Imogene King's theory says something that sounds obvious and is routinely ignored: nursing works when the nurse and the patient are pursuing the same goal, and a great deal of care fails because nobody ever established that they were.
Background
King was born on January 30, 1923 in West Point, Iowa. She took her nursing diploma at St John's Hospital School of Nursing in St Louis in 1945, a bachelor's in nursing education at St Louis University in 1948, a master's there in 1957, and a doctorate at Teachers College, Columbia in 1961.
She taught at Loyola, Ohio State and the University of South Florida, and spent a period in the 1960s at the federal Division of Nursing working on nursing research.
Systems, then goals
King built a conceptual system of three interacting levels:
- Personal systems — the individual, with perception, self, body image, growth, time and space.
- Interpersonal systems — two or more people interacting, involving communication, transaction, role and stress.
- Social systems — families, workplaces, hospitals, with authority, power, status and decision-making.
Out of the middle level she derived the theory of goal attainment, published in 1981. Nurse and patient come to an encounter with different perceptions of what is happening. They communicate. If the communication works they reach a transaction — an explicit, mutual agreement about what the goal is and how to pursue it — and goals set that way are far more likely to be met.
The corollary is the useful part. When a patient does not follow a plan, King's framework does not treat it as non-compliance. It treats it as evidence that no transaction ever occurred: the nurse set a goal, the patient held a different one, and nobody surfaced the difference.
That is now standard language in patient-centred care, shared decision-making and discharge planning, and King was arguing it in the early 1960s.
Her framework is also unusually testable for a grand theory. Because transactions are observable events, the theory generates measurable questions, which is why it produced more empirical research than most of its contemporaries.
King was a Living Legend of the American Academy of Nursing and was inducted into the American Nurses Association Hall of Fame in 2004. She died on December 24, 2007 in St Petersburg, Florida.
Related
Sources
- Imogene King, for the chronology, degrees and career. Accessed September 9, 2026.
- A Theory for Nursing: Systems, Concepts, Process, Imogene M. King. John Wiley, 1981. Accessed September 9, 2026.
- ANA Hall of Fame inductees. American Nurses Association. Accessed September 9, 2026.
- Nurse theories repository. Nursology. Accessed September 9, 2026.