Nursing Theory and Practice

Both the theoretical framework and practical issues are significant in nursing. Newly employed nurses may have difficulties while applying their knowledge to real-life situations due to the gap between theory and practice. This challenge is thoroughly described in the present-day academic literature, but the problem remains. It is not uncommon to witness how nurses defy the principles of the culture of safety and patient care and work in a slipshod manner.

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In this context, it may be difficult to find the right strategy. In this paper, two cases are analyzed. The culture of safety and reflective thinking becomes the determinant attributes that help arrive at the appropriate decision. It is argued that a nurse’s primary task is to provide patients with a safe environment and sound care while neglecting one’s duties is unacceptable. Despite good fellowship, a nurse must not conceal facts and jeopardize patients’ lives and health.

The correlation between theory and practice is a pressing problem. Opposed to practical issues, the theory is represented in a triplex form: nursing textbooks, documented policy in hospitals, and published literature. As a rule, their contents are similar in terms of standards, instructions, and the general idea that patient care is the task of paramount importance. However, apart from the core differences concerning practice and other aspects mentioned, there are gaps within the theory itself. It is vital to consider them because a nurse must know how to act rapidly regardless of obstacles.

Theoretical background and practice

To face real-life situations is probably the most challenging experience for newly qualified nurses: it is often described as a transition shock (Hatlevik, 2012). They realize that the actual work differs from what they expected since their reflective thinking skills need improvement. Reflection exerts mediating effect between knowledge and practical issues and helps in making a decision. Gaps between theory and practice are explained by limitations of studies and various external factors that influence a certain situation; consequently, reflective thinking should become a part of daily practice.

Published literature and other sources

Proper research is closely connected with reality: observation, experiments, and other methods are implemented. In the process of research, new knowledge is produced. In relation to the existing rules, it may be atypical and conflict textbooks or hospitals’ internal rules. Thus, one or several gaps appear. One cannot ignore them: the choice of operating policy depends on them. It is significant to decide whether innovations should be introduced.

  • The main goal of a culture of safety is to reduce harm to patients and health care providers via system effectiveness and individual performance; in this context, organizational priority, teamwork, patient involvement, openness/transparency, and accountability become the core principles (Barnsteiner, 2011). While Drew might feel uncomfortable because of judging the experienced RNs technique, the patients’ health is the area of focus. Since his behavior is determined by patient care, he must openly take action. If the hospital’s safety culture is strong, it will benefit Drew’s self-belief and work performance. As for the patients, their health is likely to improve owing to safer conditions.
  • The culture of safety incorporates teamwork: Drew should not try to solve all the problems alone. Since vitally important issues, such as infection-control procedures, are examined, immediate action is needed. Drew may address to the experienced RN who does not perform her duties in a proper way, politely ask her to follow the standards, and provide her with a rationale. If the request has no effect or the time is pressing, Drew should appeal to the hospital authorities. To protect the patients from an unsafe environment, Drew may check the conditions from time to time, have a conversation with his colleagues, and establish contact with the hospital’s management.
  • As the term implies, continuous quality improvement deals with the sphere of constant services enhancement. In health care, patients’ interests become the spotlight. As a nurse, Drew plays an active role in quality improvement because he can actually notice irregularities concerning his patients and adopt new strategies that are supposed to amend health care. As the worker familiar with the circumstances and hands-on facts, he can put forward proposals intended to affect the most challenging issues. Potentially, Drew is a professional caring not only about individuals but also protecting all patients.
  • In this case, a direct approach will hardly make a difference: the nurse will only deny the allegations. First of all, patients complaining of pain should be treated. Later on, it is necessary to report the suspicions to the hospital’s management. If Lindsey has drug problems, the employer will offer her a drug treatment program. If the suspicions are dispelled, it will still bring more good than harm because the nurse is likely to improve the quality of her work and provide patients with proper care.
  • The decision to do nothing is the worst scenario. Not only the nurse neglecting her duties will suffer but also the patients in the surgical ICU who especially need care. In the near future, the nurse is likely to fail in giving her patients care. She may also be involved in a workplace incident.


Barnsteiner, J. (2011). Teaching the culture of safety. The Online Journal of Issues in Nursing, 16(3). Web.

Hatlevik, I. K. R. (2012). The theory‐practice relationship: Reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. The Journal of Advanced Nursing, 68(4), 868-877.

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