Martha Rogers's Science of Nursing PDF

Abonales, Alforque, Alo, Arañas ROGER’S SCIENCE Unitary Human Beings Unitary Page 1 of 36  Martha Rogers Nursing involves care of the unitary human beings. The u...

Abonales, Alforque, Alo, Arañas ROGER’S SCIENCE Unitary Human Beings Unitary Page 1 of 36  Martha Rogers Nursing involves care of the unitary human beings. The unitary human being and the environment are not dichotomous. Human are viewed as integral with the universe. Nursing focus on people and the manifestations that emerge from the mutual human/environmental field process. Unitary Page 2 of 36  History & Background Martha Elizabeth Rogers was born May 12, 1914 in Dallas Texas. Received her nursing diploma from Knoxville General Hospital School of Nursing (1936). Obtained a Bachelor of Science degree from George Peabody College in Nashville Tennessee. Masters of Arts degree in Public Health Nursing Supervision from Teacher’s College, Columbia University, New York (1945) Doctor of Science degree (1954) from John Hopkins University, Baltimore. Unitary Page 3 of 36  Roger’s publication includes three books and more than 200 articles. Her three books are as follows: 1. Theoretical Basis of Nursing (Rogers, 1970) 2. Nursing Science and an Art: A Prospective (Rogers, 1988) 3. Nursing Science of Unitary Irreducible Unitary Human Beings (Rogers, 1990) Unitary Page 4 of 36  Several assumptions regarding the nature of nursing, which are as follows: 1. Nursing science is an organized body of abstract scientific knowledge that develops from research analysis. This science of nursing helps explain the human experience (Rogers, 1970). 2. Nursing is learned profession and therefore must be based on solid scientific information. 3. Formulated, knowledge is to be used creatively for human betterment (Rogers, 1970). Nursing knowledge provides the tools for the emergent artistic application for nursing care of the unitary human beings. Unitary Page 5 of 36  Basic Life Process in Human: A. ENERGY FIELD The energy field is the fundamental unit of both the living and the nonliving. This energy field provides a way to perceive people and their environment as irreducible wholes. The energy field is the conceptual boundary of all that is. B. OPENNESS The human field and the environment field are constantly exchanging energy. There are no boundaries or barriers to inhibit energy flows between fields (Rogers, 1970). Unitary Page 6 of 36  C. PATTERN Pattern is defined as the distinguishing characteristic of an an energy field perceived as a single wave. Roger calls it “an abstraction” that gives identity to the field. D. PANDIMENSIONALITY The parameters in language that humans use to describe events are arbitrary. The present is relative, there is no temporal ordering of lives. Unitary Page 7 of 36  Basic Life Process in Human: E. HOMEODYNAMIC PRINCIPLES Its principles postulate the way of perceiving unitary human beings. The fundamental unit of the living system is an energy field. Unitary Page 8 of 36  The three principles of Homeodynamics as proposed by Rogers are: Describes the Encompasses the The intensity of unpredictable but mutual, continuous change, embraces the continuous, nonlinear relationship of the continuous variability evolution of energy human energy field of the human energy fields as evidenced by and the environment field as it evolves. nonrepeating energy field. "An ordered rhythmicities. Change occurs by arrangement of The life process continuous rhythms evolves in sequential repatterning of the characterizing both stages along a curve human and human field and the that has the same environmental fields environmental field general shape. by resonance waves. that undergoes The principle of helicy The fields are one and continuous dynamic postulates an ordering integrated but unique metamorphosis in the of the human's to each other. human-environment evolutionary process" emergence. Unitary Page 9 of 36  Environmental Human Field Field Unitary Page 10 of 36  Openness Pattern Pandimensionality Unitary Page 11 of 36  Resonancy Helicy Integrality Unitary Page 12 of 36  Major Assumptions Person An open system in continuous process with the open system that is the environment (integrality). A unitary human being is an "irreducible, indivisible, pan- dimensional (four-dimensional) energy field identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts', a unified whole having its own distinctive characteristics which cannot be perceived by looking at, describing, or summarizing the parts". Has the capacity to participate knowingly in the process of change. Unitary Page 13 of 36  Major Assumptions Environment An "irreducible pan-dimensional energy field identified by pattern and integral with the human field". The fields coexist and are integral. Manifestations emerge from this field and are perceived (Rogers, 1994a) Each environment field is specific to its given human field. Both change continuously and creatively (p.3). Environmental fields are infinite, and change is continuously innovative, unpredictable, and characterized by increasing diversity. Environmental and human fields are identified by wave patterns manifesting continuous mutual change. Unitary Page 14 of 36  Major Assumptions Health Rogers defined health as an expression of the life process: they are the "characteristics and behavior emerging out of the mutual, simultaneous interaction of the human and environment fields." Health and illness are parts of the same continuum. The multiple events taking place along life's axis denote the extent to which man is achieving his maximum health potential and vary in their expressions form greatest health to those conditions which are incomparable with the maintaining life process. Unitary Page 15 of 36  Major Assumptions Nursing The concept Nursing encompasses two dimensions: a.) Independent science of nursing -An organized body of knowledge which is specific to nursing is arrived at by scientific research ad logical analysis. b.) Art of nursing practice - The creative use of science for the betterment of the human. - The creative use of its knowledge is the art of its practice. Nursing is a learned profession: It is a science and art. Nursing is the study of unitary, irreducible, indivisible human and environment energy fields. Unitary Page 16 of 36  Major Assumptions Nursing The art of nursing involves the imaginative and creative