1) What made the works of Nightingale, Henderson, Levine and Hall be categorized as Pre-paradigmatic?
Paradigms are widely acknowledged scientific achievements that serve as model issues and approaches for a community of practitioners over time (Kuhn, 1962). Kuhn's theory proposes that knowledge evolves in a cyclical and iterative manner rather than a linear approach. This cycle is divided into five stages: pre-paradigmatic, normal science, paradigm crisis, paradigm shift, and scientific revolution (Kuhn, 1962). Small (1980) defines paradigms as the mutually agreed-upon structure of concepts in a field. They are the fundamental unit through which change happens, according to Kuhn's theory. Once a paradigm is formed, research is considered "mature science" (Kuhn, 1962). The pre-paradigmatic phase is characterized by random data gathering, wherein ideas as left open-ended allowing for further theory development. There was a period of philosophy and observation before the creation of a dominant paradigm during which no single thought developed as the majority-accepted view of reality.
Nightingale recognized the particular focus of nursing in the mid-1800s and defined nursing knowledge to be distinct from medical knowledge. She defined a nurse's responsibility as preparing the patient for nature (God) to intervene. She established the following: that caring for the sick is founded on knowledge of people and their environment, which is different from the knowledge base utilized by physicians in their profession (Nightingale, 1859/1969). Despite Nightingale's early injunction in the 1850s, it took another 100 years, during the 1950s, for the nursing profession to seriously address the necessity to develop nursing knowledge in addition to medical knowledge to guide nursing practice. According to Henderson, the patient is a unique person who needs assistance becoming independent and whole—both physically and mentally. She made it clear that nursing practice is distinct from medical practice and stated that she views the nurse's function as a combination of several factors. Henderson emphasized the nursing art and suggested 14 fundamental human needs as the cornerstones for nursing care. Levine's Conservation Model states that every individual has a unique set of adaptive responses. According to Levine's (1973) paradigm, nursing interventions and interactions are crucial to maintaining wholeness and promoting adaptation. These connections have their roots in the scientific foundations of conservation theory, which aims to achieve equilibrium between the supply and demand of energy. Hall represented several facets of nursing and patient care with three interconnecting circles. The care circle depicts the patient's physical body, the cure circle the illness affecting the patient's physical structure, and the core circle the person's inner thoughts and coping mechanisms.
2) Do we really need theory in the practice of nursing?
Indeed we need nursing theories in practicing nursing. In fact, theory is an essential component of the nursing vocabulary in practice, education, and administration, as stated by Meleis (2007). The widespread recognition of nursing as a profession and a separate academic field was a significant prelude to the theoretical era. According to Fawcett (1984), Hardy (1978), and Kuhn (1970), the 1980s experienced significant advancements in nursing theory and marked the shift from the pre-paradigm to the paradigm period. The current nursing paradigm established perspectives for nursing research, nursing education, nursing practice, nursing administration, and theory advancement in nursing. It serves as a backbone and a guide in providing a holistic nursing care for the ill or well individuals.