Metaparadigms of Nursing

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A metaparadigm is a core concept that defines a discipline, describing its boundaries and goals. Even though individual occupations and people have different needs and do varying things, they have some shared aims and similar methods as long as they share a metaparadigm. In nursing, four commonly accepted metaparadigms are “person,” “environment,” “health,” and “nursing”. This essay looks into and discusses each of them along with a literature review.

History of the Metaparadigm

The introduction and refinement of the core concepts of nursing took a considerable amount of time since the creation of the first nursing theory by Florence Nightingale. Reed and Shearer (2017) claim the metaparadigm was created in the early 1970s by nurses in education and curriculum development. They continue by stating that the four concepts used today were codified by Jacqueline Fawcett in 1984. Since then, there have been no changes in the names of the ideas, though each nursing theory describes their meanings differently.

The Person Concept

The concept of “person” encompasses all recipients of care provided by nurses. According to DeLaune, Ladner, McTier, Tollefson, and Lawrence (2016), the definition of “recipient” can mean individuals, families, groups and even the community as a whole. The goal of a nurse is to do all in their power to assist the persons they are looking after, and this means assisting individuals as well as educating families or spreading information to the wider community.

The Environment Concept

An environment is everything that surrounds a person and influences them, both internally and externally. According to DeLaune et al. (2016), the environment is inseparable from the person, and they continuously rhythmically affect each other. Changes in one provoke the other to change as well, leading to further evolution. The work of a nurse involves changing or containing the environment of the person so that negative influences are minimized, and positive ones are promoted.

The Health Concept

The concept of health envelops the well-being and wellness of the person. According to DeLaune et al. (2016), the most recent nursing theory describes it as “an open process of becoming that encompasses a lived experience, synthesis of values, and rhythmic process of being or becoming” (p. 19). Maximizing the person’s health is a nurse’s ultimate goal, and their efforts should be aimed towards achieving the highest standard of health possible through both their work and the encouragement of the person to take care of themselves.

The Nursing Concept

The last concept, nursing, describes the nurse as a force of change in the patient’s life. According to DeLaune et al. (2016), it encompasses the nurse’s knowledge, influence, skills and actions, and its practice is described as “a performing art” (p. 19). Nursing is the framework through which the practitioner influences the person’s life, introducing necessary changes. The goals mentioned above are accomplished through methods included in this concept, and a nurse must strive to expand their abilities as much as possible.

Metaparadigms in Literature

Contemporary nursing literature appears to avoid describing the four concepts in detail, only mentioning them in passing. Van Sell (2017) states that her research into the use of nursing metatheory in literature since 2008 has discovered an absence of its mentioning, which is an issue that needs to be addressed. These findings are compounded by the author’s own, as the referenced books do not contain significant discussion on the concepts of nursing.


The four concepts that make up the metaparadigm of nursing are person, environment, health, and nursing. Each of these has evolved since the beginning and will likely continue doing so in the future. However, to advance the theory, it is necessary to familiarize the scholars with it, which the current literature fails to do. It would be beneficial to include more in-depth discussion on nursing metatheory in future publications.


DeLaune, S. C., Ladner, P. K., McTier, L., Tollefson, J., & Lawrence, J. (2016). Fundamentals of nursing: Australia & NZ edition. Artarmon, Australia: Cengage Learning Australia.

Reed, P. G., & Shearer, N. B. C. (2017). Nursing knowledge and theory innovation, second edition: Advancing the science of practice. Web.

Van Sell, S. L. (2017). Interpreting nursing metatheory through complexity integration nursing theory: A scoping review. International Journal of Nursing & Clinical Practices, 4(235). Web.

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NursingBird. "Metaparadigms of Nursing." December 16, 2021.