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CNUR 805 The Evolution Of Theoretical Knowledge

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CNUR 805 The Evolution Of Theoretical Knowledge

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CNUR 805 The Evolution Of Theoretical Knowledge

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Course Code: CNUR805
University: Ryerson University is not sponsored or endorsed by this college or university

Country: Canada


Reflection on nursing metaparadigm concepts. All the four fundamental concepts of nursing, patient, environment and health are discussed in elaborate way. Florence Nightingale, the Lady with the lamp is considered as the nursing theorist while reflecting on the metaparadigm concepts.


The following paper intends to discuss the nursing metaparadigm concepts in an elaborate manner. The nursing metaparadigm comprises of theoretical ideas which provide a structural framework on nursing discipline taking in to consideration various nursing theories. The theories describing metaparadigm revolve around four fundamental concepts centred on patient as a whole. These metaparadigm concepts gives a holistic view of nursing care to ensure patient’s health and well-being. Among plentiful nursing theories, I have chosen nursing theories of Florence Nightingale to reflect on my personal perspectives on nursing metaparadigm concepts. Florence Nightingale’s nursing theories share a congruity with anti-contagionism basis of thought. Her nursing theories are based on real life nursing experiences; thus her theories of nursing are rooted to empiricism which is based on her nursing knowledge. Nursing theories of Florence nightingale are directly focussed on the environmental circumstances and their role in developing patient’s health. Her theories are framed through validation of nursing care roles that she performed during nineteenth century to improve sanitary conditions and promote reduced mortality among patients. This is the reason I chose nursing theories of Florence Nightingale to reflect on the metaparadigm concepts.
The nursing theory of Florence Nightingale is based on her personalized nursing experience, unlike thoughtful ideas of mind. According to her nursing views, the nursing discipline is different from that of medicine and should not be confused with medicine approach. Nightingale addresses in her nursing theories that nursing care is intended to provide a healing environment where a patient can be acted upon by best possible interventions to achieve quality care and healthy life. Her belief in nursing concept is that symptoms and sufferings of patient are not a manifestation of disease or sickness, rather they are related to the environmental influences (Alligood, 2017). Nightingale’s theories addresses that diseases are not always involved in patient health.
Sometimes, poor environmental aspects largely contribute to disturbances in social, mental, emotional states of an individual which impact the overall health and wellbeing. My perceptions of nursing concept lies in the nursing practice through development of nursing skills and providing nursing actions in the form of nursing interventions. Experienced based skill development is essential in bringing out nursing interventions to accurately treat individual patients. Education and training are both required in enhancing professional and technical skills to attend to patient care. According to my personal view of nursing concept, the nursing responsibilities and actions evolve with new care requirements for a patient. Time and experience along with education and training help to build to strong and direct nursing care approach towards a patient. According to me, nursing component of metaparadigm involves developing a mutual caring bonding between the patient and nurse. This is achieved through promoting a safe and healthy environment around a patient. Therefore, according to my perception, nursing and environment are related and interdependent with respect to maintaining patient health and wellbeing. Nursing does not consider providing medications to eliminate illness; rather nursing care is provided to identify the root of illness to provide recovery. I feel that nursing services are an integration of understanding the patient condition, identifying the roots of illness, evolving through experience and education, developing and implementing treatment and care plans.
According to Florence Nightingale’s environmental theory, the environment plays a momentous role in determining a person’s health condition and promoting healthy maintenance. Environment has a stimulatory effect on a patient; patient’s health condition is affected due to disease that emerge due to environmental disturbances. The components of environment also involve social factors like customs, beliefs and the society where a person lives. Florence nightingale discusses in her environmental theory of nursing that diseases result from environmental influences and affect human life contributing to mortality (Hegge, 2013). Nursing approach plays a crucial role in maintaining environment of a person to promote healthy life and energy. Nightingale addresses in her theory that nursing should be intended to promote a suitable healthy environment around a person in order to promote delivery of complete care to achieve faster recovery from illness. In alignment with Nightingale’s environmental theory, my perception of environment is inclusive of internal and external surroundings of a person.
