1. Is nursing a science or an art, or both? Explain your answer.
2. In your own words, define the following terms. Use your text and other
sources:
a. ontology
b. extant
c. epistemology
d. empiricism
e. logical positivism
f. post-positivism
g. received view
h. perceived view
i. paradigm
3. The metaparadigm of nursing generally is defined by the following 4
concepts: person, environment, health, and nursing. Do you agree with
this global representation of nursing? Why or why not? Would you add any
other components or sub-components?
4. Up until now, has nursing theory or philosophy been important to your
own practice? Why or why not?
Nursing: Science or Art
Nurses have an enormous impact on healthcare as frontline healthcare
workers. Nursing itself is founded on the scientific findings and evidence-
based practices that allow for nurses to consistently and effectively provide
the safest patient care. As nurses, we study for years the science of the
human body and how to best master the science of nursing, and along the
way, we master the art to caring for patients. Our role as a nurses bridge
both the science and art of nursing.
According to Oliveira et al (2017), the science of nursing is the
“pathophysiology, disease process, and techniques learned during the
nursing education and applied during patient care,” and the art of nursing is
the “caring, compassion, understanding, communicating, and loving in
caring for patients.” While we master the science of nursing in our education
and through continuing education, it is imperative as nurses to best apply
and understand the art of nursing. We must empathize with our patients in
order to advocate for their needs. Nursing combines both art and science
because we use scientific research and findings and our ability to understand
and enact upon unmeasurable components of patient communication.
Definitions
Ontology – the study of theory of being (McEwen & Wills, 2019); in my own
words, devoting time and attention to acquire the knowledge of a set of
principles to explain the phenomena of existence.
Extant – still in existence (McEwen & Wills, 2019); in my own words,
continued survival.
Epistemology – the study of knowledge; in my own words, devoting time and
attention to acquire awareness gained through experience.
Empiricism – the belief that what is experience is what exists, and the
experiences are verified through scientific methodology (McEwen & Wills,
2019); in my own words, acquiring awareness through sensory experiences.
Logical positivism – the logical and empirical bases of science with no
interpretation from metaphysics, understanding, or meaning within the realm
of science (McEwen & Wills, 2019); in my own words, solving philosophical
issues with logical analysis.
Post-positivism - the subjective nature of inquiry but still supports rigor
and objective study through quantitative research methods (McEwen & Wills,
2019); in my own words, acquiring awareness through objectivity and prior
experience.
Received view – individuals learn by being told or receiving knowledge
(McEwen & Wills, 2019); in my own words, acquiring awareness that is
perceived to be correct without further criticism.
Perceived view - centers on descriptions that are derived from collectively
lived experiences, interrelatedness, human interpretation, and learned
reality, as opposed to artificially invented reality (McEwen & Wills, 2019); in
my own words, interpretation through becoming aware or conscious of lived
experiences.
Paradigm - an organizing framework that contains concepts, theories,
assumptions, beliefs, values, and principles that form the way a discipline
interprets the subject matter with which it is concerned (McEwen & Wills,
2019); in my own words, shared perceptions and assumptions of acquired
awareness to form mutual views.
Metaparadigm of Nursing
Metaparadigm is a set of ideas that provide the structure for how
something, i.e., a discipline, should function. The metaparadigm of nursing
was first defined by Jacqueline Fawcett into four categories: person,
environment, health, and nursing. Throughout the years, many scholars have
rejected Fawcett’s metaparadigm but have not proposed an agreed-upon
alternative. While I do agree with this metaparadigm of nursing, I feel that it
should be re-conceptualized. First, let’s break down each category of the
metaparadigm. Person is the recipient of nursing care, i.e., an individual,
group, family, or community. Environment is the internal and external
surrounds that affect the “person.” Health is the degree of wellness or
wellbeing that the “person” experiences. And nursing encompasses the
attributes, characteristics, and actions of the nurse that is providing the care
on behalf of or in conjunction with the “person.” These basic concepts of
nursing theory lay a great foundation that should further be expanded upon.
This nursing metaparadigm has been considered central to nursing
theories and practice, but a major flaw to the metaparadigm is that it
provides little to no ontological foundation for nursing (Reed, 2019). Many
scholars wish to move away from the metaparadigm towards the use of a
midparadigm. Midparadigm is defined as shared concepts that are more
specific to the practice environment; these concepts are derived from the
knowledge and experiences from one’s practice settings and academic
studies (Littzen et al., 2019). While I agree with the metaparadigm of nursing
being a great foundation for nursing theory, I do agree that it is time to step
away from this concept of theoretical work and move towards the more
practical framework of midparadigms as it best represents nurses’
knowledge from all areas. By viewing the midparadigm as a prism, one can
further reveal through the prism’s “lenses” the dynamics of nursing practice.
Littzen et al (2019) derived the prismatic midparadigm nursing theory that
expands upon the metaparadigm concepts through the prism “lenses.” Their
theory adds the concept of vulnerability as the central concept to which this
expands into unitary human-environment-health and healing relationships
tiers. By utilizing this midparadigm model, nurses can bridge the theory-
practice gap into relevant nursing practice by taking into consideration one’s
own perceptions, expertise, and knowledge across different settings.
