Initially, when I read the criteria for this paper, I asked myself, how have I applied the nursing metaparadigm in practice. However, I could not refrain myself from going back to what brought me to nursing. In 2012 just as I was finishing my bachelors in Kinesiology, I received one of the worse news in my life. My best friends mother whom I have known since the age of 7 and who is practically like a second mother to me had been diagnosed with stage 3 breast cancer. The diagnose was so devastating, not only was Mrs. Guerra diagnosed with cancer, but she was also dealing with a divorce that was turning out to be a battlefield on its own.
To say the lease, Mrs. Guerra needed all the emotional support she could get. As an “adopted daughter” I accompanied her to many of her appointments and even chemotherapies—That’s when my world changed. I met the most wonderful oncology nurses ever. Their holistic nursing practice and their approach in the care of the person, environment, health, and nursing (nursing metaparadigm) convinced me to go into nursing. The purpose of this paper is to explain how I have used the four concepts of the nursing metaparadigm to guide my nursing practice and to describe how I have used the grand theory of human caring by Jean Watsons has influenced my nursing philosophy.
Defending The Four Concepts
Although I am currently not working, I have always tried to guide my practice by the four concepts of the nursing metaparadigm (person, environment, health, and nursing). Through clinical and preceptorship, I always had in mind those oncology nurses I met at Mrs. Guerra’s chemotherapy sessions. They helped me understand how the person, environment, health, and nursing are essential concepts for patients healing. Wu X (2008) describes the person to be associated with the patient who is the receiver of care and can extend to the person’s culture, family, friends, spiritual condition and social status (as cited in Fawcett, 2000). The metaparadigm environment is the place or community where care is provided, and it includes internal and external factors. The metaparadigm of health is defined as the quality and wellness of the patient or illness experienced by the person (Wu X, 2008). The last component of the metaparadigm, and the one I consider the most important is nursing—standing for the nurse who will apply their experience, skills, and knowledge to provide the most appropriate care for their patients.
Jean Watson Theory of Human Caring
The little nursing practice I have had in the past two years have been trial and error on what nursing theories fit my personality the best. Jean Watsons Theory of Human Caring has been the theory that I have connected with the most. Also, it has helped me understand and apply the nursing metaparadigm into practice. According to Wadsworth (2012) Jean Watson believes in holistic nursing care, which is defined as “the totality of the human being—the interconnectedness of the body, mind, emotion, spirit, social/cultural, relationship, context, and environment” (as cited in American Holistic Nurses Association, 2011).
Moreover, Parker and Lane-Tillerson (2014), explained that Watson’s Theory of Caring is a theory that describes how nurses care for patients and advocate that caring is essential to nursing practice (as cited in Nursing Theory, 2015). Parker and Lane-Tillerson (2014) state that there are three major concepts found in the Theory of Caring that stem from the nursing metaparadigm which include a human being, health, and nursing (Parker & Lnae-Tillerson, 2014). Human is defined as being broad and related to any gender, race, and socioeconomic status. “Health refers to holistic accord amongst the parts of a human being; the mind, body, and soul are in agreement as experienced and perceived by the individual” (Parker & Lnae-Tillerson, 2014).
Using the Nursing Metaparadigm
There is one particular occasion that I remember the most; I had a 34-year-old female patient who was hospitalized for severe dehydration and had a history of mental illness. This patient who I will call Alex was lovely, reserved but very scared about being in the hospital. Initially, when my preceptor introduced me to her, she did not look at me or acknowledge me. She would not answer me and look away when I talked to her. However, it did not take long before I built rapport with her. She finally spoke to me when I became interested in one of her drawings of a little girl (her daughter). As she became more comfortable with me throughout the day, she asked me if I could please adjust her meal plans because on Tuesdays and Wednesdays she did not eat dairy products. So I called the nutrition and placed all her meal orders for the day and the next day that did not contain dairy. In this situation, I satisfied the persons needs through human caring.
The next day, my nurse had Alex again, and this time the nurse had mentioned that Alex denied drinking more than two small sips of water which made it very difficult for my nurse to administered medication. My preceptor asked me if I could go in and talk to her since it seemed that Alex trusted me the most. When I spoke to Alex, I found out why she didn’t want to drink water. Her daughter had passed away in a drowning accident, and she hated the thought of water. That’s when I asked her if she would like juices to be brought into her room so she could drink at any time of the day. She was so delighted and agreed to drink as much as possible. Here I addressed the metaparadigm of health. Although Alex needed to drink more fluids, it was not initially understood why she was not hydrating herself until she told me why she was not drinking water.
Furthermore, also was able to meet the metaparadigm of nursing by building rapport with Alex and creating a relationship with her. Environmentally, I knew she was afraid about being in the hospital, so I always tried to keep her environment quiet and calm. One thing I found that helped her was keeping the infusion pump from beeping, so I made sure fluids were replaced before they ran out.
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