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The Roper-Logan-Tierney Theory and Its Application in Neonatal ICU


The Roper-Logan-Tierney Theory is one of the most common nursing theories in the world. This paper will explain the theory and show its strengths and weaknesses. The paper will also show how the theory can be applied in the neonatal ICU. The neonatal intensive care unit is an intensive care unit for premature babies (Ritchie & Hall, 2011). The Roper-Logan-Tierney Theory can be applied in this sector successfully because it is easy to use and it focuses on an individual. This theory is based on the activities of living, normally called the ALs. It was expounded by Nancy Roper, Winifred Logan, and Alison Tierney. It is from their names that the theory was coined. Despite the extent to which the theory is studied in schools, it has only been successfully used in the United Kingdom. However, this paper will show that the theory can be used anywhere, especially in the neonatal intensive care unit (Baker, 2000).

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An overview of the Roper-Logan-Tierney Theory

As mentioned earlier, the Roper-Logan-Tierney Theory is a nursing theory that is based on the ALs. These are the activities of living. In simpler words, this theory is based on all the activities that make human beings to be human. Some of the basic activities of living include being able to communicate, breathing, eliminating wastes, controlling temperature, working and playing, and mobilization and dying. The patient should be able to do some, if not all, of the listed activities of living for them to not only be considered human, but also be able to get treatment. The theory suggests that individuals can do all the activities of living at once. However, there are times when one cannot do one or several of the activities of living, for example when one is sick. This means that one has to be taken care of (Roper Logan & Tierney, 2000).

Applicability of the theory in the current nursing practice

The Roper-Logan-Tierney Theory can be applied successfully in the context of the neonatal intensive care unit. Taking care of premature babies can be very challenging. Many of the babies know how to communicate by crying, but this does not necessarily tell the nurse what is wrong with the baby. However, application of the Roper-Logan-Tierney Theory can help the nurse involved understand their actions and avoid guesswork. This is very important because it can help with maintaining consistency in handling the baby. This can, in turn, improve the condition of the baby.

One of the advantages of using the Roper-Logan-Tierney Theory is that it considers every patient to be unique. This is very important because it is very difficult to measure the pain and discomfort of everyone. Different people will react differently to different kinds of treatment. Many care givers agree with the idea that babies are similar. However, this theory suggests that even babies have their own preferences. Using the theory, the nurse involved will be able to notice a relationship between the baby and the basic activities of living. This will, in turn, show them what is wrong with the baby easily than checking for symptoms that one cannot see.

The Roper-Logan-Tierney Theory suggests that everyone does the previously mentioned activities of living differently. For example, the way one person sleeps is very different from the way another person sleeps. One can find that one baby likes to sleep on their left hand side, while another one child likes the right hand side. It is this individuality that causes people to react differently to diseases and treatment. Learning the individual traits of the baby will ensure that they have treatment options that best suit them, thereby saving more lives.

There are several things that a nurse has to consider when using the Roper-Logan-Tierney Theory in the neonatal ICU. The first thing that they need to consider is the medical orientation of the child. This involves the medical procedures or the drugs that the baby has already been given. Medical procedures and medicines usually make babies dull and sleepy. Knowledge on what the baby has been given medically will, therefore, tell the nurse involved why some of the activities of living are different from those seen in a healthy baby. The theory states that if the baby depends on medicine and medical procedures to do some of the crucial activities of living, for example breathing and excreting waste products, then the nurse involved should know why. This can not only enable the nurse to take better care of the baby, but it can also give a solution to the problem.

Another factor that a nurse has to consider when using the Roper-Logan-Tierney Theory is the continuity of the same intensive care. Babies, even the premature ones, tend to be attached to their care givers. It is, therefore, crucial that the same care giver be willing to take care of the same baby until they are completely healed. This might be time consuming and unrealistic in some places. However, it has been proven to work. The reason why babies get attached to the nurses who take care of them is due to the sense of protection that all babies develop. Changing the nurses who give the care often detaches the baby. It also affects some of their activities of living. Some babies might become moody and easily irritated (Boxwell, 2010).

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There are various strengths and weaknesses that this theory presents in the nursing field. One such strength is that it focuses on a person’s individuality to help them get healed. This is true regardless of the unit in which the nurse is working. As explained, it is the difference in personalities that makes people do things differently. It is also true that this difference is important in ensuring the successful care of an individual.

Another benefit of the Roper-Logan-Tierney Theory is that it is very easy to use. There are other nursing theories that have been presented since time immemorial. However, this specific theory is easy to remember because it focuses on the activities that human beings do. It also focuses on the importance of the care that the nurse gives the patient. These aspects are easy to remember and the nurse involved also has an easier time applying them.

It is arguable that the theory is very flexible because it allows the nurse to see each patient differently. The theory has no rules that the nurse needs to remember, unlike other nursing theories. It uses logical thinking to solve some of the conditions that the patient might have. The flexibility of the model can also be seen in the fact that it can be applied successfully in any field in nursing (Meleis, 2012).

There are, however, some weaknesses that have been cited in relation to the theory. One such weakness is that the activities of living can be prioritized differently. For some nurses, their difference in sleeping is of less relevance compared to the difference in sleeping habits in the patients. There is, therefore, no universal agreement on the extent of worry in the change of the activities of living. This can lead to misdiagnosis. According to Murphy et al. (2000), it is also very difficult to give the scope of the activities of living. For example, it is hard for a nurse to tell whether sleeping on the right side is bad compared to sleeping on the left because babies turn while they are asleep. It is also very difficult to know when one should be concerned and when one should not be concerned about the changes in the activities of living (Holland, 2008). The theory has also been criticized for focusing entirely on the physical care of the patient and giving no credit to the medical attention that the patient might also need, yet it is the medical practices that make the patient recover from an illness.


In conclusion, there are numerous reasons why nurses should use the Roper-Logan-Tierney Theory. Some of the reasons listed include its flexibility, its ability to focus on individuality, and its ease of use. There are, however, several disadvantages that the theory has. These include the fact that there is no universal measure of the scope of the activities of living and their relationship with the health of the living. The Roper-Logan-Tierney Theory has been used successfully in the United Kingdom and some parts of Ireland.


Baker, J. P. (2000). The incubator and the medical discovery of the premature infant. Journal of Perinatology, 20(5), 312- 323.

Boxwell, G. (2010). Neonatal intensive care nursing (2nd edn). New York, NY: Routledge.

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Holland, K. (2008). Applying the Roper-Logan-Tierney model in practice. Philadelphia, PA: Churchill Livingstone.

Meleis, A. I. (2012). Theoretical nursing: Development and progress. Philadelphia, PA: Wolters Kluwer Health.

Murphy, K., Cooney, A., Casey, D., Connor, M., O’Connor, J., & Dineen, B. (2000). The Roper, Logan and Tierney (1996) model: Perceptions and operationalization of the model in psychiatric nursing within a health board in Ireland. Journal of Advanced Nursing 31(6), 1333-1341.

Ritchie, D., & Hall, C. (2011). What is nursing? Exploring theory and practice. Exter, UK: Learning Matters.

Roper, N., Logan W., & Tierney A. (2000). The Roper-Logan-Tierney model of nursing: based on activities of living. Edinburgh, UK: Elsevier Health Sciences.

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