Ramona Mercer's Maternal Role Attainment: Nursing Theory ...



Ramona Mercer's Maternal Role Attainment: Nursing Theory EvaluationMonique VeneyCoppin State UniversityNURS 620: Theoretical Foundations of NursingDr. Patricia SetlowJanuary 22, 2015Ramona Mercer's Maternal Role Attainment: Nursing Theory EvaluationNursing can be defined as both a discipline and profession. The work of pioneers such as Florence Nightingale and nursing theorists in the vocation turned profession, have help lead to the recognition of nursing as both an academic field of study (discipline) and a highly reputable specialized field of practice (profession). Since the work of Florence Nightingale in early 19th century, many additional theorists and their contributions to the profession have been recognized. The work of other theorists such as Ida Jean Orlando, Jean Watson and Patricia Benner, to name a few, in addition to Nightingale, have paved the way for the growth of professional nursing practice. One modern nursing theorist whose work has had substantial influence on the way in which maternal-child health nursing is viewed and practiced is Ramona Mercer. Her theory of Maternal Role Attainment is significantly relevant to how these nurses work with mothers and their children. The theory seeks to describe and highlight the way in which women develop into their new roles as mothers and caretakers. Much of Mercer’s early career and life work has been dedicated to the study of role identity in motherhood. Ramona T. Mercer, born in 1929, was initially educated as a diploma nurse and later received her bachelor’s, master’s and doctorate degrees from various educational institutions. Her master’s and doctorate degrees are both in the area of maternal-child nursing and her early career work in academia are also in the field of maternal and family nursing. Dr. Mercer has published and written extensively about her work and is the recipient of numerous nursing and educational awards. Her research has focused primarily on the role of motherhood and led to the publication of six books on the subject since 1979. Throughout her career and research, she has worked with and published extensively with breastfeeding mothers, adolescent mothers, mothers with postpartum depression and mothers of infants born with congenital defects (Alligod & Tomey, 2010). Description of TheoryMercer’s most famous work is her development of the Maternal Role Attainment (MRA) theory based on her mentor Reva Rubin’s earlier theory of maternal role attainment (1978). MRA theory is also loosely based on developmental theorists such as Turner, Mead, Thornton and Bronfenbrenner and has been widely accepted in nursing, psychology and sociology (Alligood & Tomey, 2010). The foundation of Mercer’s theory is that there are many different factors or variables that influence the maternal role, how women progress or develop into the role and how the perceive themselves in that role. All of these factors them in turn influence the attachment and bonding that occurs between mother and child, therefore, also impacting the health of woman, child and the family.The theory of Maternal Role Attainment uses many concepts that makes its use practical among the different academic disciplines but more importantly to the nursing profession and nursing practice. There are more than twenty concepts identified and defined within Mercer’s theory. The two majors concept identified and most closely related to the understanding of the theory are maternal role attainment and maternal identity. According to Alligood and Tomey, maternal role attainment is defined as “an interactional and developmental process occurring over a period of time, during which the mother becomes attached to her infant, acquires competence in the care-taking tasks involved in the role, and expresses pleasure and gratification in the role”. Likewise, maternal identity is defined as “having an internalized view of the self as a mother” (Alligood & Tomey, 2010, p. 584). Understanding these two defined concepts is integral to understanding the basis of Mercer’s work.Similarly, understanding the major assumptions that underlie Mercer’s theoretical work is equally as important as well understanding the context for in which they are used. The assumptions provide a framework for application of the theory in nursing practice. These six assumptions as outlined by Mercer in Alligood and Tomey’s Nursing Theorists and Their Work are:A relatively stable core self, acquired through life long socialization, determines how a mother defines and perceives events; her perceptions of her infant's and others' responses to her mothering, with her life situation, are the real world to which she responds. The mother's developmental level and innate personality characteristics also influence her behavioral responsesThe mother's role partner, her infant, will reflect the mother's competence in the mothering role through growth and developmentThe infant is considered an