Hildegard Peplau

- born on September 1, 1909 at Reading, Pennsylvania.

- often regarded as Psychiatric nurse of the century.

- in 1931, she graduated from Pottstown, Pennsylvania Hospital of Nursing.
- in 1943, she received a Bachelor of Arts in Interpersonal Psychology from Bennington
college, Vermont.

Metaparadigm of Nursing
1. Person - She defines a person as a man who is an organism that Jives in an
unstable balance of a given system.
2. Health - She gave importance to the belief that for one's health to be achieved and
maintained, his needs must be met, and these needs are physiological demands
and interpersonal conditions.
3. Environment – Environment for her are forces outside the organism and in the
context of the socially-approved way of living, from which vital human social
processes are derived, such as norms, customs, and beliefs. However, these given
conditions that lead to health always include the interpersonal process.
4. Nursing - Nursing for her is therapeutic because it is a healing art, assisting an
individual who is sick or in need of health care.

Interpersonal Relations in Nursing Theory

Interpersonal Relations Theory Peplau described the nurse-patient relationship as a four-
phase phenomenon. One can view them as separate entities, but they could overlap with each
other over the course of the nurse-patient interaction. Each phase is unique and has distinguished
contributions on the outcome of the nurse-patient relationship. The four phases of nurse-patient
relationship is the orientation, identification, exploitation, and resolution. The interpersonal
therapeutic process was based on the theory proposed by Peplau and particularly useful in
helping a psychiatric patient become receptive for therapy. She also advocates the roles of the
nurse in the nurse-patient interpersonal relationship which he or she needs to assume for him/her
to be empowered and equipped in meeting the patient needs.
The theory explains nursing’s purpose is to help others identify their felt difficulties and
that nurses should apply principles of human relations to the problems that arise at all levels of
experience. The theory involves the healthcare professional working to understand their own
behaviour, as well as that of their clients.
Virginia Henderson
- Henderson is popularly known and tagged as The Nightingale of Modern Nursing,
Modern-Day Mother of Nursing, First Truly International Nurse, and The 20th century
Florence Nightingale.
- She began her career in public health nursing in Washington, DC, and was the first full-
time instructor in nursing when she was at Norfolk Protestant Hospital.
- She was an early advocate for the introduction of psychiatric nursing in the curriculum
and served as a committee to develop such a course at Eastern State Hospital in
Williamsburg, Virginia, in 1929.

Metaparadigm in Nursing
1. Person - According to her, a person is an individual who requires assistance to
achieve health and independence or, in some cases, peaceful death.
2. Health - She viewed health as a quality of life and is very basic for a person to
function fully.
3. Environment - caring for the sick, it is the responsibility of the nurse to help the
patient manage his surroundings to protect him from harm or any mechanical
injury.
4. Nursing - In the role of the nurse as a healthcare provider, the nurse must be
knowledgeable in both biological and social sciences and must have the ability to
assess basic human needs.

14 Basic Human Needs

Virginia Henderson's writing is not only still relevant today but is also widely applied in
routine nursing. When she discusses what the nurse should be for the patient, the writing style is
almost poetic. She was clearly concerned for the wellbeing of every patient, and that is why this
system is so extensive, while also being understandable to a layman. One may argue that her
personality and method of providing healthcare are closely related to this viewpoint. Independent
practice of healthy behaviors was one of the key components of health as stated by Henderson.
Even though a person can be healed in a hospital, without independence they will once more
require care.This type of approach to healthcare is timeless, because a person has to be able to
care for his health, no matter the era. Because of this, the majority of contemporary nurses have
put her beliefs into practice, making it one of the most current theories in nursing.
Florence Nightingale
- Born on May 12, 1820, in Florence, Italy.
- She took her nursing program from Fleidener School of Nursing in Kaiserswerth,
Germany (July 6, 1851 - October 7, 1851).
- Called as "Lady with the Lamp" and the Founder and Mother of Modern Nursing.
- Her birthday marks the International Nurses Day celebration each year.

