Exploring Middle Range Theories and Framing Practice Issues Essay Paper

Analyze your nursing practice for issues of particular interest or concern to you. Identify one issue as the focus of your application of theory to practice.
Review the Week 2 Learning Resources to identify specific middle range theories that may apply to your practice issue.
Choose at least two middle range theories that might be most relevant and valuable in addressing your practice issue.
Search the Walden Library for scholarly articles that address application of middle range theories to practice issues.
Consider how to frame your focus practice issue in terms of the middle range theories that you have selected
Week 2 learning resources
1) https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/dr-nurs/nurs-8114/week-02/Chapter%2010,%20Introduction%20to%20Middle%20Range%20Nursing%20Theories.pdf
2) https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/dr-nurs/nurs-8114/week-02/Chapter%2019,%20Application%20of%20Theory%20in%20Nursing%20Practice.pdf
3) https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/dr-nurs/nurs-8114/week-02/Handout-Writing%20a%20Philosophy%20of%20Nursing%20Practice_to_Build.docx . Exploring Middle Range Theories and Framing Practice Issues Essay Paper

Exploring Middle Range Theories and Framing Practice Issues

An issue of concern is incivility, violence and bullying in nursing practice. This includes nurses facing uncivil behavior from peers, other medical personnel, patients and other stakeholders. Although the nursing profession is dedicated to helping others, nurses practice in a highly changed environment where emotions can easily boil over and get out of hand, especially when facing life and death decisions and outcomes. In this case, nurses can be targeted through repeated, unwanted, disrespectful, discourteous and rude actions undertaken with negative intent to cause distress, offend and humiliate (Green, 2019). These aggressive acts targeted at nurses, whether physical or verbal, are entirely unacceptable, whether delivered by peers, colleagues, patients or other stakeholders. When faced with these acts of aggression, the nurses in question are likely to have negative serious effects on their wellbeing as well as their ability to care for their patients. Given this awareness, there is a need for the workplace in which nurses operate to protect them from the acts of aggression through providing resources, policy and advocacy. A key resource that can be provided is training on how to handle incivility, violence and bullying so that nurses are better equipped to handle and address such issues. With these efforts, a supportive, respectful, safe and healthy environment would be created to ensure that positive health outcomes are the highest priority (Green, 2019).


Dorothy Johnson’s Behavioral Systems Model and American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care are two middle range theories that apply to the issue by facilitating efforts to develop and apply effective long-term solutions. Firstly, Johnson’s Behavioral Systems Model fosters effective and efficient behavioral function to prevent illness and stresses. In applying the theory, each nurse would be considered as a behavioral system that is composed of seven behavioral subsystems: achievement, aggressive, sexual, eliminative, ingestive, dependency and affiliative. Each of the seven subsystems can be targeted for meeting three functional requirements in terms of protecting the nurses from noxious influences, providing a nurturing environment and stimulating growth (Butts & Rich, 2018). Any imbalance in any of the behavioral subsystems results in a disequilibrium. Acts of incivility, violence and bullying perpetrated against nurses create an imbalance in the behavioral systems resulting in disequilibrium that has a negative effect on the health of nurses as well as their ability to provide high quality care. Through applying the theory, three goals would be targeted: firstly, assisting each nurses to apply behavior that is proportional to social demands; secondly, modifying behavior in ways that support biological imperatives; and finally, benefiting to the fullest from professional nursing knowledge and experience. Overall, this theory help nurses in identifying and appropriately addressing issues of concern in the workplace (Butts & Rich, 2018).

Secondly, AACN’s Synergy Model for Patient Care aligns the needs with competencies. The central idea in the theory is that needs drive competencies required. When competencies stem from needs, then a synergy occurs. Through incorporating this theory, development programs for nurses can be applied that allow them to develop the right competencies for the workplace environment. When a synergy is achieved between nurses’ competencies and workplace needs, then optimal outcomes can be achieved in terms of nurses’ performance and outcomes of their care efforts (Hardin & Kaplow, 2017). Overall, the two discussed middle range nursing theories can be applied to ensure that nurses are equipped to handle incivility, violence and bullying in nursing practice.


Butts, J., & Rich, K. (Eds.) (2018). Philosophies and Theories for Advanced Nursing Practice (3rd ed.). Jones & Bartlett Learning, LLC.

Green, C. (Ed.) (2019). Incivility Among Nursing Professionals in Clinical and Academic Environments: Emerging Research and Opportunities. IGI Global.

Hardin, S. R., & Kaplow, R. (2017). Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care (2nd ed.). Jones & Bartlett Learning, LLC.

Exploring Middle Range Theories and Framing Practice Issues Essay Paper

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