Modeling & Role-Modeling Theory

Helen C. Erickson

Presented by: Claudette Erungel & Elizabeth Semmelmann

Professional Background
Saginaw General Hospital of Nursing-1957
◦ Emergency Room
◦ Medical –Surgical Nurse
BSN University of Michigan-1974
Masters Degree-1976 medical-surgical &
psychiatric nursing
PhD Educational Psychology-1984
Holistic Spiritual View
AHNA 2012 Holistic Nurse of the Year
History

Modeling and Role Modeling: A Theory and Paradigm

for Nursing

◦ Published:1983
◦ Contributing Authors: Evelyn M. Tomlin & Mary Ann P.
Swain
Wholistic Model Holistic Model

Wholistic vs. Holistic

(Reference Figures: Erickson, Tomlin, & Swain, 1983, p. 45-46)
Modeling and Role Modeling Theory
Concepts drawn on:

◦ Piaget's Theory of Cognitive Development

◦ Maslow's Theory of Hierarchy of Needs

◦ Erikson's Theory of Psychosocial Stages

◦ Selye and Lazarus's General Adaptation Syndrome

Modeling and Role Modeling Theory
Modeling

A process that enables the nurse to understand the patient’s unique

perspective of his or her world and to learn to appreciate its value

and significance.

“…the nurse…develops an image and understanding of the client's

world as the client perceives it…" (Erickson, et al., 1983, p. 254)

Modeling and Role Modeling Theory
Role-Modeling
A process by which the nurse accepts the patient unconditionally.

“The facilitation and nurturance of the individual in attaining, maintaining or

promoting health through purposeful intervention." (Erickson, et al., 1983, p.
254)

In other words, the patient helps guide the care plan.

Nursing Paradigm: The Patient

The patient is the expert!

Unique perspective of his or her world

Combination of body, mind, emotion, & spirit

Think patient-centered care

Nursing Paradigm: The Patient
Affiliated Individuation
◦ Support system accepts patient’s individuality

Self-Care

◦ Knowledge - Resources – Actions

Response to stressors
Adaptation Potential
 Equilibrium vs. maladaptive equilibrium
 Arousal
 Impoverishment
Nursing Paradigm: The Nurse

Nurses Roles
1. Facilitation
2. Nurturance
3. Unconditional Acceptance
Nursing Paradigm: The Nurse
Five goals of nursing intervention
1. To build trust
2. To promote the patient's positive orientation
3. To promote the patient's control
4. To affirm and promote the patient's strengths
5. To set mutual, health-directed goals.
Nurse-Patient Relationship

(Reference Figure: (Erickson, et al., 1983, p. 44)

Nursing Paradigm: The Environment
What can promote optimal health?
◦ Strong support system
◦ External resources

What can detract from optimal health?

◦ Stress and Anxiety
◦ Attachment and Loss
Nursing Paradigm: Health
Intrinsic Abilities

◦ Genetics and prenatal/perinatal occurrences

Selye’s General Adaption Syndrome

◦ Physiological response to stress

Psychosocial Stages → attitudes & strengths

Cognitive Abilities → depend on sequence
Nursing in the 1970s
Hospice founded in 1971
Center for Research created from Division Nursing grant in 1975
Nurses Health Study began in 1976
Promotion of minority nurses
Nurse Practice Act
National Certification programs for nursing specialties began
Critical nursing shortage due to Medicare expansion
What does this mean?
Nursing research became recognized.
Nursing training moved from hospital setting to universities and colleges.
More nursing specialties were established (ex. Nurse Practitioner and
Doctorate of Nursing).
Focused patient care became more defined.
First nurse strike happened. Salaries improved.
Nursing force became more diverse.
Educational impact on nursing
1997-American Association of College of Nursing

“…baccalaureate nursing schools have the responsibility to

provide education that emanates from nursing’s core values, which
include caring for the person, facilitating healing, and protecting
the environment.” (Erickson, 2007)
2004-American Holistic Nurses’ Certification Corporation offers
two holistic nursing certifications (HN-BC & AHN-BC)
Modern Practical Use of MRM
Acute Setting
◦ Patient perceptions of care (HCAHPS) guide Medicare
hospital reimbursements
◦ Example: Depression Diagnosis and Hospital Readmissions
Modern Practical Use of MRM
Long Term Care
◦ Nursing roles of facilitation, nurturance, and unconditional
acceptance are essential for optimal health.
◦ “…people could die and still be healthy if they experience
comfort and peace in their mind and soul and were connected
with loved ones.” (Erickson, 2007)
Modern Practical Use of MRM
Ambulatory Care
◦ Currently, health plans and hospitals are establishing care management
teams to case manage, educate, and promote self-care of patients with
complex chronic disease using individualized care plans.
◦ This team reduces readmission rates and ED visits.
◦ The focus is connecting the patient with resources, establishing a better
support system, and developing coping skills for stress and anxiety.
Modern Practical Use of MRM
Cultural competency
ETHNIC framework
Complimentary/alternative modalities (CAM)
Integrative medicine
Patient-centered care
Reference List
Erickson, H. L. (2007). Philosophy and Theory of Holism. Nursing Clinics of North America, 2, 139-163.

doi: 10.1016/j.cnur.2007.03.001

Erickson, H. L., Tomlin, E. M., & Swain, M. P. (1983). Modeling and Role-Modeling: A Theory and Paradigm for

Nursing. Englewood Cliffs, NJ: Prentice-Hall, Inc.

Sappington, J. and Kelley, J. H. (1996). Modeling and Role-Modeling Theory: A Case Study of Holistic Care.

Journal of Holistic Nursing, 14:2, 130-141.

Nursing Planet | Nursing Theories. (2012). Retrieved April 16, 2015, from

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Why I Want To Be A Nurse . Org | Helen C. Erickson-Nursing Theorist. (2011). Retrieved April 16, 2015, from

http://www.whyiwanttobeanurse.org/nursing-theorists/helen-erickson.pho

Nursing Theory | Helen C. Erickson-Nursing Theorist. (2013). Retrieved April 16, 2015, from

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