Martha Roger's Science of Unitary Human Beings

Martha Roger's Science of Unitary Human Beings

This page was last updated on November 6, 2010

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Introduction Born :May 12, 1914, Dallas, Texas Diploma :Knoxville General Hospital School of Nursing(1936) Graduation in Public Health Nursing, George Peabody College, TN, 1937 MA :Teachers college, Columbia university, New York, 1945 MPH :Johns Hopkins University, Baltimore, MD, 1952 Doctorate in nursing :Johns Hopkins University, Baltimore, 1954 Fellowship: American academy of nursing Position: Professor Emerita, Division of Nursing, New York University, Consultant, Speaker Died : March 13 , 1994 Publications of Martha Rogers Theoretical basis of nursing (Rogers 1970) Nursing science and art :a prospective (Rogers 1988) Nursing :science of unitary, irreducible, human beings update (Rogers 1990) Vision of space based nursing (Rogers 1990) Rogers nursing theory Nursing is both a science and art. the uniqueness of nursing, like that of any other science, lies in the phenomenon central to its focus. Nurses long established concern with the people and the world they live is in a natural forerunner of an organized abstract system encompassing people and the environments. The irreducible nature of individuals is different from the sum of the parts. The integral ness of people and the environment that coordinate with a multidimensional universe of open systems points to a new paradigm :the identity of nursing as a science. The purpose of nurses is to promote health and well-being for all persons wherever they are. Evolution of abstract system The development of the abstract system was strongly influenced by an early grounding in arts and background of science and her keen interest in space The science of unitary human beings originated as a synthesis of facts and ideas from multiple sources of knowledge The uniqueness is in the central phenomena : people and environment The Rogerian view of a causality emerges from an infinite universe of open system. Overview of Rogerian model Rogers model provides the way of viewing the unitary human being Humans are viewed as integral with the universe The unitary human being and the environment are one ,not dichotomous Nursing focus on people and the manifestations that emerge from the mutual human /environmental field process Change of pattern and organization of the human field and the environmental field is propagated by waves The manifestations of the field patterning that emerge are observable events The identification of the pattern provide knowledge and understanding of human experience Basic characteristics which describes the life process of human: energy field, openness, pattern, and pan dimensionality Basic concepts include unitary human being, environment, and homeodynamic principles Concepts of Rogers model Energy field The energy field is the fundamental unit of both the living and nonliving This energy field "provide a way to perceive people and environment as irreducible wholes" The energy fields continuously varies in intensity, density, and extent Openness The human field and the environmental field are constantly exchanging their energy There are no boundaries or barrier that inhibit energy flow between fields Pattern Pattern is defined as the distinguishing characteristic of an energy field perceived as a single waves "pattern is an abstraction and it gives identity to the field" Pan dimensionality Pan dimensionality is defined as "non linear domain without spatial or temporal attributes" The parameters that human use in language to describe events are arbitrary. The present is relative ;there is no temporal ordering of lives. Unitary Human Being (person) 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" and "a unified whole having its own distinctive characteristics which cannot be perceived by looking at, describing, or summarizing the parts" The people has the capacity to participate knowingly and probabilistically in the process of change Environment The environment is an "irreducible ,pan dimensional energy field identified by pattern and integral with the human field" The field coexist and are integral. Manifestation emerge from this field and are perceived. 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 environmental fields" Health and illness are the part of the sane continuum. The multiple events taking place along life's axis denote the extent to which man is achieving his maximum health potential and very in their expressions from greatest health to those conditions which are incompatible with the maintaining life process Nursing The concept Nursing encompasses two dimensions Independent science of nursing An organized body of knowledge which is specific to nursing is arrived at by scientific research and logical analysis 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 Assumptions about people and nursing Nursing exists to serve people………..it is the direct and overriding responsibility to the society The safe practice of nursing depends on the nature and amount of scientific nursing knowledge the individual brings to practice…….the imaginative, intellectual judgment with which such knowledge is made in service to the man kind People needs knowledgeable nursing Homeodynamic principles The principles of homeodynamic postulates the way of perceiving unitary human beings The fundamental unit of the living system is an energy field Three principle of homeodynamics Resonancy Helicy integrality Resonance Resonance is an ordered arrangement of rhythm characterizing both human field and environmental field that undergoes continuous dynamic metamorphosis in the human environmental process Helicy Helicy describes the