1. Sharpnack, Patricia A. DNP, RN, CNE, NEA-BC, ANEF

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A Nursing Theory Think Tank was convened at Case Western Reserve University, Frances Payne Bolton School of Nursing, on November 7, 2017. This gathering provided opportunity for prominent theorists and leaders in research, education, and practice to discourse about nursing knowledge and the importance of the influence of theory on these 3 domains of the profession. Arguably, nurses cannot fully appreciate the purpose and distinct nature of their work unless theory is at the core. The need to disseminate, reinforce, and regenerate theory knowledge and development so that the practicing nurse is confident in articulating, questioning, and applying theory is critical for the advancement of the profession. Nonetheless, are nurse educators and theorists able to breathe life into theory in order for this to come to pass?


Barriers exist that prevent nurses from education, research, and practice from magnifying the body of knowledge that is nursing. These barriers include a nursing shortage, the growing demand for a practice-ready workforce, moderated health care reimbursement, and efforts to reduce higher education credit hours pressure educators to reduce exposure to coursework that is considered nonessential. Yet, the escalating impact of health care economics, a shift to high reliability organizational models, the need for broad systems-thinking competencies, intensified consumer expectations, and full scope of practice changes demand that nurses articulate the importance of the work of the profession and effectively use theory to inform and improve practice. Nursing theorists must seize this opportunity to challenge the perception that theory is irrelevant. Closing the gap between theory and practice, reinforcing the partnership between science and service as mutually and meaningfully informed is the key to success.


Most nurses at the bedside are unable to connect theory to practice, and frankly, perceive little value in this connection. Theorists have failed to relevantly link nursing theory and knowledge to authentic practice. In order for this connection to occur, nurse theorists must work in close partnerships with education and practice to promote leaders that value and champion the discipline's knowledge and its application to the clinical setting.


From baccalaureate through to the graduate level, the clinical setting inspires students. Situated learning is a requisite to appreciably apply theory to practice, and it is essential to establish a robust theory-practice connection for this association to occur. If the prelicensure nursing student is unable to apply theory to practice, it is then, not unexpected, that those same students who progress to graduate programs are not able to appreciate the applicability of nursing theory and how it informs their practice. Undergraduate nursing programs teach nursing theory in isolation, and while graduate programs emphasize a deeper understanding, it is neither adequately integrated nor considered meaningful to the work of the advanced practice nurse. While most research and practice-focused doctorates support the linkage between theory and practice, there is no mechanism to ensure that the student is intuitively capable to continue this connection and application beyond graduation.


For theory to be relevant, nurse educators and practice leaders must better articulate the phenomena of nursing and elucidate this phenomenon to students and new nurses through robust educational strategies and application. Nursing theory cannot be taught in abstract, compartmentalized, isolated, and without soul. A regenerative approach supports the recognition of nursing's unique contribution to the health care team. This regeneration must begin at the prelicensure level and be integrated into RN to BSN curricula to ensure that the undergraduate foundation is robust. The future of nursing, as a profession, requires foundational support through curricula established in nursing theoretical perspectives.


The current status of nursing theory pleads for collaboration between nurse theorists and leaders from education, research, and practice to safeguard and magnify the body of knowledge that is nursing. At the core of this collaboration is the need to disseminate, reinforce, and regenerate theory development through educational endeavors that support the practicing nurse in articulating, questioning, and applying theory in daily work. The importance of theorists and education and practice leaders assembling and deliberating theory is essential for the future of the discipline.


Theory think tanks provide for this deliberation. Comprised of leaders from all spheres of nursing theory think tanks provide opportunity for rich dialogues that foster the promotion of creative strategies to effectively integrate theory in education and practice. Exchange of philosophies and thought-provoking discourse can assist in providing exemplars that are practical, applicable, and operational in the clinical setting. I challenge those in attendance at the Nursing Theory Think Tank at the Frances Payne Bolton School of Nursing in March to abandon current presuppositions about nursing theory for fresh perspectives that will ultimately lead to the advancement of the profession in a meaningful, deliberate, and realistic way.


-Patricia A. Sharpnack, DNP, RN, CNE, NEA-BC, ANEF


The Breen School of Nursing,


Ursuline College, Ohio