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Nursing Philosophy: Meta-Paradigms and Concepts


Nursing is one of the most important careers in human healthcare. The profession has led to the employment of thousands of qualified nurses. This line of work complements other professions in healthcare to ensure that patients get the best care. Just like most other professions, theories have been developed to guide the practice of nursing care. These premises have been put in place because of experience in the management of different conditions and interpersonal interaction. In addition to the theories that are utilised in nursing care, nursing researchers described four metaparadigms, namely patient, nurse, environment, and health. The interaction of these metaparadigms led to the development of nursing as a professional occupation. The metaparadigms are also applied in the daily personal application of nursing care. This paper looks at the four basic nursing metaparadigms, the application of scientific concepts, and statements that clearly connect the concepts. The paper also provides the propositions that link with the theories and concepts.

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The Four Metaparadigms

The four basic metaparadigms of patient, nurse, health, and the environment in nursing are applied in the personal practice of nursing care (Thorne, Canam, Dahinten, Hall, Henderson, & Kirkham, 1998). Patients are considered an important part of nursing as the main players in their health. The personal approach to patients in the nursing metaparadigms is that of a partner. According to most researchers, human beings are energy sources who should be treated in a holistic manner (Mason, 2014). The management of patients in nursing should focus on mending all areas where the patient may demonstrate a deficiency, including the physical, social, and spiritual areas. The management of any patient should also take a multidimensional approach.

The concept of considering patients in a humane manner during their management allows nurses to practice empathy and care while at the same time engaging the patient in a constructive communication and language. In the personal practice of nursing, human beings are viewed as sources of respect. They are allowed to make informed choices. Patients are generally considered in the intellectual, physical, psychological, socio-cultural, and spiritual dimensions (Thorne et al., 1998). The above dimensions of human beings are also the stages of development. Hence, human beings should be treated in a manner that respects all their dimensions (Thorne et al., 1998). Any client in nursing can be viewed as an open system that is in a constant change. Therefore, the management considerations should be carried out in a changing environment to coincide with these changes. Any interaction between the nurse and a member of the society is a chance to use the available experience in management and the exercise of the above metaparadigm.

The environment is also a significant part of nursing care for any patient. It is considered in the daily management of any patient. According to Lopes (2008), the environment is the area within which human social experience takes place. Variations in time, space, and quality of the environment determine the treatment and nursing care of any patients. Hence, the personal consideration of the environment is crucial to patients. Nursing of patients considers their personal space and social interactions among other national and global factors. The societal beliefs of patients are addressed in their management as a personal preference. Values, morals, customs, and expectations of the patients are respected, with the result being the positive performance of patients. The contemplation of these environmental factors is important in the holistic management of patients.

The other factor that is taken as part of the nursing metaparadigms is the health of the patients who are being taken care of. Health can be viewed as the wellbeing of individuals, with some researchers stating that it is simply the absence of illness (Thorne et al., 1998). The wellbeing of patients can usually be addressed in the social, physical, and spiritual realms. The provision of care ensures that the health of patients is maintained in all these dimensions. The health of patients under personal care is given priority.

The fourth personally practiced metaparadigm of nursing is a nursing practice. As a profession, nursing is significant in the management of any patient. It is part of the holistic care of patients. This profession has values such as responsibility, human freedom, and choice. These aspects are personally pinpointed in the care of all patients (Thorne et al., 1998). The theories and research that are utilised in nursing care are part of the management that is accorded to nursing patients. Some of the personal characteristics that are employed in nursing care include the use of knowledge in the care of patients, clinical judgment, and critical thinking. The holistic management of patients encompasses the involvement of family, society, and individuals.

The application of values such as nursing therapy requires the nurse to show devotion to serving patients, acquaintance, and adequate contact. The provision of care in nursing is individualised since different patients have diverse needs. Mason (2014) confirms that care, as applied in nursing, is specific and contextual to form the basis of nursing work. The capability to function autonomously is a personal strength that enables the efficient use of power to improve the health of patients. Current scientific research is also applied in the management of patients in nursing care. This scrutiny demands exposure to the available knowledge and skills. The main goal of nursing is to enhance the health potential of patients, provide special care for the well clients, those who are ill, and those who are in their deathbed.

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The application of the above metaparadigms in nursing has enabled the personal excellence in nursing care. Most of the patients where these paradigms are applied and respected have fully recovered, with the well patients reporting improved health. The nursing metaparadigms are expected standards of care that any nursing professional should revere and/or uphold. The most specific care is offered to individual patients, with the results being the improvement in their health conditions.

Practice-Specific Concepts

The personal area of practice has enabled the development of additional concepts in the nursing practice. The personal area of nursing is respiratory care unit that handles complicated cases of TB in the state of Florida. This environment has contributed to the development of some specific concepts such as care and holism. These characteristics have been developed from experience in working with chronically ill patients. The concept of care that is practiced in the management of patients dictates that all the needs of patients are tackled. Caring nurses are an inspiration to patients under their care and often report better results in patient management.

The personal application of this concept in the management of patients has been crucial in a number of ways. The first means through which this concept has allowed better management of patients is through the provision of a basis through which the patients’ requirements can be addressed. Care requires the nurse to know the patients’ physical social and psychological deficiencies. Once the nurse who is providing care knows these issues, the appropriate changes are made to the management of the patients. Different institutions offer different degrees of care to patients with different conditions. The tuberculosis patients who are under care in the personal institution receive care that is customised to them.