Metaparadigm in Nursing
1. Person - viewed the essence of a person as a patient and envisioned as comprising
physical, intellectual, emotional, social & spiritual components.
2. Health - according to her. "Healthy is not only to be well but to be able to use well
every power we have."
3. Environment - Anything that can be manipulated to place a patient in the best
possible condition for nature to act.
4. Nursing - she believed nursing to be a spiritual calling, and nurses were to assist
nature to repair the patient.

Nightingale’s Environmental Theory

Environmental Model in Nursing Nightingale viewed the manipulation of the physical
environment as a major component of nursing care. She believed that when one or more aspects
of the environment are out of balance, the client must use increased energy to counter the
environmental stress. She believed that when one or more aspects of the environment are out
balance, the client must use increased energy to counter the environmental stress, and these
stresses that drains patients’ energy needed for healing. She identified the 13 canons in her
theory as major areas of the physical, social, and psychological environment that the nurse could
control: Ventilation and warmth, light, cleanliness, health and houses, noise, bed and beddings,
personal cleanliness, variety, chattering and hopes, taking food, what food? , petty management,
and observation of the sick.
The environmental theory has an impact on many aspects of current nursing practice,
including noise, good housekeeping practices, balanced diet administration to speed wound
healing, and surveillance of the ill, to mention a few
Imogene King
- January 30, 1923 – December 24, 2007
- Nursing Diploma, St. Johns Hospital School of Nursing, St. Louis, Missouri 1945
- Bachelor of Science in Nursing Education, St. Louis, Missouri 1948
- Master of Science in Nursing, St. Louis University, 1957  Doctorate of Education,
Teachers College, Columbia University, NY 1961

Metaparadigm in Nursing
1. Person - A spiritual being and rational thinker. King believes that individuals have
the ability to think, choose, feel, set goals, perceive, make decisions and achieve
goals.
2. Health - Involves a patient’s life experiences and ongoing assessments of internal
and external environment stressors through the use of resources available for the
patient to maximize their daily living potential.
3. Environment - The atmosphere where human interaction takes place. a. Internal:
patient’s inner coping skills to adjust with the external environments conditions.
b. External: patient’s surroundings such as the nurse.
4. Nursing - Function of professional nurse: ―To interpret information in nursing
process to plan, implement and evaluate nursing care.

Goal Attainment Theory

The Goal Attainment Theory is based on philosophy of human beings and a conceptual
system. King’s theory uses concepts of self, perception, communication, interaction, transaction,
role, and decision making.
This theory is widely generalizable and relevant in different health care situations. The theory
focuses on attaining certain life goals. Theory describes a dynamic, interpersonal relationship in
which a person grows and develops to attain certain goal.
The theory helps nurses to easily facilitate the present problem. It facilitates proper and
correct range for the use of evaluation system. It has been applied to different professional
practice setting such as in nursing administration, theory-based practice in the emergency
department, in tertiary hospital and in the community.
Nursing according to her is a process of action, reaction, and interaction whereby nurse
and client share information about their perceptions in nursing situations.
Dorothy Johnson
- Born August 21st 1919 in Savannah, Georgia.
- 1942 – B.S.N. from Vanderbilt University, Nashville, Tennessee.
- 1948 – M.P.H. from Harvard University, Boston, Mass. Massachusetts.
- Died in February 1999 at the age of 80.

Metaparadigm in Nursing
1. Person - Johnson views human beings as having two major systems: the
biological system and the behavioral system.
- It is the role of medicine to focus on the biological system, whereas
nursing’s focus is the behavioral system.
2. Health - It is an elusive state that is determined by psychological, social,
biological, and physiological factors.
- Johnson’s behavioral model supports the idea that the individual is
attempting to maintain some balance or equilibrium.
3. . ENVIRONMENT - Refers to the environment in which an individual exists.
- According to Johnson, an individual’s behavior is
influenced by all the events in the environment.
4. NURSING - Nursing is an external regulatory force which acts to preserve under
the organization and integration of the patient’s behavior at
an optimal level under those conditions in which the behavior constitutes a
threat to physical or social health or in which illness is found.
- Nursing is viewed as part of the external environment that can
assist the client to return to a state of equilibrium or balance.
- Nursing is concerned with the organized and integrated whole,
but that the major focus is on obtaining a balance in the behavioral system
when illness occurs in the individual.
- Johnson believes that nurses need to be well grounded in the
physical and social sciences; particular emphasis should be placed on
knowledge from both the physical and social sciences that is
found to influence behavior.
Behavioral System Model