active partner in the maternal role-taking process, affecting and being affected by the role enactmentThe father or mother's intimate partner contributes to role attainment in a way that can't be duplicated by any other supportive personsMaternal identity develops with maternal attachment and each depends on the other ((Alligood & Tomey, 2010, p. 586)Theory AnalysisConcepts used within theories must be defined to avoid confusion or ambiguity in meaning for the reader of the work. Theoretically, definitions may have multiple meanings in different disciplines of study. However, Mercer carefully defines the concepts that give meaning to the use of this theory (operational definition).Additionally, the theory of maternal role attainment uses a visual model (image) to depict the intertwining of the various factors that exert influence on role attainment in motherhood.Theory EvaluationMercer’s theory is congruent with both current nursing standards as well as advance nursing practice interventions. Although the theory was first developed and recognized in the 1970s and 80s, its use and application is still practical in nursing of mothers and infants today. It Maternal role attainment theory and maternal role identity are still widely taught and used in nursing programs and nursing practice. Alligood and Tomey note that Mercer’s theory and research that has been conducted based on her theory, “linked her research findings with nursing practice at each interval from birth through the first year, making her theory applicable in a variety of pediatric settings” ((Alligood & Tomey, 2010, p. 591).Further proof that MRA theory is relevant throughout nursing, occurs in its use within literature. Mercer’s theory is both socially and culturally relevant and she has conducted research on the maternal role and maternal identity on various populations of mothers. She has done work on adolescent mothers, first time mothers, mothers of medically fragile infants and mothers of different age groups. One research article by Copeland and Harbaugh, “Transition of Maternal Competence of Married and Single Mothers in Early Parenthood”, studies differences in mothering role identity of single vs. married mothers (2004). Nursing theory is important to the furtherance of the discipline and profession. Another article by Fenwick et al. (2008) is useful in nursing practice to help mother of infants in neonatal or special care nurseries make the transition and assume their mothering role even when they may are not physically be able to be close to their babies due to their medical conditions. The use of Mercer’s theory across different areas of nursing and its applicability in nursing practice, education and research make it both socially and culturally relevant. The theory transcends academic disciplines, racial classes and age groups.The work of Ramona Mercer and other nurse theorists has been foundational for the recognition of nursing as discipline. Nursing theories serve as a basis for knowledge that will affect nursing practice. The maternal role attainment theory and other nursing theories help guide nursing’s knowledge about and practice about how to best help new mothers transition from being a women who is carrying or birthing a child into a woman who identifies with the role and obligations associated with motherhood. The theory helps the nurses assess, plan, implement and evaluate care of mothers and children. Furthermore, the inclusion of nursing theories such as the MRA help the practice aim educational and interventional programs at mothers who are at risk for not transitioning well into their role. Advanced practice nurses who work in obstetric services (nurse midwives) or with pediatric patients (family nurse practitioners or pediatric or neonatal nurse practitioners) can also benefit from knowing Mercer’s work as they care for their clientele specific. They often see both mother and child interactions and maybe aware of family dynamics and factors that exert an influence on how well mothers do or do not transition into their role or identity. Their added clinical knowledge and experience may also help to identify women or mothers with postpartum depression and be in need of intervention. Theory and scientific knowledge within nursing are key to ensuring the future of the nursing and nursing practice flourishes as a practice and a discipline.ReferencesAlligood, M. R., & Tomey, A. M. (2010). Chapter 27: Ramona T. Mercer. In Nursing theorists and their work (7th ed., pp. 581-598). Maryland Heights, MO: Mosby Elsevier.Copeland, D. B., & Harbaugh, B. L. (2004, Fall). Transition of maternal competence of married and single mothers in early parenthood. The Journal of Perinatal Education, 13, 3-9. Retrieved from , J. Barclay, L. & Schmied, V. (2008). Craving closeness: A grounded theory analysis of women's experiences of mothering in the Special Care Nursery. Women and Birth, 21, 71–85. ................
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