Nursing Theory and Philosophy: Relevance in My Nursing Practice
The many nursing theories and philosophies provide a foundational
knowledge for nursing care. However, it is important to expand upon these
theories and philosophies to include other components for more modern-day
nursing care. The application of evidence-based nursing and traditional
practice is imperative to current nursing practices. Applying nursing theories
to nursing education helps nursing students understand the basic principles,
values, and meanings of the nursing practice, but needs to further expand
upon the individual’s perception of these theories.
By applying my own experiences and knowledge, I have built upon my
own personal nursing theory that is relevant in my nursing practice. Without
the foundation of nursing theory and philosophy, I would not have the basic
understanding of what it means to be a nurse. These theories and
philosophies have been important in my nursing practice because they have
guided my values and beliefs on how to perceive health processes and have
allowed me to seek further awareness of patient care through continuing
education. My personal worldview has also helped build upon my own
nursing theory for practice. I follow a more humanistic worldview where the
source of caring is within the person rather than founded on biblical
principles. While I do agree with many biblical Scriptures of caring, such as
Philippians 2:4, “Let each of you look not only on his own interests, but also
to the interests of others” (Holy Bible, 2015). It is imperative that as nurses
we are able to maintain our own beliefs and values but to ensure our
patient’s beliefs and values are considered when providing care.
References
Holy Bible, New Living Translation (2015). Tyndale House Publishers.
https://www.bible.com/bible/116/GEN.1.NLT
Littzen, C. O. R., Langley, C. A., & Grant, C. A. (2019). The prismatic
midparadigm of nursing. Nursing Science Quarterly, 33(1).
https://journals.sagepub.com/doi/pdf/10.1177/0894318419881806
McEwen, M. & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.).
Wolters Kluwer.
Oliveira, M., Dendasck, C. V., Oliveira, E. (2017). The art and science of
nursing. Multidisciplinary Scientific Journal, 11(4).
https://www.nucleodoconhecimento.com.br/health/the-art-and-science-of-
nursing
Reed, P. G. (2019). Moving on: From metaparadigm to midparadigm for
knowledge development. Nursing Science Quarterly, 33(1).
https://journals.sagepub.com/doi/pdf/10.1177/0894318419881796
Jina,
Your explanation of nursing as a science and an art is spot on. I loved your
sentence stating nursing is an art by nature and scientific by practice. To
truly be a nurse, one must master both the art and science, but also the
heart and the mind. At the heart of nursing lies a respect for human dignity
and an intuition for a patient’s needs, aka the art (ANA, n.d.). This aspect is
supported by the mind, which is the knowledge obtained, aka the science.
With this in mind, nurses are able to use the metaparadigm of nursing as a
foundation to provide patient care. We use our judgement and critical
thinking skills to objectively provide care while integrating the subjective
experience of the patient’s environmental, biological, physical, and
behavioral needs. By tailoring each concept of the metaparadigm to the
specific patient, we are able to alter our practice to best suit the patient.
I, too, have worked in the emergency department (ED) setting and have
experienced the fast-paced environment that I had to constantly be able to
change and morph my nursing practice to each individual patient’s needs at
the drop of a hat. I agree with you that it can be difficult to remember whole
health nursing in an environment based on quick turnover. It is imperative to
utilize the metaparadigm of nursing as a foundation to our nursing practice
to ensure the patient’s basic needs are being met to prevent them from
another ED visit or readmission. It’s easy to get lost in the monotony of the
ED but I was able to quickly learn how to balance the art and science in this
setting and care for each unique patient. Thank you for your post!
American Nurses Association (ANA). (n.d.) What is nursing?
https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/
Colleen,
As nurses, we use our hearts and our heads to utilize critical thinking and
compassion to provide the best care solutions; this is why nursing is both an
art and a science and one can’t exist without the other. I agree with your
statement that the art of nursing focuses on the compassion,
communication, and empathizing with our patients. The science side of
nursing involves the theory and evidence. While I believe that nursing is a
fine balance between the two, many tip the scale in favor of the science side,
which is a problem for nursing (Henry, 2018). The art of nursing embodies
compassion and holism which is in turn supported by the technical functions
of nursing practice (Chinn & Kramer, 2011 as cited in Henry, 2018).
The metaparadigm nursing theory is a great foundation for nursing, however,
it should definitely be expanded upon. As you said, no matter what field of
nursing you practice, it is important to recognize the differences in the
environment concept of the metaparadigm. In my nursing career I have seen
how this plays out. The care that I provided is very dependent on my
environment and the environment my patients come from. I’ve worked as an
emergency department nurse and currently work as a forensic nurse. Taking
into consideration these environments and the environments my patients
come from, allows me to tune into the art of nursing. I am able to provide my
forensic patients, who are possibly having one of the worst days of their life,
with the utmost compassionate and trauma-informed care. Overall, the art
and science of nursing has influenced my everyday nursing practice. Thank
you for your post!
Henry, D. (2018). Rediscovering the art of nursing for nursing practice.
Electronic Theses and Dissertations. https://dc.etsu.edu/cgi/viewcontent.cgi?
article=4900&context=etd
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