The surrounding in which a person resides and the internal state of mind, both play considerable roles in determining and maintaining healthy balance between a patient and his environment. I agree with Nightingale’s environmental theory in that, proper ventilation and health of patient houses, cleanliness of rooms and beds, warming atmosphere, personal cleanliness and hygiene,  noise, light act together in facilitating a healthy environment for a patient. According to my understanding of environment, the susceptibility of a person to a disease or any form of sickness is largely dependent on the environment. My nursing concept of environment is in agreement with Nightingale’s theory that both social and psychosocial environments have an impact on patient’s mental health and wellbeing. Therefore, I feel that nursing approach and care to maintain a healthy environment, both external and internal, would be immensely beneficial in curing a patient from an illness. Nightingale addresses in her environmental theory that availability of nutritional resources and food intake at the right moment in adequate quantity are also a part of environmental determination in promoting a patient’s health. Therefore, I believe that nursing skills should be to make beneficial alterations in environmental aspects to achieve improvement in patient’s health. Nursing should also make improvements of both internal and external environment of patient s to promote an overall wellbeing of the patients. Nursing care therefore focusses on the environmental aspects of providing holistic care to patients. Nursing care provides a prime focus on improving environmental conditions to improve patients’ health condition as the environment is directly involved in promoting health of a patient.
As stated in Florence Nightingale’s theory of Nursing, the term ‘person’, refers to the individual who is receiving treatment and care. In accordance to this theory, the person must be considered as a being possessing multidimensional facets, which comprises of psychological, spiritual, biological and social platforms (Koffi & Fawcett, 2016). Hence, following this theory in my nursing practice, I am required to utilize appropriate treatment procedures, care planning and medication administration, for the purpose of tending to the biological component of the patient. In order to improve and result in positive feelings of wellbeing in the psychological components of the patient by following Nightingale’s theory, I make sure that I engage in active listening, empathy and compassion while tending to my patients so that they feel emotionally and psychologically safe, secure and empowered to adhere to their treatment (Mackey & Bassendowski, 2017). For the successful treatment of the social component of the person receiving care following Nightingales nursing theory, I make sure that I exhibit appropriate family-centered approach to treatment which involves communicating the treatment conditions of the patient, with his or her close peers and family members, which not only reassures the family but also results in positive health outcomes of the patient, through improvement of their social interactions and networks (Zborowsky, 2014). In my present nursing practice, my adherence towards Nightingale’s theory also makes me realize the importance of maintaining the spiritual health and wellbeing of the person receiving care. Hence, by following this theory the treatment given to the patient by me, must also focus on making the person feel value, empowered and optimistic, which I successfully try to incorporate in my nursing practice by respecting the religious and spiritual beliefs of the person and incorporating the same in their care plan. Lastly, I believe that application of Nightingale’s theory in my nursing practice would be incomplete without me considering the usage of ‘Holism’ – which emphasizes the integration of the environmental needs of the patient with his or her psychological, spiritual and social needs (Pirani, 2016).
As popularly stated the by the World Health Organization , the health of the person, lies beyond merely the absence of a disorder, but must also include the prevalence of wellbeing in the social, physical, emotional and spiritual levels (Charlier et al., 2017). As stated by Florence Nightingale in her theory of Nursing, the health of a person is defined by not just the lack of illness, but also by the maximum capability of the person to function in his daily life. Hence, I attempt to incorporate this nursing paradigm in my current clinical practice in accordance to Nightingale’s Nursing model, by providing a holistic and multidisciplinary approach to the treatment of my patients, resulting in removal of symptoms as well as enhancing the wellbeing of the patient so that he or she can exhibit healthy performance of daily life activities for a lifetime, even after treatment (Kamau et al., 2015). Florence Nightingale also emphasized on actively observing patients without which, disease pathophysiology cannot be understood. Hence, following this theory, I attempt to regularly monitor my patients which allow me to respond actively to any changes which may occur in their health conditions. Lastly, the health paradigm in accordance to Nightingale’s theory focuses on the importance of environment for the recovery of the patient. Hence, during treating my patients, I follow this theory my ensuring that my patients are provided with hygienic food and water, adequate ventilation, lighting and electricity resulting in patient comfort and positive health outcome (Mughal & Ali, 2017).
