Nursing Theories, Metaparadigms, and Ways of Knowing

Introduction

The nursing field is complex for an individual to define since it is evolving, dynamic and extensive study involving theoretical as well as practical skills. The nurses are identified by clients in various ways. The nurses are identified using aspects such as empirics or science, ethical, aesthetics or art, personal as well as social-political understandings. There are different concepts applied in the nursing career, and they include metaparadigms and paradigms. Other fundamentals in the nursing career include various ways of knowing nursing theories in details. This paper discusses metaparadigms and paradigms concepts applied in nursing and ways of identifying nursing theories.

Metaparadigms

It is a combining force in the nursing discipline that is used to name phenomena. The central concepts applied in metaparadigms concept include nursing, environment, person, and health. Many philosophical disagreements have emerged from this theoretical project. First, conceptualization of the individual has been developed by the different theorist. Most of the nursing theories are distinguished in various manners in which they conceptualize the client. However, some of the nursing theories have expanded to the family and community level. Currently, there are several disagreements between the theorists on how nurses should understand the client as required by their profession. The understanding of human beings is a crucial aspect of nursing theory and practice. According to the ancient nursing practices, nurses employed the use of biomedical perspective which focused on the patient’s body. The method involved descriptions that determined the state of illness. It was prone to laboratory tests. Currently, nursing practice and science have been identified by the clients and community as the only determinant of sickness (Wagner, n.d). Besides, conceptualization of health has been identified as a prior aspect. Currently, nurses have defined life as a critical outcome for any patient. Some of the theorists have identified health and quality life as totality paradigm. They have identified life as human wholeness as a compound of spiritual, social and psychological aspect dimensions. On the other hand, science theorists view human nature as complex and whole beings. Thus, health can only be reflected as a whole person.  The terms such as life gratification, functional status and well-being coping are attributed to quality life. According to Parse (1994), “quality of life cannot be separated from the person’s lived experience and thus can only be described at that moment by the person living the life.” Similarly, the human science research identified quality life as an ‘apprehension of the whole-in-motion’’ (Parse 1994 pp.19). The aspect has changed the nursing perspective which involved state and process of self-actualization or use of an individual’s life to wholesome being. Conceptualization of the environment is apparent to nursing theories. Some of the nursing theories identify environment as an immediate surrounding and circumstances of the individuals without giving detailed information to social, political and economic forces. Conversely, simultaneity paradigm determines person and environment as spreadable to the degree that a person is attached from the cosmos. Therefore, simultaneity theories have come up with a different view on the individual know-how of the environment decontextualized from common or political understandings. Regarding the environment concept to the perception of a person, challenges emerge the moment people are confronted with problems that cannot be comprehended in the absence of skilled personnel (Maville & Huerta, 2008). In both theories, that is totality and simultaneity paradigms orientation is mainly meant to the individuals and not the society. Although the concept of a person is linked to family and community, most of the nursing theories including the traditional health promotion are individualistic. The theories mainly focus on the life variations for the individual’s behavior. Furthermore, conceptualization of nursing is a crucial aspect. The social aspirations of nursing career were developed as a result of scientific proficient knowledge and skills. The faulty moral superiority in the 1970s and 180s led to the emergence of the health consumer movement. The clients or patients interrogated their nurses, claimed for their rights and were exposed to an original source of information to make the decision about their health. The aspect changed the role of the nurse from ``intervening’’ the cause of disease. Most of the radical expressions viewed or identified nurses as contaminants of the individual’s health. As a result, nurses were eliminated from the perspective since people know their own way more efficiently. The theory of human becoming, ``individuals know their own way and reflectively. The nurse in real presence bears witness to the person’s unfolding and becoming’’ (Mitchell & Cody 1992 p. 60). Thus, the clients were given the responsibility to determine about health.

