Four Metaparadigms of Nursing
The personal nursing theory highlights those aspects of care that are most important for a nurse to visualize. In my nursing philosophy, there are four metaparadigms, including a patient as a person, health, nursing, and environment. This philosophy of nursing reflects the attitude of the nurse to patient-centered activities, forms a holistic view of nursing, and specifies the role and place of nursing in it.
The first paradigm of a person considers each patient individually. Nurses have to work with different categories of patients, and for each patient, they create an atmosphere of respect for his or her present and past, values, culture, and beliefs. A set of physical, psychological, religious, and other peculiarities should be considered by a nurse to meet the patients’ expectations and improve or at least maintain their quality of life. I consider that this is the paramount role of the nurse to regard patients as persons.
The second paradigm of my nursing philosophy is health. I agree with the definition given by the World Health Organization (WHO): health is a state of complete physical, social, and mental well-being, but not merely the absence of disease (Smith & Parker, 2015). Sometimes it is difficult to determine what health is, but it is necessary to remember that this is a dynamic process. Health can be explained as the goal to strive for to provide a sense of integrity, cope with stress, and ensure growth and development.
I believe that the ultimate goal of nursing as an element in the system is to meet the requirements and expectations of society. Quite often, the main goal of nursing is to improve the patient’s health. Although definitions of the notion of health are rather diverse, it is possible to come up with the specific definition: nursing is integrity of science and art. This means that nursing should be based not only on medical knowledge, but also on psychology, sociology, history, ethics, aesthetics, and a range of other important disciplines, as noted by McCutcheon and Stalter (2017). In the process of the professional activity, I strive to develop certain conceptual approach, on the basis of which my practice is being enriched and developed.
The last but not least is the metaparadigm of environment that has always influenced people’s lives. Hippocrates proceeded from the determining influence of environmental factors on the formation of body and mental peculiarities of an individual by emphasizing such factors as climate, weather, state of winds, people’s way of life, their habits, the laws of the country, and even forms of state organization, etc.). In her turn, Florence Nightingale also considered environment a significant factor in preventing diseases and maintaining health (Hegge, 2013). Personally, I think that environment is an aggregate of natural, social, psychological, and physical conditions that identify one’s life and health. As a nurse, I build up my relationships with patients, depending on their environment, personal issues, health presentation, and nursing standards.
Two Practice-Specific Concepts
The first concept I would like to discuss in terms of my nursing philosophy is patient education. Training of patients, their families, and health care representatives is an integral part of the effective nursing. Taking into account that nowadays rapidly changing world presents new technologies, diseases, and ways to treat them, it becomes critical to be aware of the latest trends, sharing them with others. The process of patient education should consist of the following points:
Evaluation of knowledge and skills of a person related to the improvement, preservation, and restoration of health;
Preparation and provision of the necessary information at the appropriate level;
Evaluation of the results of implemented educational programs;
Application of accepted and relevant cultural, ethical, and professional standards.
After determining the training objectives of a certain patient, I plan the content and methods of education, also focusing on timeframe and possible changes. The content of the patient’s training and his or her family can be different: maintaining health or a certain level of quality of life, emergency care, caring for the sick or disabled people. Among the most widespread diseases that require self-care and attention from the family, there are diabetes, cardiovascular diseases, and bronchial asthma.
Education in nursing is a mutual process of the purposeful activity of a nurse and a patient, consisting of the transfer of knowledge and skills from the former to the latter or relatives in the course of the learning process. As a result, a patient and his or her form a certain set of skills to meet the basic human needs. Thus, I believe that patient education is an integral function in the activities of a nurse.
The second practice-specific concept that I strive to apply is the development of nursing practice through critical thinking and research. This nursing function includes the introduction of innovative methods of work to achieve better results in nursing practice and identification of areas of nursing research. At this point, it seems essential to adhere to ethical and professional standards to guide the nursing research.
I would like to point out the practical value of evidence-based research. LoBiondo-Wood and Haber (2017) claim that evidence-based practice is “the collection, evaluation, and integration of valid research evidence combined with clinical expertise and an understanding of patient and family values and preferences to make clinical decision-making” (p. 6). I consider that the formation of a qualitatively new level of nursing assistance to the population should be based on the improvement of professional training, the development of scientific research in the field of nursing, and the use of results in practical health.
The scientific research in nursing allows nurses to find the best ways to care for patients. The development of such a research as a priority direction is likely to give answers to what care to provide to a particular patient with the aim of achieving the best health outcome possible.
List of Propositions
In order to connect the above concepts, it seems important to provide five assumptions regarding their application in practice.
Linking evidence-based research to patient education, it is necessary to emphasize that the latter is to be based only on relevant knowledge that, in its turn, may be received as a result of proper studies.
The radical changes in the economic, political, cultural, and social activities have a significant impact on health. Many stages in the life of each of the individual are associated with various moments of both successful and unsuccessful, active and passive, scientifically based or blind implementation of innovations and reforms (Scott, Matthews, & Kirwan, 2014). The level of research as well as the consideration of internal and external variables largely determines the success of innovations. At the same time, if the external variables of success often reflect the stability or instability of the system or a particular situation, the internal variables are the result of decisions taken by the nurse. It is the internal variables such as goals, structure, strategy, etc. that are the focus of the nurse.
Traditionally, the training scheme of patients consists of five stages: the presentation of the necessary information; the repetition by the patient of everything that he or she remembered; demonstration of what the patient should master; the mastering process; independent explanation and demonstration of the patient’s skill from the beginning to the end. Each stage of this scheme can be repeated several times until the patient learns the planned material. The nurse should strive to move from knowledge transfer to skill development and then to a sustainable experience.
Nurses need to make sure that the patients correctly understood the information being transmitted. For this, the nurse systematically checks and evaluates their knowledge and skills (Scott et al., 2014). In the process of teaching the patient, it is necessary to constantly keep them interested, ask them leading questions or build a conversation on the “question-answer” principle, and emphasize information that is important for the patient. It should also be stressed that at the end of the conversation, it is important to briefly repeat all the basic information.
Understanding the goals, expectations, and principles of patient education along with the ability to use a variety of methods, strategies, and means of teaching helps to effectively teach patients and their families and, consequently, improve their quality of life.
Hegge, M. (2013). Nightingale’s environmental theory. Nursing Science Quarterly, 26(3), 211-219.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research: Methods and critical appraisal for evidence-based practice (9th ed.). St. Louis, MI: Elsevier.