TFN Theories in View of Metaparadigms

NURSING PERSON HEALTH ENVIRONMENT

FLORENCE Nightingale’s view of nursing was comparable to The person is the patient himself. Patients are the Nightingale viewed health as being well. Health is The environment was viewed as “those elements
NIGHTINGALE that of motherly instincts. She believed that recipient of our care. A passive patient is a patient who also living up to one’s potential to the fullest extent. external to and which affect the health of the sick
every woman would be a nurse because nursing depends wholly on the nurse for tasks and control of his Disease and illness are viewed as reparative processes and healthy person” and included “everything from
is having the responsibility for someone else’s environment. The nurse is totally in control of the that are instituted by Mother Nature herself when the the patient’s food and flowers to the patient’s verbal
health – a characteristic shared by women, patient and his environment. Nightingale viewed the person did not attend to his personal health concerns. and nonverbal interactions.” Central to Nightingale’s
especially mothers. Nursing is a vocation that patient as a person who needed nursing care regardless Nightingale emphasized the promotion and theory is the concept of a therapeutic environment
needs formal learning and application of scientific of the patient’s social worth. maintenance of health and prevention of diseases that will enhance the comfort and recovery of the
principles in the care of patients. Nursing through prudent control of the environment and social patient.
personnel were thus having more skill in terms of responsibility.
assessment and reporting of the patient’s health
status. At the same time, the nurse is also able to
perform nursing interventions that will allow the
patient to heal and recover.

JEAN WATSON Nursing is the human science of persons and Personhood (human being) ➔ “…illness is not necessarily disease; [instead it is a] ➔ Society – provides the values that determine how one
human health – illness experiences that are ➔ a unity of mind/body/spirit/nature subjective turmoil or disharmony within the spheres of the should behave and what goals one should strive toward.
➔ Unitary Transformative Paradigm-Holographic thinking: person, for example, in the mind, body, and soul, either Watson stated, “Caring (and nursing) has existed in every
mediated by professional, personal, scientific,
“…unity within an evolving emergent world view consciously or unconsciously.” society. Every society has had some people who have cared
aesthetic, and ethical human care transactions. for others. A caring attitude is not transmitted from
connectedness of all…”
➔ three words: Mind, Body, Soul generation to generation by genes. It is transmitted by the
➔ “… humans cannot be treated as objects and that humans culture of the profession as a unique way of coping with its
cannot be separated from self, other, nature, and the larger environment.”
universe.

PATRICIA • Described as a caring relationship and practice • It is viewed as a self-interpreting being. The person • This is defined as what can be assessed. Well-being • Benner talked about situations instead of
BENNER that cares for and studies the lived experiences of does not come into the world predefined. He gets is the human experience of health or wholeness. environment. Situation is described as the social
• Patients on health, illness, and disease, and the defined in the course of living a life. He has an effortless • Wellbeing and being ill are understood as distinct environment with a social definition and
relationships among these three elements. and non-reflective understanding of the self in the ways of being in the world. Health is not merely the meaningfulness. Each person’s past, present, and
world. He is a participant in common meanings and he is absence of disease or illness. A person may also have future, including their own personal meanings,
embodied. a disease but not an illness. habits, and perspectives, influence the present
• Illness is the human lived experience of loss of situation.
function or dysfunction.
• A disease is a state that can be assessed physically.

MARILYN Holistic, relational, spiritual and ethical caring that A spiritual and cultural being. are created by God, the Provides a pattern of meaning for individuals, families, A complex spiritual, ethical, ecological, and cultural
ANNE RAY seeks the good of self and others in complex Mystery of Being and engage co-creatively to find and communities. Beliefs and caring practices about phenomenon. It embodies knowledge and conscience
community, organizational and bureaucratic meaning and value. illness and health are central features of culture. about the beauty of life forms and symbolic systems
cultures. or patterns of meaning. These patterns are
transmitted historically and are preserved or changed
through caring values, attitudes, and communication.

KARI ▪ Caring is fundamental to nursing. This means bearing fellowship of tradition that turns the Health does not only reflect the condition of the Space and situation – a person is always in a
MARTINSEN ▪ Trinity of Caring: individual into a person. organism. It is also an expression of the current level particular situation in a particular space.
✔ Relational means that caring requires at least two ✔ Parallel between the person and the body of competence in medicine. The tendencies of the In space are found time, ambience, and power.
people. One has concern for the other. One suffers, the ✔ Bodies that we relate to ourselves, to others and to the modern concept of health are such that if one has an ✔ Our interaction with each other, use of objects, words,
other will "grieve" and provides for the alleviation of world. It is the unit of soul and flesh, or spirit and flesh.
unnecessary 'defect' or an organ which 'could' be knowledge, our being-in-the room- all set the tone and
pain. Caring is the most natural and fundamental aspect ✔ As bodies, we both perceive and understand. color the situation and the space.
of the person's existence. ✔ Practical is about concrete better, one is not completely healthy.
✔ Our challenge is to give patients and each other dignity
and practical action. Caring is trained and learned ✔ IMPORTANT is to cure sometimes, help often and
 through its practice. ✔ Moral refers to "if caring is to be comfort always. in these spaces.
genuine, must relate to the other from an attitude which
acknowledges the other in light of his situation”. Must
NOT overestimate or underestimate his ability to help
himself.

