.

Conclusion. Nurse educators and practitioners should embrace theory-based

practice as well as evidence-based practice.

Keywords: evidence-based practice, nursing models, nursing theory, philosophy

Introduction

The legitimacy of any profession is built on its ability to

generate and apply theory. While enjoying a cherished status

in society, nursing has struggled to assert itself as a

profession. Despite efforts to improve its academic

credentials, the discipline lacks esoteric expertise, and while

an eclectic pragmatism may serve patients well, failure to

articulate a distinct theoretical framework exposes nursing to

external control (Macdonald 1995). Aggleton and Chalmers

(2000, p. 9) assert: ‘Until nurses themselves value the unique

contribution that they make to health care and the special

body of knowledge that informs their practice, the subordi-

nate role to that undertaken by doctors will continue’. Over

several decades, scholars have attempted to encompass the

trinity of physical, psychological and social aspects of care in

theories and models of nursing, which were intended to guide

practice and provide a platform for training curricula and

research, thus supporting the development of professional

knowledge.