Theoretical Application in Nursing Practice
I attempt to incorporate the principles of the nursing model stated by Florence Nightingale, in my current nursing practice, my providing a holistic, inter-professional treatment to my patients, which aims at not only alleviating the disease symptoms, but also in the physiological, psychological, functional and developmental improvements in the patient. I believe that for successful administration of Nightingale’s theoretical principles in nursing practice, one must adhere to the Clinical Practice Guidelines for Nurses in Primary Care, which have been formulated by the Government of Canada, and which I try to exhibit in my daily nursing performance (Chauvette & Paul, 2016). Hence, in accordance to these guidelines, I engage in effective nursing practices of identifying the nature and onset of symptoms, presented by the patient, adequately diagnosing the disease condition, treating the illness with the help of an efficient care plan and using the same knowledge to adequately train and educate the subordinate staff and patients. Nightingale’s theory of Nursing as well as the Clinical Practice Guidelines presented by the Canadian Government focus on the spiritual wellbeing of the patient, which I attempt to adhere to in my daily practice by the administration of appropriate culturally competent care to the patient (Basch, Loblaw & Rumble, 2014). Application of such theoretical and standardized principles in my practice, not only allows me to exhibit care plans which are sensitive to the cultural background of the patient, but also allows to me to inculcate positive feelings of optimism, wellbeing, value and empowerment in them. The application of Nightingale’s model of Nursing, also necessitates the maintenance of the social and wellbeing of the patient, which I attempt to incorporate by usage of family centered and patient centered approach to treatments of my clients (de Souza et al., 2017).
Hence, to conclude, I believe that Florence Nightingale’s theory and model of Nursing, proves to be an effective way to enhance and improve nursing knowledge and current nursing practice, due to its perception of patients, as an individual possessing multiple dimensions of health, each of which, requires adequate treatment and caring. By following the four paradigms of nursing theory, I engage in the practical application of Nightingale’s theory in my daily nursing practice, by offering a holistic treatment approach to the patient as well the community, by considering their environmental, social, psychological and spiritual wellbeing. For further successful administration of the usage of Nightingale’s theory of Nursing, the application of governmental standards is of utmost importance, which I attempt to incorporate by simultaneously adhering to the Clinical Practice Guidelines for Nurses in Primary Care by the Government of Canada. Hence, it can be concluded, that my following Florence Nightingale’s Nursing Model, I can practice high quality nursing activities in my professional field.
Alligood, M. R. (2017). Nursing Theorists and Their Work-E-Book. Elsevier Health Sciences.
Basch, E., Loblaw, D. A., & Rumble, R. B. (2014). Systemic therapy in men with metastatic castration-resistant prostate cancer: american society of clinical oncology and cancer care ontario clinical practice guideline summary. Journal of oncology practice, 10(6), e418-e420. Retrieved from:
Charlier, P., Coppens, Y., Malaurie, J., Brun, L., Kepanga, M., Hoang-Opermann, V., … & Deo, S. (2017). A new definition of health? An open letter of autochthonous peoples and medical anthropologists to the WHO. European journal of internal medicine, 37, 33-37. doi:
Chauvette, A., & Paul, P. (2016). History of Nursing Informatics in Canada. Canadian Journal of Nursing Informatics, 11(4), 1-13.
de Souza, M. A. R., Wall, M. L., de Moraes, A. C., de Almeida, B., & de Lima, D. M. (2017). The vital power and the legacy of florence nightingale in the health-disease process: integrative review. Revista de Pesquisa Cuidado é Fundamental Online, 9(1), 297-301. doi: 10.9789/2175-5361.2017.v9i1.299-303.
Hegge, M. (2013). Nightingale’s environmental theory. Nursing science quarterly, 26(3), 211-219.
Kamau, S. M., Rotich, R. J., Cheruiyot, B. C., & Ng’eno, L. C. (2015). Applying Florence Nightingale’s Model of Nursing and the Environment on Multiple Drug Resistant Tuberculosis Infected Patients in the Kenyan Setting. Open Access Library Journal, 2(08), 1-10. doi:
Koffi, K., & Fawcett, J. (2016). The two nursing disciplinary scientific revolutions: Florence Nightingale and Martha E. Rogers. Nursing science quarterly, 29(3), 247-250. doi:
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. doi:
Mughal, F. B., & Ali, B. H. I. (2017). Enhancing Patient Well-Being: Applying Environmental Theory in Nursing Practice. Ann Nurs Pract, 4(3), 1-3. Retrieved from:
Pirani, S. A. (2016). Application of Nightingale’s theory in nursing practice. Annals of Nursing and Practice, 3(1), 1-3. Retrieved from:
Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: Nursing research focusing on the impact of healthcare environments. HERD: Health Environments Research & Design Journal, 7(4), 19-34. doi:

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