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Nursing Theorists: Concept Comparison and Analysis


Nursing is one of the most respected professions in the world. The role of nurses in health and recovery of patients is obvious. In practice of nursing, nurses are guided by various concepts on nursing. The concepts have been developed over a period that nursing has been in use. The theoretical knowledge of nursing has a long history. The theories date back to the concepts developed by nursing pioneer Florence Nightingale. Many nursing scholars that have come after her have contributed highly to nursing theories. Although there are questions over the maturity of nursing theories, the various nursing theories help to understand and guide nursing practice (Fitzpatrick & Whall, 1996, p.56). Among the popular nursing theorists are Florence Nightingale, Jean Watson and Dorothea Orem. The theorists view nursing from different perspectives. This paper discusses nursing theories developed by the theorist; comparing and contrasting their concepts on nursing.

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Florence Nightingale Environmental Theory

Nightingale is regarded as the pioneer of nursing. She is also considered as the first nursing theories. As pioneer and the first nursing theorist, her contributions have high influence to nursing theory. Her nursing theory also has high influence to other nursing theories by other theorist that came after her (Walker & Avant, 2005, p.128). Nightingale emphasized on the role of environment in health and a patient’s recovery.

Nightingale’s Environmental Theory of nursing focus on the role environment and response of a patient to environment. Her nursing theory is based on conviction that a patient’s environment could be altered in order to create a favorable environment for recovery. Nightingale understood nursing as the act of making use of a patient’s environment in order to facilitate recovery. A nurse is supposed to configure the environment of a patient in order to achieve an environment that promotes gradual recovery. Factors such fresh air, sufficient food supplies, pure water, light and proper sanitation are emphasized in the theory (Tomey & Alligood, 2006, p.77).

According to Nightingale, nursing is concerned with creating environment that promote health and encourage recovery. External factors, environment, have great influence of patient health and recovery. According to her, a patient’s environment consists of effluvia, warmth, noise, light and ventilation. Environment also includes other physical, social and psychological conditions. A patient, according to the theory, has reparative capabilities that can be promoted by good environment. Thus, the role of a nurse is to provide fresh air, cleanliness, warmth, good diet and environmental condition in order to facilitate a patient’s reparative process.

Jean Watson’s Caring theory

Jean Watson’s Caring theory of nursing has developed to be of great influence to nursing theory. The theory emphasizes the caring aspect of nursing. According to Watson, caring is the most valuable role that nursing offer to human being. She believes that health can be fully attained without care. Through caring, a nurse can help a patient to become more knowledgeable, gain control and promote recovery. Watson emphasize on freedom of choice and autonomy of a patient. Unlike other theories, patients are in charge of their recovery but with caring help from a nurse. The relationship between a nurse and a patient is more than objective assessment; the nurse shows concern for a patient’s health care situation. The nurse aims at enhancing the patient’s human dignity. The caring nature of a nurse is communicated to the patient in order to show that the nurse view the patient as another person other than object. According to Watson, since intentional connection, perception and experience are taking place, the caring nature of a nurse has healing potential.

Caring occasion, according to Watsons, occurs when a nurse and another person interact in a way that moment of human caring is formed. The nurse and the other person come together in a human-to-human interaction. According to Watson, the phenomenal field of interaction constitute of totality of human experience which include bodily sensations, feelings, spiritual beliefs, thoughts, environmental considerations and expectations (Kim, & Kollak, 2005, p.143). The nurse is not supposed to just care for patients and other persons, the nurse should be conscious of their caring role. The person providing care and the person cared for are influenced by the caring relationships and this becomes part of their history.

Jean Watson identified ten carative factors that should be used in nursing. The carative factors are considered as a guide to human dimension of nursing. The carative factors address the aspects of nursing that has influence to the person providing the care and the person receiving the care. According to her, a nurse should allow formation of humanistic system of values, be sensitive to others, instill faith and hope, develop human caring relationship, use creative problem solving caring process, provide supportive environment, provide assistance with gratification, encourage transpersonal learning-teaching and allow phenomenological-spiritual forces to be used in nursing (Tomey & Alligood, 2006, p.103). The carative factors, caring occasion and transpersonal caring relationship are the foundation of Watson’s Caring theory of nursing.

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Dorothea Orem’s Self-Care Theory

Self-Care Deficit model of nursing is widely used in nursing. Dorothea believed that self care was required in order to maintain the necessary level of health and wellness. According to her, each individual has the ability and responsibility to provide self-care. According to her, nursing is required when self care is lacking. She defines self-care as the ability to perform the activities that ensure health and wellness of body, spirit and mind. These activities are learnt behaviors that influenced by the meta-paradigm of health, person, environment and nursing (Tomey & Alligood, 2006, p.93). She identifies universal self-care needs, health deviation and developmental self-care needs as the components of the theory. The universal self-care needs are the factors that promote good health. They include food, water, air, activity and rest, elimination, solitude prevention of harm and social interaction (McGee, 1988, p.51). Developmental self-care needs, on the other hand are the teaching or training that are aimed at retuning an individual to optimal health. Health deviation self-care constitutes the variations that can result from disability, injury or illness. According to Orem, nursing is required when an individual is not to meet self-care need due to disability, illness and other factors. Thus, nursing aims at identifying the limitations to self-case and implement appropriate interventions.


Nightingale, Watson and Orem are some of the most popular nursing theorists. Theories developed by the three provide vital insight into theory of nursing. Nightingale’s environmental theory views the role of nursing as to provide the appropriate environment for health and recovery. In her theory, Watson emphasizes the human nature of nursing. Orem’s self-care general theory of nursing views the role of a nurse as to assist those who are not able to achieve self-care by themselves. Each of the theories shed light into the role of nurses in the society and how nursing in practiced.

Reference List

Fitzpatrick, J. & Whall, A. (1996). Conceptual Models of Nursing: Analysis and Application. New York: Prentice Hall

Kim, H. & Kollak, I. (2005). Nursing Theories: Conceptual and Philosophical Foundations. New York: Springer Publishing Company.

McGee, P. (1988). Models of nursing in practice: a pattern for practical care. London: Nelson Thomes.

Tomey, A. & Alligood, M. (2006). Nursing theorists and their work. St. Louis: Elsevier Health Services.

Walker, A. & Avant, K. (2005).Strategies for Theory Construction in Nursing. New York: Prentice Hall.

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