Nursing theories can be described as one of the critical foundations to the nursing profession. Right from the early stages of nursing, these theories contributed to the defining purpose of nursing and have since changed the way nursing care is delivered. The main purpose of nursing theories is to provide a basis for practicing nursing, establish knowledge for practice, and set boundaries that ensure the provision of quality patient care. Margaret Newman's Theory of Health as Expanding Consciousness and a Nursing Intervention from a Unitary Perspective has an aim of helping patients find sense in different situations in their lives by enabling both patients and nurses realize higher levels of consciousness. This paper analyzes the key elements of Margaret Newman’s Theory and considers various applications to psychiatric nursing.
Purpose of Nursing Models, Theories, and Frameworks
The establishment of nursing models, theories, and frameworks is important to ensure that nursing professionals can work together to realize a common goal. Nursing theories are created by scholars that share a common goal of being able to advance nursing through the establishment of evidence-based practice. Theories can be used to organize knowledge, guide nursing practice, ensure quality patient care, and to guide the further inquiry of nursing (Kaakinen et al., 2018). The theories that have been established in the modern world enable nurses to become experts in patient care. Nursing has also been labeled as a cycle of research, theory, and practice (Kaakinen et al., 2018). It is those theories that are used to sustain, research, and advance the nursing profession.
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Margaret Newman’s Theory
Margaret Newman's Theory of Health as Expanding Consciousness and a Nursing Intervention from a Unitary Perspective is based on Roger’s theory of unitary human beings. Rogers observed that “Man is a unified whole possessing his own integrity and manifesting characteristics that are more than and different from the sum of his parts” (Endo, 2017). He observed that health and disease are not two separate entities but as a transformative and unitary process. Newman’s theory of health came about from her early family experiences. Her mother struggled with chronic illness when Newman was young and she had to take care of her for several years. The caregiving and dependency from Newman sparked her interest in nursing. From that time, she felt that there was a need to recognize the pattern of life and accept what the patterns meant to her as a person.
Rogers’ also observed that health and disease were appearances of the recurring variations of the life processes. He observed that health and illness can be referred to as a unitary process where one moves through a process of order and disorder. From such a view, one can no longer view health and illness and to separate processes in medical science. Instead, one views health as an absence of disease and disease simply as an absence of health. The movement from health to illness can be referred to as a continuum from illness to wellness.
Margaret Newman’s Theory of Health as Expanding Consciousness (HEC) was based on the concern of individuals whose recovery from disease was not possible. Nurses usually find difficulty relating to people that are facing uncertainty, hurt, and maybe eventual death. The theory observes that “every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness” (Macharia et al, 2015). The expansion of ones’ consciousness involves becoming more aware of oneself, establishing a grand meaning of life, and trying to establish new ways where they can be more connected with the world and other people around them (Macharia et al, 2015).
Pattern
One of the assumptions held by the theory is based on a pattern. The theory observes that pattern is a “process of understanding the information that depicts the whole understanding of the meaning of relationships at once” (Smith & Parker, 2015). Wholeness is a critical element of pattern and pattern is on the constant path to change. The pattern occurs in a practical sense through order and chaos. In some instances, someone’s life could be orderly while in other instances their lives could be filled with chaos. The order and disorder is a pattern in life is what leads to an expansion of consciousness.
The nurse gets in touch with the patient at the time when they are experiencing disorder and chaos in their lives. In order to deliver adequate services, the nurse should identify the pattern of chaos so that one can undertake the right course of action. The key to proper service delivery is that one must continually engage in a process of pattern recognition. Patient too should be made to understand that they are in a part of their lives which is filled with chaos. Understanding of pattern by both the nurse and the patient will enable the two to evolve in a higher level of consciousness. The nursing intervention thus calls for an action that should be used in pattern recognition. Such a recognition of pattern should provide insight and meaning in life and would reveal the next action and the way forward. Newman’s theory is based on pattern recognition where the patient and nurse can identify the current pattern in their life. The theory has thus been labeled as a form of caring partnership within the relationship of the patient and nurse.
Higher Consciousness
Consciousness can be defined as the capacity of a system to gain information. For the given case human beings, it refers the ability to interact with their environment and gain information about it. Consciousness entails a form of cognitive and affective awareness. It also involves an interconnectedness with one’s entire life and the entirety of living systems. It can include one’s physiochemical maintenance, various growth processes, and one’s immune system. Consciousness forms a pattern of information where one moves towards an undivided pattern of the expanding universe.
Margaret Newman’s theory also follows that human beings are open to the entire energy system of the universe and that they are in constant interaction with energy. Throughout the process of interaction with energy, human beings are continually evolving their individual patterns. Understanding of pattern forms a critical aspect of expanding one’s consciousness and is a critical part of pattern recognition. Any appearance of disease shows is based on the pattern of an individual. According to Margaret Newman, the pathology of disease was apparent before any symptoms appear and thus the mere removal of disease and its symptoms may not really create much of a difference.
