Theory and Philosophy of Nursing …

My own philosophy of nursing is evolving, and the process of identifying, expanding on, and encoding its elements has been an important part of my development as a professional Registered Nurse. I have observed patterns during my years of practice that repeat in predictable ways – repeat not because of the inter-connectedness of ephemeral energy fields, but because the human mind has evolved to act and interact with its environment in structured, recognizable ways. I recognize in myself some of these patterns of action/interaction, and introspection has been an important part of my nursing theory development. But humans do not exist apart from their environment, and just as medicine, nursing, and other health-scientists debate the roles of nature and nurture, so must a nursing theory take the effects of all into account.

Environment. Every human being is born into an environment. The environment can be defined as everything that surrounds and affects that human, from other humans to the inanimate rocks on her path. Each element in the person’s environment has an effect on that person, and the effects of the elements are determined by external (it’s cold) factors, internal (I can cope with cold) factors, and distance (it’s cold outside but I’m not there) factors.

Health. In my evolving understanding of the interactions of humans with their environments, I have been able to define and detect patterns of human health and existence that make me more proficient at providing nursing care to those who come to me for care. In my theorizing I have found that everything from human anxiety to Maslow’s hierarchy has a place.

Nursing practice. I am taking control of my vision of nursing, in part by formalizing my own theories of nursing, from the grand to the practical. I may never reach the end of my explorations, and will certainly never be satisfied with “what is” or “what was” as long as there is a “how come?” left. While the answer may indeed turn out to be 42, I still need to know why. The process is more important to me than the product, and by continuing to write, I believe that I will establish a solid foundation for my future professional practice.

Nursing Theory as Worldview: To Be Determined …

It is difficult for me to choose a single grand nursing theory to wrap my practice around. After years of studying nursing theory, both as part of required coursework and as ongoing intellectual entertainment, I have yet to find a Nursing Grand Theory that comes close to fitting my own worldview. I have read the works of many of the Grand Dames of nursing theory, and from most I have gleaned useful concepts, ideas, and philosophies that have informed (and improved) my nursing practice. But I do not feel entirely comfortable with any one theory to the extent that I can base my entire practice on it. No one theory yet holds the answers for me.

While exploring, reading, and discussing nursing theory with fellow nursing students in the past, and in the present with a collegial group of nursing friends who are admitted theory geeks, I have been encouraged to analyze, encode, and verbalize my own views. To me, nursing theory is neither static nor immutable. Nursing theories, my own included, change, develop, and evolve, becoming (with luck and work) more useful, practical, and elegant as time passes.

A very good friend of mine is a nurse practitioner, nursing scholar and an unabashed Rogerian, and she believes that at the core I am one as well. She and I discuss pattern recognition whenever we get together, and that remains one area where I do feel that I recognize the intent and usefulness of Martha Rogers’ theorizing. I am unable, however, to buy into her many of her theoretical constructs, such as pandimensionality, unitary energy fields, and therapeutic touch. I place my faith in what I can see and feel, and my feet are firmly planted in three dimensions. A fourth all-encompassing dimension in which humans interact as energy-beings is one I can’t rationalize, and therefore I am unable to integrate that Rogers concept into my practice. In addition, while many nurses today have become expert in the use of physical therapeutic touch as a means to bond with and help their patients heal, Martha Rogers’ “laying on of the hands” to repattern a patient’s energy fields without touching that patient’s body is just too much of a stretch for this skeptic.

To be continued …