Chapter 19Models and Theories Focused on Human

Existence and Universal Energy

Introduction• Martha Rogers pioneered energy-focused nursing

that posited a radically different view of the human being and the environment.

• Her theory was followed by those of Margaret Newman, Rosemarie Rizzo Parse, and Elizabeth Barrett.

• Each theory describes nursing as having roots outside of the biomedical model and offer a different vision of nursing.

• Rogers proposed the science of unitary human beings based on four postulates:– Energy fields: Infinite, continuously flowing energy

that is fundamental to all life– Openness: No division exists between energy

fields, allowing energy to flow unbroken– Pattern: Energy flow is subject to field patterning– Pandimensionality: Phenomena are

manifestations of changing field patterns

Rogers’ Science of Unitary Human Beings (1 of 4)

• Continuous change within the human-environmental field is homeodynamics, which relies on three principles:– Resonancy: Continuous change from lower to higher

frequency wave patterns– Helicy: Continuous, unpredictable, increasing diversity

of field patterns– Integrality: Continuous mutual human and

environmental field process• Principles describe unpredictably changing mutual

patterning of fields.

Rogers’ Science of Unitary Human Beings (2 of 4)

Rogers’ Science of Unitary Human Beings (3 of 4)

• Rogers identified three theories of her science:– Theory of accelerating change (evolution): Change is

accelerating in field patterning, creating new norms– Theory of emergence of paranormal phenomena:

Paranormal experiences are manifestations of innovative field patterning

– Theory of manifestations of field patterning in unitary human beings: Change in field patterning is nonlinear, creative, and unpredictable

• Emphasis on human rights, client decision making, and noncompliance.– Noncompliance: Clients know themselves best

and have the right to make informed decisions

• Assumption of increasing diversity calls for the greater individualized care.

• Theory derivation from the science of unitary human beings continues.

Rogers’ Science of Unitary Human Beings (4 of 4)

• Barrett’s theory builds on Rogers’ science by proposing that human’s knowing participation in change is power.

• Promotes power-as-freedom, a spiritual worldview proposing that power is awareness of what one chooses to do, feeling free to do it, and doing it intentionally.

• Important for the development of power profiles to enhance client awareness.

Barrett’s Power as Knowing Participation in Change

Other Rogerian-Based Practice Examples

• Cowling’s pattern appreciation method proposed 10 constituent characteristics of Rogerian practice based on knowing participation in health pattern change.

• Butcher’s comprehensive practice model identified the focus of nursing care as pattern manifestation recognition and health promotion as voluntary mutual patterning.

Rogerian Research

• Early research focused on tool development tied to proposed manifestations of change.

• More recent research has focused on qualitative, rather than quantitative, research methods designed to unfold human-environmental field patterns.

• Three important current research methods are the Rogerian process of inquiry, Bitcher’s unitary field pattern portrait research, and Cowling’s unitary case inquiry.

Applications: Science of Unitary Human Beings

• Rogerian ideas can be applied through therapeutic touch, relaxation techniques, imagery exercises, and storytelling that comfort and rejuvenate patients when administered in conjunction with standard therapies.

• These practices center on understanding and applying the unique aspects of nursing in addition to the science of nursing.

Newman’s Theory of Health as Expanding Consciousness (1 of 4)

• Foundational concepts include movement, time, space, and consciousness.

• Newman’s theory proposes that the person is a pattern of the evolving whole, continually transforming through seemingly chaotic processes.

• Expanding consciousness is a form of transformation that results from disruptive patterns, such as the inability to move freely in bed-ridden patients.

• These patterns change client perceptions of time and space in a dynamic way.

• This dynamic situation offers the client opportunity to reflect on evolving new patterns of relating because the old patterns no longer work.

• A move toward compassionate consciousness reflecting wholeness (health), caring, evolving pattern, mutual process, and transformation.

Newman’s Theory of Health as Expanding Consciousness (2 of 4)

Newman’s Theory of Health as Expanding Consciousness (3 of 4)

• Theory can be synthesized in three basic assumptions:– Health is an evolving unitary pattern of the whole,

including patterns of disease– Consciousness is the informational capacity of the

whole and is revealed in the evolving pattern– Pattern identifies the human-environmental

process and is characterized by meaning

Newman’s Theory of Health as Expanding Consciousness (4 of 4)

• Theory necessitates a paradigm shift in which order is revealed through emerging relationships.

• Shift encompasses important conceptual movements:– Finding patterns rather than treating symptoms– Viewing pain as an important source of pattern

information– Treating disease as a process rather than an entity– Viewing the body as a dynamic energy field

Newman Praxis• Praxis based on theory-research-practice.– An interactive unity

• Research involves recording nurse-client conversations with a focus on meaning rather than data.

• Conversations form the basis of a chronological narrative used to detect patterns.

• Theory is applied to these patterns to determine if transformation has taken place.

Applications: Health as Expanding Consciousness

• Newman’s ideas are applied by nurses who are fully present in the nurse-client relationship and function as a transforming presence in the client’s life.

• The fully present nurse guides clients through phases of self-awareness, deepening awareness, appreciating meaning, and transformation in a mutual partnership that facilitates personal healing.

Rosemarie Rizzo Parse’s Humanbecoming School of Thought (1 of 2)

• Parse’s humanbecoming is a unitary construct that describes a person’s co-creation of rhythmical patterns of relating in a mutual process with the universe.

• As a result, health is becoming, or a way of living and a synthesis of personal values.

• Three principles form the basis of humanbecoming:– Rather than confronting external reality, humans

construct their own reality by giving significance to situations

– Creating patterns of relating requires humans to engage in paradoxical rhythms

– Becoming requires humans to move beyond what is to what could be while resisting new ways of viewing both the familiar and the new

Rosemarie Rizzo Parse’s Humanbecoming School of Thought (2 of 2)

Humanbecoming Research (1 of 2)

• Research focuses on understanding the meaning of lived experiences as described by the people experiencing them through four steps:– Participant description of experiences– Data gathering through dialogue– Synthesis of information to identify study focus– Linkage of findings back to theory

• The three processes are dialogical engagement, extraction–synthesis, and heuristic interpretation.

• Parse perceived the nurses role as being truly present with people to enhance their quality of life.

• Methodology involves three principles:– Explicating– Dwelling with– Moving beyond

• Practice involves the nurse and client in discussion, which opens the door for reflection on health pattern choices.

Humanbecoming Research (2 of 2)

Applications: Humanbecoming Theory

• Parse’s ideas are applied by nurses who are present with clients, respect their dignity, make decision-support information available, provide helpful services, and encourage and participate in movement.

• Humanbecoming nurses make a significant investment of time in order to develop close relationships with their clients.

Summary

• Theory-based practice differentiates nurses from other health care providers and resonates meaningfully with clients.

• Immersion in theory is the key to practicing it, and like-minded colleagues can prove helpful in this pursuit.

• Eventually, this process leads to personal and professional change.