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NURS 239 Introduction to Nursing Theory For Medical Health

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A meta-paradigm can be defined as the set of theories or the ideas that help in providing the structure about how a disciple should be functioning effectively. In case of a nursing disciple, the theories of meta-paradigm is seen to be comprised of four important but basic concepts that can help to address patients as whole as well as the health and well being of the patients, the environment of the patient as well the nursing responsibilities of the professionals (Mc Arthur & love, 2017). Therefore, these four basic nursing paradigms can be seen to point towards the holistic view or care where the well-being and medical health of the patients are connected to the four interactive components (Alligood, 2017). This assignment will mainly be a reflective one which will compare about the definitions that I had put forward in the first assignment and that of Betty Newman’s model. It will also describe about the various incidents that I had gone through in the placements that had enhanced my skills and knowledge.

First component – person (my definition):

One of the first components of the meta-paradigm concept is the “human being” or “person”. The concept of human beings is often defined as open fields of energy that possess unique and various types of life experiences. It can be said that as energy fields, they are considered larger than as well as different from the total sum of their various parts and cannot be connected be predicted from the knowledge of their part (Bender, 2018). My definition therefore states that persons are holistic beings that are dynamic, unique, multidimensional, sentient and even capable of aesthetic appreciation, abstract reasoning, creativity as well as self-responsibility. I also believe that language, caring, empathy and other abstract patterns of communication are all important aspects of an individually higher level of complexity and diversity. These factors thereby enable one person to increase their knowledge about their own self as well as that of the environment (Decker & Hamilton, 2018). Therefore, I believe that humans need to be viewed as valued persons who need to be respected, nurtured as well as understood and should be given the right to make their own informed choices regarding their health.

First component – person (Betty Neuman’s definition):

The definition as provided by Betty Neuman, while describing the concept pf person, is not entirely dependent and reflects another prospect of the concept.  The definition provided by me has judged the concept of person from a microanalysis level describing the different characteristic feature that explains the cause of persons being called the holistic individuals (Founds, 2018). Betty Newman had represented similar concept but she had described human beings as the multi-dimensional being consisting of five important subsystems of variable. Although, Betty had used the term called multidimensional for explaining human beings, I have not used the term “multi-dimensional’. However, the concept that I have used is similar to that of the Neuman’s model where persons are complicated systems of various interplaying factors that make them a holistic being. Betty had described the five person variables or the subsystem as the physiological system, psychological, socio-cultural, developmental and even spiritual components (Vaughn et al., 2016). She had discussed that each of the layers remain present in persons as concentric circles. This mainly comprises of the central core, lines of resistance as well as lines of normal defense and lines of flexible defense. I did not discuss these important components in my definition that shows my definition could not capture the real essence of “persons”. Betty had also described human beings as the open systems that are on the constant changes and move towards a dynamic state or system stability or towards illness of varying degrees (Rosenberg et al., 2017).


During the time of my placements, I got the opportunity to undertake health assessment and health evaluation of many patients who came for seeking healthcare services. I noticed that only physical health issues only did not affect them but they also suffered massively due to their psychological and socio-cultural issues.  One of the patients who came for foot amputation not on suffered from diabetes. He was also found to be depressed and had poor income and employment that affected his health as well. Moreover, he had to travel large distances to reach the healthcare centre as he lived in remote areas of the nation that became another of the issue that affected his health. Therefore, it can be seen that both every person is affected and governed by different components as mentioned by Betty Neuman. Therefore, I had understood the concept of Betty and I would inculcate its meanings in my definition as well.

Second component – environment (my definition):

The environment component is another important part of the meta-paradigm that needs to be discussed. According to my definition, the environment aspect mainly focuses on the different surroundings that can affect the patient. The environment might comprise of both the external and the internal influences.  Environment thereby contends that the ways a person can interact with the surrounding can affect the health and wellness of the persons (Francis, 2016). I believe that interactions with the family, friends and other people are indeed the part of the environment as like that of the physical and social factors like that of the economic conditions and the social factors, culture, society, connection and geographic location. This meta-paradigm component is seen to theorize that a person can modify her environmental factors that can indeed result in the improvement of her health status (Reed & Shearer, 2017). An in-depth analysis of the factor can reveal that the environment is the energy field that remains in mutual process with that of the human energy field.  This can be conceptualized as the particular arena in which the nursing client encounters aesthetic beauty and caring relationships along with different threats to wellness and lives experiences of the health.

