What is Nursing Theory | Concepts, Models and Theories

Nursing theory advances patient care through nursing systems, concepts, and procedures.

It utilizes systematic and structured approaches to promote purposeful treatment allowing for adequate care and recovery.

Fundamentally, nursing theories look at healthcare factors to identify ways to improve them through four main concepts.

These four concepts of nursing theory (by Jacqueline Fawcett, Ph.D.) are the person, environment, health, and nursing.

Some believe the first nursing theory began in the 1,800’s (1,860’s to be specific) by Florence Nightingale.

This theory, known as the environmental theory, relates to environmental factors affecting patient well-being.

Florence Nightingale states that five environmental factors influence the mortality and morbidity of patients.

These include cleanliness or sanitation, efficient drainage, fresh air, light or direct sunlight, and pure water.

Florence Nightingale’s Five Environmental Factors:

  1. Cleanliness or sanitation
  2. Efficient drainage
  3. Fresh air
  4. Light or direct sunlight
  5. Pure water

Florence Nightingale concludes that patients’ overall health improves by improving these environmental factors.

Although this theory is quite old in healthcare, its ideas remain remarkably relevant.

It is incredibly reflective in locations that lack good care of these five environmental factors.

For instance, water and air pollution and poor drainage lead to lower life expectancies, poor health, and medical complications.

Accordingly, a lack of direct sunlight negatively impacts sleep, increases vitamin deficiency, and can lead to medical disorders.

Moreover, Florence Nightengale is known as the founder of modern nursing through her revolutionary ideas on nursing education.

Since the introduction of Florence Nightingale’s environmental theory, many proposals for nursing theories have evolved.

Nurses can follow nursing theories regardless of their specialization.

Nursing theories provide foundational guidelines for nursing care across an extensive range of nursing practices.

Nursing Metaparadigms

First introduced by Jacqueline Fawcett, nursing metaparadigms focus on the holistic care of patients through four essential concepts.

It includes the person, environment, health, and nursing aspects of care.

These metaparadigm concepts are fundamental to all nursing theories because they ensure patients receive adequate medical support.

Eliminating a single concept reduces patient care by leaving an essential healing component out of the holistic process.

The Four Main Concepts of Nursing Theory

  • Person
  • Environment
  • Health
  • Nursing

Each concept focuses on a specific area that influences medical care in a positive/negative way.

As a result, nurses must incorporate and integrate these concepts to maximize healthcare outcomes.


The person component of the metaparadigm refers to the individual, patient, family, group, or community.

This concept focuses on the social, spiritual, and healthcare needs of the person(s) receiving medical care.

As a result, it’s central to the four main concepts because the other components remain irrelevant without the person.

Acknowledging the person’s needs enables the nurse and patient to manage their health better.

It also helps them develop strategies and processes to accommodate the person’s social, spiritual, and healthcare needs.


The health component of the metaparadigm focuses on the health aspects influencing a person’s well-being.

It includes the physical, emotional, intellectual, spiritual, and social aspects of the person/patient.

Incorporating healthy processes and strategies into practices maximizes the patient’s healthcare outcomes.

A person’s health fluctuates across their entire lifespan.

As a result, nurses must consider the factors influencing a person’s health at a given time and circumstance.


The environment component of the metaparadigm considers the impact the environment has on the person(s).

It includes culture, financial circumstances, geographic location, living standards, work environment, and technology.

According to this theory, a person’s environment dramatically impacts their overall health and wellness.

As a result, they can improve their health and well-being by changing their environment or aspects of their setting.


The nursing component of the metaparadigm focuses on the relationship between the patient and nurse.

It centers on the actions and interventions nurses can take to ensure patients receive optimal care.

It also considers the nurse’s knowledge and technical and soft skills.

Nurses must communicate effectively with team members, deliver compassion and be knowledgeable in their nursing roles.

Understanding areas of improvement allow nurses to develop the skills needed to provide adequate care and support.

Types of Nursing Theories

There are several types of nursing theories utilized today,

It includes grand nursing theories, mid-range nursing theories, and nursing practice theories.

Each approach benefits nurses by influencing different levels/aspects of patient care and improving patient outcomes.

Grand Nursing Theories

Grand nursing theories focus on abstract, broad, and complex concepts.

It provides a general overview and a high-level framework for nursing ideas and theories.

However, it gives less consequential details or impactful information than other levels.

Mid-Range Nursing Theories

Mid-range nursing theories provide greater detail and specificity than grand nursing theories.

However, it lacks the principles offered by practice-level nursing theories required to manage specific problems.

Mid-range nursing theories result from daily nursing practice, research, related concepts, or other methodologies.

Practice-Level Nursing Theories

Practice-level nursing theories are relatively situation-specific.

In other words, these theories concentrate on the aspects of particular patient populations.

This level is more specific and defined than mid-range and grand nursing theories.

As a result, nurses can implement specific theories to address distinct patient needs in their daily practice.

Nursing Theory in Practice

Nursing theories act as frameworks by providing nurses with systems for healthcare management, investigation, and decision-making.

It also allows nurses to develop communication structures with fellow nurses and healthcare team members.

Nursing theories administer a structure for communicating with nurses, representatives, and healthcare team members.

It also supports the development of nursing by formulating beliefs, values, and goals.

Nurses utilize these frameworks/nursing theories during medical care to ensure optimal patient outcomes.

Grand theories enable nurses to focus on abstract, broad, and complex concepts and develop a framework of ideas.

They can then dial into greater detail with mid-range theories.

Nurses use daily practices, research, and other methodologies to develop practice-level nursing theories at this level.

Once the theories are relatively sound, nurses put them into daily practice to manage the needs of their patients.

The Importance of Nursing Theory

Nursing theories introduced valuable concepts, beliefs, and systems for patient care from a historical standpoint.

It was essential because nurses lacked formal knowledge of healthcare and the practices necessary for proper medical care.

As a result, patients received inadequate healthcare, contributing to ailments, illnesses, and preventable deaths.

Nurses formed guidelines and systems to improve the daily care of patients through nursing theory development.

Naturally, it allowed nurses to acquire valuable knowledge related to their field.

It also provided standardized systems for nurses to ensure effective communication and optimal patient outcomes.