The Four Nursing Metaparadigms

The nursing metaparadigm concepts described by Fawcett (as cited in McEwen & Willis, 2011), are a primary phenomena of interest to a discipline, which identifies globally by ways in which, nursing can deal with those phenomena in a distinctive and applicable manner. The functional aspects of the meta-paradigm according to Kim (as cited in McEwen & Willis, 2011), involve a combination of intellectual and

Throughout the history of nursing, there have been many nursing theorists who have each made significant contributions towards the shaping of nursing knowledge. Each of these theorists have differing perspectives and interpretations of how each domain of the nursing metaparadigm fit into their respective theories. The four domains of the nursing metaparadigm are: person, environment, health and illness, and nursing. The purpose of this reflection is to provide an overview of the domains related to the metaparadigm of nursing as well as to introduce this author’s perspective on their developing personal philosophy of nursing. In this paper, the author will take a closer look at each of these areas, how they are individually defined, and how they each fit into the nursing metaparadigm as a whole. At the conclusion of this overview, readers will be introduced to how these theorists and their perspectives have enabled this author to begin to create their own philosophy of nursing.

Some researchers have suggested that other concepts should be added to the nursing metaparadigm. For

It is my personal belief that environment plays a considerable role in the patient’s short term and long-term wellbeing. When nurses acknowledge the environment that the patient is interacting in while receiving their care we know this greatly impacts the overall successfulness of the care plan. The patient’s feelings must be

“The concept of person refers to the recipient of nursing, including individuals, families, communities and other groups, regardless of their physical,

Families always affect one another, even when they feel distanced. The family unit can promote health or it can be a source of stress. It is the nurse's task to use family relationships to act as health facilitators for the patient, and, if necessary, treat the family as part of the patient's social environment. The family creates the patient's environment just as much as a clean room or an accessible place to exercise or access to appropriate medication.

The environment part could affect the health of the person, the process of adjustment results complicated when ecological, real physical environment, cultural and monetary parts surrounding the patient cannot be change. This component is related to everything that impacts the patient’s wellbeing. The adaptation model, it has three levels which are compensatory, integrated, and the comprised life forms. The three adaptation models don’t stay consistent as change is unavoidable every once in a while (Marchuk, 2014). When the practitioner notify the patient of the diagnoses and provide a plan of care, assuring patient’s environment is not only supportive, but accepting is key for compliance. Understanding the surroundings around the patient’s and make the pertinent changes will avoid a futile impact on outcomes and recuperation will be accomplished.

In Dorothea E. Orem’s Self-Care Deficit Nursing Theory, humans are defined as “men, women, and children cared for either singly or as social units and are the material object of nurses and others who provide direct care” (McEwen & Willis, 2014, p. 143).

The metaparadigm has four central concepts to the discipline of nursing and they are interrelated although they have different meanings. They are:

Each professional discipline has a responsibility to identify concepts that provide a general description of this discipline. These concepts are named as the profession’s or concept’s metaparadigm (Fawcett, 1994). The Metaparadigm for nursing is the framework for the discipline that sets the phenomena of interest, propositions and the method of discipline. Metapardigm is very general and is intended to reflect the agreement of discipline member about the field of nursing (Marilyne Parker,2001).

Florence Nightingale developed the environmental model theory of nursing. Nery, (2015) states that Florence Nightingale’s environmental theory of nursing, “focus primarily on the environment, interpreted as all external conditions and influences that affect the life and development of an organism, that are able to prevent, suppress or contribute to disease and death.” The four metaparadigm concepts of this theory consist of person, environment, nursing, and health. Within this theory, the patient is being cared for by the nurse, has been influenced by the environment, and has reparative powers (“Nursing Theories, 2011). Nightingale’s theory does not have a clear definition of the person; however, it can be inferred that the person correlates “in relation to the environment and the impact of the environment on the person’s health status” (Butts & Rich, 2018). The highlight of Nightingale’s theory is the environment. Both the external and internal environment needs to be in sanitary conditions. The environment concept of this theory contains “physical, psychological, and social” factors (“Nursing Theories, 2011). The goal of the nurse is the control the patient’s environment to achieve ideal health for the patient. Nightingale’s theory did not define health; however, she stated that nature itself can heal ailments (Butts & Rich, 2018). Nightingale (1859) stated that health is ‘not only to be well, but able to use well every power we have to use it.”

The discipline of nursing is characterized into four metaparadigm concepts. The first concept is person. I believe that nursing requires me to think of each person as an individual and take time to be with that person using human-to-human interaction. Working in the emergency room I try my best to listen to each patient with proper eye contact to provide the visual cues of compassion. The second is environment. My nursing philosophy also incorporates all of the patient’s surroundings and their situation that may be causing an illness or a nursing need. It could be the people

Nursing has made much advancement since Nightingale Environmental Theory but the focus on a healthy environment has remained the same. Pulliam (1997) noted in her article that Nightingales’ theory formed a solid foundation for nursing: fresh air, cleanliness, clean water, warmth, proper drainage, plenty of light, and stress free environment provided an optimum environment for healing.

The fourth meta-paradigm is nursing. The root of nursing is caring which has been defined as the essence of nursing (Clarke, 2009, p. 233).

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Alice Petiprin, 2014). It involves the nurse’s initiative to make environmental settings appropriate to aid in the recovery of the patient’s health. According to Nightingale all external factors are somehow associated with the patient and affects their life physically, mentally, and socially (Alice Petiprin, 2014).