Roger’s There are eight concepts in Rogers’ nursing

Roger’s
theory of the Unitary Human Being is how I feel nursing should be practiced. Nurses
should view the person as a whole and not as a machine. Parse described the simultaneity
paradigm, humans are unitary, irreducible, and in continuous mutual process
with the environment (Rogers, 1970, 1992). In contrast to Parse, Newman
identified three paradigms. One of them is the Unitary-transformative paradigm
is similar to Parse’s simultaneity theory. The unitary-transformative theory describes
humans as patterned, self-organizing fields within larger patterned,
self-organizing fields. Applying the Unitary
Transformative Nursing theory in a clinical setting will require me to view not
only what is visible and obvious, but also that which is obscure as influences
in the entire environment.

An exploration of my own thought patterns, beliefs, and
behaviors is necessary in order to do that. For example, at times when I
find nursing overwhelming or upsetting it is important for me to step back and
center myself. By doing this I can be a healer for a patient in need. Instead
of passing on my negative energy to them and their environment. “A
change is characterized by fluctuating rhythms of organization-disorganization
toward more complex organization. Health is unidirectional, unitary process of
development, expansion of the unconscious, and a fusion of disease and
non-disease.”1
It is a reflection of continuous change. Therefore, to put the patient in the
best position to heal the nurse must be whole themselves to influence a
positive change in health for the patient.

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There
are eight concepts in Rogers’ nursing theory: energy field, openness, pattern,
pan-dimensionality, homeodynamic principles, resonance, helicy, and
integrality. “Resonancy is an ordered arrangement of rhythm characterizing both
the human and environmental fields that undergo continuous dynamic
metamorphosis in the human environmental process. Helicy describes the
unpredictable, nonlinear evolution of energy fields as seen in non-repeating rhythmicity’s,
and postulates an ordering of the human evolutionary emergency. Integrality
covers the mutual, continuous relationship of the human and environmental
fields.”2Changes occur by the
continuous re-patterning of the human and environmental fields by resonance
waves. The fields are integrated into each other, but are also unique. Unitary
Transformative Nursing is a reflective practice, informed by theory, science,
and clinical experience. By a reflective practice I mean one has to look within
themselves and their environment to learn about themselves and be able to
provide the best care to their patients. This can be referred to as looking
into the mirrors in the environmental field to learn about field patterning.
Field patterning is continuous, innovative, and unpredictable. The
manifestations of the field patterning that emerge are observable events. By
identifying the pattern, there can be a better understanding of human
experience.

Rogers
uses the term unitary human being in place of person and defines who we are as
“an irreducible, indivisible, pan-dimensional, energy field identified by
pattern and manifesting characteristics that are specific to the whole and
which cannot be predicted from knowledge of the parts.”  Rogers defines the energy field as the
“fundamental unit of the living and non-living. Field is the unifying concept. The
energy field is the fundamental unit of both the living and the non-living. It
provides a way to view people and the environment as irreducible wholes. The
energy fields continuously vary in intensity, density, and extent. There are no
boundaries that stop energy flow between the human and environmental fields,
which is the openness in Rogers’ theory. Energy signifies the dynamic nature of
the field; a field is in continuous motion and is infinite. The energy field is
open, interconnected with the universe. Rogers defines person and environment
as “open systems” and states that “man and environment are continuously exchanging
matter and energy with one another” This means that all humans are connected,
and our interactions affect each other and everyone in our environment. With
this being said, everyone and everything that exists in our environment are
continuously exchanging matter and energy with us. In Rogers’ Theory of Unitary
Human Beings, a person is defined as an indivisible, pan-dimensional energy
field identified by pattern, and manifesting characteristics specific to the
whole, and that can’t be predicted from knowledge of the parts. A person is
also a unified whole, having its own distinct characteristics that can’t be
viewed by looking at, describing, or summarizing the parts. Rogers also
explains that people have the capacity to participate in the process of change.
The environment is an “irreducible, pan-dimensional energy field
identified by pattern and integral with the human field.” The two fields
coexist and are essential to each other. The idea that we are connected
challenges people to constantly change their lives and way of being. If humans
act in a way that promotes healing, they must themselves be whole and healed.
By being whole and healed means that a person is self-aware and has
self-knowledge.

