Stages of Nursing Theory Development

What are the Three Stages of Nursing Theory Development?

Imagine navigating a complex healthcare landscape without a sturdy map. For generations, nurses relied on a tapestry of unspoken practices and intuition, but the winds of change swept through the 20th century, ushering in an era of systematic theory development.

This article demystifies the three stages of nursing theory, revealing how we transitioned from rote procedures to evidence-based frameworks that guide compassionate care and drive transformative research.

So, join us as we embark on a journey through the silent, subjective, and constructed knowledge stages and discover how nursing evolved from following orders to forging its path of knowledge and understanding.

What is a Nursing Theory?

A nursing theory is a framework that guides clinical decision-making and assists nursing care. By studying nursing theories, you can appreciate how previous theories influence current practice. In addition, these theories can enable you to acquire knowledge relevant to enhancing patient care, whether in practice or research.

What are the Levels of Nursing Theory?

The level of a nursing theory indicates whether a concept is complex or simple. Below are the three primary nursing theory levels, including:

  • Grand nursing theory
  • Middle-range nursing theory
  • Practice-level nursing theory

Grand Nursing Theory

Grand nursing theories are usually more abstract or complex and may need research to understand the theory’s concepts comprehensively. Moreover, theories at this level may focus on systems rather than protocols for specific interventions. An example of a grand nursing theory may be the transcultural nursing theory.

Middle-Range Nursing Theory

Middle-range nursing theories are typically less abstract than grand nursing theories as they focus on more definitive subjects. However, people who develop middle-range nursing theories expand on grand nursing theories by contributing additional research or recording their nursing experiences. An example of a middle-range theory is the self-care theory.

Practice-Level Nursing Theory

Practice-level nursing theories are more specific than grand or middle-range theories. In addition, they focus on addressing specific situations. Moreover, theories at this level can provide you with strategies for performing specific interventions or guidelines for nursing best practices.

Furthermore, you may also use practice-level nursing theories to help with daily nursing tasks. An example of a practice-level nursing theory is the theory of human caring.

What are the Three Stages of Nursing Theory Development?

Nursing theory development involves systematically creating and refining theoretical frameworks that guide nursing practice and research. The process typically entails three stages, including:

  • Silent stage
  • Subjective stage
  • Constructed knowledge

Silent Stage

The first stage of nursing theory development is described as the silent stage. It can be traced back to the 19th century and prevailed until the mid-20th century. In this stage, nursing knowledge is envisaged as a set of distinctive rules that you are taught to execute nursing activities.

In essence, nursing phenomena are related to a set of descriptive rules that apply moral support in patient care with the intent of doing good. During this time, the impact on nursing was that there was no provision of explanatory power, and authorities legitimated regulations.

Moreover, Benner’s theory of skills acquisition can also be incorporated at this stage. Benner’s first stage as a novice is also applicable in this context. A novice nurse focuses more on context-free, predetermined objectives and rules, leading to obeying and carrying out physician orders without conceptual and theoretical affiliations.

Subjective Stage

The second stage of nursing theory development is subjective. Initiated in the 1950s, the first nursing theories emerged during these times. In addition, the focus of nursing knowledge shifted towards the nature of nursing theory development as an independent practice.

Moreover, the impact of nursing is evident when the set of descriptive rules by the authorities is ceased, and a distinctive body of nursing knowledge is established in relationship to vindicating practice and integrating hierarchies.

Constructed Knowledge Stage

During the contracted knowledge stage of theory development, many scholars sought to find meaning in nursing. In addition, many focused on developing theories with research. Applied theory in research and practice was the primary focus during the constructed knowledge stage.

According to McEwen &amp Willis, evidence-based practice (EBP) was introduced into nursing to ‘address the widespread recognition to move beyond the attention given to research per se to address the gap in research and practice.

What are the Four Elements of Nursing Theories?

Nursing models and theories serve as strategies for nursing education and implementation. In addition, the elements of nursing theories provide guidelines on how healthcare disciplines operate. Moreover, they serve as a foundation for the growth of conceptual models.

The four main elements of nursing theories include the following:

  • Person
  • Environment
  • Health
  • Nursing


A nursing theory’s person components emphasize the patient and the people in their lives. In addition, it considers the patient’s spiritual, social and medical requirements. Moreover, the hypothesis states that supportive interpersonal relationships can give a person positive control over managing their health.


the environment is the client’s internal and exterior surroundings. In addition, it encompasses all circumstances that impact the patient’s health and well-being. Furthermore, it entails their immediate surroundings, including their family and the location where they get medical services and describes how these surroundings affect an individual’s health.


A patient’s level of health is their degree of wellness or well-being. In addition, this level signifies numerous meanings for different patients in a specific clinical situation. Moreover, it recognizes the different aspects of a patient’s well-being, including physical, social, spiritual and emotional well-being.


The nursing element of nursing theories acknowledges the interaction between a nurse and a patient. Additionally, the theory recognizes the nurse’s responsibility for creating a caring environment and emphasizes services that deliver positive patient health outcomes.

With the patient’s assistance, the nurse provides care through their traits, behaviors and activities.


The evolution of nursing theory has been a remarkable journey. From the silent era of unquestioned doctrines to the subjective stage of fledgling frameworks, nurses have steadily constructed an empirical body of knowledge. Evidence-based practice reigns supreme today, integrating research and theory to elevate care.

While the path was long, each stage built the foundation for the next leap forward. Therefore, nurses are responsible for testing hypotheses and developing theories to push the boundaries of compassionate science. There is still much to learn, but the future is bright for a profession dedicated to relieving suffering through the light of understanding.

By honoring our theoretical forebears while contributing our insights, we can fulfill Florence Nightingale’s vision of nursing as both an art and a science. However, if you are looking for the highest quality nursing essays and nursing dissertations, you can place your order here

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