Introduction
This paper aims at critically analyzing the role played by the knowledge possessed by nurses and how it helps in the delivery of services in health cares. The research also seeks to highlight the importance of the resources used by nurses to acquire the much-needed knowledge (Barker, 2009). The staffing crisis problem occurs when knowledge in the provision of care is limited in nursing. When nurses lack inadequate knowledge in providing care, it is equal to not having enough staff. The costs of healthcare are very high, which means that patients need to get the best form of care from nurses. As a result, nurses constantly need to update their knowledge through available resources. They often need to find new knowledge and improve their performance with the current one. Intellectual capital is the gathering of knowledge from all professionals who affects the outcome of performance in healthcare facilities. The collection of this knowledge is then studies under the intellectual capital theory. The study of nursing knowledge is important and needs to be addressed because the knowledge determines the outcome in different patient cases in a healthcare. A study of how nurses gather their knowledge and where they apply it is essential for the growth of healthcare. Given the amount of influence nurses have in healthcare, an understanding of the knowledge they possess will help the health facilities perform better and find ways of improving that knowledge. Limitation of knowledge or lack is, therefore, incapacitating to a healthcare. A study on intellectual capital is necessary to help discover the available structures for knowledge to be exploited, for instance, social media. Knowledge in nursing is an investment for healthcare facilities that needs to keep growing for better profits, in which case that is the reward in provision of excellent patient care.
The middle range theory
The middle-range theory was developed by Robert Merton, sociologist who was born in July 1910. The theorist was involved in many works of sociology until his demise in 2003. He taught in Colombia University for most of his life, where he participated in works that sought to develop the sociological aspect of science. Robert received many awards for his contribution to the sociology including a nationally acclaimed one for founding social science. The theorist was born in Philadelphia from a humble background and later migrated to the USA. His journey in sociology began in the temple and graduated until it gave him a career in respected institutions such as Harvard and Tulane University.
Apart from introducing the aspect of sociology to science, Robert has participated in many works. Robert has more than 50 publications on sociology. In addition, he contributed to understanding of organizational structures through the middle-range theory. He was also involved in finance, where he provided information on the various forms of capital available besides financial capital that could affect the organization.
The middle-range theory embraces the empirical approach through the use of data to support general points. The theory is not a single entity, but seeks to incorporate aspects of other theories in an effort to substantiate their claims. The middle-range theory highlights the two-sided nature of other theories that explain phenomena. It states that a positive theory has empirical aspects and data to support its arguments, whereas the opposite does not. The theory applies to the hypothesis found in a research and enhances the social nature involved (Peterson & Bredow, 2009). The middle-range theories note that other theories are centered on the same mode of thinking to form a law on the shape theories should take. A good theory is one that appreciates both the social and empirical an aspect of the research. The theory unites others in a unified, scientific approach that is well-founded on the research carried out.
In the review, the empirical nature of middle-range theory has been applied to create a better hypothesis. The paper highlights the processes and different channels of knowledge in nursing and comes up with a hypothesis that translates to good results. Structural, human and relational capital is some of these aspects are unified to give rise to good outcomes in patient care. Human capital is the contribution made from employees, where their knowledge and expertise helps in the development of better outcomes in an organization. This knowledge is acquired through interrelationships within the organization and avenues such as social media. The social aspect is influenced by the middle-range theory which appreciates the presence of social phenomena. Social phenomenon can be used to substantiate claims and create a balance in the research. The balance has to include the social aspects of science, which explain interaction in human beings that fosters interrelationships. The social aspect that contributes to the hypothesis is the opposite of the empirical data sought in the research but helps in the evidentiary part. Structural capital is a contribution of nurses’ accountability.
The degrees and registrations help nurses become qualified for the jobs. As such, they can only contribute when they are qualified hence the form of capital helps in performance. They provide evidence to support the theory on intellectual capital. Evidence of findings is one principle that is applied in the middle-range theory. A theory has to have some evidence that would support the results found in a research. Therefore, the evidence or supporting statements, based on real events or truth as it is in science, give the research in the theory accountability. In essence, nurses contribute to the positive outcomes in healthcare facilities when they become registered. The registration process is an investment made by the nursing fraternity to hospitals. Such is the case that when a nurse drops out or leaves the practice, the hospital experiences a loss in what would have been beneficial to them. Therefore, a nurse contributes to knowledge when they join the profession.
Relational capital is also represented in the middle-range theory. Relational capital stands for knowledge from interactions that is benefited from the healthcare. Through relationships with other qualified personnel, nurses gain experience in their job. The organization helps them in training and gives them a good framework for practice to perfection. Thereafter, when the nurse quits, the institution experiences a deficit in performance, which is in this case the profit, since an investment exits the organization. They take the skill with them, leaving the health institution with a shortage of stuff. Even if new staff is brought immediately after, it takes time for the same to become experienced. Thus, just like a business, the exit of trained personnel hinders performance.’