Johnson believes each individual has patterned,

purposeful, repetitive ways of acting that comprise a
behavioral system specific to that individual. These actions
or behaviors form an ―organized and integrated functional
unit that determines and limits the interaction between the
person and his environment and establishes the relationship
of the person to the objects,events, and situations in his environment.
The theory helps nurses address patients at first and not their disease; the approach to a
patient as a whole or a behavioral system can improve nurse-patient interaction and reduce the
number of possible misunderstandings. The theory provides a comprehensive understanding of
the interconnection between nursing, environment, health, and patient behavior. It directly
addresses issues that can lead to disequilibrium and indicates how equilibrium can be restored.
The theory can be applied in psychiatric nursing care, treatment of children, infants, adolescents,
pregnancy care, obesity, oncology, etc.

FAYE GLEEN ABDELLAH

- Born: March 13, 1919 in New York City
- Education: Columbia University
- Hall of fame induction:2000
- Died: 24 February 2017

Metaparadigm of Nursing
1. Person - Describes the recipients of nursing as individuals (and families, and thus,
society), but does not delineate her beliefs or assumptions about the nature of human
beings.
2. Health - Although Abdellah does not give a definition of health, she speaks to total
health needs and a healthy state of mind and body‖ in her description of nursing as
a comprehensive service.
3. Environment - Included in planning for optimum health on local, state, national,
and international levels.She indicates that by providing service to individuals and
families, society is served but does not discuss society as a patient nor define society.
 4. Nursing - Abdellah considers nursing to be a comprehensive service that is based on
an art and science and aims to help people, sick or well, cope with their health needs.
Broadly grouped into the 21 problem areas to guide care and promote the use of nursing
judgment.

21 Nursing Problem
Abdellah's theory states that nursing is the use of the problem-solving approach with key
nursing problems related to the health needs of people. The theory helped improve nursing
practice. It transformed the focus to patient centered to provide a better care.
Abdellah's Twenty-one Nursing Problems focus on the physical, biological, and socio-
psychological needs of the patient and attempt to provide a more meaningful basis for
organization than the categories of the systems of the body. The twenty-one nursing problems is
classified into: basic to all patients, remedial care needs, sustenance care needs, and restorative
care needs.

MADELEINE LEININGER
- 1948- Diploma in Nursing from St. Anthony’s School of Nursing Denver, Co.1950- BS
in Biological Science from Benedictine College, Atchinson, Kansas
- 1953- MSN from Catholic University, Washington, D.C.
- 1953- MSN from Catholic University, Washington, D.C.
- 1965- Ph. D in Anthropology from University of Seattle

Metaparadigm of Nursing
1. Person - Humans are believed to be caring and to be capable of being concerned about
the needs, wellbeing and survival of others. Human care is universal, that is, seen in all
cultures. Humans are universally caring beings who survive in a diversity of cultures
through their ability to provide the universality of care in a variety of ways according to
different culture, needs and settings.
2. Environment - Being represented in culture, as a major theme in Leiningers’ theory.
The totality of an event, situation or experience.
3. Health - Health systems, health care practices, changing health patterns, health
promotion and health maintenance. Health is an important concept in transcultural
nursing. Health is viewed as being universal across cultures but defined within each
culture in a manner that reflects the beliefs, values and practices of a particular
culture. Health is both universal and diverse.
 4. Nursing - Goal of nurse: ―To help individuals to maintain their health so they can
function in their roles.Domain of nurse: ―includes promoting, maintaining, and restoring
health, and caring for the sick, injured and dying. Function of professional nurse: ―To
interpret information in nursing process to plan, implement and evaluate nursing care.

