Analysis of Nursing Theory: Grand, Middle Range, and Practice-Level Theories

Respect for life, dignity and human rights is a fundamental tenet of the philosophy of nursing. The nurse acts both independently and in collaboration with other health care professionals to meet the health needs of the community and individual patients. Nursing has no restrictions on race, age, gender, political or religious beliefs, or social status.

Regarding the theories of nursing, it can be safely assumed that their emergence is largely due to the evolving need to systematize nursing and explain its most important phenomena. The most serious shortcoming in the development of nursing as a profession and a scientific discipline was the lack of a single terminological and conceptual apparatus for all nurses. In other words, any nursing theory’s first purpose is to establish a common professional language for all healthcare professionals. Terminological confusion created significant obstacles for professional communication and mutual understanding of nurses. For example, different names were given to the same phenomenon: symptom, syndrome, need, or patient problem. The lack of classification of such concepts, fundamental for nursing practice, and significant discrepancies in their definition ultimately led to the development of proper theoretical background.

Nursing theories, in general, describe what nursing is and what it should be, while also explaining how it is fundamentally different from other professions. Mudd et al. (2020) supply that “without theory to act as a guide, nurses are independently analysing and critically evaluating situations, putting pressure on the individual to personally develop suitable outcomes” (p. 3655). Some theorists who viewed nursing as a practical applied discipline believed that theories should guide nursing, help explain typical nursing situations, provide the necessary medical information, especially in terms of strategy and tactics of action.

Nursing theories affect different levels of nursing experience and work. Grand theories approach the question of healthcare in relation to the whole world, and include the frameworks build for supporting general health of our population. Although this scope is mostly not useful in specific situations or day-to-day practice, it still holds important knowledge for any nurse. Grand nursing theories are usually reviewed and discussed widely in the academical circles, and this results in the high rate of their reliability. They are all-encompassing, and operate on the generalization caused by induction, without any data. As opposed to them, middle range theories draw their conclusions from a great amount of observation and abstract data collected through a general research. Moreover, this kind of nursing theories is less foolproof than the grand one due to their higher specification. Middle range theories are also differentiated by medical fields, and get their context from the subject of study.

Finally, the practice-level or situation specific theories present the lowest scope in comparison to the previous kinds of approach. They have the highest specification, and apply only to the situation at hand, as they base on the data gathered from this particular practical experience. These theories are prone to false results due to the low reliability of the data, as well as the decreased possibility of the situation repeating itself. This does not allow the theory to be proved or disproved by scientific methods.

Despite the differences between the theories and the scope they have, each level of theoretical approach is important to nursing practice. Differentiating and using properly every kind of nursing theories has proven to be crucial for any nurse – both practicing and theorizing.


Mudd, A., Feo, R., Conroy, T., & Kitson, A. (2020). Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts. Journal of Clinical Nursing, 3652–3666.

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