Grand Theory and Clinical Nursing Practice Essay

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Grand Theory and Clinical Nursing Practice


Grand theory and clinical nursing practice

A nursing theory is a contextual structure that is intended to organize knowledge while explaining existing phenomenon using concrete evidence specific to nursing practice. In fact, theories direct inquiry in nursing while distinguishing it from other professions through a unique focus on subject specific knowledge development. An example of this can be seen in organ donation practice after brain death. In this case, there is an acknowledgement that given the present medical technologies, serious brain damage eliminates the concept of ‘self’ and turns the patient into a potential organ donor. While this statement is true, there is need for a set of principles to determine how the ‘brain dead’ patient should be handled prior to the organs being harvested and how nurses should approach the donation process (Nicely, 2011). The present paper compares and contrast Virginia Henderson’s Need Theory and Dorothea Orem’s Self-Care Model as they concern nurses’ approach to the concept of patients’ care.

Orem’s theory defines nursing care as a necessary practice when the patient is unable to fulfil biological, psychological, developmental and/or social needs. This implies that a patient is defines as such by the incapacity to be independent. Henderson’s theory similarly emphasizes the need for independence by identifying fourteen basic needs. Grand Theory and Clinical Nursing Practice Essay. This implies that an individual ceases to be a patient when he or she can successfully meet the self-care requisites, particularly with regards to developmental and universal need, as components of primary care to prevent ill health. To be more precise, the two theories describe the nurse’s role as a substitute who does something that the patient should have done if he or she had been independent, or a complement who accompanies the patient in the process of seeking independence (Kaakinen et al., 2015). In this respect, the two theories identify patients as dependent persons with the nurses acting to help them become as independent as possible. Another common feature of the two theories is the recognition that patients are graded within a spectrum that moves from slight deficit requiring little intervention to complete dependence that makes the patients rely wholly on the nurses. Orem’s theory acknowledges that nursing intervention will depend on how much the patient can do for himself or herself. Henderson’s theory similarly notes that a nurse can play a substitutive role when the patient requires little help or play a complementary role when the patient is unable to care for himself or herself (Meleis, 2017). Grand Theory and Clinical Nursing Practice Essay.

Although the two theories share the mentioned similarities, there are significant differences between the two. Firstly, although a common feature in both models is that they demonstrate the same ‘players’ in terms of addressing dependence, the core concepts defining these players defer. Orem’s model notes that every person is a rational being capable of making decisions, whether good or bad. This means that every person is independent to direct self-care aspects so that there are those who would strive for optimum self-care while there are those who would strive for minimum self-care. Grand Theory and Clinical Nursing Practice Essay. In contrast, Henderson’s theory accepts that although people are independent beings, their capacity to make decisions can be overruled when striving for optimum self-care (Meleis, 2017). Secondly, the two theories consider health as a state and process of integrating the individual to the environment. Orem’s theory further adds that health is achieved through deliberate practices and activities over the individual’s lifetime. Henderson’s theory presents a contrasting opinion by noting that health focuses on independence with regards to basic human needs that include physiological, psychological, spiritual and social needs (Kaakinen et al., 2015) Grand Theory and Clinical Nursing Practice Essay. Based on this discussion, it is evident that although both Orem’s model and Henderson’s model highlight the need for nursing care within the healthcare environment, they present different interpretations of what constitutes nursing care and the position that nurses play in achieving health.


Kaakinen, J., Coehlo, D., Steele, R., Tabacco, A. & Hanson, S. (2015). Family health care nursing: theory, practice, and research (5th ed.). Philadelphia, PA: F. A. Davis Company.

Meleis, A. I. (2017). Theoretical Nursing development and progress (6th ed.). Philadelphia, PA: Wolters Kluwer.

Nicely, B. (2011). Virginia Henderson’s principles and practice of nursing applied to organ donation after brain death. Progress in Transplantation, 21, 72-77. Retrieved from Grand Theory and Clinical Nursing Practice Essay

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