Transcultural nursing model

Transcultural nursing theory plays a vital role in nurses on how deal with patients To
start, it helps nurses to be aware of how the patient's culture and faith system provide resources
for their experiences with illness, suffering and even death. It helps nurses understand and
respect the diversity that is often present in a nurse's patient load. It also helps strengthen a
nurse's commitment to nursing based on nurse-patient relationships and emphasizing the whole
person rather than viewing the patient as simply a set of symptoms or ilnesses. Finally, using
cultural knowledge to treat a patient also helps a nurse be open-minded to treatments that can be
considered non-traditional, such as spiritually-based therapies like meditation and anointing.
According to her, health is a state of well-being that is culturally defined, valued, and
practiced. It reflects individuals (or group's) abilty to perform their daily role activities in
culturally expressed, beneficial, and patterned lifeways. Nursing is defined as a learned
humanistic and scientific profession and discipline which is focused on human care phenomena
and activities to assist, support, facilitate, or enable individuals or groups to maintain or regain
their well-being (or health) in culturally meaningful and beneficial ways, or to help people face
handicaps or death.

Betty Neuman
- Born in 1924 on a farm in rural Ohio - this background helped her develop compassion
for those in need.
- Education, 1947- RN from diploma program in OH , 1957-BSN, UCLA mental health
& public health, 1966-MSN, UCLA, and 1967-1973, UCLA faculty.
- Developed first community mental health program for graduate students at UCLA.
- 1985 - PhD Western Pacific University-clinical psychology

Metaparadigm in Nursing
1. Person - The person is a layered multidimensional being. Each layer consists of five
person variables or subsystems: Physical/Physiological Psychological Socio-cultural
Developmental Spiritual. Neuman sees a person as an open system that works
together with other parts of its body as it interacts with the environment. An open system
that interacts with both internal and external environmental forces and stressors. Open system
 is characterized by the presence of an exchange of information and reaction with other
factors surrounding a person.
2. Health - “Health is a condition in which all parts and subparts (variables) are in
harmony with the whole of the client.” Considers health as dynamic in nature in which
the person’s health is at the level of health continuum—wellness or illness. Equated with
wellness
3. Environment - The totality of the internal and external forces which surround a person
and with which they interact at any given time. These forces include the intrapersonal,
interpersonal and extra personal stressors which can affect the person's normal line of
defense and so can affect the stability of the system.
 INTERNAL ENVIRONMENT – exists within the system; all forces and interactive
influences that are solely within the boundaries of the client system
 EXTERNAL ENVIRONMENT – exists outside the client system.
 CREATED ENVIRONMENT – developed unconsciously by the client and is symbolic
of system wholeness; it represents the open system exchange of energy with both the
internal and external environments.
4. Nursing - A unique profession that is concerned with all of the variables which
influence the response a person might have to a stressor
- Neuman believes that nursing requires a holistic approach that considers
all factors affecting a client's health—physical, physiological, psychological, mental,
social, cultural, developmental and spiritual well-being.
- The primary concern of NURSING is to define the appropriate action in
situations that are stress related or in relation to possible reactions of the client or client
systems to stressors.

System Model
The Neuman Systems Model can guide to strengthen the management of stressors in the
workplace for the nurses. The willingness of a nurse to bounce back, respond to stress and
adversity, and survive after becoming especially active in stressful circumstances are considered
to be optimistic, multidimensional resilience adaptations affected by individual variables such as
age, life experience, education, and spirituality. The use of the model of Neuman systems
provides the framework for understanding the idea of adversity by delineating the relationship
between parts and whole, the effects of circumstances, and the client's contact with his or her
environment.
The Neuman Systems Model views the person as an open system that responds to
stressors in the environment. The client variables are physiological, psychological, sociocultural,
developmental, and spiritual. Stressors are intra-, inter-, and extra personal in nature and arise
from the internal, external, and created environments. Nursing interventions occur through three
prevention modalities. Primary prevention occurs before the stressor invades the system;
secondary prevention occurs after the system has reacted to an invading stressor; tertiary
prevention occurs after secondary prevention as reconstitution is being established.

