Imogene M. King and a New Theory of Nursing

Profiles in Nursing

Imogene M. King and a New Theory of Nursing

Building a nurse-patient relationship

By Elizabeth Hanink, RN, BSN, PHN
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Nursing professor, scholar and theorist Imogene M. King was one of the profession’s true pioneers. Her conceptual frameworks and theories have shaped the modern concept of evidence-based practice and helped to define how we understand and talk about the science of nursing.

Her First Love: Teaching

Born in a small town in Iowa in 1923, King attended nursing school at the suggestion of her uncle, a local surgeon, who provided financial support. Although he seems to have intended for her to join the wartime armed services, she did not graduate from St. John’s Hospital Nursing School in St. Louis until a week after World War II ended in 1945.

King practiced in a number of settings, including college health and a stint as a private-duty nurse, but she continued her education with the intention of pursuing her first love: teaching. She worked as a clinical instructor at St. John’s both before and after earning her BSN in 1948. She became the school’s assistant director of nursing in 1951.

After earning her MSN from St. Louis University in 1957, King moved on to Teachers College of Columbia University, where she completed her doctorate in education in 1961. She held several nursing faculty posts in the ‘60s and ‘70s, teaching at Loyola University in Chicago and then at Ohio State University before returning to Loyola in 1972. She spent the ‘80s teaching at the University of South Florida School of Nursing.

A Profession of Relationships

From the very beginning of her career, King was interested in nursing theory as well as practice. In the ‘40s and ‘50s, nursing and nursing education followed the medical model. Like doctors, nurses were trained to focus on the diagnosis rather than on the patient.

Even as a graduate student, King sought to change that and establish a model with a different point of view.

King’s model describes nursing not as a set of actions to perform, but rather as a relationship between nurse and patient. That relationship is shaped by three sets of factors: the personal characteristics of each individual; the interpersonal interactions between the patient and the nurse; and the larger social systems in which they both exist.

Beyond the Diagnosis  

The objective of the nurse-patient relationship is to set shared goals and then develop and implement a plan to achieve them. The goals are health-related, but are defined by the patient’s personal and social needs, not just the diagnosis. Under King’s goal attainment model, a satisfactory goal might be to reunite a patient with his family or to maintain a dying patient’s dignity.

These theories, which King spelled out in her many articles and her books Toward a Theory for Nursing: General Concepts of Human Behavior (published in 1971) and A Theory for Nursing: Systems, Concepts, Process (published in 1981), offered a framework not only for understanding nursing as a profession, but also for studying it and for relating research back to practice.

Woman of Influence

King’s work had a major influence on nursing education both in the U.S. and in Japan, where her books were translated by her friend and colleague Midori Sugimori, whom King met at a 1969 World Health Organization seminar.

King retired from the University of South Florida in 1990, but continued to travel, lecture and mentor nursing students and scholars. In the ‘90s, she was also on the cutting edge of the new science of informatics, delivering the keynote address at the Sixth International Congress on Nursing Informatics in Stockholm, Sweden, in 1997.

King received many nursing honors, including the 1996 Jessie M. Scott Award from the American Nurses Association, which elected her to its Hall of Fame in 2004. In 2005, two years before her death, the American Academy of Nursing named her a Living Legend.   

Elizabeth Hanink, RN, BSN, PHN, is a Working Nurse staff writer with extensive hospital and community-based nursing experience.

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