Paradigms

The term refers a pattern of shared empathize and conventions about the authenticity of a particular word. Paradigm acts the determinant of the research topics to be analyzed, how to carry out the investigation and derivation of theories in the nursing career. Paradigm is divided into various categories which include empirical paradigm, interpretive paradigm, and critical paradigm. Different phenomena analyzed that nursing research is diverse and thus pragmatic methodology is crucial to understand the discipline better.  Besides, pragmatic approach is essential as it allows nurses to address research questions with the correct guiding strategies. Moreover, this concept enables the objective of nursing to promote health and at the same time relieve sufferings (Weaver & Olson, 2006). Therefore, the researchers are not required to support the ideological camp firmly instead they are supposed to select a research methodology appropriate to the phenomenon under investigation. The types of paradigms include empirical paradigm, interpretive paradigm, and critical paradigm. First, empirical paradigm stipulates that no reality is lawfully certified through one’s senses. Thus, skills and knowledge are acquired as a result of controlling the challenges entailed in the variables with the aim of determining their relationship. According to the researchers, empirical paradigm significantly contributes to research in the nursing career. It enables the growth and testing of the hypotheses, the interrelationships that exist between different variables as well as the comparison of the variables. The theoretical development of empirical nursing is essential since it enables one to predict the type of theory that can be established in each nursing paradigm. The empirical paradigm has contributed towards the development of various theories in nursing. For instance, the Self-Care Deficit Nursing Theory (SCDNT) theory which states, `` nursing is required when persons’ needs for self-care exceed their ability to provide self-care’’ (Orem, 2001). Secondly, the interpretive paradigm is crucial in the nursing discipline (Weaver & Olson, 2006). The interpretive paradigm inspects the phenomenon through the use of bear eyes. Thus, the experience and knowledge of the individual are important as it should be beyond quantifications of an external observer. The interpretive paradigm veracity is usually based one’s perception (Gillis & Jackson, 2002). Thus, there is no existence of reality as compared to the empirical paradigm. The interpretive paradigm is qualitative to enhance comprehension of the phenomenon that is experienced by a particular population. Therefore, the method is important as it allows the researchers to comprehend the phenomenon through eyes in the presence of other people. The theoretical development in the interpretive paradigm is different from the empirical paradigm. The general evolution of the empirical paradigm is based on deduction, analyses, and testing of the theory. Conversely, interpretive paradigm employs the use of induction and theory for its development. The middle range theory of resilience which recognizes the unique experiences and changes of a person, however, it is essential in the nursing setting (Polk, 1997). Also, the critical paradigm is an important method in the nursing career. The method mainly centers on social struggles, ascendancy as well as institutions which aim at the development of democratic civilization (Gillis & Jackson, 2002). Therefore, this method aims at the elimination of oppression of the community. According to Butterfield (2013), nurses employ the use of practice to change parents’ beliefs. The aspect aims at changing the health beliefs that individuals have. The nursing practices significantly consider the societal factors and ways that should be employed to act on the elements. The research in this method mainly focuses on the creation of change. Besides, critical paradigm focuses on strategy development, partnership and consciousness-raising (Wuest, 2012). The theoretical development that can be applied to this method is the feminist theory. The theory is relevant to nursing as a female profession. Thus, lack of knowledge in the nursing career is linked with lack of respect for women in the society. According to Wuest (2012), indicates that feminist theory should be applied in research to eliminate the aspects of feminism in the society.

Ways of Knowing Nursing Concepts

The clients identify nurses in various ways.  The nurses are identified using aspects such as empirics or science, ethical, aesthetics or art, personal as well as social-political understandings. First, the science of nursing is used in nursing identification. Carper stated that "there is a critical need for knowledge about the empirical world, the knowledge that is systematically organized into general laws and theories for the purpose of describing, explaining and predicting phenomena of special concern to the discipline of nursing" (Carper 1978 pp.14). The knowledge is essential since it links the nursing theory to application practice. The application of empirical knowledge enables nurses to interpret unidentified clinical challenges and have an immediate response. Also, an art of nursing is used in the identification of nurses. The aspect of art in nursing is identified as the ability to connect or relate with patients. The art is crucial as it enables an individual to pursue a degree nursing field. The art of nursing varies from science nursing. The art cannot be physically touched or examined. It involves factors such care and empathy that should be employed to the patients (Carper, 1978). Besides, ethical knowledge is used to influence patient’s care. The nurses are required to comprehend the moral principles such as privacy, advocacy, autonomy, and confidentiality. Nurses should employ the principles in an atmosphere of respect of the values as well as morals of other individuals. It is necessary for nurses to develop the code of ethics to stick to the nursing profession. Watson's theory of human caring demonstrates the concepts of the nurse to be aware of any decisions and exceptionality of each client with the aim preserving one's dignity (Watson, 2009). Moreover, personal knowledge is applied in the identification of nurses. This process involves self-reflection and legitimacy of the nurses. Additionally, social, political experience is essential as entails the social, economic, political and the cultural practices of the nursing career. The socio-political can be practical in the nursing field through examination of minor sociological factors such as labeling (Community Health Nurses Association of Canada, 2008).

Types of Theories in Nursing

The grand nursing theory presents the widespread perceptions and propositions. Most theories at this level can be used to explain attitudes, but on the other hand, they are not applied in empirical testing. Thus, the grand theory is limited to direction and prediction of nursing in certain conditions. At this level, all theories are projected to be relevant to all cases in the nursing field. Additionally, the middle range nursing theory is appropriate in nursing practice. This theory was anticipated by Robert Merton (1968); a sociologist provided this approach to be used in challenging condition and proper empirical testing. The middle range theories are not detailed as compared grand theories. However, they provide an effective bond between the grand theories and nursing practices (Fawcett, 2000). Furthermore, the nursing practice theory is applied in nursing situations. The theory has the most limited scope and is particularly used in particular nursing conditions. All theories developed at this level have direct effects in the nursing practice. The theories in this level provide contexts for nursing interventions and its impacts. Additionally, theories in this level employ the use of nursing questions and events in nursing exercise (Hickey, 2009).

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