Metaparadigm of Nursing Concepts: My Personal Nursing Philosophy

 As I have grown from a nurse into the nurse practitioner role my personal nursing philosophy has shifted and also grown over the years. My philosophy of nursing is centered around the metaparadigm of nursing concepts (Kenney, 2013) and two theories: Jean Watson’s Theory of Human Caring and the Theory of Modeling and Role Modeling by Erickson, Tomlin and Swain’s (Parker and Smith, 2010). Both theories continue to have a positive influence on my nursing career. The Model and Role Modeling theory is based around … The Theory of Human Caring is guided by the “moral idea that involves the mind, body, and soul (Chinn & Kramer, 2011, p. 43)

Metaparadigm of Nursing

The metaparadigm of nursing includes; the person, health, environment, and the nurse. The person focuses on the patient receiving the care and encompasses everything the patient considers important such as: their faith, family, friend, and/or their status in the community. The environment can mean different things to everyone. It can be their home, society, how they view the people around them, a store they visit frequently, anything external that can impact their well-being. Their health refers to the quality of life they are living or the potential to improve their lives through their health, including access to health care. The fourth metaparadigm is the nurse, and how they use their knowledge and skills when caring for the patient.

Theory of Human Caring

The Theory of Human Caring centers around “holistic care and the authentic relationship between caregiver and patient” (Lukose, 2011). Watson’s theory consists of ten carative factors, the transpersonal relationship, caring moment/caring occasion along with caring-healing modalities. This theory brings “nursing and healing work” (Parker & Smith, 2010, p. 353) past the standard ways of thinking.

The ten original carative of this theory serve as a guide to what is referred to as the “core of nursing” (Parker & Smith, 2010, p. 354). “The ten carative factors included in the original work are: formation of a humanistic- altruistic system of values, installation of faith-hope, cultivation of sensitivity to one’s self and to others, development of a helping-trust relationship, promotion and acceptance of the expression of positive and negative feelings, systematic use of the scientific problem-solving method for decision making, promotion of interpersonal teaching-learning, provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual environment, assistance with the gratification of human needs, allowance for existential-phenomenological forces” (Parker & Smith, 2010, p. 354). The transpersonal relationship seeks to connect with the patient in a spiritual way through “caring and healing” (Parker & Smith, 2010, p. 356). The caring moment/caring occasion occurs when the patient and the nurse connect which “involves an action and choice by both the nurse and” patient (Parker & Smith, 2010, p. 358). The caring-healing modalities occur within a single caring moment, when the patient and the nurse are connected, the feelings of the nurse are conveyed to the patient which “exists through and transcends time and space” (Parker & Smith, 2010, p. 358).

Appling the four concepts of metaparadigm of nursing to the Theory of Human Caring is essential. The person must be cared for in a respectful and nurturing manner. While at the same time the nurse must be able to recognize they need the same care for themselves. The health of the patient encompasses harmony of the mind, body, and soul from the patient’s perspective (Parker & Smith, 2010). The environment should include external and internal processes that focus on a calming and healing setting that promotes health. The nurse places a value on the caring relationship she has with the patient which is done in a holistic manner.

The strength of this theory includes focusing on the patient rather than the technology and aligning the family, community, and culture around the patient to promote holistic care. The limitation of this theory includes focusing on the psychosocial needs of the person (Chinn & Kramer, 2011).

The Theory of Modeling and Role Modeling

The Modeling and Role Modeling (MRM) theory was developed by Erikson, Tomlin and Swain and published in 1983. MRM is best described as a grand theory comprised of several mid-range theories. This theory was drawn from four other works: Maslow’s Hierarchy of Needs, Erikson’s Theory of Psychosocial Stages, Piaget’s Theory of Cognitive Development and the General Adaption Syndrome by Selye and Lazarus (Modeling and Role Modeling Theory: An Introduction, 2015). The MRM focuses on respecting uniqueness, through holistic individualized patient care. Nurses use Modeling as they try to understand the patient and all aspects of their life through the patient’s perspective. Nurses use Role Modeling through acceptance, knowing each patient is unique and care must be individualized. The nurse looks to the patient to guide their care, they are their own expert. The nurse will then help the patient facilitate their care with unconditional acceptance (Parker & Smith, 2010).

Utilizing the metaparadigm of nursing through the MRM theory demonstrates how this theory guides my nursing practice. The patient should be treated holistically through mind, body, and spirit which are indistinguishable and connected. The environment, both internal and external, cannot be divided without losing part of the patient’s history, a loss that will diminish our capacity to understand the patient. Health, is the perception of one’s well-being, this includes; life quality, ability to find meaning in their existence, and capacity to receive joy (Parker & Smith, 2010). Using the MRM theory, the nurse recognizes the patient needs to feel respected, worthy, and loved. This can be achieved through fostering growth, development, and healing (Parker & Smith, 2010).

The strength of this theory focuses on the patient holistically including their whole environment which make up their whole being. Limitations include the patient personality, are they slow to warm up, withdrawn, shy or angry, all these feeling can limit the amount of information that is shared.

Conclusion

My personal philosophy of nursing focuses on caring for the patient in a holistic and respectful manner. Jean Watson asserts that caring restores life and potentiates our abilities. The benefits are enormous while encouraging self-actualization on both a personal and professional level. Showing caring and receiving caring can be a positive experience for both the patient and the nurse (Butts & Rich, 2018). Erikson’s Theory of Modeling and Role-Modeling allows nurses to care for and nurture patients while respecting the patient’s uniqueness. This theory centers around providing holistic care with the goal of achieving the best possible health outcome for the patient. I believe that if the patient feels cared for and respected the patient will be able to achieve

For the eighteenth year in a row, nurses are ranked as the number one most ethical and honest profession, while it is an honor to hold this title, we are still responsible to society. We should recognize how our nursing practice influences the public views of the health care profession. Implementing the theories developed by the nurses before us, should continue to grow our profession and improve our to provide amazing care regardless of theory you practice or personally use.

References

1. Butts, J. B., & Rich, K. L. (2018). Philosophies and Theories For Advanced Nursing Practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
2. Chinn, P. L., & Kramer, M. K. (2011). Integrated Theory and Knowledge Development in Nursing (8th ed.). St. Louis, MO: Elsevier Mosby.
3. Locsin, R. C., & Purnell, M. J. (2009). A Contemporary Nursing Process: The (Un)Bearable Weight of Knowing in Nursing. New York: Springer Publishing Company, LLC.
4. Modeling and Role Modeling Theory: An Introduction. (2015). Retrieved January 15, 2020, from MRM Nursing Theory: mrmnursingtheory.org
5. Parker, M. E., & Smith, M. C. (2010). Nursing Theories & Nursing Practice (3rd ed.). Philadelphia, PA: F.A. Davis Company.