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This article demonstrates three major nursing theories in practice. The uniqueness of each theory is clarified through their presentation of nursing formulations and practice implications. The discussion provides a metaperspective of how practice based in nursing theory is different from traditional practice and how nursing theory can guide practice. [ABSTRACT FROM AUTHOR]

Objectives: Results from basic science and narrative reviews suggest a potential role of β-blockers in patients with sepsis. Although the hypothesis is physiologically appealing, it could be seen as clinically counterintuitive. We sought to assess whether patients previously prescribed chronic β-blocker therapy had a different mortality rate than those who did not receive treatment., Setting: Record linkage of administrative databases of Italian patients hospitalized for sepsis during years 2003-2008 were identified and followed up for all-cause mortality at 28 days., Interventions: None., Measurements and Main Results: We identified 9,465 patients aged≥40 yrs who were hospitalized in critical care units for sepsis. Of these, 1,061 patients were on chronic prescription with β-blockers and 8404 were not previously treated. Despite a higher risk profile, patients previously prescribed with β-blockers had lower mortality at 28 days (188/1061 [17.7%]) than those previously untreated (1857/8404 [22.1%]) (odds ratio 0.78; 95% confidence interval 0.66-0.93; p=.005 for unadjusted analysis, and odds ratio 0.81; 95% confidence interval 0.68-0.97; p=.025 for adjusted analyses). Sensitivity and pair-matched results confirm the primary findings., Conclusions: As far as we are aware, this pharmacoepidemiologic assessment is the largest to examine the potential association of previous β-blocker prescription and mortality in patients with sepsis. Chronic prescription of β-blockers may confer a survival advantage to patients who subsequently develop sepsis with organ dysfunction and who are admitted to an intensive care unit. Prospective randomized clinical trials should formally test this hypothesis.

The relentless drive to be thinner is an experience lived by many individuals in the present sociohistorical context. Since fundamental questions concerning the structure of this lived experience remain unanswered in the literature, theory-based approaches to nursing practice have yet to be conceptualized for these individuals. The investigator was unable to find even a single nursing study related to the target phenomenon. The present study addresses the foundational question: What is it like to live the experience of the relentless drive to be ever thinner? Retrospective written and verbal accounts from two women who had lived this experience were analyzed using the Giorgi modification of the phenomenological method. The central finding of this study was: The relentless drive to be ever thinner is a persistent struggle toward an imaged self lived through withdrawing-engaging. This theoretical proposition was found to be congruent with Parse's theory of nursing. The study findings suggest directions for innovative nursing practice and support Parse's theory as a useful perspective for the investigation of health experiences.

This article presents a dissenting view of the expanded role nurse in light of contemporary nursing theory. Nursing has moved beyond the vision of expanded practice as conceptualized by provincial and federal nursing associations more than two decades ago. A body of scientific knowledge has emerged which distinguishes nursing practice as unique, and there is a trend away from practice based upon the medical model. The expanded role nurse represents a retreat to physician-dominated, medical model practice and runs counter to the goal of theory-based practice. It is suggested that the concept of the physician's assistant is an appropriate response to cutbacks in medical residents rather than the delegation of medical functions to nurses. If nursing is to survive into the 21st century, theory-based practice must be firmly established and expanded through research. It is proposed that the expanded nursing role as presented in the literature is incompatible with theory-based nursing practice and diminishes the hope for autonomous professionhood.