My View of the Ontological Dimension of Nursing



My View of the Ontological Dimension of NursingAssignment #1Edna M. Grajalesfor Dr. R. KohrMHST/NURS 608Athabasca UniversityJune 4, 2019AbstractThe metaparadigm of nursing concepts appropriated by Fawcett (1984) include person, environment, health, and nursing. These concepts will be closely examined in relation to personal perspectives and experience in community health nursing as a public health nurse. The concepts of social justice are also addressed within each concept as an integral part of this practice area. Nursing knowledge (epistemology) as well as a perspective of nursing (ontology) is also discussed.Keywords: Ontology of nursing, ontological perspective, ontological dimension, metaparadigm of nursing, metaparadigm, community health nursing, public health nursingMy View of the Ontological Dimension of NursingIn this paper, I attempt to answer the question of what it personally means to be a nurse. I will explore contributing factors to my response in the context of my current experience in community health nursing as a public health nurse, which may include shared views within other nursing practice areas. I will then explore Fawcett’s (1984) metaparadigm of nursing concepts, which include person, environment, health, and nursing as it relates to my ontological perspective and what I refer to as nursing service. I will also address Bender’s (2018) perspectives on my personal views and examine the notion of social justice as a central concept to community health nursing.Metaparadigm of Nursing“Fawcett appropriated a set of “notions” that were popular in nurse education curricula in the 1970s and interpreted them as “the central concepts of the discipline” (Fawcett, 1984, p. 84). Her purpose was to set nursing apart from other sciences by identifying the necessary types of knowledge seen as foundational within the discipline rather than providing a perspective of nursing (Bender, 2018). Fawcett (1984) describes the concepts of the metaparadigm of nursing as non-relational and independent domains. However, I agree with Bender (2018) that these concepts have an interdependent relationship and cannot be fully understood in isolation without consideration of the other concepts. This viewpoint allows for a more holistic approach by the community health nurse.PersonThe first concept of the metaparadigm of nursing is Person. Person is described as “individuals, families, groups, communities, and populations” receiving nursing services (Community Health Nurses of Canada, 2019) to address a diversity of health issues and needs (Schim, Benkert, Bell, Walker & Danford, 2007). I believe person as an individual is understood as having their own context and experiences that make their intersection with healthcare unique to their situation. An example of this in community health nursing is a parent seeking parenting support for their two-year old child. Although there is are common developmental milestones for a two-year old, health teaching is based on the parent’s specific concerns, the child’s temperament, and the dynamic of the parent-child relationship. On the other end of the spectrum, person as a population is seen as having a common health need. Nursing services at a population health level, implements interventions that assist in shifting the health status of the population of interest in a desirable direction. In community health nursing, an example of this includes teaching related to health eating. As population knowledge increases related to healthy eating, risks related to poor nutrition decreases, thus increasing the health of the targeted population.EnvironmentThe next concept of the metaparadigm of nursing is Environment. The environment in which the person exists is impacted by internal and external factors that influence health and nursing service (Salem Press Encyclopedia of Health, 2018) and is closely interrelated to the person. These internal and external factors for clients in the community include facets of both the physical and psychosocial environment, political and economic factors (Schim et al., 2007), as well as the social determinants of health. According to the World Health Organization (n.d.), the social determinants of health are the conditions in which people are born, grow, live, work and age. Each factor can have a variety of impacts on a person’s health outcomes that are often beyond a community health nurse’s scope of practice in addressing. However, a community health nurse must understand that these factors contribute to a person’s health context, their interpretation and response to nursing service. Furthermore, it is equally important for community health nurses to draw on various types of knowledge and consider health equity principles during nursing service. HealthThe third concept of the metaparadigm of nursing is Health. Health refers to the physical, psychological, emotional, and spiritual aspects of well-being as defined by the person (Salem Press Encyclopedia of Health, 2018). It references the spectrum of health ranging from wellness to illness (Schim et al., 2007). This concept also includes a person’s access to healthcare, and other supports. As Fawcett (1984) explains, it is necessary to plan nursing service based on the person’s health goals and their level of acceptable health. I believe this is an essential aspect of community health nursing when visiting clients in their home. Clients are recognized as the expert within their own lives including their health and take the lead in collaboration of nursing service. Nurses use knowledge to help guide this process, allowing clients to make informed decisions regarding their health.NursingThe last concept of the metaparadigm is Nursing. This concept is described in community health nursing as the actions that a nurse takes to promote and maintain health, or prevent disease, illness and injury. It also includes the application of knowledge, understanding and skill of nursing knowledge while incorporating person and family centred care. Fawcett & DeSanto-Madeya (2013) describe nursing as involving the person and nurse, and includes activities known as the nursing process of assessment, nursing diagnosis, planning, implementation, and evaluation. In my experience as a public health nurse, the nursing process aims to address the concepts of human rights and equity. It also requires community health nurses to incorporate knowledge of culture and ethnicity of the populations receiving nursing service, which Schim et al. (2007) states is crucial to nursing practice. ConclusionI have described Fawcett’s (1984) metaparadigm of nursing as it relates to my experience as a public health nurse in community health nursing. Each concept is described incorporating aspects of social justice that are embedded within my practice area and personal practice. Social justice also guides public health practice in changing systems to assist marginalized groups in meeting their health needs. I believe that it is within the context of exploring the metaparadigm of nursing aspects further and specifying interpretation in relation to my own practice and beliefs about nursing, that I agree with scholars like Bender (2018) that the metaparadigm of nursing is a useful construct and framework that has contributed to my unique perspective or view about the discipline, also known as ontology of nursing.ReferencesBender, M. (2018). Re‐conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry,?25(3), 1-munity Health Nurses of Canada (2019). Canadian community health nursing professional practice model & standards of practice. Midland, ON: AuthorFawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. The Journal of Nursing Scholarship, 16(3), 84-88.Fawcett, J., Desanto-Madeya, S. (2013). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. Philadelphia, PA: F.A. Davis CompanyKim, H.S. (2015). The essence of nursing practice: Philosophy and perspective. New York, NY: Springer Publishing Company, LLCSalem Press Encyclopedia of Health (2018). Metaparadigm?concepts in?nursing. Retrieved from , S., Benkert, R., Bell, S., Walker, D., & Danford, C. (2007). Social justice: Added metaparadigm concept for urban health nursing. Public Health Nursing, 24(1), 73-80 ................
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