Second component – environment (Betty Neuman’s definition):

This definition was quite similar to the definition that had been provided by the famous nursing stalwart Betty Neuman. The environment as described by her is the totality of the different internal and external forces that surround a person and with which they can interact at any given time. There forces are seen to include the different interpersonal as well as intrapersonal and extra stressors that can affect the normal line of defenses of systems and therefore can influence the stability of the systems. Therefore, she had stated that environment might be viewed as all the significant factors that can affect or would be affected by the systems. She had further classified the environment as the internal environment and the external environment (Ahmadi et al., 2017). The internal environment mainly exists within the client system. According to her, all forces and interaction have the ability to influence any factors that are solely within the boundaries of the system make-p of the client that makes this environment. O the other hand, the external environment comprises of any factors that exist outside the system of the client (Memmott et al., 2017). This definition can be stated to align with that of the definition that I have used in assignment 1. Although my definition does not clearly demarcate the definition and explanation of the internal and external factors of the environment governing the life of individuals, I have clearly defined about the impact of both external and internal influences and have clearly established the identity of its impact on the health and well-being of individuals.   However, I have researched further as has concluded environment to be an energy field working in mutual procedures with that of the human energy field ensuring and governing the well-being of individuals. Therefore, it can be stated that I have clearly being able to establish the same points as mentioned by Betty Neuman and had developed the quality of the definition by linking it with the other components of the meta-paradigm like human beings and heal and wellness.


During the time of my placement, I was able to assist one of the senior nurses who were handling a case study of twins where only one of the children was found to be continuously prone to skin infections while the other did not. The nurse found out from the mother that their economic stability is affected and that they cannot afford proper housing and had to live in overcrowded rooms. This external environment was influencing the health of the child making him suffer from skin infections. Again, an in-depth analysis showed that as the internal environmental factors like that of the immune system was stronger in the unaffected child and weaker in the affected child. In this way, internal environmental factor affected only one child whereas could not affect the other child.

Third component – health (my definition):

Health component is one of the most important of the four component of the meta-paradigm. It refers to the extent to the wellness as well as the healthcare access that patients might have. This component can be described as the one that has a multiple number of dimensions that reside in the constant state of motion. Health and wellness can successfully cover the lifespan and genetic make-up of the person and considers of the ways by which emotional, physical, social, intellectual and spiritual well-being are integrated in the healthcare so that the people can have maximum health benefits (Aronowitz & Fawcett, 2016). Therefore, the theory explains that these factors can have enough potential for influencing the state of well-being of persons. However, the concept of health and well-being can vary according to the perspective of the patient. What one individual can consider as an acceptable quality of life or healthy lifestyle might be or an unacceptable quality of life or unhealthy by another.

Third component – health (Betty Neuman’s definition):

Betty Neuman’s definition always equates health to be equal to wellness. She had described as the health and wellness as the condition in which all parts and sub parts work in harmony with the whole as the client. Because the persons remain in content interaction with the environment, the state of wellness is in dynamic equilibrium rather than in any kind of steady state. She described health as the condition as well as the degree of the system stability and is mainly viewed as a continuum from the wellness to illness. She had clearly described that when the optimal needs are met, a person can enjoy optimal wellness 9Tovar et al., 2016). When the needs are not met, illness can develop. Both my definition as well as the definition of the author had been entirely similar, as both had clearly focused on the fact that health and wellness are governed by important factors needs and when these needs of the system are met through achieving emotional, physical, social, intellectual and spiritual well-being, persons can live high quality lives.


