Grand Nursing Theories

In the effort to infuse nursing with professionalism, many theories have been developed since the days of Florence Nightingale. Grand nursing theories are those with the broadest scope, presenting general concepts. While grand nursing theories are often best for practice, they are not designed to be tested empirically.

Two of the best-known proponents of grand nursing theories are Dorothea Orem and Callista Roy. Orem developed her theory in the 1950s, with the most developed form coming in her landmark 1971 work Nursing: Concepts in Practice. Orem's theory rests on the foundation that individuals should strive to meet their own care needs through self-care. Much of this grand theory rests on assumptions about the individual's independence in daily life. Orem's theory then dissolves into three subsets: Self-Care, Self-Care Deficit, and Nursing Systems. Orem's grand theory is often applied to numerous areas of nursing practice.

In contrast, Roy's theory states that three types of stimuli (conditions, circumstances, influences) affect a person's four modes of functionality (physiologic needs, self-concept, role function, inter-dependence). Roy's theory is classified as a grand nursing theory in that it revolves around the idea that health is a continuum of degrees, from wellness to sickness. Roy's theories are useful in developing nursing care plans that promote patient health.