Middle-Range Theory Continues to Guide Nursing Practice

Topics: Nursing / Pages: 6 (1367 words) / Published: Nov 21st, 2012
Middle Range Theory Continues to Guide Nursing Practice
Lisa M. Sanford
Maryville University

Middle Range Theory Continues to Guide Nursing Practice
Nursing theory has three distinct categories to describe the level of abstraction: Grand, Middle-Range, and Situation-Specific (Meleis, 2012, p. 33). Hugh McKenna (1997) defined these three categories, stating:
Grand theory is highly abstract and is broad in scope. Middle-range theory is more focused and is normally the end product of a research study. Narrow-range theory is even more specific and while also being based on research findings, it guides specific actions in the achievement of desirable goals (p. 17).
When thinking about nursing theory, one might ask: What is the purpose of theory? Is it even relevant to current nursing practice? The best response to answer these questions I have found is from Meleis (2012): The primary uses of theory are to provide insights about nursing practice situations and to guide research. Through interaction with practice, theory is shaped and guidelines for practice evolve. Research validates, refutes, and/or modifies theory as well as generates new theory. Theory then guides practice (p. 35).
This explanation of theory by Meleis identifies nursing as a profession. Without theory to shape and guide nursing practice and research, nursing would not evolve and would remain stagnant. Additionally, without theory could nurses really claim that we are a profession? I think not. I believe that theory is necessary for the identity of nursing as a profession verses a vocation.
The nursing profession as a whole has had issues with identity for various reasons. I believe this to be true in part due to the numerous educational ways of entering the profession. I cannot think of any other field where one could earn either a diploma, two-year associate’s degree or a four-year baccalaureate degree as a starting point into a profession. The educational debate

References: Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational Levels of Hospital Nurses and Surgical Patient Mortality. The Journal of the American Medical Association, 290(12), 1617-1623. Averill, R. F., McCullough, E. C., Hughes, J. S., Goldfield, N. I., Vertrees, J., & Fuller, R. L. (2009, Summer). Redisigning the Medicare Inpatient PPS to Reduce Payments to Hospitals with High Readmission Rates. Health Care Financing Review, 30(4), 1-15. Geary, C. R., & Schumacher, K. L. (2012). Care Transitions: Integrating Transition Theory and Complexity Science Concepts. Advances in Nursing Science, 35(3), 236-248. Liehr, P., & Smith, M. J. (1999). Middle Range Theory: Spinning Research and Practice to Create Knowledge forthe New Millennium. Advances in Nursing Science, 21(4) 81-91. McKenn, H. (1997). Nursing Theories and Models. New York: Routledge. Meleis, A. I. (2012). Theoretical Nursing Development and Progress (5th ed.). Philadelphia: Lippincott, Williams & Wilkins. Sanford, R. (2000, March). Caring through Relation and Dialogue: A Nursing Perspective for Patient Education. Advances in Nursing Science, 22(3), 1-15.

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