During the time of my placement, I got the opportunity to interact with many obese patients who were concerned with their health. This was because they were also suffering from many different types of chronic conditions like osteoarthritis, diabetes, cardio-vascular disorders and many others. One common aspect I noted is that their health and wellness were impacted by their food pattern. Most of them used to eat take-away fast foods that were cheaper and did not make the patient cook. These were high on calories, this affected their health, and wellbeing among them gains calories and making them gain weight. While many of the patients stated their financial inability to the reason of not buying organic foods, others stated lack of time from busy life to cook foods. As their healthy living conditions were not met, it resulted in poor health and well-being of people making them live poor quality of lives.

Fourth component – nursing (my definition):

Another very important component of the emotional, physical, social, intellectual and spiritual well-being is called the nursing constituent. This component mainly involves the deliverance of best possible health outcomes for the patients throughout different mutual rapport in a safe as well as the caring environment (Smith et al., 2015). Nurses need to apply the principles of the knowledge as well as skills, technology, collaborations and even the professional judgments and communication. These are needed in carrying out the duties and the tasks for the achieving the best potential state in service user’s health outcomes. This constituent of nursing would be mainly valuing a high degree of services and thereby integrating it with other emotional, physical, social, intellectual and spiritual well-being components for the well-being of the patients (Joseph & Sreedevi, 2018). The nursing procedure is a form of critical thinking methodology that need to ensure effective observation, intuition, reflection, empowering, caring , communication , assessment as well as the choice of alternative actions. This help in development of health and wellness of every person who come to seek for health.  

Fourth component – nursing (Betty Neuman’s definition):

Betty Neuman had described this nursing component as a unique profession that remains concerned with all the important variables that can influence the response a person might have to a particular type of stressor (Smith, 2017). She has described that persons need to be considered as completely and it is the job of the nursing professionals to address the patients as holistic human beings. Therefore, Neuman’s definition of the nursing described this as the action, which helps in assisting the individuals, families and even the groups for maintaining the maximum level of wellness (Schaffner et al., 2016). The primary aim is actually establish the stability of the patient with the help of different nursing interventions that would help in reduction of the stressors. Therefore, it can be seen that my definition and Betty’s definition both tried to explain the same components of helping patients to achieve wellness through introduction of different types of care plans and interventions (Khatiban et al., 2016). However, while Betty had focused on explaining it from the viewpoint of helping individuals to overcome stressor and included families and groups as well, my definition had focused more on the critical thinking attributes of nursing along with other attributes that helps patient in living lives well.


During my placement, I had witnessed how nursing professionals had helped patients and included them in their own care planning as active decision makers. They had maintained the dignity and autonomy of the patients and established therapeutic relationship with them. With the application of best of the interventions, they had ensured that high quality comprehensive care is given to the patients. This would help in the health development of the patients making them lead quality lives.

Betty Neuman –Totality:

Betty Neuman had stated that four important components like person, environment, health and nursing are the four important met paradigms on which healthcare service provisions need to be designed. The nursing stalwart can be considered as a totality as her definitions of the four paradigms had developed a picture of the client as the holistic being who has the right to enjoy not only high quality physical health but also social, economical and emotional stability. Nurses who try to control their patients can never achieve their goal of successfully ensuring high level of patient care (Khatiban et al., 2016). This is because the nurses can never align themselves with the real values and principles on which healthcare services are based on. According to Betty, nurses need to consider human beings as holistic being who are governed by their social, economical, psychological, well-being factors and are indirectly associated with the impact of internal and external environmental impacts. Their health and well being can only ensured by nurses when they base their care not only on their physical symptoms management but caring for them spiritually, psychologically and emotionally (Joseph & Sreedevi, 2018). Respecting their dignity and autonomy and putting them at the centre of decision making would empower the patients and encourage them in effective partnership development with nurses. In this way, nurses should never try to control patient but in turn make them active members in decision making sessions and provide them the best care and patient satisfaction.


From the above discussion, it can be seen that four important components of meta-paradigm had been successfully define by me. Both the components of health and nursing had entirely aligned with the definitions provided by Betty Neuman, the other two definitions had not entirely aligned with that of Betty’s definition. Although the central viewpoint had been more or less similar, the approach and components included in the definitions had been varied. However, this approach had helped me to gather more insights into the four components of meta-paradigm and helped me to enhance my skills and knowledge effectively.   


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