Middle-Range Theory in 21st-Century Nursing

Nursing theory is defined as a well-organized structure that helps in the guidance of nurses in the provision of good healthcare. Several theories have been developed in efforts of ensuring that quality nursing care, decision making and the other duties of nurses have a clear foundation. The use of the theories varies from time to time depending on the current issues facing the profession and the expectations of the society. The most common nursing theories include grand, middle- range, and situation-specific. Grand theory gives a broad view of the nursing practice by providing general concepts and principles while situational-specific theory explores the particular nursing situation. Middle range theory analyses a small group of nursing practice situations, therefore offering a bridge between range and situational-specific theories (Meleis, 2010, p. 122). The use of nursing theories in the current century is affected by several issues that face the nursing profession varying from the expectation of the customers to economic matters of the heath care centers. In this regard, there an increasing trend of using middle range theory in nursing practices that the other two in the 21first century.

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In the 21-first century, human beings behavior and general lifestyle change relatively fast because of the improved technology and enhanced knowledge. Nurses are expected to embrace the changes and incorporate them into the nursing practice. Therefore, a theory that allows them to include the changing human behavior and lifestyle is needed for improved and expected quality nurse care. Middle range theory offers the expected room for the changes to be installed into the nursing practice and keep on updating any relevant changes to meet the expectations in patients care. The enabling ability results from the linking nature of the theory to the others as it allows one to look into a particular situation and connect it with the general guidelines that govern the nursing profession (Smith & Liehr, 2008, p. 14). The scope of the middle range theory permits the improvement of the practices often because it is not too broad or too narrow, and hence, allowing the meeting of the increasing changes.

The nursing practice is changing from general care to particular area nurse specialization (Smith & Parker, 2015, p. 17). The process of training and practicing the nurse care require a clinical nurse practitioner to have a lot of knowledge in a specified area in the field. Improvements and advanced knowledge in patient care also concentrate on making a nurse become an expert in specified field. The areas of specialization are not very broad or too specific but include a reasonable subset of nursing care situations such as caring for a post surgery artery bypass patient. This practice in the 21 first century makes middle range theory more useful than the other two theories because of the areas it covers, given that it allows nurses easily advance their knowledge as per the expectations.

The financial implications of the offering healthcare in the 21first century are a major determinant of the number of professionals employed. Nursing care is necessary for the offering of healthcare, and therefore, there is a need to separate it from the other professions such as medicine. Failure to separate would make the nursing profession lose its meaning, and the numbers of nurses to patients ratio reduce. In efforts to prevent this from happening, nurses should use middle range theory to ensure that the importance of nurse profession is clearly stated in the health centers because of its address to the particular group of nursing situations.

The current healthcare environment prompts nurses to carry out a lot of research and development for quality and adequate care. The research and development should meet the need of specific situations in the nursing practice that normally involve different subsets (Peate & Offredy, 2006, p.76). The middle range theories lie in between grand and situation-specific theories, and hence, it is the one that is used as the base for carrying out the required research and development to ensure that the nursing practice is improved. In the process of investigation and development, a particular situation that is under particular-specific theory is analyzed and the related to a general procedure or practice to come up with a practice that can suit specific subsets of situations in the nursing practice. The process of improving the nursing practice involves a specific situation that the patients are suffering from in a particular society, limiting the improvements made to limited variables; hence, middle range theories involved.

Technology is profoundly affecting health care provision in the 21first century. The way in which nursing care is being offered changes from one situation to the other, depending on the particular population and patients complication being addressed (Callara, 2008, p. 154). Middle range theory enables nurses to identify the best way of offering care even with the technology because of its scope. Range theory is too broad to allow easy incorporation of the technology into the nursing practice while situation-specific is too narrow to meet the economic factors of the health care centers.

Middle range theory is involved with specific areas of nursing practice that covers a group of situations in the nursing practice. The personal interaction of a nurse and patient in the 21first century involves the performance of specified duties depending on the situation of the patient, for example, encouraging them before going to a theater and general preparation. The tasks performed by nurses and the expectations laid on them requires more application of middle range theory as compared to range and situation-specific ones.

References

Callara, L. (2008). Nursing Education Challenges in the 21st Century. New York: Nova Science Pub.

Meleis, A. (2010). Transitions theory. New York: Springer Pub. Co.

Peate, I. & Offredy, M. (2006). Becoming a Nurse in the 21st Century. Chichester, England: John Wiley & Sons.

Smith, M. & Liehr, P. (2008). Middle Range Theory for Nursing (2nd ed., pp. 1-33). Newyork, NY: Springer Publishing Company.

Smith, M. & Parker, M. (2015). Nursing Theories and Practice. Philadelphia: F.A. Davis Company.