Care for patients is not only physical, but also takes the dimension of psychological and spiritual areas. The physical illnesses are not adequately taken care of when there are underlying social illnesses. A nurse should consider all these characteristics. Care is exhibited in the manner in which nurses communicate to patients, perform procedures, connect with the patients’ relatives, and/or consult with other health professionals who provide care to the same patient. In the area of communication, the personal part of practice requires empathy, which is one of the most basic ways of ensuring that patients perceive to receive the best care.

The management of any individual should take into account all aspects of their health as addressed above. This approach leads to the second practice-specific concept, namely holism, which dictates that the patients are considered along the different lines that make up a complete individual (Mason, 2014). Social aspects in the management of a patient entail the consideration of factors in the social environment of patients that contribute to the wellbeing of the individual. The family, environment in which the patients are located, and the work areas are important in the management of any patient.

The personal management of TB patients at the respiratory care unit consists of knowing the social conditions in which the patients exist. Janie and Karen (2013) reveal that any individual is part of a larger social system that has direct and/or indirect effect on his or her general health. The social system in which clients exist should be factored in their management to ensure full recovery. For the patients who are in the respiratory care unit, the conditions that they present with are acquired from the social units within which they exist. A complete resolution of the respiratory symptoms in these patients takes the input of the society as a whole. If a society is not taken as part of the management, the result is that the patients have recurrence of the respiratory conditions.

Psychological aspects in the holistic management of patients consist of managing their expectations, educating them, providing skills that are required in their management, and/or attending to any added psychological needs. The satisfaction of the psychological needs of these patients requires the nurse to pay attention to the needs of the patients. In most of the patients in the respiratory care centre, the care that is accorded to the patients is dependent on the identified psychological aspects. The holistic management of patients requires that they be viewed as a unit with multiple areas of management.

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The other aspect in the holistic nursing care for patients is the physical aspect where the material conditions of the patient are managed. Most patients visit health institutions because they have physical illnesses or conditions. This aspect means a lot to the patients, with most of them considering physical recovery as their target. The personal nursing care that is provided to patients at the respiratory care centre treats physical management of patients as crucial in their recovery. Most of the areas that patients are managed in nursing use the physical progress to assess the patients’ conditions and wellbeing.

Many researchers support the holistic management of patients as personally practiced at the respiratory care centre. They emphasise that patients should be viewed as a unit with numerous needs. According to Pesut (2013), the needs of patients are satisfied only through the reflection of the different aspects of their care. Each of the dimensions of care of patients in nursing can lead to their wellbeing if effectively managed (Pesut, 2013). Research into the different dimensions of care shows that patients respond better when they are managed along all the aforementioned dimensions.

Different researchers also show that the recovery of patients’ physical conditions is dependent on the effective management of the patients’ social and psychological wellbeing (Janie, & Karen, 2013). Most patients who are not managed this way often end up performing poorly. Janie and Karen (2013) confirm that the general wellbeing of patients is dependent on the ability of a health professional to satisfy all their needs. The psychological and social needs of patients are often ignored in their management with grave consequences (Janie, & Karen, 2013). The holistic management of patients is the main concept around which some of the major health institutions are built. The two concepts of care and holistic management of patients are the main extra concepts in the management of patients at the respiratory care centre. These concepts are adequately practiced.

The role and change theories are applied in the daily personal management of patients as indicated above. The role theory entails taking care of patients as a career and job. Most of the patients who require nursing care at the institution are treated based on their level of training and skills that they have obtained in practice. These two theories are relevant to personal practice in that they contribute towards the effective management of patients at the centre. However, a number of possible propositions are evident in the care and management of patients at the respiratory care centre. These propositions are highlighted in the section below.

List of Propositions

The holistic management and care of patients such as the one that is personally practiced at the respiratory care centre requires that some assumptions and propositions be made as revealed in this section.

  1. All patients have a requirement for care along important domains such as social, psychological, and physical domains.
  2. The severity of illness is a key determinant of the level of care that patients are accorded.
  3. Nurses are required to offer physical care as a basic minimum care for clients and patients in the ward.
  4. The environment within which patients exist is under the direct control of their patients, health practitioners, and nurses.
  5. A patient is not just the individual with physical illness, but also any client (well or sick) who requires any form of medical attention.


In conclusion, nursing is an important profession that leads to the effective management of patients. The paper has looked at the four main nursing metaparadigms of patient, nurse, health, and the environment. It has also discussed two practice-specific concepts of care and holistic management of patients that are applied in the personal care of patients. These concepts have been supported by the main theories in nursing care.

Reference List

Janie, B., & Karen, L. (2013). Philosophies and Theories for Advanced Nursing Practice. Sudbury, MA: Jones & Bartlett Learning.

Lopes, F. (2008). Environment as a dimension in nursing metaparadigm. Servir (Lisbon, Portugal), 56(5-6), 189-199.

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Mason, M. (2014). Holism and Embodiment in Nursing. Holistic Nursing Practice, 28(1), 55.

Pesut, B. (2013). Nursings’ need for the idea of spirituality. Nursing Inquiry, 20(1), 5-10.

Thorne, S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham, S. (1998). Nursing’s metaparadigm concepts: disimpacting the debates. Journal of Advanced Nursing, 27(6), 1257-1268.

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