Nursing theories are the creative products of nurses who seek to thoughtfully describe relationships and interactions that exist within nursing practice. Theories address the many questions that confront nurses daily. Theories are multilayered and consist of numerous tangible and intangible components. Attempts at initial understanding of complex nursing theories are often overwhelming and intensely unsatisfying for beginning students.
Most undergraduate nursing students are exposed to nursing theory in a limited way during the process of completing basic nursing education. Unfortunately, the attitude of students taking nursing theory for the first time is often one of dread. Many express the opinion that theory has little relevance for present or future clinical practice. Often, it becomes the task of nursing educators to try and convey the idea that theory is important for the continued growth and development of nursing practice. This text is designed for first-time nursing theory students who may believe that theory will be irrelevant, uninspiring, and difficult to grasp.
When beginning the study of nursing theory, two things must be made clear to students:
1. Nursing theory is relevant to present and future practice.
2. Students are not expected to become nurse theorists or experts.
Traditional theory teaching methods have not always been effective in communicating this to students. In theory classes, papers and other writing-based projects often are assigned in which the student is required to somehow comprehend the complex web of ideas that constitutes nursing theory and then expound on how theory informs practice or applies to personal professional experience. Producing coherent assignments about nursing theory requires a relatively advanced level of understanding that may not be accessible to students with limited exposure to the material. Students expend a great deal of energy in the struggle to produce "perfect" assignments with acceptable levels of understanding, and in the course of this struggle, teaching/learning opportunities to draw the student in, to experience the Gestalt and beauty of nursing theory, melts away. After struggling through what often seems to be an exercise in confusion and futility, many students vow never to study nursing theory again after formal education is complete.
Most currently available theory texts are more complex and detailed than what is needed, or desired, for classes taught at the beginning level, and therefore may be more confusing than helpful for most students. Unfortunately, this often leads to either frustrated students and instructors, or (in response to the frustration), the elimination of all but cursory content at the baccalaureate level. If students are instead encouraged to approach the challenge of comprehending nursing theory from a position of beginner's mind, with creativity, curiosity, thoughtfulness, and joy, then the learning process has the power to clarify and illuminate depths of nursing theory in ways that will hold meaning for the student long after the class is over.
This text offers a different approach to teaching and learning nursing theory. The essential definitions and basic concepts are presented along with a brief overview of the most common nursing theories. However, what is unique about this text is the use of art to illuminate nursing theories. This method mobilizes creativity for the construction of personal meaning. In encouraging creativity through the use of the universal language of art, students become engaged and active learners. When this text and learning activities are used as a guide for learning, students do not sit passively in a classroom, memorizing definitions and facts. The activities outlined in this text are visual, tactile, and kinesthetic. Students are able to read, see, touch, and manipulate the learning materials. Although comprehensive understanding of theory (perfect understanding) is not the intent or result of this creative approach, a light of beginning understanding will be ignited by this approach.
A quote by Leonard Cohen says it well:
Ring the bells that still can ring,
forget your perfect offering.
There is a crack in everything.
That's how the light gets in. (Schiller, 1994, p.26).
Another way to explain this creative approach is the chocolate chip cookie example. As with nursing theory, a chocolate chip cookie consists of numerous components, both tangible (i.e., color, texture, size) and intangible (i.e., how tempting it may look to the casual passerby). To convey a complete understanding of all that is a chocolate chip cookie, a teacher might thoroughly describe, diagram, and explain down to the chemical and atomic levels exactly what one is. The information obtained during this type of teaching/learning exchange would be undoubtedly accurate in every detail. Unfortunately, if the student has never tasted a chocolate chip cookie, the prospect of trying to appreciate and understand one seems, at best, bewildering, and, at worst, frustrating busywork. And so it is with the introductory study of nursing theory.
The alternative learning methods suggested in this handbook offer beginning opportunities for learning through visual and experiential pathways, similar to tasting a cookie before studying it in-depth. The methods are also meant to support personal discovery and the construction of individual meaning, for instance, "This cookie tastes pretty interesting! I want to learn more!" This is a somewhat back-door approach to generating learning moments by offering glimpses of the complete picture before attempting to dissect and understand the complexity of the components. Most nursing theories are unquestionably complex, however, simplicity of explanation is used in this text in order to foster freedom of thought and creativity and to draw the student in so that in-depth study will be more willingly embraced later.