KATIE Love and charity, or caritas, as the basic motive of The conception of the human being in Eriksson’s theory Defines health as soundness, freshness, and well- Good caring and true knowledge become visible
ERIKSSON caring, principal idea. The foundation of the caring is based on the axiom that the human being is an entity being. Implies being whole in body, soul, and spirit. through ethos. Ethos originally refers to home, or to
professions through the ages has been an of body, soul, and spirit. The human being is Health means as a pure concept wholeness and the place where a human being feels at home. It
inclination to help and minister to those suffering. fundamentally holy, and this axiom is related to the idea holiness. She sees health as both movement and symbolizes a human being’s innermost space, where
Caring is something natural and original. Eriksson of human dignity, which means accepting the human integration. he appears in his nakedness. Ethos means that we
thinks that the substance of caring can be obligation of serving with love and existing for the sake feel called to serve a particular task. This ethos she
understood only by a search for its origin. This of others. The human being is seen as constantly Health as movement implies a change; a human being sees as the core of caring culture.
origin is in the origin of the concept and in the becoming; he is constantly in change. The dual tendency is being formed or destroyed, but never completely;
idea of natural caring. The fundamentals of of the human being also emerges in his effort to be health is movement between actual and potential; Ethos, which forms the basic force in caring culture,
natural caring are constituted by the idea of unique, while he simultaneously longs for belonging in health is movement in time and space; health as reflects the prevailing priority of values through
motherliness, which implies cleansing and a larger communion. movement is dependent on vital force and on vitality which the basic foundations of ethics and ethical
nourishing, and spontaneous and unconditional of body, soul, and spirit; the direction of this movement actions appear.
love. The human being is fundamentally dependent on is determined by the human being’s needs and desires;
communion; where he can give and receive love, the will to find meaning, life, and love constitutes the
experience faith and hope, and be aware that his source of energy of the movement; and health as
existence now has meaning. The human being we meet movement strives toward a realization of one’s
in care is creative and imaginative, has desires and potential.
wishes, and is able to experience phenomena; So, a
human being only in terms of his needs is insufficient.
When the human being is entering the caring context,
he becomes a patient in the original sense of the
concept — a suffering human being.

MYRA E. • “Nursing intervention must be founded not only • This refers to holistic being; wholeness is integrity. • This is the ability to function in a reasonable manner. • This is not a passive backdrop, the individual
LEVINE on scientific knowledge, but specifically on Integrity means a person has a freedom of choice and actively participates in his environment. The process
recognition of the individual’s behavioral movement. of interaction is adaptation.
responses which indicate the nature of the
adaptation taking place.”
• The goal of nursing care is to support
adaptation and the strong drive of the individual
to seek wholeness. Because of the uniqueness of
each individual, nursing care for each patient must
be highly individualized. Nursing interventions are
both therapeutic and supportive.

MARTHA E. A learned profession and is both a science and an An open system in continuous process with the open Passive health – to symbolize wellness and the Associated to open systems.
ROGER art. system that is the environment. absence of disease and major illness.

DOROTHEA Nursing is an art through which the practitioner of Humans are defined as “men, women, and children Health is “being structurally and functionally whole or The environment has physical, chemical, and
OREM nursing gives specialized assistance to persons cared for or either singly or as social units” and are the sound”. Also, health is a state that encompasses both biological features. It includes the family, culture, and
with disabilities, making more than ordinary “material object” of nurses and clothes who provide the health of individuals and groups, and human community.
assistance necessary to meet self-care needs. The direct care. health is the ability to reflect on oneself, symbolize
nurse also intelligently participates in the medical experience, and communicate with others.
care the individual receives from the physician.

IMOGENE KING Nursing is a process of action, reaction, and Individuals are social beings who are rational and Health is a dynamic life experience of a human being, The environment is the background for human
 interaction whereby nurse and client share sentient. Humans communicate their thoughts, actions, which implies continuous adjustment to stressors in interactions. It is both external to, and internal to, the
information about their perceptions in the nursing customs, and beliefs through language. Persons exhibit the internal and external environment through individual.
situation. The nurse and client share specific common characteristics such as the ability to perceive, optimum use of one’s resources to achieve maximum
goals, problems, and concerns and explore how think, feel, choose between alternative courses of daily living potential.
to achieve a goal. action, set goals, select the means to achieve goals, and
make decisions.

