Federal laws have been passed that indicate that
patients must be involved in decisions about their
care and about dying.This transaction process pro-
vides a scientifically based process to help nurses
implement federal laws such as the Patient Self-
Determination Act.
Goal Attainment Scale
Analysis of nursing research literature in the 1970s
revealed that very few instruments were designed
for nursing research. In the late 1980s, the faculty
at the University of Maryland, experts in measure-
ment and evaluation, applied for and received a
grant to conduct conferences to teach nurses to
design reliable and valid instruments. I had the
privilege of participating in this two-year con-
tinuing education conference, where I developed
a Goal Attainment Scale (King, 1989b). This in-
strument may be used to measure goal attainment.
It may also be used as an assessment tool to pro-
vide patient data to plan and implement nurs-
ing care.
Use of King’s Conceptual
System and Theory
Over the years of presenting my ideas at theory
conferences throughout the world, nurses have
asked many excellent questions, which I have tried
to answer. Initially, the questions pertained to, How
does one implement this in practice? This moti-
vated me to design the documentation system to
show the relationship between the nursing process
as method and my nursing process as theory. Prior
to presenting this at a national meeting, several staff
nurses tested this and suggested this system be im-
plemented in practice. I reminded the nurses that
they were not applying a theory, but were applying
the knowledge of the theory’s concepts. This has
become a repetitive statement of mine; that is, one
cannot apply an abstraction, which is what concep-
tual frameworks, models, and theories represent.
What one applies is the knowledge of the concepts
of the structure and process proposed in the ab-
stractions. Before retiring from a full-time teaching
position, the last thing I had to do was design an in-
strument to measure goal attainment. The use of
my ideas in practice, education, administration,
and research is overviewed here and is detailed in
Part 2 of this chapter.NURSING EDUCATION
My first faculty position was as an assistant profes-
sor at Loyola University, Chicago. Because my area
of study was curriculum and instruction, I was
selected to chair a faculty committee to develop a
curriculum leading to a master of science degree
in nursing. This was one of the first master’s pro-
grams that used a nursing framework to design a
curriculum. The theoretical model was designed by
a nurse as part of a dissertation from the University
of California (Kaufman, 1958). The model was
composed of three concepts—time, stress, and
perception. Needless to say, this approach to de-
velop a new graduate program was revolutionary
in 1961. This activity provided the impetus for
me to reflect on my knowledge of curriculum
and instruction, and also to think about struc-
ture for organizing undergraduate and graduate
nursing programs. The rest is history and is
recorded in my books and articles over the past
30 years (King, 1986a).
In the 1970s, the professional nursing staff at
the National League for Nursing conducted con-
ferences to disseminate information about the cur-
riculum process for developing or revising a
baccalaureate nursing program (King, 1978). The
major components in a curriculum discussed
at these conferences were “a philosophy, concep-
tual framework, course objectives, and evaluation
of the curriculum” (National League for Nurs-
ing, 1978).
The scope of knowledge is so vast that it is im-
possible to teach students everything they need to
learn to begin to practice nursing today and tomor-
row. It is imperative that nursing curricula be based
on a conceptual framework. Such curricula must be
structured to provide students with the essential
concepts, skills, and values that serve as founda-
tions and as catalysts to continue to learn after
graduation (National League for Nursing, 1978).
As a participant observer who provided admin-
istrative support for a faculty engaged in construct-
ing a new undergraduate curriculum, I witnessed
the development of a curriculum that moved nurs-
ing education into the future (Daubenmire & King,
1973). This baccalaureate nursing curriculum,240 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration