martha rogers 1914 - 1994 -...

DENISE BARGER, BSN, RN PAT SCHLAGEL, BSN, RN LISA THIELKE, BSN, RN

MINNESOTA STATE UNIVERSITY MOORHEAD

NURSING 600

Martha Rogers The Science of Unitary &

Irreducible Human Beings

Martha Rogers 1914-1994

Grand

Nursing

Theorist

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retrieved from: http://www.nurses.info/nursing__theory__person__rogers__martha.htm

Origins

Rogers was one of the first nurse scholars to explicitly identify the person (unitary man) as the central phenomena of nursing concern

1970 – Science of Unity Human Beings (SUHB)

Rogers realized there had to be something to know in nursing that required increased education for its transmission

(Fawcett interview, n.d.)

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Purpose

• SUHB theory offers a new look at nursing, providing a framework for practice, education and research that moves away from the traditional medical model approach to the delivery of nursing care

(Fawcett interview, n.d.)

To promote human-environment field patterning and the nursing process

(n.a., 2009, para. 11)

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Evolution Over Time

Radical

Difficult to understand

Greatly influenced all facets of nursing

(n.a., 2009, para. 7)

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Science of Unitary Human Beings

• Five basic assumptions underlay Rogers' conceptual framework:

1. Wholeness

2. Openness

3. Unidirectionality

4. Pattern and Organization

5. Sentience and Thought

(Rogers as cited in Barrett, 2009, para. 4)

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Science of Unity Human Beings

There are four main topics (metaparadigms) that are addressed by nursing theorists:

1. People

2. Environment

3. Health

4. Nursing

(Rogers as cited in Barrett, 2009, para. 5)

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Application to Health

Individually defined

Multicultural dimensions

Influenced by health behaviors

Goal of nursing: health promotion

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Application to Nursing

Promote health

Positive optimistic approach

“The study of unitary, irreducible, indivisible human & environmental fields: people and their world.”

(Rogers as cited in McEwen & Wills, 2007, p.204)

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Application to Environment

Continually exchanging energy with the unitary human being

Constant state of change

Helix

Represents environment energy field

Co-existing & interactive with unitary human

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INTERACTION BETWEEN

HUMAN AND ENVIRONMENT 11

Environment

Energy Field

Human Being

Energy Field

Application to Person

Unitary energy system

Whole entity – sum of the parts

Continually exchanging energy with the environment

“These energy fields may be described as open systems, with each person having his/her own unique pattern of energy which constitutes the person’s identity.”

(Tettero, Jackson, & Wilson, 1993, p.777)

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Examples of Application to:

Nursing Practice

Education

Research

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Application to Nursing Practice 14

Maintain Health

Prevent Illness

Promote Health

Application to Research

Model is abstract & testable in principle

Study humans as individuals & groups

Challenges traditional thinking

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THE FLOW OF ENERGY

Energy is constant and ever flowing

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Application to Education

“Nursing aims to assist people in achieving their maximum health potential”

Martha Rogers – 1970 (as cited by Wright, 2007, p. 65)

Rogers stated nurses must commit to lifelong learning and noted, “the nature of the practice of nursing (the use of the knowledge for human betterment)”. Martha Rogers – 1990 (as cited by Tomey & Alligood, 2006, p. 252)

•

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CLARITY

SIMPLICITY

GENERALITY

EMPIRICAL PRECISION

DERIVABLE CONSEQUENCES

SPECIFIC EXAMPLES

Critique of the Theory

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Clarity

Major elements of Rogers’ work: 5 key definitions

3 principles of homeodynamics

6 assumptions

This approach appears simplistic

But is difficult for nurses to understand

Too abstract

Parsimony

(McEwen & Wills, 2007)

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Simplicity

• “Ongoing studies and work within the model have served to simplify and clarify some of the concepts and relations. However, when the model is examined in total perspective, some still classify it as complex”

• More work is required: use in practice, research and education needed

• May determine that the model is simple

(Tomey & Alligood, 2006)

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Rogers’ Nursing Theory Implementation

1981 at San Diego Veteran’s Medical Center

(SDVMC)

