This paper concentrates on three nursing theories put forth by nursing theorists, as published in various journals. The three theories include Rogers’s unitary human beings theory, Watson’s human care theory and Nightgale’s environmental theory. The paper provides an insight into the application of the theories into nursing practice. A critical analysis is made into the three theories with the aim of exposing the strengths and limitations of the three paradigms with regard to utilization in nursing practice.
Summary of the nursing theories
Martha Rogers’s theory of science of unitary human beings advocates looking at nursing as an art and a science. According to Rogers, nursing is a unique science that encompasses people and their environments. The theory is based on three postulates and four principles. This includes: energy field, openness, pattern, pan-dimensionality, unitary human being, environment, and health (Madrid & Barrett, 1994). The theory finds wide application in the sense that nurses have a part to play in advancing the wellbeing of all people. This arises from the belief that human beings are irreducible.
Jean Watson introduced a nursing theory that calls us to look at nursing as a process in which a nurse and the patient can be changed. This is the theory of human care. Watson (2000) asserts that nurses have caring as the prime reason of their work which can lead to actualization of the patient. The theory can be integrated into the nursing profession especially through developing caring relationships with patients. Watson’s theory puts an emphasis on the nurse-patient relationship. It calls for nurses to approach patients as holistic beings, show them acceptance, and treat them with positive regard.
However, Nightgale’s model calls for a different approach (from Rogers’s and Watson’s) to nursing. Nightgale’s theory calls for nurses to put patients in an environment that allows nature to act on them (Slanders, 1998). This arises from the belief that a patient’s environment can influence their healing process. The focus is, therefore, on the relationship between the patient and the environment.
Comparison of the three theories
Scholarly, nursing literature suggests that there are two competing nursing paradigms: totality paradigm and simultaneity paradigm. Totality paradigm and simultaneity paradigms differ in their attempt to guide the nursing profession. Totality paradigm is upheld by nursing theorists such as Parse, Roy, Oreom and Nigthgale. On the other hand, simultaneity paradigm is upheld by nursing theorists such as Rogers, Watson and Parse.
Totality paradigm, as advanced by Nigthgale, suggests that an individual is made up of biological, spiritual, psychological as well as social parts. These features interact with the environment to achieve health goals and maintain balance. The patient’s environment consists of both internal and external stimuli. Every individual has to manipulate the environment in order to gain better health. Therefore, the goals of a nurse are to care, promote health, and prevent illnesses. However, in simultaneity paradigm, advanced by Watson and Rogers, the interaction between the environment and the individual is looked at differently.
Simultaneity paradigm differs from the totality paradigm in developing goals of nursing and the implications of research and practice (Selanders, 1998). For example, in Nightgale’s theory, the nurse is the main decision maker while, in Watson and Rogers’s theory, the patient is the key decision maker. Therefore, the patient guides the process and activities regarding health patterns. The goals of nursing come from an individual and the quality of life can only be looked at from the standpoint of that individual. This makes the patient the key decision maker.
Rogers and Watson’s theory are in alignment concerning the manner in which a patient is looked at from a nursing standpoint. The view within these theories is that a patient is a unitary being, in continuous, mutual and simultaneous interaction with the environment. People are more than the sum of their parts (Madrid & Barrett, 1994). Health is experienced by an individual and can only be experienced by that individual.
Influence of the theories on nursing practice
Integration of nursing paradigms into practice has made nursing achieve the professionalism it enjoys today. Theoretical models provide knowledge to improve nursing goals and practice. For example, Watson advocates for philosophy and science of caring. Providing care is something moral. It requires the engagement of the body-mind-and soul. This is best practiced under interpersonal relationships. Therefore, nurses require a humanistic approach due to the aspects of caring. Such views are upheld by Martha roger’s who sees nursing as a discipline that can be used for human betterment. It requires distinct focus into the unique irreducible human being. The models also provide the basis for guiding nursing research. Health is a process achieved through set practices. Simultaneity is gaining more acceptances to guide nursing research, education and practice. On the other hand, totality paradigm has given rise to other theories that focus on helping patients to undertake self-care, adapt, interact and attain health.
However, there are some limitations to the nursing theories. For example, Roger’s model does not address the client-nurse relationship. This is one of the biggest limitations to this theory. The model is also abstract and hard to understand. The concepts and relationships described in the model require deductive reasoning to understand. They are not based on empirical support. This effectively limits the utilization of this theory in nursing practice.
Nightgale’s theory has some limitations in the sense that environmental measures can only be able to treat and prevent diseases. The model is silent about the utilization of medical technology in nursing. Medical technology finds wide application in nursing practice today but does not get a mention in Nightgale’s theory.
References
Madrid, M., & Barrett, E. (1994). Rogers scientific art of nursing practice. New York : National League for Nursing.
Selanders, L. C. (1998). The Power of Environmental Adaptation: Florence Nightingale's Original Theory for Nursing Practice. Journal of holistic nursing , 16 (2), 247-263 doi: 10.1177/089801019801600213 .
Watson, J. (2000). Leading via caring- Healing: the four fold way toward Transformative Leadership. Nursing adminstration quarterly, 25(1). 1-6.