use of nursing knowledge. The purpose of nurses is to promote health and well- being for all persons and groups Wherever they are using the art and science of nursing. The health services should be community- based. Rogers challenges nurses to consider nursing needs of all people including future generations of space kind: as life continues to evolve from earth to space and beyond. Unitary Page 17 of 36  Major Assumptions Nursing Her view provides a different world view that encompasses a practice of nursing for the present time and for the imagined and for the yet to be imagined future. Rogers envisions a nursing practice of noninvasive modalities, such as therapeutic touch, humor, guided imagery, use of color, light, music, meditation focusing on health potential of the person. Professional practice in nursing seeks to promote symphonic interaction between man and environment, to strengthen the coherence and integrity of the human field, and to direct and redirect patterning of the human and environmental fields for realization of maximum health. Unitary Page 18 of 36  Theoretical Assertions " the life process is homeodynamic...."Rogers (1970). Rogers identified the principles of change as helicy, resonancy, and integrality. In 1970, Rogers identified the following five assumptions that are also theoretical assertions. Unitary Page 19 of 36  Five Assumptions 1. "Man is a unified whole possessing his own integrity and manifesting characteristics more than and different from the sum of his parts" 2. Man and environment are continuously exchanging matter and energy with one another" (openness). 3. "The life process evolves irreversibly and unidirectionally along the space time continuum" (helicy) Unitary Page 20 of 36  Five Assumptions 4. "Pattern and organization identify man and reflect his innovative wholeness" pattern and organization). 5. "Man is characterized by the capacity for abstraction and imagery, language and thought, sensation and emotion" (sentient thinking being). Unitary Page 21 of 36 Acceptance by the Nursing Community Practice Unitary Page 22 of 36  Practice Rogers' model is accepted as basis for practice of nursing. Within Rogerian framework, nursing is based on theoretical knowledge that guides nursing practice. Unitary Page 23 of 36  Education Rogers clearly articulated guidelines for the education of nurses within the "Science of Unitary Human Beings". Rogers discusses structuring nursing education programs to teach nursing as a science and as a learned profession. Unitary Page 24 of 36  Research Rogers' conceptual model provides stimulus and direction for research and theory development in nursing science. Emerging from the Rogers' In addition, numerous model are theories that middle-range theories have emerged from Rogers' three explain human phenomena homeodynamic principles, and direct nursing practice. (1) helicy, (2) resonancy, (3) integrality. Unitary Page 25 of 36  Application of Rogers’ Science of Unitary Human Beings Unitary Page 26 of 36  Case History of Mrs. Lily H Mrs. H. is a 32-year old female, married, elementary graduate (Grade Six), admitted in a psychiatry unit with severe depression secondary to diagnosis of ovarian cancer. She becomes tearful during history taking. She is accompanied by her husband and 10-year old child. Her husband appeared anxious but supportive and attentive...he is working as an accountant in Makati City. She was diagnosed with ovarian cancer 4 months back and underwent bilateral salphingo- oopherectomy and hysterectomy 2 months ago. She is undergoing chemotherapy due to its metastatic pattern. Unitary Page 27 of 36  For the past 3 weeks she started sitting lonely, decreased ADL (decreased activities of daily living), repeated crying spells, decreased talks, neglects hygiene, muttering to self, decreased sleep and appetite, neglecting her child care, complains of severe pain in the body. She links her illness to her personal belief of being punished for her past sins. She attempted suicide by consuming rat poison. Current assessment findings: her general appearance is a teary eyed young woman, ill-kempt, clinging to her husband looking perplexed, not talking, poor nutritional intake. When asked about her illness, she cries inconsolably; on repeated asking expressed sadness of mood. Unitary Page 28 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Nursing care involves: Pattern Appraisal Mutual Patterning Evaluation Unitary Page 29 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Pattern Appraisal Is a comprehensive assessment of Human and Environmental field patterns of commumication, exchange rhythms, and dissonance (abnormalities/illness) Unitary Page 30 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Pattern Appraisal Mrs. H has a pattern of manifestation of dissonance.... depression with suicidal ideation, ovarian cancer, pain Decreased environmental energy transfer is visible by decreased talking and crying. Has a manifestation of fear, links her illness to her personal belief of being punished for her past sins. Appraisal is needed in her sleep patterns, nutrition and her perception of self. Time between nurse and Mrs. H is needed to foster her healing. Unitary Page 31 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Mutual Patterning Sharing knowledge, offering choices, and empowering Unitary Page 32 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Mutual Patterning The surgery performed The patient needs to be assessed fully regarding her ability to understand and agree with different patterning modalities Therapeutic touch can be introduced to the patient Use humor for increase socialization and developing self-confidence Human environmental patterning needs to involve the other individuals who share her environment including husband and son. Unitary Page 33 of 36  Nursing Care of Mrs. Lily H. with Rogers’ Model Evaluation Centers on the perceptions of dissonance that exist after the mutual pattern activities The appraisal process is repeated Manifestations of worry, pain, fear, sadness of mood have to be appraised with family members. A summary of the dissonance that is perceived is then shared to Mrs. H and mutual patterning is modified and indicated based on the evaluation Unitary Page 34 of 36  ACTIVITY TIME! Pass the ball Unitary Page 35 of 36  the end People are at the center of nursing's purpose (Rogers, 1970, p.) Unitary Page 36 of 36