Nursing scholarship: sense and sensibility.

This paper explores the relationship between nursing theory, research and practice. It suggests that the frequently discussed difficulties in operationalizing, testing and implementing nursing theories are perhaps indicative of their lack of fit with clinical practice. The insistence of fitting theories within the four metaparadigm concepts-person, environment, health and nursing-forces nursing theory to an inappropriate level of abstraction and to a level that dilutes its relevance for clinical application. It is possible that, while these theories are useful as philosophies, they lack the clinical relevance that is a critical criterion for theory. Confounding the status quo, the present practice of teaching theory as fact within education and using theory to drive nursing curricula removes the tentative and guiding contribution that a theory contributes to a profession. A plea is made for research that supports the exploration and identification of nursing concepts and for the development of appropriate theory that will guide both nursing research and nursing practice. Since nursing is an applied discipline, this responsibility necessarily falls on the shoulders of researchers who, in partnership with clinicians, can explore, test and refine theory.