Currently, nursing theories find wide application in nursing practice as they give the boundaries for professional conduct (George, 2011). Apart from highlighting the importance of patient-nurse relationships that emerge during caring, conceptual nursing frameworks give a comprehensive view that guides the nursing practice. Nursing theories also guide the reasoning process in professional nursing practice. Martha Roger’s, a leader in nursing, came up with one conceptual nursing paradigm called the science of unitary human beings. The theory addresses the focus of nursing and knowledge needed to develop the science of nursing. According to Roger’s, nursing is the study of human, as well as, environmental fields. Human beings and the environment are irreducible energy fields characterized by patterning (Rice, 2006). The patient and the nurse come together in a process involving mutual choice, mutual awareness and mutual caring (Rice, 2006).
According to (Rogers & FAAN, 1994), the theory is based on the following pretexts:
A human is a unified whole; different from the sum of its parts.
Human beings and the environment continuously exchange energy, as well as, matter in open systems.
Human beings evolve in one direction; they cannot go back to a previous state.
Life’s patterns identify human beings and reflect their wholeness.
Human beings are capable of abstract thoughts.
The theory is anchored on the concepts of energy fields, openness, homeodynamism, and pandimesionality. The theory implicitly states that energy is the most fundamental unit for living and nonliving organisms (Taylor, Lillis, & LeMone, 2001). In the same breath, energy field varies in intensity, density and extent; something cognizant of human beings. This provides the basis for viewing people as irreducible beings. Openness and dynamic movement are the building blocks that distinguish characteristics of an energy field. Openness is used to imply that there is no barrier between the human field and environmental field. They exchange energy continuously; the same thing happens in the nursing practice whereby nurses interact with their clients in an unrestricted relationship. The homeodynamic principle provides a way of perceiving unitary human beings. On the other hand, pandimesionality implies nursing is something without boundaries of space and time.
A key construct of Roger’s work is on the healing modalities. The focus of shared, noninvasive healing modalities is the human-environmental field rather than that of direct physical care (Rice, 2006). The modalities evolve as people’s awareness transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. Such modalities include chanting, therapeutic touch, imagery and meditation.
Rogers’s model indicates that nursing is not a pure science or a unique service on its own right. It is an applied science. The view that human beings are unitary is characteristic of simultaneity paradigms that see man as more than the sum of parts, changing simultaneously with the environment(Basford & Slevin, 2003).. This is in contrast to the totality paradigm which sees a man as a sum of parts as highlighted in Table 1(A table comparing various nursing aspects using nursing theories).
It is necessary to note that Roger’s model rightly implies that nursing is a learned profession, as an art and science. It is an art in the sense that it is involves the creative application of the science of nursing for human betterment. The focus of nursing is the life processes of human beings which are irreversible in a space-time continuum. The focus of science is the unitary human being, the wholeness, integral and continuous relationships with the environment. Unitary human beings use abstraction, imagery, language, thought, emotion and sensation.
One of the key strengths of Roger’s theory is the clear identification of the nursing goals. Rogers makes it clear that nursing supports the progress of the patient in the quest to attain maximum potential for health as highlighted in Table 1. The scope of health is defined by the patient and the nurse should strive to assist the patient to move towards their definition of health. Therefore, nurses should strive to maintain health, promote health, prevent diseases, formulating nursing diagnosis, develop nursing interventions, and actions for rehabilitation. From these goals, it is clear that Martha Roger’s believed that people require nursing services irrespective of their backgrounds and geographic location. As a result, nursing is an activity which shares broad orientations towards caring.
The theory views the nurse as part of the client’s environmental energy field, because the nurse is external to the client. The interaction between the environment and the individual enables the nurse to work with the client to attain maximum potential. This is contrast with other nursing theorists’ work whereby the nurse works for the client (Meleis, 2011). Another major strength of the theory is that it is holistic: it takes into account phenomena associated with nursing such as psychological, social, environmental, physiological and physical; realms of human existence.
This holistic concept advocates for nurses to come out from the isolated self, to collaborate, coevolve and be in coherence with the client. This moves nurses from seeing clients as isolated objects. Recognizing that the client is integral is central to the nursing practice. Participation in the whole process enables nurses to move away from obsessive focus on control to using subtle actions to facilitate change rather than managing change. Such a holistic view of treating patients, not just the illness, is crucial in establishing beneficial nurse-client relationships. It gives an alternative approach to treating patients beyond the traditional scope.
