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My Nursing Ontology and how it is influenced by the Nursing MetaparadigmMichelle De Weerd Student ID: 3405195Athabasca UniversityAuthor NoteMichelle De Weerd, Faculty of Health Disciplines, Athabasca UniversityContact: mdeweerd1@athabasca.eduAbstractOntology is defined as the theory about the nature of being or the kinds of things that have existence (Merriam-Webster, n.d.). It is the study of things that exist and the study of what is. Each individual nurse needs to understand their personal nursing ontology and what nursing means to them. This paper will examine my nursing ontological views and how this is influenced by the metaparadigms of nursing, including health, environment, and person. My Nursing Ontology and how it is influenced by the Nursing MetaparadigmNursing practice is defined as “facilitating, supporting, and assisting individuals, families, communities and societies to enhance, maintain and recover health, and to reduce the effects of illness” (Thorne, et al., p. 1265). This overarching definition of nursing practice is the basis for my individual nursing ontological stance and is largely influenced by the metaparadigm of nursing. My Ontological StanceWatson writes that, “nursing is a lifetime journey of caring and healing, seeking to understand and preserve the wholeness of human existence, and to offer compassionate, informed, knowledgeable human caring to society and humankind” (Watson, p. 479, 2009). Nursing with compassion and empathy, allows for holistic, patient-centered care that honours the whole human being (Watson, 2009). In my nursing practice, I place the patient at the center of care and the focus of my attention (Thorne et al., 1998). Through patient-centered care, I develop purposeful therapeutic relationships which allows me to understand the needs, wants, and preferences of the patient beyond their disease. This view is supported by Thorne et al., who writes, “The person is more than the disease, indeed a composite of physical, psychological, social and spiritual dimensions” (p. 1259, 1998). I believe active listening and patient advocacy are vital parts of what patient centered care is. Through active listening, I begin to understand the lived experiences of my patients and therefore, understand how to advocate and care for their needs (Thorne et al., 1998). Peplau’s theory of interpersonal relations supports active listening to promote purposeful communication (Senn, 2013). It is important to respect and advocate for patient’s rights, values, customs, and health as we hold knowledge and spend the most time with patients and their families and therefore are in the best position to advocate for their needs and wellbeing (Choi, 2015). In summary, my nursing stance centers around the human caring theory; nursing with compassion, empathy, and active listening that centers around patients as whole human beings. My nursing stance values developing therapeutic relationships with patients enabling me to confidently advocate for their rights and promote the best possible patient care. The Metaparadigm of Nursing The concepts of the nursing metaparadigm include person, health, environment, and nursing (Thorne et al., 1998). Person goes beyond the individual patient to also include their family and community (Thorne et al., 1998). Health refers to the patient’s overall wellbeing and their own perception of their health (Salem, 2016). The environment is both the external and internal factors that affect a patient’s treatment and health. Finally, nursing refers to the physical, hands-on actions of a nurse (Salem, 2016). Each of these paradigms influence my nursing ontology in unique ways. Nursing with compassion and kindness through active listening and human caring considers the patient as a whole and includes their families and communities as part of that whole (Thorne et al., 1998). It honours the whole human being as a person (Watson, 2009). Patient-centered care allows for the “individual person to be the basic focus of nursing’s attention (Thorne et al., p. 1258, 1998). Seeing the patient as more than their disease and focusing on their lived experience (Thorne et al., 1998), fits into the person paradigm as well. My nursing ontology is influenced by the environment paradigm as providing compassionate and empathetic nursing care in a holistic manner allows one to understand how a patient’s environment and social culture affects and shapes their health (Watson, 2009). It is important for nurses to be aware of the “social structures that constrain person’s health, limit their life possibilities, and restrict their equal and fully conscious participation in society” (Thorne et al., p. 1262, 1998). The paradigm of nursing influences how I physically care for my patients. As Thorne et al., writes, “it is thought that a focus on caring would serve to reposition nursing at the client’s side attending to persons rather than machines and technology” (Thorne, et al., p. 1264, 1998). When physically caring for patients, I aim to focus on the patient and their families rather than the machines at the bedside, therefore providing quality patient centered care. The health paradigm hugely influences my nursing ontology. A patient’s health “cannot be conceptualized as anything less than a reflection of the whole person” (Thorne et al., p. 1261, 1998). Through the human caring theory and patient-centered care, I consider how the individual views their own health and what a healthy lifestyle means to them. It is important to be aware of the “social structures that constrain person’s health, limit their life possibilities, and restrict their equal and fully conscious participation in society” (Thorne et al., p. 1262, 1998) and this is obtained through active listening which then promotes patient advocacy to best care for patients and promote their health. Social Justice My nursing ontology is also influenced by social justice. Through active listening, person-centered care, and nursing with compassion and empathy, nurses can advocate for the health rights of all individuals. “Equal access to the benefits and protections of society are characteristics of a just society and a caring profession” (Schim, p. 78, 2007). Regardless of a patient’s culture or background I believe in “championing social justice to ensure universal access to adequate nursing care” (Choi, p. 54, 2015) for all patients. Importance of published critiqueImmersing myself in scholarly articles such as the one written by Thorne et al. (1998), has a significant impact on my ontological stance as it allows me to integrate credible resources into my understanding of myself as a nurse and “how and why nursing operates within a society” (Thorne, et al., p. 1265, 1998). Furthermore, using scholarly articles allows me to define myself as a nurse, and believe “that we do what we do for some important social purpose” (Thorne et al., p. 1266, 1998). Reviewing published articles that critique the metaparadigms and ontology of nursing enables me to remain open minded as I progress through my nursing career to the changes within nursing and my own evolving nursing ontology. ConclusionPatient-centered care and human caring with compassion, empathy, and patient advocacy is an integral part of my nursing ontology. My nursing ontology fits into the entire metaparadigm of nursing because through caring I understand the whole patient beyond the disease, the patient’s understanding of their own health, and how the patient’s environment influences their health. Furthermore, it is important to consider critiques of nursing ontology and the nursing metaparadigm so that my definition of who I am as a nurse and how I view the nursing profession are based on relevant high-quality scholarly sources. ReferencesChoi, P. P. (2015). Patient advocacy: The role of the nurse. Nursing Standard (2014+), 29(41), 52. doi: Press Encyclopedia of Health (2016). Metaparadigm of concepts in nursing. Retrieved from: Schim, Benkert, R., Bell, S. E., Walker D., & Danford, C. (2007). Social Justice: Added Metaparadigm concept for urban health nursing. Public Health Nursing (2007), 24(1), 73-80. Retrieved from: charon.athabasca.ca/cnhsgrad/nurs608_s2019/docs/Schim_2007.pdfSenn, J. F. (2013). Peplau’s Theory of Interpersonal Relations: Application in Emergency and Rural Nursing. Nursing Science Quarterly 26(1), 31-35. doi: , S., Canam, C., Dahinten, S., Hall, W., Henderson, A., & Kirkham, S. R. (1998). Nursing’s metaparadigm concepts: disimpacting the debates. Journal of Advanced Nursing (1998), 27(6), 1257-1268. doi: , J. (2009). Caring science and Human caring theory: Transforming personal and professional practices of nursing and health care. Journal of Health and Human Services Administration, 31(4), 466-482. Retrieved from ................
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