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Analysis of a Nursing Metaparadigm
by
Jennifer Pawson
NURS 900
Discipline of Nursing
The University of New Hampshire
Department of Nursing
March 8, 2010
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The University of New Hampshire (UNH) promotes their metaparadigm for nursing
through their graduate program in nursing handbook. “The organizing framework of the nursing
curriculum is derived from the philosophy and built on the four meta-paradigm concepts of
professional nursing: person, environment, health, and nursing” (Direct Entry Master’s in
Nursing Handbook, 2004, p. 9). Through this definition, one can see parallels between the
department’s philosophy of nursing and theories presented by nursing theorists, such Florence
Nightingale, Dorothy Johnson and Ernestine Wiedenbach. By comparing the theorists’ views of
the definition of nursing and UNH’s given metaparadigm, one finds that the department has used
various theories to provide a solid framework for nursing students.
In the definition of person, UNH’s handbook had similarities with Wiedenbach’s theory
of professional nursing. “The person is viewed as holistic in nature possessing both dignity and
intrinsic worth” (Handbook, 2004, p. 9) According to Wiedenbach, professional nursing is
epitomized when the nurse “respect[s] the dignity […] and individuality of each human being”
(Parker, 2006, p. 73). With this respect for others’ humanity, nurses can focus upon helping each
person to achieve the health they desire. This central component in both Wiedenbach’s and
UNH’s philosophies reflects the need for nursing to maintain its status as a compassionate and
humanistic profession. I see this definition of person as a tribute to many of the great nursing
theorists, but I feel that more emphasis should be given to the community and family and not
simply the individual. Frequently, the individual is the only one seen as needing health care,
when it is truly the nurse’s duty to see factors outside of the individual that prevent illness or
promote health.
UNH’s nursing department also values the importance of promoting various types of
knowledge in the same way that Florence Nightingale envisioned professional nursing education.
“The faculty believe[s] that nursing is an art and a science” (Handbook, 2004, p. 9). This is also
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the view of Nightingale, as she valued both “the ‘science’ of observation” and saw nursing
as“‘[…] one of the Fine Arts” (Florence Nightingale, cited in Parker, 2006, p. 52). While
spirituality is less prominent in the university’s metaparadigm when compared to Nightingale’s
philosophy, it is clear that nursing has maintained its status as both an artistic and scientific
endeavor. Nurses should be proud to continue in this interdisciplinary profession. Likewise, I
feel that UNH properly defined “environment” in their philosophy. UNH’s handbook states “the
environment is the context in which a person exists including that which is internal to the person
and that which is external” (2004, p. 9). So while Johnson defined environment more concretely,
the handbook’s definition is open to a larger interpretation as to the environment of the person.
In terms of definitions within the metaparadigm, I agree the most with how UNH defined
“health”, because it incorporates holistic nursing with a respect for multiculturalism. “Nursing
supports the goal of optimal health [… h]owever, the nurse must respect each individual's
personal interpretation of health” (Handbook, 2004, p.9). In modern healthcare settings, this
respect for an individual’s definition of their own health will allow nurses to provide the best
supports for health in the individual, family, and the community. Nurses, who can adapt their
nursing to span cultural barriers, will be able to continue to provide the best nursing care to all
patients. Consider a belief expressed in the book, The Spirit Catches You and You Fall Down.
“[T]he Hmong believe that illness can be caused by a variety of sources – including eating the
wrong food, drinking contaminated water, […] by far the most common cause of illness is soul
loss” (Fadiman, 1998, p.10). While this is not a current source about the specifics of other
cultural beliefs, UNH correctly included the possibility that modern nurses must account for a
variety of explanations for both health and illness, regardless of their own beliefs. In treating
patients, nurses with this multicultural philosophy have an advantage in patient interactions, and
therefore they are more likely to implement changes which benefit their patients.
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The University of New Hampshire’s metaparadigm clearly reflects careful consideration
of nursing theorists such as Wiedenbach, Johnson and Nightingale. While the handbook expands
upon these theories and incorporates them into modern multicultural practice and modern
expectations of the nursing profession, it lacks a statement within the definition of nurse about
the importance of nurses using theory within practice. According to Peplau, “[p]ractice provided
a context for initiating and testing nursing theory” (Parker, 2006, 61). While the importance of
using and preparing to use evidence-based practice is remarked upon in the mission statement of
the department and in the curriculum, nursing theory based in practice is not addressed as one of
the fundamental parts of nursing. Without this use of theory within modern practice, students
may not be able to bridge the gap between nursing theory and nursing practice, a bridge which is
essential to unlocking the full potential of nursing scholarship. I feel that with the addition of that
single component, the UNH metaparadigm would best prepare nurses to achieve their full
potential. Currently, UNH’s philosophy does adequately and succinctly define modern nursing,
but it can be improved to include modern standards of practice and academic expectations of the
discipline.
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Bibliography
Direct Entry in Master’s Handbook. (2004). Durham, NH: University of New Hampshire
Department of Nursing.
Fadiman, A. (1998). The Spirit Catches You and You Fall Down. New York City, NY: Farrar,
Straus, and Giroux.
Parker, M. (2006). Nursing Theories and Nursing Practice, Second Edition. Philadelphia, PA:
F.A. Davis Company.