However, the constructs of the theory are unique to Roger’s conceptualization. The concepts, synonymous with the author, are primitive. The concepts are abstract, general and limited in operational referents. This explains the slow uptake of the nursing theory in practice. The theory does not define the operational framework for the nursing process in administering services. Unlike in other theories, there is no explicit definition of health, and the process of nursing. This is evident when Roger’s states that health is defined by personal values. Moreover, the terminology used in the theory is complex. This makes it a complex concept to grasp for nursing professionals. Vivid definition of health terminologies in simple terms helps nurses to describe, explain, and predict everyday experiences that serve to guide assessment, interventions, and evaluation of nursing care (Meleis, 2011). They also provide a rationale for collecting reliable, valid data about the status of the client, and help to describe criteria for measuring the quality of nursing practice. It is baffling how such an important aspect in nursing theories was overlooked.
Roger’s theory also comes short in defining the methods of identifying clients’ needs, and effectively communicating with them. It is vital for nursing theories to help assess the patient condition explained by various methods, identifying the client’s needs, and demonstrating effective communication with the patient. This is crucial in applying the theory to solve problems identified and evaluating the extent to which the process is fruitful. However, Rogers’s theory also comes short of this vital aspect.
All in all, Martha Rogers' ideas have challenged nurses worldwide for many years. Rogers challenges people to understand nursing as a human service based on knowing rather than isolated functional activities. Rogers challenges people to consider nursing as empathizing and caring for human beings in the unity and interdependence of the individual-environment operation instead of detached activities and reactions in a restrained case and consequence fashion (Taylor, Lillis, & LeMone, 2001). This is evident from the way Rogers patiently and systematically underlined the demand to see the process in totality instead of distinct expressions or scenes of reality. Therefore, awareness of the Martha Roger’s nursing theory helps nurses to understand their role in health care.
The theory finds relevance in home care especially in hospice applications and palliative care. Appreciating integrality increases one’s awareness of nonlocal connections with a pandimesionality universe and provides an understanding of paranormal events. Feelings of faith, love and hope, exist although they are not easily measured. When death approaches and traditional therapy fail, patients seek alternative forms of care and comfort such as complementary therapies as well as intrapersonal exchanges (Rice, 2006).
Martha Rogers’s theory is vital in helping nurses compassionately help patients in flowing with difficult situations. The theory recognizes the central role of the patient which is vital in forming client-nurse relationships. It advocates for a holistic approach to nursing that integrates the psychological, social, environmental and physical realms of human existence. This is a distinguishing feature that is not factored in other nursing theories. As a result, the theory is crucial in the nursing practice as it highlights elementary aspects aimed at maximizing the potential of nursing.
References
Basford, L., & Slevin, O. (2003). Theory and Practice of Nursing: An Integrated Approach to Caring Practice. Cheltenham: Nelson Thornes.
George, J. B. (2011). Nursing theories: The base for professional nursing practice. Upper Saddle river, NJ: Pearson Education.
Martha E. Rogers, F. (1994). The Science of Unitary Human Beings: Current Perspectives. Nursing Science Quartely, 7 (1), 33-35 doi: 10.1177/089431849400700111.
Meleis, A. I. (2011). Theoretical Nursing:Development and Progress. Philadephia, PA: Lippincott Williams & Wilkins.
Rice, R. (2006). Home Care Nursing Practice: Concepts And Application. Cambridge, MA: Elsevier Health Sciences.
Taylor, C., Lillis, C., & LeMone, P. (2001). Fundamentals of nursing: The art & science of nursing care. Philadephia, PA: Lippincott.
Table 1: A table comparing various nursing aspects using nursing theories
Aspect
Florence Nightingale- Environmental Theory
Martha Rogers -Unitary Human Beings
Jean Watson - Philosophy and Science of Caring
Rosemary Parse - Human Becoming Theory
Health
Is defined by the individual
Complete physical, mental social functioning
Open process of being and becoming.
Nursing
Helps in reparative health
Helps in restoring good health
Should help in promoting health
Human science and art which appliesabstract ideas to serve people
Environment
Includes social, psychological and physical being
Is an integral part
Involves the society
Inseparable
Person
Individual acted by the nurse
Is more than sum of parts
Should be valued, nurtured and assisted
More than sum of parts