Patricia Benner
Life:

- Patricia Benner was born in 1942 in Hampton, Virginia. And spent her
childhood in California.
- She was married to Richard benner on 1967; they have a son and a daughter.
Professional:
- Bachelor degree in nursing from Pasadena College, in 1964.
- Master in medical-surgical nursing from the University of California, San
Francisco (UCSF), in 1970.
- PhD - from the University of California Berkeley, in 1982.
- 1985, Benner was inducted into the american academy of nurses.

Metaparadigm in Nursing
1. Person - The person is a self-interpreting being, that is the person does not come into
the world predefined but gets defined in the course of living a life.
2. Health - Dr. Benner focuses on the lived experience of being healthy and being ill.
Health is defined as what can be assessed, whereas well-being is the human
experience of health or wholeness. Wellbeing and being ill are understood as distinct ways of
being in the world.
3. Environment - Benner uses situation rather than environment because situation
conveys a social environment with social definition and meaningfulness..
4. Nursing - Nursing is described as a caring relationship, an ―enabling condition of
connection and concern. Caring is primary because caring sets up the possibility
of giving and receiving help. Nursing is viewed as a caring practice whose science is guided
by the moral art and ethics of care and responsibility.

Novice to Expert
The theory covered how nurses develop their abilities and knowledge of patient care from
the moment they start working as nurses until they are fully qualified professionals who can
handle complicated cases. Nursing has made considerable use of Benner's Novice to Expert
Nursing Theory to boost nurse retention and give new nurse administrators and managers
experience. The model explains how beginner nurses move through a number of phases as they
develop their abilities, knowledge, and experience to become specialists.
5 levels of Capabilities according to Benner

 Novice – A person with no background experience of the situation in which he or

she is involved. Generally this level applies to nursing students
 Advance Beginner – The advance beginner stage develops when the person can
demonstrate marginally acceptable performance having coped with enough real
situations to note, or to have pointed out by mentor, the recurring meaningful
components of the situation.
 Competent - the most pivotal in clinical learning because the learner must begin
to recognize patterns and determine which elements of the situation warrant
attention and which can be ignored.
 Proficient – Nurses at this level demonstrate a new ability to see changing
relevance in a situation including the recognition and the implementation of
skilled responses to the situation as it evolves.
 Expert – Achieved when “the expert performer no longer relies on analytical
principals to connect her or his understanding of the situation to an appropriate
action.

Lydia Hall
- Born on September 21, 1906 in New York City as Lydia Eloise Williams.
- She was the eldest child of Louis V. Williams and Anna Ketterman Williams and was
named after her maternal grandmother.
- Graduated from York Hospital School of Nursing in 1927 with a diploma in nursing.
However, she felt as if she needed more education.
- She entered Teacher’s College at Columbia University in New York and earned a
Bachelor of Science degree in public health nursing in 1932.
- After a number of years in clinical practice, she resumed her education and received a
master’s degree in the teaching of natural life sciences from Columbia University in
1942.
- Later, she pursued a doctorate and completed all of the requirements except for the
dissertation.
Metaparadigm in Nursing
1. Person - The individual human who is 16 years of age or older and past the acute stage
of long-term illness is the focus of nursing care in Hall’s work. The source of energy and
motivation for healing is the individual care recipient, not the health care
provider. Hall emphasizes the importance of the individual as unique, capable of growth and
learning, and requiring a total person approach.
2. Health - Health can be inferred to be a state of self-awareness with a conscious
selection of behaviors that are optimal for that individual. Hall stresses the need to help
the person explore the meaning of his or her behavior to identify and overcome problems
through developing self-identity and maturity.
3. Environment- The concept of society or environment is dealt with in relation to the
individual. Hall is credited with developing the concept of Loeb Center because she
assumed that the hospital environment during treatment of acute illness creates a
difficult psychological experience for the ill individual. Loeb Center focuses on providing
an environment that is conducive to self-development. In such a setting, the focus of
the action of the nurses is the individual, so that any actions taken in relation to
society or environment are for the purpose of assisting the individual in attaining a personal
goal.
4. Nursing - Nursing is identified as consisting of participation in the care, core, and cure
aspects of patient care.

