I. Nursing is both a science and an art, but it is also more. Carper characterized nursing
best by breaking it into four categories: science, art, personal knowledge, and ethics
(1978, as cited in McEwen & Wills, 2019, pg. 15) Nursing is a science because it can be
theorized, observed and measured. Nursing is an art because it requires practice,
repetition, and it can be either definite or indefinite. It requires personal knowledge of
one’s own beliefs, values, and personal strengths in order to be successful. Nursing
requires ethics in order to maintain balance and stability.
II. Ontology is a branch of philosophy that studies the theory of existence or being
(McEwen & Wills, 2019).
Extant means existence, it comes from Latin which means “Able to be seen or reached”
(Merriam-Webster, n.d.).
Epistemology is the study or the ways of actual knowledge (McEwen & Wills, 2019).
Empiricism is a belief that is passed along between individuals and grows between the
individuals. It is founded on what is extant, what is experienced by observation. Once it is
observed it has to be duplicated, and then a conclusion is based upon the data. Empiricism is an
attempt to understand the process as a whole, or the “science of nursing” (McEwen & Wills,
2019, pg. 15). It also uses quantitative research. An example of this in nursing would be
guidelines for monitoring vital signs during a moderate sedation with ketamine.
Logical positivism theories are much more rigid than empiricism but are still part of empirical
philosophies. The conclusion is either right or wrong. It is based upon facts that are obtained
through objectivity and it is very faulty (McEwen & Wills, 2019).
Post-positivism is the view most used today. It came about after positivism was found to be
inaccurate, due to the fact that the results are of very little consequence. It focuses on quantitative
data, uses the scientific method, but also understands that the individuals involved in the study
have biases that can interject into the interpretation (McEwen & Wills, 2019).
Received view is knowledge passed along through individuals being spoken to or given to.
Empiricism, positivism and post-positivism rely on/ are the received view to increase knowledge
base but to also grow upon it.
Perceived view relies on the belief that what exists depends on what the researcher perceives to
exist. It includes phenomenology, constructionism, and historicism. The comprehension of the
researcher and the subject studied focus on stringent control and experimentation (McEwen &
Wills, 2019). There are multiple possibilities to the results as opposed to logical positivism where
there is only true and false. The perceived view focuses on experiences and interactions.
Paradigm is a framework of common understanding regarding the subject matter. It details the
work that needs to be discovered, and there can be a large quantity of details that need to be
investigated (McEwen & Wills, 2019).
III. The metaparadigm of nursing is defined by person, environment, health and nursing. This is
accurate, but should add the subcategory of family into the environment category. During the
Covid Pandemic, hospitals have learned that family has been a crucial part of the healing
process. The Journal of Family Nursing published an article that stated families and patients are
connected, and the health of one affects another (Family Health in Europe-Research in Nursing,
2020). Family and intimate acquaintances need to be incorporated into the metaparadigm of
nursing. The relationship between patients and families and the possibility for improved health
should be progressively studied and incorporated into theories of health. I also agree with Schim
et al. that social justice should be incorporated into the nursing metaparadigm as its own category
(2007, as cited in McEwen & Wills, 2019). It is an important topic and relative to the care and
health of all humans. According to the Center of Disease Control and Prevention, minorities such
as African American and Native American women are twice as likely to die during childbirth
than Caucasian women (Center of Disease Control and Prevention, 2019). This is evidence that
social disparities and social justice need to be theorized in order to improve the nursing practices
and to improve the social injustices that are occurring.
IV. Nursing theory and philosophy has not been important in my nursing practice up until now. I
took nursing theory for my BSN degree, but was under the impression that it would have no
impact on my practice or help improve the outcome for my patients. It was not until I read the
two assigned chapters for this class that I understood why theory and philosophy are important to
my practice. Chapter 2 of Theoretical Basis for Nursing really helped me understand that it took
a century after Florence Nightingale to advance nursing theory and to grow practice guidelines.
The reading helped me understand that advancing nursing theory leads to growth in fields such
as nurse practitioners and advanced nurse practitioners (McEwen & Wills, 2019). I now look
forward to learning more about nursing theory and philosophy and allowing it to impact my
nursing practice and career. “The Lord is my shepherd, I shall not want” (King James Version,
1611/2017, Psalm 23:1), the lord is there watching over us and protecting us, even when we do
not want him to be. This is how I perceive nursing theory. It protects nurses, develops nursing
and care practices, whether we want it or not.
References
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science,
1(1), 13–23. https://doi.org/10.1097/00012272-197810000-00004
Center for Disease Control and Prevention. (2019, September 6). Racial and ethnic disparities
continue in pregnancy-related deaths. Centers for Disease Control and Prevention.
https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html
Family health in Europe-Research in Nursing. (2020). The COVID-19 pandemic: a family affair.
Journal of Family Nursing, 26(2), 87–89. https://doi.org/10.1177/1074840720920883
King James Bible. (2017). Thomas Nelson Publishing. (Original work published 1611)
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer
Merriam-Webster. (n.d.). Extant. Merriam-Webster. https://www.merriam-
webster.com/dictionary/extant
Schim, S. M., Benkert, R., Bell, S. E., Walker, D. S., & Danford, C. A. (2007). Social justice:
added metaparadigm concept for urban health nursing. Public Health Nursing, 24(1), 73–
80. https://doi.org/10.1111/j.1525-1446.2006.00610
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