Deconstructing the intersect between nursing theory and practice: A grounded theory study

Abstract

The difficulty experienced by some practicing nurses in articulating their practice to nursing theories has fueled the debate among nurse scholars on the theory-practice gap and the need to close it. The theory-practice gap is problematic in nursing because it creates an environment where practicing nurses need help integrating knowledge learned in the classroom with real-world clinical practice. This study explored nurse educators' understanding of the intersectionality between nursing theory and practice and how this relationship is enacted. We utilized the constructivist grounded theory approach to explore the relationship between nursing theory and practice. Data were collected from 18 clinical nurse educators through semi-structured face-to-face interviews. Our finding suggests a grounded theory of "situational reciprocity" that theorizes a "reciprocal active theory/practice process". Active theory practice engagement suggests that nursing theory and practice are in a mutual, non-deterministic relationship. The argument that purports a gap between nursing theory and practice may be counterfactual because the relationship between these constructs is not causal; instead, both are inseparable, as in praxis. Although nursing practice should be reflected in nursing theories, theory should not be expected to inform and determine practice in a hierarchical, unidirectional manner due to the inherent complexity of practice. Theory informs and is modified by reflective practice reciprocally. Nursing theories may not be able to predict all nursing practice outcomes due to practice complexities, but they can help to understand care outcomes within the context of the complexities that characterize the human response to care and the nurse-client relationship. Nurse educators and practitioners, administrators, and researchers need to weave together a coherent theory-practice connection so that nurses will continue to advocate for and provide knowledge-based, evidence-informed, safe, and cost-effective care to promote the well-being of patients and facilitate positive health outcomes.

Keywords

• theory-practice gap
• relationship
• nursing
• reflective practice
• grounded theory
• praxis