The Essence of Middle Range Theory

The question regarding the nurse turnover seems to be significant to solve. The issue affects not only the financial side, however; in addition, it can cause the negative client’s outcome and decrease the level of quality of the health service. It should be stressed that the middle range theory gains momentum and becomes important concerning finding possible ways to struggle with the nurse turnover. The major reason for the nurses to quit their job is the dissatisfaction with the working environment. The pivotal aim of the paper is to evaluate the connection between the nurse turnover and middle range theories.

According to the recent statistic, almost 20% of licensed nurses get the job in a year; however, around 40% quit within the following couple of years (Kovner, Brewer, Fatehi, & Jun, 2014). The nurse turnover indicates the level of comfortable and the prolific working environment in the sphere of the health care. When the nurse leaves the workplace, the hospital faces some issues, namely cost-related problems and more significantly the reduction of the quality of care. In some cases, nurse turnover is beneficial; however, it still affects the hospital, as they should replace the nurse. The benefit is that when the nurse does not perform the job in a correct way, and she quits, it has a positive influence on the quality of care and client’s safety. There can be different reasons for the turnover, for example, dissatisfaction with the workplace, environment, moving to a different town, willingness to get a promotion, or dismissal (Meleis, 2012). The medical health-care institution with a high rate of the registered nurse turnover can be considered as one with poor work conditions and atmosphere. The turnover is deemed to be costly not only to organization but society as well.

Middle range theories are commonly used in the nursing practice and contain a certain amount of concepts. Middle range theories describe the nurse’s intervention and the client’s outcome (Barker & DeNisco, 2012). The theories are used in both, the research and practice. The examples of the most widespread middle range theories are the following, theory of uncertainty, comfort, social support, and pain (Barker & DeNisco, 2012). Middle range theories can be used to tackle the problem of nurse turnover. The turnover negatively characterizes the medical establishment. To eliminate the problem, certain actions regarding the increase of the satisfaction of the workers with the working environment should be taken. The attitude towards workers and how they feel on the workplace is believed to have a significant effect on the patient’s outcome. The middle range theory suggests that professional development impacts the successful treating of the patient. There is a vital connection between engagement into the working process, job satisfaction, patient’s treatment, and turnover.

The theories are useful tools in shaping phenomenon and getting closer to the understanding of concerns. Those health care establishments that aim to get the Magnet status now should direct their work in accordance with middle range theories. The quality of health care environment and satisfaction of work are two major objectives that should be taken into account while performing. The work based on the middle range theories will improve fulfillment and will contribute to the professional model of nursing behavior.

Middle range theories were originally developed to combine practice and research in one and to be adaptable to a wider spectrum of practices. The theories are believed to be cogent as they aim to address issues that the nursing science face in the modern world (Smith & Liehr, 2013).

According to recent studies, there are three different types of the middle-range theories, namely descriptive, explanatory, and predictive. The first type, descriptive theories, is considered to be fundamental. It describes the phenomenon through the observation of events or groups of people. Moreover, it describes hierarchical relationships while dividing the phenomenon into categories. Explanatory theories deal with the evaluation of the relationships between the concepts, whereas predictive types describe the changes that happen in the phenomenon. The most widespread middle range theories that address the issues of the nurse turnover are the following, namely caregiver effectiveness model, advancing technology, caring and nursing, attentively embracing stories, and behavioral systems and nursing.

The family caregiving theory was implemented in the working process of the medical centers. The major aim was to provide the highly professional service and offer the family-centered approach (Talley & Travis, 2014). The fundamental idea was to establish relationships between the nurse and the client based on trust and respect that consequently lead to the improving of the overall work of the health care providers. The implementation of the middle range theories into the working process will have a positive effect on the nursing practice. The stated above approaches aim to increase the satisfaction of the nurse with the workplace, and that is, the theory should be used while making positive changes.

In conclusion, it should be stressed that the working environment and the atmosphere of the medical establishments should be significantly improved to eliminate or decrease the nurse turnover as it is costly not only for the organization but for society as well. Those health care providers that aim to get the Magnet status should follow the middle range theories as they can be considered as an effective tool that will support the medical establishment in the way of accomplishment the stated above goal.


Barker, A., & DeNisco, S. (2012). Advanced Practice Nursing (2nd ed.). Sudbury, MA: Jones and Bartlett Learning.

Kovner, C., Brewer, C., Fatehi, F., & Jun, J. (2014). What Does Nurse Turnover Rate Mean and What Is the Rate? Policy, Politics, & Nursing Practice, 15(3-4), 64-71.

Meleis, A. I. (2012). Theoretical nursing: Development and progress (5th ed.). China: Lippincott Williams & Wilkins.

Smith, M., & Liehr, P. (2013). Middle range theory for nursing (3d ed.). New York, NY: Springer Publishing Company.

Talley, R., & Travis, S. (2014). Multidisciplinary coordinated caregiving: Research, practice, policy. New York, NY: Springer Science Business Media.