Care, Core, Cure model

Lydia Hall’s theory has three components which are represented by three independent but
interconnected circles. The three circles are: the core, the care, and the cure. The size of each
circle constantly varies and depends on the state of the patient.
A nurse functions in all three circles but to different degrees.
The care circle
The care circle defines the primary role of a professional nurse such as providing
bodily care for the patient and helping the patient complete such basic daily biological functions
as eating, bathing, elimination, and dressing. When providing this care, the nurse’s goal is the
comfort of the patient.
The Core Circle
This area emphasizes the social, emotional, spiritual, and intellectual needs of the patient
in relation to family, institution, community and the world. This is able to help the patient
verbally express feelings regarding the disease process and its effects by the use of the reflective
technique. Through such expression, the patient is able to gain self-identity and further develop
maturity.
The Cure Circle
These are the interventions or actions geared toward treating the patient for whatever
illness or disease he or she is suffering from. During this aspect of nursing care, the nurse is an
active advocate of the patient.

 This theory comprises of three intersections: the “Care” relates to the nursing as the
treatment of the body, the “Cure” is the aspect of disease’s medical treatment, and the “Core”
refers to the psychological aspect of nursing. The nurse takes care of physical needs. Giving
physical care enables the nurse to calm the patient and learn about their pathology, treatment
plan, and personality. The nurse can effectively teach and nurture patients because of the
understanding that results from the combination of all three circles.

Myra Estrin Levine

- Born in Chicago, Illinois.
- Graduated from Cook Country School of Nursing in 1944 and obtained her BS in
Nursing from the University of Chicago in 1949.
- She authored 77 published articles which included ―An Introduction to Clinical
Nursing.
- Also received an honorary doctorate from Loyola University in 1992.
- She died on 1996.

Metaparadigm in Nursing
 1. Person - It refers to the unique individual in unity and integrity, feeling, believing,
thinking, and whole.
2. Environment - Includes both the internal and external environment. Three Aspects of
Environment Drawn upon Bates’ (1967) Classification:
 The operational environment consists of the undetected natural forces and that impinge on
the individual.
 The perceptual environment consists of information that is recorded by the sensory
organs.
 The conceptual environment is influenced by language, culture, ideas, and cognition.

3. Health - Refers to the pattern of adaptive change of the whole being

4. Nursing - The human interaction relying on communication, rooted in the organic
dependency of the individual human being in his relationships with other human beings

Relevance of The Conservation Method

According to Levine's conservation model, nursing intervention is a conservation action
with four nursing conservation principles at its core. It directs nurses to focus on what matters
and how people respond at their level. By preserving energy, structure, and moral character on a
personal and social level, nurses achieve the goal of the theory.
Every patient has a unique set of adaptive reactions that change depending on personal
aspects including age, gender, and sickness. Conservation is the central idea of Myra Estrin
Levine's philosophy. An individual can adapt to health issues with the least amount of effort
while they are in a period of conservation. Levine's Conservation Model's major goal is to
enhance a person's physical and mental wellbeing by taking into account the four conservation
domains she identified. This nursing theory directs nurses in giving care that will help sustain
and improve the patient's health by addressing the conservation of energy, structure, and personal
and social integrity.
Myra Estrine Levine has a four principles of conservation;
1. The Conservation of energy of the individual
2. The Conservation of the structural energy of the individual.
3. The Conservation of the personal integrity of the individual.
4. The Conservation of the social integrity of the individual.
Ida Jean Orlando
- A first generation American of Italian descent was born in 1926
- She receives her nursing diploma from New York Medical College, her BS in public
health nursing from St. John’s University, NY, and her MA in mental health nursing from
Columbia University, NY
- Professor at Yale School of Nursing where she was Director of the Graduate Program in
Mental Health Psychiatric Nursing.
- It was from this research that she developed her theory which was publish under 1961
book: The dynamic Nurse-Patient Relationship.
- She also developed her theory when at Mclean Hospital in Belmount, MA as director of
a research Project: Two systems of Nursing in a Psychiatric Hospital.