Realism is the fundamental holding point for the theory of middle-range. In the theory, the unity in other theories is brought together but should not be too big as to warrant it unreal. It should be based on concepts that can have accurate results when empirically tested. As such, the nursing intellectual theory should be based on realness as opposed to a mere theory of assumed facts. The literature on nursing intellectual theory is based upon a sense of realism where performance is indeed affected when staff in a healthcare is not adequately prepared to handle patients. Adequate preparation has to start with having the right qualification and experience in handling patients (Covell & Sidani, 2013). The environment in a healthcare will influence staff in either a good or bad performance. When there is a decrease in human capital, the performance of the healthcare will decrease. The above is a realist approach that can be tested and proved using empirical values and data in a research. When nurses do not have knowledge on taking care of patients, the consequences on the institution could be severe. Patients could choose to sue them, and their performance rating would considerably reduce. The performance level compared to the knowledge of staff can be represented in the data analysis with figure to support it. The representation would make the research realistic. The lack of knowledge in nursing is the same as when a hospital is understaffed. The result is a chaotic environment with few individuals who can perform.
The middle-range theory often seeks to identify the use of a research through its hypothesis. It often seeks to answer the question as to hoe useful a hypothesis can be, and the meaning of it. The usefulness of a hypothesis can range from the contribution to the development or for providing insight into a certain topic. The theory is used in the article studied to give insight into the importance of making knowledge available to nurses at work. The importance is that it directly influences the performance, which is related to people’s lives (McEwen & Wills, 2011). The relationship needs to be studied to encourage nurses to pursue knowledge because they are investments to a healthcare. The general idea is to educate readers on the different types of investments afforded to nurses. It is also paramount in encouraging hospitals to provide the right avenues and environment to enable nurses to carry out their duties with respect to the care of patients. In the outcomes of the research, it is proposed that health cares should provide a platform where nurses acquire the right skills and knowledge. Nurses who are registered have acquired training; hence, most health institutions do not bother to reinforce their skills. They base their performance on already acquired skills and rely on long practice in the profession. However, they need constantly to provide avenues that nurses can learn, through routinely training sessions and checks. It is important that nurses update their knowledge from time to time. The medical world is dynamic in nature and grows on a near daily basis. Medical professionals are often involved in fighting new diseases and conditions. Because of this, they need to update themselves constantly of what is happening around them. Books and interactions serve as a good training tool for nurses, but more formalized methods could do better. Such methods could include routinely forums where nurses are informed of new things and reminded of old ones.
The middle-range theory can, therefore, be applied in the practice problem, which is based on the knowledge of nurses. From the above, the theory has helped in sensitizing the reader on the importance of being knowledgeable in all spheres of the nursing profession. Ignorance in a service oriented profession is not acceptable because the performance of the hospital is at risk. In addition, healthcare prices have escalated, and patients deserve the best care they can get. In the structural organization of the healthcare system, provision of care should be systematically organized according to qualification and expertise. In this case, testing in knowledge is necessary to determine where a nurse should be placed. The theory of middle-range emphasizes the need for testing in order to find results. That is how the principle of realism applies. For something to be real, it needs to be tested (Smith & Liehr, 2014). The hypothesis should reflect the research in truth. Therefore, performance of nurses who have knowledge should be put to test. Nurses should be tested on their knowledge on a period basis, therefore making the findings realer. The practice would change when the theory is applied because it ensures method realistic methods to acquisition of knowledge are adopted in research. The theory gives room for change in performance through the change in how nurses conducted their practice and provided a new viewpoint about knowledge. The method advocated by this method is a practical approach that probes health cares to change tactics.
Conclusion
There is importance to apply this theory because patients can acquire more knowledgeable care. The care would ensure the performance of nurses is increased. Hospitals will be able to look at nurses as investments since their knowledge is considered as capital. The theory is realistic in nature, which stimulates the same kind of approach when dealing with nurses. However, applying the middle-ranged theory can be overwhelming because that kind of approach might not be suitable for all situations. The theory might be hard to apply in a healthcare environment, and would require a lot of supervision, time and resources. The intellectual capital theory might be costly to apply since involving all those resources needed for facilitation of knowledge is expensive.
References
Barker, A. M. (2009). Advanced practice nursing: Essential knowledge for the profession. Boston: Jones and Bartlett.
Covell, C., Sidani, S. (2013) "Nursing Intellectual Capital Theory: Implications for Research and Practice" OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 2.
McEwen, M. & Wills, E. (2011). Theoretical basis for nursing. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Smith, M. J., & Liehr, P. R. (2014). Middle range theory for nursing. New York: Springer
