Nursing is a set of organized care activities carried out by specially trained professional nurses to provide care to needy people of all age groups, taking into account existing and potential health problems. This definition brings together four nursing metaparadigms. The first metaparadigm – the patient – is the core concept of nursing. The overarching concept of the person means that the person is viewed from physical, mental, and social perspectives (Bender, 2018). The person in nursing is viewed through the lens of humanistic theory. A person lives by communicating and coming into contact with other people and must be perceived as independently capable of making decisions and carrying them out. The physical essence of the human being is a set of organs. The sensual side of the human being’s mental characteristics includes memory, thinking, ability to operate with concepts, aspirations, and feelings.
The second metaparadigm is the environment. A person’s environment is inseparable from a person’s health and well-being. The individual influences the background, just as the environment influences the individual. The physical environment includes the relationships in which a person lives. The mental and social environment consists of the relationships between people, communication, language, culture, and norms of behavior. Nursing care aims to support the person in an environment as close as possible to their surroundings. A good environment during inpatient care makes the person feel safe and comfortable.
The third paradigm is health: a person can be viewed in terms of health on a scale, on one end of which is perfect health and on the other end of which is death. Health does mean not only the absence of disease but also a sufficiently good physical, mental and social balance, by which good health and capacity for work are achieved. Capability is understood to be the ability of the individual to fulfill his or her basic needs in the physical, mental and social areas of life.
The final paradigm is nursing. It is a professional activity that responds to the needs of the patient. The modern understanding of nursing brings to the fore the prevention of illness, the maintenance of health through teaching and education, and counseling. Important in nursing is the ability to give the patient hope and maintain it and reduce suffering. The primary nursing methods are helping the patient, listening, talking, supporting, caring, teaching and counseling.
One of the theories that has had the greatest impact on nursing is the needs theory. To live, a person needs to satisfy physiological needs: to breathe, to drink, to eat, to excrete, to sleep, and to move (Selvam, 2018). The social needs of the individual in this theory are called needs for belonging. This includes a sense of belonging to something or someone, a sense of being accepted by others, and a sense of social interaction, affection, and support. These are people’s relationships in society – family, friends, companionship, approval, affection, and love.
Concerning this theory, there is a concept proposed by Virginia Henderson in 1960. It focuses nursing staff on the physiological needs and then on the psychological and social needs that can be met through nursing care (Gligor & Domnariu, 2018). The main focus of this model is the involvement of the patient in the process of planning and implementation of care. Henderson suggests fourteen needs for everyday life. A healthy person has no difficulty in meeting these needs. On the contrary, a sick person is not able to meet these needs on their own. Henderson argues that nursing care should aim to restore the person’s independence as soon as possible. This concept relates to my clinical setting primarily because the needs-based approach to the patient is used in both nursing education and practice. The nurses in my locality focus on the patient’s basic needs and their satisfaction when providing care. According to Henderson’s interpretation, the staff focus on the satisfaction of physical needs first, followed by psychological and social needs.
The second concept, Dorothea Orem’s self-care deficit model, is based on the principles of self-care, which she defines as life, health, and well-being activities that people initiate and carry out independently. The patient is regarded as a single functional system with a motivation for self-care. A person carries out self-care regardless of whether he or she is healthy or ill. Their capabilities and self-care needs must be in balance. Universal needs, according to Orem, include adequate intake of air, fluids, food, sufficient capacity to excrete, and maintaining a balance between activity and rest (Gligor & Domnariu, 2018). This concept correlates with the primary theory because the needs it highlights correlate with the needs of the theory. In my clinical setting, this concept manifests itself in the provision of self-care for patients. In my area, when the patient can take care of their health, they can do so under the supervision of a nurse. This practice helps patients learn to take care of themselves after discharge from the hospital.
Bender, M. (2018). Re-conceptualizing the nursing metaparadigm: articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3), 1-23.
Gligor, L., & Domnariu, C, D. (2020). Patient care approach using nursing theories: comparative analysis of Orem’s self-care deficit theory and Henderson’s model. Acta medica transilvanica, 25(2), 11-14. 10.2478/amtsb-2020-0019.
Selvam, I. (2018). Nursing theories: a review. International journal of advances in nursing management, 6(3), 271-274. 10.5958/2454-2652.2018.00061.6.