Metaparadigm in Nursing
1. Person - A developmental being with needs. Nursing clients are patients who are under
medical care and who cannot deal with their needs or who cannot carry out medical
treatment.
2. Environment - Not defined directly in Orlando's Theory but implicity in the immediate
context for a patient.
3. Health - A sense of adequacy or wellbeing, fulfilled needs, and Sense comfort.
4. Nursing - A dynamic nurse-patient relationship. Responsive to individuals who suffer
or anticipate a sense of helplessness. The goal of nursing is increased sense of wellbeing,
increase in ability, adequacy in better care of self and improvement in patient's behavior.

Deliberative Nursing Process Theory

Talking with patients and explaining the plan of treatment is one of the most crucial
things nurses perform. Nevertheless, no matter how carefully thought out a patient's nursing care
plan is, unforeseen issues with the patient's recovery are always possible. It is the nurse's
responsibility to be aware of these issues and know how to handle them so the patient can
continue to recover and regain his or her well-being. Ida Jean Orlando created the Deliberative
Nursing Process, which enables nurses to create a nursing care plan that is both
successful and easily adaptable when and if the patient's needs become more complex.
 The reciprocal interaction between the patient and the nurse is emphasized in Ida Jean
Orlando's nursing theory. It stresses how crucially important patient involvement in the nursing
process is. Orlando regarded nursing as a separate vocation as well. He distinguished it from
medicine, where mandates from doctors, organizational requirements, and previous personal
experiences were not the primary drivers of nurses' actions. She had the opinion that nurses
should not follow a doctor's directions.

Dorothea E. Orem
- Born in Baltimore, Maryland in 1914
- One of America’s foremost nursing theorists
- 1939 – BS Nursing Education
- 1945 – Master of Science in Nursing
- Staff nurse, Private duty nurse, Nurse educator, Administrator and Nurse consultant
- 1976 – Doctor of Science Degree
- Recognized the need to continue developing a conceptualization of Nursing

Metaparadigm in Nursing
1. Person - Distinguished from other living things by their capacity to:
 Reflect upon themselves and their environment.
 Symbolize what they experience.
 Use symbolic creations (ideas, words) in thinking, in communicating, and in guiding
efforts to do and to make things that are beneficial for themselves or others.
 Integrated human functioning includes physical, psychological, interpersonal, and social
aspects.
- Orem believes that individuals have the potential for learning and developing.
2. Environment - An external source of influence in the internal interaction of a person’s
different aspects.
3. Health - Orem supports the WHO’s definition of health as ―a state of physical,
mental, and social well-being and not merely the absence of disease or infirmity. She
states that ―the physical, psychological, interpersonal and social aspects of health
are inseparable in the individual‖.
4. Nursing - Nursing actions are geared towards independence of the client. If the client is
highly dependent, there is a need for the nurse to assist and address the needs of the
client. Nursing is a distinguished human service since its focus is on persons with
inabilities to maintain continuous provision of health care. Nursing is based on values.

Self-Care Deficit theory

 This theory emphasizes the significance for patients themselves of preserving autonomy
over their self-care processes, and it is essential in helping nurses decide what component of
patient care they should focus on in a specific setting. This theory focuses on each individual's
ability to perform self-care, defined as the practice of activities that individuals initiate and
perform on their own behalf in maintaining life, health, and well-being. This theory emphasizes
the significance for patients themselves of preserving independence over their self-care
processes, and it is essential in helping nurses decide what component of patient care they should
focus on in a specific situation.