BETTY Nursing’s primary concern is to define the Humans are defined as “men, women, and children Health is defined as the condition or degree of system The environment is a vital arena that is germane to
NEUMAN appropriate action in situations that are stress cared for either singly or as social units” and are the stability and is viewed as a continuum from wellness the system and its function. The environment may be
related or concerning possible reactions of the “material object” of nurses and others who provide to illness. When system needs are met, optimal viewed as all factors that affect and are affected by
client or client system to stressors. Nursing direct care. wellness exists. When needs are not satisfied, illness the system. Neuman's Systems Model identifies
interventions aim to help the system adapt or exists. When the energy needed to support life is not three relevant environments: (1) internal, (2) external,
adjust and retain, restore, or maintain some available, death occurs. and (3) created.
degree of stability between the client system
variables and environmental stressors, focusing
on conserving energy.

SISTER In the Adaptation Model, nurses are facilitators of Based on Roy, humans are holistic beings that are in Health is defined as the state where humans can The environment is defined as conditions,
CALLISTA ROY adaptation. They assess the patient’s behaviors constant interaction with their environment. Humans continually adapt to stimuli. Because illness is a part of circumstances, and influences that affect humans’
for adaptation, promote positive adaptation by use a system of adaptation, both innate and acquired, to life, health results from a process where health and development and behavior as an adaptive system.
enhancing environment interactions and helping respond to the environmental stimuli they experience. illness can coexist. If a human can continue to adapt The environment is a stimulus or input that requires a
patients react positively to stimuli. Nurses Human systems can be individuals or groups, such as holistically, they will maintain health to reach person to adapt. These stimuli can be positive or
eliminate ineffective coping mechanisms and families, organizations, and the whole global completeness and unity within themselves. If they negative.
eventually lead to better outcomes. community. cannot adapt accordingly, the integrity of the person
can be affected negatively.

DOROTHY This is viewed as an external force that acts to This is a behavioral system with patterned, repetitive, Health as an elusive, dynamic state influenced by The environment consists of all the factors that are
JOHNSON preserve the organization of the patient’s and purposeful ways of behaving that link the person to biological, psychological, and social factors. A lack of not part of the individual’s behavioral system, but
behavior by means of imposing regulatory his environment. The person is a system of balance in the structural or functional requirements of that influence the system. The nurse may manipulate
mechanisms or by providing resources while the interdependent parts that requires some regularity and the subsystems leads to poor health. some aspects of the environment so the goal of
patient is under stress. Nursing activities are not adjustment to maintain balance or equilibrium. A health or behavioral system balance can be achieved
dependent on medical authority, rather, nursing is person’ attempt to regain balance may require an for the patient.
complementary to the practice of medicine. unnecessary use of energy.

FLORENCE - Was born in Italy (May 12, 1820)

NIGHTINGALE - Crimean War between Russia and Turkey with 38 nurses. (to Turkey)
- “The Lady with the Lamp”
ENVIRONMENTAL - Returned to England as a national heroine in 1856
THEORY - Notes on Hospital, Notes on Nursing (1859)
 - Nightingale School and Home for Nurses at St. Thomas Hospital
- “Nursing is the art of utilizing the patient’s environment for his or her recovery.”

JEAN WATSON - Was born in a small town of Welch West Virginia; youngest of eight
- Began developing her theory while she was assistant dean of the
PHILOSOPHY & undergraduate program at University of Colorado
THEORY OF - Worked from 11 curative factors to formulate her 10 carative factors
TRANSPERSONAL - Developed the caritas processes, which have a spiritual dimension and use a
CARING more fluid and evolutionary language
- Authorized 11 books which reflect the evolution of her theory of caring
- Transpersonal Caring Relationship depends on the nurse’s moral commitment
in protecting and enhancing human dignity as well as the deeper/higher self.
- The theory acknowledges the unity of the person’s mind-body spirit.

PATRICIA BENNER - Born in Hampton, Virginia

- "The Nurse - Patient Relationship is not a uniform, professionalized blueprint
STAGES OF NURSING but rather a Kaleidoscope of intimacy and distance in some of the most
EXPERTISE dramatic, poignant, and mundane moments of life"
- Dreyfus model (Novice, Adv Beg, Competent, Proficient, Expert)

MARILYN ANNE RAY - Chaos theory - …challenges nurses to step back and renew their perceptions of
everyday events, to discover the embedded meanings.
BUREAUCRATIC - Holography (whole), Caring (complex transcultural), Spirituality (creativity and
CARING choice), Spiritual (choices for the good), Educational, Physical, Social-Cultural,
Legal, Technological, Economic, Political.
- Caring is bureaucratic as well as spiritual/ ethical, given the extent to which
meaning can be understood in relation to the organizational structure.
- Caring is the primordial construct and consciousness of nursing.

KARI MARTINSEN - …Care is the positive development of the person through the Good”
- Care is a trinity: relational, practical, and moral simultaneously.
PHILOSOPHY OF - “Without professional knowledge, concern for the patient becomes mere
CARING sentimentality”