Nursing theories to help define your nursing practice


Patricia Benner: From Novice to Expert

Benner applies this theory to the nursing profession by outlining the same five stages or levels of clinical competency: novice, advanced beginner, competent, proficient, and expert. These five levels represent an overall change in two aspects of a nurse’s skills, increased independence in reliance on abstract ideas and principles and an increase in critical thinking. As one collects more concrete experiences, they are then able to use these as paradigms rather than abstract principles, which also leads to an increase in critical thinking. Experiences gained over time will enable a change in perception. Such a change in perception will then open up a new level of thinking that is based on each situation and is more holistic, rather than abstract and pieced-together knowledge that a novice might have.

Virginia Henderson: Needs Theory

“The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge”

Martha Rogers: Unitary Human Beings

  • Nursing is both a science and art; the uniqueness of nursing, like that of any other science, lies in the phenomenon central to its focus.
  • Nurses’ long-established concern with the people and the world they live is a natural forerunner of an organized abstract system encompassing people and their environments.
  • The irreducible nature of individuals is more than the sum of the parts.
  • The integralness of people and the environment that coordinate with a multidimensional universe of open systems points to a new paradigm: the identity of nursing as a science.
  • The purpose of nursing is to promote health and wellbeing for all persons wherever they are.

Dorothea E. Orem: Self-Care Theory

Orem’s nursing theory states self-care as a human need, and nurses design interventions to provide or manage self-care actions for persons to recover or maintain health.

Betty Neuman: System Model

The Neuman systems model is a nursing theory based on the individual’s relationship to stress, the reaction to it, and reconstitution factors that are dynamic in nature.

The central core of the model consists of energy resources (normal temperature range, genetic structure, response pattern, organ strength or weakness, ego structure, and knowns or commonalities) that are surrounded by several lines of resistance, the normal line of defense, and the flexible line of defense. The lines of resistance represent the internal factors that help the patient defend against a stressor, the normal line of defense represents the person’s state of equilibrium, and the flexible line of defense depicts the dynamic nature that can rapidly alter over a short period of time.

The purpose of the nurse is to retain this system’s stability through the three levels of prevention:

  1. Primary prevention to protect the normal line and strengthen the flexible line of defense.
  2. Secondary prevention to strengthen internal lines of resistance, reducing the reaction, and increasing resistance factors.
  3. Tertiary prevention to readapt and stabilize and protect reconstitution or return to wellness following treatment.

Hildegard Peplau: Interpersonal Theory

In her interpersonal relationship theory, Dr. Peplau emphasized the nurse-client relationship, holding that this relationship was the foundation of nursing practice. The essence of Peplau’s theory was creation of a shared experience between nurse and client, as opposed to the client passively receiving treatment (and the nurse passively acting out doctor’s orders). Nurses, she thought, could facilitate this through observation, description, formulation, interpretation, validation, and intervention. For example, as the nurse listens to her client she develops a general impression of the client’s situation. The nurse then validates her inferences by checking with the client for accuracy. The result may be experiential learning, improved coping strategies and personal growth for both parties.

Madeleine Leininger: Transcultural Nursing

While Leninger initially started with the creation of the cultural care theory she would later build the theory into a nursing specialty called Transcultural Nursing. In Leninger’s own words Transcultural nursing is:

“a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs and practices of individuals or groups of similar or different cultures. Transcultural nursing’s goal is to provide culture specific and universal nursing care practices for the health and well-being of people or to help them face unfavorable human conditions, illness or death in culturally meaningful ways.”

Combining her nursing experience with the doctorate in Anthropology she had received, Leninger wanted to have nursing look at patients with a cultural perspective, utilizing the indigenous perspective from the patient’s own culture and how the outside world would perceive them.


I think we can all relate to Patricia Benner’s From novice to expert theory. It’s crazy to think of how far all of my coworkers and I have come since we were new grads.


Yah. I think so too. And it is also an inspiration to the beginners.


Maslow’s hierarchy of needs. No one cares about anything you’re trying to do if they are hopeless and hungry.