Review the process SDVMC nursing applied to arrive at this nursing model

Process took 8 years to implement

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CNS Committee Evaluation Process

Implementation of Rogers’ Nursing Theory (Heggie, Schoenmahl. Chang, & Grieco, 1989)

Current care model was a medical model

Limitation to nursing practice

Model needed to change focus

Medical problems focus individual focus

CNS committee determined need for model change

Review of nursing models and theories

Review of nursing service philosophy and care standards

Determined focus a metaparadigm model

400 Nurse knowledge/attitudes survey

Creating disequilibrium drove need for change

Discussion groups validate conflict with present medical

model framework A

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Implementation of Rogers’ Nursing Theory

Rogerian Theory Expert visits to present application

of Rogers’ Theory

Created openness and awareness of new ideas

Survey results/nursing philosophy compared to

nursing theories

CHOSE ROGERS’ THEORY

RATIONALE: 1. Most congruent with hosp. philosophy

and nursing staff beliefs 2. Foundational for future oriented

growth 3. Holistic in nature

Staff attend classes on nursing theory models

Staff attend classes on Rogers’ Theory

Classes included actual patient application

Leadership attend classes on Rogers’ Theory

B

Continued nursing staff education over 3 years

Martha Rogers visited and addressed nursing staff

Generality

Rogers’ theory is a synthesis of phenomena

Important to nursing

Abstract, unified, and highly derived framework

Does not define particular hypotheses or theories

Instead provides a worldview

Nurses may derive theories and hypotheses and propose relationships specific to different situations

(McEwen & Wills, 2007)

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Rogers’ Theory Applied to ADN Program 25

hel

icy

• Increasing diversity

• Humans and their environment characterized by increasingly complex change

• Example: Nursing students as they study will find their beliefs changing

reso

na

ncy

• Continuous change

• Humans and their environment are constantly changing and evolving together

• Example: Sleep patterns change as humans age

inte

gra

lity

• Mutual process • Continuous

interaction between humans and their environment and is constantly changing

• Example: As an new nursing student learns skills, coming aware of the way their tensions elicit to the patient

(Hellwig & Ferrante, 1993)

Empirical Precision

Early criticism identified major limitations

Difficult to understand principles

Lack of working definitions

Poor tools for measurement

Deductive in logic

Characteristic lack of immediate empirical support

(Tomey & Alligood, 2006)

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Derivable Consequences

Intends to assist in the understanding of human evolution and human potential

Organized in a manner that place nursing’s identity as a science

Focus is on the human and environmental connection as highly significant

Many have used the conceptual model for research

(Tomey & Alligood, 2006)

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Summary

To understand the Rogers’ Theory principles and concepts requires:

A general education base

A readiness to part from the traditional

Be imaginative in viewing our world

New and challenging theories are emerging to move the understanding of the unitary human being

(Tomey & Alligood, 2006)

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References

Fawcett, J. (n.d.). Interview of Martha Rogers nursing theory [Video file]. Retrieved from http://www.youtube.com/watch?v=V1XN3rPKndE

Heggie, J., Schoenmehl, P., Chang, M., & Grieco, C. (1989). Selection and implementation of Dr. Martha Rogers' nursing conceptual model in an acute care setting. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 3(3), 143-147.

Hellwig, S. & Ferrante, S. (1993). Martha Rogers’ model in associate degree education. Nurse Educator, 18(5), 25-27.

McEwen, N. & Wills, E. (2007). Theoretical basis for nursing (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkin

n.a. (2009). Martha Rogers. Retrieved from http://www.scribd.com/doc/17667393/NURSING-THEORIST-MARTHA-ROGERS

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References

Read, P., Shearer, N., & Nicoll, L. (2004). Perspectives on nursing theory (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkin

Tettero, I., Jackson, S., and Wilson, S. (1993). Theory to practice: Developing a Rogerian-based assessment tool. Journal of Advance Nursing, 18(5), 776-782. doi:10.1046/j.13652648. 1993.18050776.x

Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier.

Wright, B. W. (2007). The evolution of Rogers’ s Science of Unitary/Human Beings: 21st century reflections. Nursing Science Quarterly, 20(1), 64-67.doi: 10.1177/089-4318406296295

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