nursing metaparadigm (discussion reply)


The nursing metaparadigm concept I intend to focus on is person (patient or client). Person refers to a human being composed of needs: physical, intellectual, biochemical, and psychosocial (McEwen & Wills, 2019, p. 42). The person is an open system and is “greater than the sum of his or her parts” (McEwen & Wills, 2019, p. 42). The concept of person is most often the center of the nurse’s attention and is the recipient of care.  

Regarding my personal and professional experiences, I have two very different definitions of what constitutes a client. In my pediatric cardiac ICU background, the person, or patient, was generally an infant with a cardiac defect. Currently, in my practice at a medical spa, my clients range from adolescents to the elderly, focusing on physical appearance. My focus on the “person” differs significantly from my previous role to my current role. 

In 1972, B. Neuman’s theory stated that stress reduction is the nursing practice system model’s goal (Nursing Theories – Overview, 2020). Her theory defines “person” as the combination of the interrelationships between physiologic, psychological, sociocultural, developmental, and spiritual variables (McEwen & Wills, 2019, p. 43). Similarly, D. Johnson’s 1968 nursing theory’s goal is to reduce stress, as she focuses on how stressors affect illness adaptability (Nursing Theories – Overview, 2020). Johnson’s definition of “person” is a behavioral system with purposeful ways of behaving that connect them to their environments (McEwen & Wills, 2019, p. 43). Both Neuman and Johnson focus on decreasing stress as a way to care for patients. However, their definitions of person vary. Johnson implies that a patient’s link to their environment is of most importance, and Neuman believes a person is a more integrated whole that can be singular or plural (as in a community, group, or entire social system) (McEwen & Wills, 2019, p. 43). 

Within my years of practice in nursing, my definition of person, client, or patient has altered. In my earlier career, I would have been more aligned with Neuman’s theory. My patients, albeit more complex, needed more from me as their nurse from more than just an environmental standpoint; I correlated their needs as a holistic being. I was focusing on not just the patient but their support system as well. As a nurse in a med spa, my clients have patterned, repetitive concerns that influence their perceived environment in different ways, which coincide more with Johnson’s theory