Introduction
This paper highlights some of the personal reflections on and future implications of the application of selected nursing theories. This paper explores theories related to nursing care and the human experience; and how certain elements of said theories relate to personally held values and aspirations. Theories include those of Martha Rogers and M. Simone Roach. Discussion of relation of these theories to wholeness, futurism, authenticity, and respect follow.
Personal Story
Service to the Community
From a young age, I always knew that I wanted to help others. As vague and cliché as it may seem, this was one of the driving forces for me to eventually see nursing as my true calling. In short, I have always been passionate about serving my community. Offering my time and effort to those in need has always brought me a great deal of satisfaction and joy. Many of the resources provided to aid those in the local community are based through the work of non-profits and volunteerism. I was once told that if we all spent an hour per week providing service, many organizations and charities would never know low funds or volunteer shortages. This inspired me to approach service on a larger scale. Nurses are many things, and of those many, nurses are always strong advocates. Serving others through advocacy (among other attributes) has inspired me to become a nurse.
Medicine and Healing
Along with an interest in service, for as long as I can remember, I have always loved learning about medicine and health. I can remember reading a book of diagnoses when I was about 10 years old and just being enthralled with knowing the signs, symptoms, and treatments for common ailments. I don’t know where the book came from, but as soon as someone in the house was feeling unwell, I would consult the book for remedies. I loved the idea of treating people, and from then on had a strong feeling healthcare would suit me. Career ideas came and went over the next decade or so, but one final passion lead me to nursing.
Compassion and Kindness
Out of anything, something I am most passionate about is providing compassion and kindness to others. I firmly believe that compassion is the framework of providing any service, whether that pertains to the community or to those receiving care. For many years, I involved myself in a school-based national movement that worked to spread compassion through simple deeds and actions. It showed me that even one kind action can cause a “chain reaction” of compassion. What it also did was foster the idea within me that I was meant to provide compassion to others through healing service. Nursing is the culmination of all my interests, ideas, and passions; and I wouldn’t dedicate myself to any other career path. Further, in my current practice I have found ideas that emulate my own values in nursing as well as inspire future aspirations in the field.
Literature Review
The Science of Unitary Human Beings
Bridging the science and the art of nursing. Martha Rogers was an influential nurse theorist who originally developed the idea of The Science of Unitary Human Beings in 1970
(Alligood & Fawcett, 2004). Rogers’ initial theory sought to “view nursing as understanding and caring for human beings in the wholeness and mutuality of the person-environment process;” meaning that patients were to be viewed as a unit, not separate from their environments (Alligood & Fawcett, 2004). Rogers developed the idea that nursing itself is not based on isolated tasks or having the knowledge, it is based on a plan of care that relies more on the use of said knowledge and critical thought to care for the unique individual (Rogers, 1994). With that in consideration, Rogers did not see nursing rooted solely in facts, skill, or intuition. Rather, she saw it as all three. Rogers helped to “bridge the gap” between the science and the art of nursing (Rogers, 1994). The aforementioned “knowledge,” and “sets nursing up as an independent discipline and a science” rooted in the idea of “unitary irreducible humans and their world” (Rogers, 1994, pp. 68-69). The art involves Rogers’ highly-emphasized “non-invasive modalities” such as color, therapeutic touch, and even humor. Blending these together creates nursing that cares for every aspect of a human being, body, mind, and “energy-spirit” (Rogers, 1994, p. 73).
Change as a means for healing. In addition to Rogers’ idea of nursing as a dualistic profession, Rogers’ theory of Unitary Human Beings also focused on the idea that inevitable change is what incites healing. Rogers, a self-described “futurist,” gave way to ideas of nursing and healthcare shifts long before they occurred (Rogers, 1994, p. 78). Rogers, in a more current iteration of her original theory, stated that the change in wellness would move to preventative care from acute care, focusing on changing nursing to a more “community-based” profession (p. 72). Within the idea of change, Rogers also theorized that with the changing universe, humans and their focuses tend to stay consistent. Further, Alligood and Fawcett (2004) sought to study the use of Rogers’ idea of “patterning,” the way in which she described the observable ways human energy stayed constant in the midst of change (p. 277). In the review of three works of
Rogers’ literature, there was a consistent use of the words “pattern” or “patterning” to describe this phenomenon (Alligood & Fawcett, 2004, p. 280). Meaning, within the updates to her original theory, Rogers kept true to the idea of humans (and patients) as whole, and that “patterning of the life of a patient…is an observable emergent of the person environment process” (Alligood & Fawcett, 2004, p. 280).