The nursing process to recovery identified by Newman involves a process of identifying how someone relates to their world and the energy around them. This is a process of simply understanding consciousness and a proper understanding will lead to higher consciousness. The nurse should help people to use the power in them to be able to move to a higher level of consciousness. Moving to a higher level of consciousness will be beneficial in realizing disease and should help in patient recovery and future disease prevention.
Newman also observed the relationship between time, space, and movement as an important part of her theory. She observed that time and space as temporary patterns of an individual which usually have a harmonizing relationship. Human beings are continuously moving through time and space and this indicates that there is a unique pattern of reality. A person can be identified by their patterns which is a reflection of the patterns experienced by a person as they move through the larger environment.
The field of nursing can be referred to as a process of recognizing the position of oneself to that of the environment. Such recognition is simply understanding one’s consciousness. It is the role of the nurse to help people to expand their consciousness into pattern recognition. Human beings should be able to understand the constant changes they undergo as they move through space and time. Such an understanding involves a pattern of unfolding consciousness where an individual moves towards a deeper understanding of themselves and the world around them.
Caring Partnership
Newman’s theory is founded on a caring partnership and is based on a series of steps and procedures that are used to find meaning in different experiences. The first step in a caring partnership involves a joint process of review that is created with the patient and their family. The second step involves the patient being given a chance to talk of the important events in their lives and significant relationships about their life. The nurse would then translate the information given by the patient into a narrative diagram which shows the successive configuration of relationships and occurrences. Such a translation of information and events would take place after the first meeting. The third step would involve the diagram that is given to the patient where dialogue can continue freely. The fourth step would involve the patient realizing their pattern and the relation between the nurse and patient would be terminated (Fujiwara & Endo, 2017). SUhc a process of caring established between the nurse and the patient has been indicated in figure 1.
Figure 1: Process of caring partnership based on Newman's theory of health as expanding consciousness.
Implications of Margaret Newman’s Theory to Psychiatric Nursing
Psychiatric nursing and mental health nursing involves caring for people of different ages that are experiencing mental health and distress. Patients suffering from issues of mental health can first have a caring connection through a caring partnership proposed by Margaret Newman. While there are several demands of nursing care, nurses should establish time and energy in order to establish treatment-focused care. The caring partnership should be applied in psychiatric nurses in order to identify with the suffering experienced by psychiatric patients. The family of the patients and the patients themselves should be able to find meaning in the difficult situation of their lives. The result is that both patients and nurses should be able to realize mental growth even in extremely difficult situations.
Margaret Newman’s concept of consciousness and self-awareness can also be applied in psychiatric nursing. The concept observes that there is a need for nurses to be able to establish self-knowledge in order to facilitate a proper nurse-patient relationship and improve the outcomes of patient care during psychotherapy. The process of expanding consciousness would involve the mentally ill patients acknowledging and accepting that their difficult mental condition is a time when they are experiencing chaos.
The nurse can help the patient move towards higher and new consciousness. When designing a care plan, the nurse should be able to involve the patient. He or she should define the goal of moving towards a higher form of consciousness. One of the observations made by Newman was that nurses should make deliberative observations about the patients and reflect the observations to the patient. Such specific attention should stimulate the patient where they should respond about what is meaningful within their unique situation.
The unitary perspective of Newman’s theory can be applied to enable individuals to understand their movement from a pattern of health to disease. Nurses should enable patients suffering from mental illness to understand that health is not simply the absence of disease. Instead, one can be very healthy even when they are going through difficult times. Health would be achieved in cases where one has a healthy mindset, a positive mindset, has social support, and adheres to treatment. The science of unitary human beings shows that human beings are in constant interaction with the environment and it through such interactions that people achieve total well-being. Psychiatric nurses should enable patients to observe that people can experience health even when they are mentally ill.
Summary and Conclusion
Margaret Newman's Theory of Health as Expanding Consciousness and a Nursing Intervention from a Unitary Perspective shows the significance and relevance of nursing theories in facilitating quality delivery of care. The theory can also be used to enhance knowledge in nursing. The major components of the theory are pattern recognition, higher consciousness, and caring partnership. Pattern recognition is based on Roger’s theory of unitary human beings which observes that health and disease are not separate entities but are part of a single continuous process. Human beings thus move through a continuous process of order and chaos. Higher consciousness will involve an understanding of the specific patterns in their lives. The caring partnership will involve a series of steps that nurses can use to enable patients to understand the current patterns and move towards a level of higher consciousness. All these processes can be applied in psychiatric nurses to help patients suffering from mental illness. Mental ill patients should understand that they can health by creating order and identifying that health does not simply mean the absence of disease.
References
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Fujiwara, Y., & Endo, E. (2017). A patient with cancer and her family in a caring partnership based on Margaret Newman's theory of health as expanding consciousness. Asia-Pacific journal of oncology nursing , 4 (3), 265.
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Macharia, K. S., Jelagat, R. R., & Juma, M. D. (2015). Applying Margaret Newman’s theory of health as expanding consciousness to psychosocial nursing care of HIV infected patients in Kenya. American Journal of Nursing Science , 4 (2), 6-11.
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