The
nursing theory states that nursing encompasses two dimensions: nursing as art
and nursing as science. From the science perspective, nursing is an organized
body of knowledge specific to nursing, and arrived at by scientific research
and logical analysis. The art of nursing is the creative use of science to
better people, and the creative use of its knowledge is the art of its
practice. Rogers states that nurses exists to serve people, and the safe
practice of nursing depends on the nature and amount of scientific nursing
knowledge the nurse brings to his or her practice. Nursing is a pattern
recognition profession that attends to “we” and meaning of that whole. Nurses
must be able to tend to the patient and their family while simultaneously
attending to the here and now. In order to be a nurse that uses the unitary
transformative theory it is shown through patience and kindness. These two
traits both will be evident through my service and help me to grow. The passion
for the profession of nursing will sustain throughout my career as long as I
remain centered and am willing to learn new concepts and ways of being.
Patience provides wisdom in difficult situations where timing is of the
essence. Offering a paradigm shift with gentleness, compassion and without a
specific outcome in mind, pan-dimensional possibilities emerge.

This
is a hypothetical clinical scenario.  Mr.
Johnson is a 53 year old African American male, admitted in the Emergency room with
the diagnosis of depression secondary to the diagnosis of hypertension. He was
very tense and sobbing during the history collection because his mother and
father also had hypertension. His wife and daughter brought him into the
emergency room after he has not been acting like himself, and he complained
about having blurry vision. Even though they are anxious, they are both being
supportive and helpful at this time. Mr. Johnson was diagnosed with hypertension
four months back and was prescribed medication, but he stopped taking the
medication because of the side effects such as erectile dysfunction. Mr.
Johnson’s wife and daughter were unaware that he had stopped taking his
medication. He was prescribed Statins and Antihypertensive medication. He
started to show the signs and symptoms of depression from the past one month.
He began to forget little things, his mood would change quickly, trouble
concentrating, and he was increasingly irritable. He stopped going out to get
the newspaper every morning. He would often start to cry suddenly. His present
findings based on the assessment shows that he is very tearful, nutritional
status is impaired, blood pressure is high, sad mood, and at risk for falling
into a hypertensive crisis.

Mr.
Johnson is experiencing depression with his hypertension because he was not
given enough information about his diagnosis. This caused him to not adhere to
his medication regimen, and not seek help when his health started to decline. It
is the mutual interaction between Mr. Johnson and the nurse for changing the
pattern and making his all emerging pattern as unitary pattern.  A new diet regimen, meditation, exercise and
creating a medication schedule are the activities planned for Mr. Johnson to
get him healthy again. The diet regimen which reduces the intake of sodium
should help to maintain his blood pressure. While exercise and meditation can
help with the depression. Also a medication schedule can encourage his family
to be more a part of the diagnosis and keep Mr. Johnson on track. The nurse
gives advice for changing the dietary pattern and improving the patient’s
health. Once this new regimen has been put into place the nurse should check up
on Mr. Johnson after the mutual patterning to determine if he is continuing to
eat healthy, exercise and take his medication.

The
areas of assessment for Mr. Johnson are the total pattern of events that
occurred after Mr. Johnson’s hypertension diagnosis. His environment includes
his Mr. Johnson’s family, his wife and daughter.  Additionally we know that Mr. Johnson stopped
taking his antihypertensive medication. This assessment should be a
comprehensive assessment of the human and environmental fields. Mutual
patterning of the human and environmental fields are sharing knowledge about
the patient’s illness. As a nurse I should teach the patient to exercise, eat
healthy, and meditate. Once he gets on a schedule there should be repeat
pattern appraisal to ensure Mr. Johnson is sticking to the health plan.

In
order to be a nurse that practices Rogers’ model, the focus of nursing should
be the patient as a person. This means putting the patient in the best position
to heal. A nurse’s energy can impact the healing of their patient, so emphasis
should be on developing self-awareness as a part of the patient’s environmental
energy field. As well as the dynamic role of the nurse pattern manifestation on
the patient.

1 Dossey,
B. M., Keegan, L., & American Holistic Nurses’ Association. (2009).
Holistic nursing: A handbook for practice. Sudbury, Mass: Jones and Bartlett
Publishers.

 

2 Science
of Unitary Human Beings. (n.d.). Retrieved December 04, 2017, from
http://www.nursing-theory.org/theories-and-models/roger-theory-of-unitary-human-beings.php