Caring, the Human Mode of Being
The six c’s of caring. In 1987, M. Simone Roach wrote the book entitled Caring, the Human Mode of Being that subsequently gave way to the theory of the same name. This theory, in essence, detailed the importance of caring in its relationship to nursing. Roach detailed that caring itself “is essential to human development. One becomes fulfilled…as one’s capacity to care is called forth, nurtured and appropriately expressed” (Roach, 1987, p. 38). Caring, as
Roach explained, can be broken down into “The Six C’s,” which are “compassion, competence, conscience, confidence, commitment, and comportment” (Roach, 1987, pp. 45-48). Compassion explores empathy, competence highlights understanding of the experience, and confidence is the instillation of faith in oneself. In addition, conscience is trusting what is right, commitment is refusing to stop, and comportment is behaving professionally and truthfully (Roach, 1987, pp. 45-48). Each modality of caring highlights exactly what a nurse is doing when they are caring for an individual; or what they should be striving for when nursing a patient. As roach theorized, caring and the ability to care go hand in hand when working within and dealing with the human experience (Terry et al. 2017).
Caring as the center of practice. Not only did Roach propose caring as essential to nursing practice, Roach solidified the idea that caring is the center of nursing practice. Without caring, nursing is not as vastly different from other professions as it is thought to be. Roach detailed that caring “alone embodies certain qualities; it exists as the sole example of specific characteristics,” which are unique to the profession of nursing (Roach, 1987, p. 39). Further,
“caring is the locus of all attributes used to describe nursing” and differentiate it from all else (Roach, 1987, p. 39). Nursing fosters the idea of nurturing the ones we serve in a caring environment, delivering fully upon The Six C’s. We work as examples of Roach’s theory, and Terry et al. (2017) proposed a study to help nurses articulate an understanding of The Six C’s once put into practice through compassionate care. It was found that nurses identified with various books, journals, poems, and films to help them understand ideas of compassion, commitment, and confidence within their practice (Terry et al. 2017). This study shows that although nurses may not think through The Six C’s specifically, they emulate Roach’s ideas into practical caring application.
Professional Transformation
A Rogerian Perspective
Being considerate. Some may find difficulty in seeing people as pieces of a larger puzzle, or see the bigger picture when it comes to care. To me, Rogers’ idea of Unitary Human Beings (1994) means consideration for the human experience in its entirety. We cannot reduce people down to one attribute when it comes to providing care. They are not just their illness, their condition, their current state of being. They are a person with feelings, thoughts, and needs like the ones caring for them. As Rogers’ details, “we are going to have to look at what it is people need and where is the role and knowledge of nursing to provide it” in order to go forth and provide adequate care (1994). Rogers’ emphasized the idea that care is not made of tasks, it is made of experiences made to fit each person. Going forward, I intend to continually consider the person first before all else, preconceived notions aside. I will learn more communicating with a patient than I ever will solely from looking at a chart.
Recognizing change in all forms. Additionally, Rogers’ Unitary Human Beings theory
emphasized both the constancy of the human experience along with the idea that the world is ever changing (1994). While this is paradoxical at the first glance, to me, this makes perfect sense. Knowing that according to Rogers (1994), the idea that humans have a theorized “pattern” of being helps to simplify and standardize care. Simultaneously, as things evolve within care (technology, scope of practice, healthcare costs, etc.) we can create a moldable standard of care that fits the person and the time being. We cannot stray from our roots as nurses or as caregivers, but we also cannot fall victim to becoming stagnant and resistant.
Roach’s Influence
Authenticity to self. In more than one way, Roach’s idea of caring as a human mode of being works to create the idea that caring should come from a place that is not fabricated or effortless. Caring is not necessarily a skill that can be taught, but a need that is consciously filled by all people, nurses and non-nurses alike (Roach, 1987, p. 56). Therefore, providing care should be authentic, and authenticity to others does not come without authenticity to oneself first and foremost. To me, being authentic means being present with every interaction. Authenticity should be the motivation behind all aspects of care. Without authenticity, we are not providing truly compassionate care. Caring is not hollow, it is not empty. Caring is “a total way of being, of relating, of acting in and of the investment and engagement in the other” (Roach, 1987, p.
39).
Respect for others. An essential attribute that M. Simone Roach provided in her nursing philosophy was the idea that caring is a way of providing respect to others, whether that is in a formal care setting or outside of one. Respecting others does not mean just respecting them as a person (an important detail), it also means respecting what is meaningful to them. “Care is the virtuous life,” as Roach mentioned; and a virtuous, caring life is filled with respect for all forms of life (1987, p. 39). Many find “life” in their passions and what they enjoy. To me, respecting people and the things they care about is what defines truly compassionate care. If we cannot satisfy all needs, the least we can do is satisfy the need for respect and understanding on the most basic human level.
References
Alligood, M.R., Fawcett, J. (2004). An interpretive study of martha rogers’ conception of pattern. Visions: The Journal of Rogerian Nursing Science, 12(1), 8-13.
Roach, M. S. (1987). Caring, the human mode of being: A blueprint for the health professions.
CHA Press.
Rogers, M. E. (1994). The science of unitary human beings: current perspectives. Nursing
Science Quarterly, 7(1), 33-35. doi:10.1177/089431849400700111
Terry, L., Newham, R., Hahessy, S., Atherley, S., Babenko-Mould, Y., Evans, M., . . . Cedar, S. (2017). A research-based mantra for compassionate caring. Nurse Education Today, 58, 1-
11.