Martha Rogers
- Born in May 12, 1914 in Dallas, Texas.
- Nursing diploma from General Hospital School in Knoxville Tennessee in 1936.
- Bachelors in nursing from George Peabody College in Nashville in 1937.
- Master’s in public health nursing supervision from Teachers college, Columbia
University in 1954.
- Doctor of Science from Johns Hopkins University, Baltimore in 1954.
- Professor and head of nursing division at New York 1954- 1976.

Metaparadigms in Nursing
1. Person - A person is defined as an indivisible, pan-dimensional energy field identified
by a pattern, and manifesting characteristics specific to the whole, and that can’t
be predicted from knowledge of the parts. A person is also a unified whole, having its own
distinct characteristics that can’t be viewed by looking at, describing, or summarizing the
parts.
2. Health - Rogers defines health as an expression of the life process. It is the
characteristics and behavior coming from the mutual, simultaneous interaction of the
human and environmental fields, and health and illness are part of the same continuum.
The multiple events occurring during the life process show the extent to which a
person is achieving his or her maximum health potential. The events vary in their
expressions from.
3. Nursing - It is the study of unitary, irreducible, indivisible human and environmental
fields: people and their world. Rogers claims that nursing exists to serve people,
and the safe practice of nursing depends on the nature and amount of scientific nursing
knowledge the nurse brings to his or her practice.
 4. Environmental - An irreducible, indivisible, pan dimensional energy field identified by
pattern and integral with the human field.
- Energy Field - The energy field is the fundamental unit of both the living
and the non-living. It provides a way to view people and the environment as irreducible
wholes. The energy fields continuously vary in intensity and density.

Science of Unitary Human Being theory

The work of Martha Rogers has been an important contribution to the nursing community
both for its reframing of the scope of the work being done and for its emphasis on scientific
processes needed to address the problems facing nursing.
It is a model that can be applied to nurses themselves and which dictates that nurses are
inherently linked in health to those around them. If the nurse is unhealthy, so too will be the
patient.
Martha Rogers used her nursing theory of “Science of Unitary Human Beings” to
promote the quality of healthcare delivered to different patients.
The work of Martha Rogers has been an important contribution to the nursing community
both for its reframing of the scope of the work being done and for its emphasis on scientific
processes needed to address the problems facing nursing. It is a model that can be applied to
nurses themselves and which dictates that nurses are inherently linked in health to those around
them. If the nurse is unhealthy, so too will be the patient. You can apply these concepts and
theories to successfully carry out  nursing practice. This theory will help me give all of the
patients a best "nursing services." This theory is significant since it offers the greatest
suggestions for improving nursing practice, something that every caregiver should take into
account.

Rosemarie Rizzo Parse

- Graduate of Duquesne University.
- Master’s & Doctorate at University of Pittsburgh.
- Dean of Nursing School at Duquesne University.
- Editor of Nursing Science Quarterly.
- Two Lifetime Achievement Awards.
- Published 9 books & 100 articles.

Metaparadigms in Nursing
1. Person - Open being is more than and different from the sum of its parts.
2. Environment - Everything in the person and his experiences.
 3. Health - Open process of being and becoming. Involves synthesis of values.
4. Nursing -A human science and art that uses an abstract body of knowledge to serve
people.

Theory of Human Becoming

Consists of three principles and nine concepts flowing from Parse’s assumptions about
humans and becoming. The Theory of Human Becoming was developed to move nursing's view
of the person from a medical model to a human science. In this theory the person is seen as a
participant in situations and nursing's role is to facilitate the patient making choices in their
health experience based on their definitions of health and perceptions of the situation. According
to Parse's theory, the goal of nursing is to try to treat quality of life as each patient sees it for him
or herself. The Human Becoming Theory stands as a comprehensive outlook on human life with
practical applications in nursing and elsewhere in the human experience.