unpredictable, but continuous, nonlinear evolution of energy fields as evidenced by non repeating rhythmicties The principle of Helicy postulates an ordering of the humans evolutionary emergence Integrality Integrality cover the mutual, continuous relationship of the human energy field and the environmental field . Changes occur by by the continuous repatterning of the human and environmental fields by resonance waves The fields are one and integrated but unique to each other Rogerian theories-Grand theories The theory of accelerating evolution The theory of paranormal phenomena The theory of rhythmicities Theory of paranormal phenomena This theory focus on the explanations for precognition, déjàvu, clairvoyance, telepathy, and therapeutic touch Clairvoyance is rational in a four dimensional human field in continuous mutual, simultaneous interaction with a four dimensional world; there is no linear time nor any separation of human and the environmental fields The theory of accelerating evolution Theory postulates that evolutionary change is speeding up and that the range of diversity of life process is widening. Rogers explained that higher wave frequencies are associated with accelerating human development Theory of Rhythmicity Focus on the human field rhythms (these rhythms are different from the biological, psychological rhythm) Theory deals with the manifestations of the whole unitary man as changes in human sleep wake patterns, indices of human field motion, perception of time passing, and other rhythmic development Theories derived from the science of unitary human beings The perspective rhythm model (Patrick 1983) Theory of health as expanding consciousness (Neuman, 1986) Theory of creativity, actualization and empathy (Alligood 1991) Theory of self transcendence (Reed1997) Power as knowing participation in change (Barrett 1998) Rogers concepts of nursing Nursing is a learned profession-it is a science and art Nursing is the study of unitary. Irreducible, indivisible human and environmental energy fields 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 person 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 generation of space kind ;as life continuous to evolve from earth to space and beyond. 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 proposes 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 potential Nursing intervention seeks to coordinate environmental field and human field rhythmicities, participates in the process of change , to help people move toward better health Nursing aims to assist people in achieving their maximum potential. Nursing practice should be emphasized on pain management, supportive psychotherapy motivation for rehabilitation. Maintenance and promotion of health, prevention of disease, nursing diagnosis, intervention, and rehabilitation encompasses the scope of nursing Roger’s contribution to nursing knowledge Rogers was one of the first nurse scholars to identify the person (unitary man) as the central phenomena of nursing concern Nursing abstract system is a matrix of concepts relevant to the life process in man Rogers conceptual system provides a body of knowledge in nursing that will have relevance for all workers concerned with people, but with special relevance for nurses; because it matters to human beings; consequently to nurses In the evolution it is properly subjected to reformulation and change as the knowledge grows, the the conceptual data will be more clearer and it will take new dimensions The utilization of Rogerian model is used as a guide for theory development, research, nursing education, and in the direct patient care practice Rules for nursing research guided by the Rogerian theory Rules for research The Rogerian research require both basic and applied research The phenomena to be studied are unitary human beings and their environmental interaction Study participants may be any person or group, with the provision that both person and environment are taken into account Research methodology Qualitative and quantitative methods can be applied Experimental researches are questionable because she rejects the notion of causality Case study and longitudinal research are better than cross sectional study Research instruments that are directly derived from science of unitary human beings should be used Data analysis – multivariate analysis (canonical correlation studies) Research tools derived from science of unitary human beings Perceived field motion scale Human field rhythm scale Temporal experience scale Assessment of dream experience scale Person environment participation scale Leddy healthiness scale Mutual exploration of the healing human-environment field scale Garon assessment of pain scale Family assessment tool Community health assessment tool Rules for nursing education guided by Rogerian theory Focus of the curriculum Nursing education can be for professional nursing , technical nursing The focus is the transmission of the body of knowledge Teaching and practicing therapeutic touch Conducting regular in-service education Nursing programs Baccalaureate degree program Masters program Doctoral program The major concepts are – principal of Resonancy, Helicy, Integrality The faculty in the nursing education must be prepared at doctoral level Teaching- learning strategies Emphasis should be on developing self awareness as an aspect of the clients environmental energy field and the dynamic role of nurse pattern manifestation on the client Emphasis on laboratory study- the lab setting include homes, schools, industry, clinics, hospitals, other places where people lives Importance of use of media in education Rules for nursing administration guided by Rogerian theory Purpose of nursing services Nursing services is the center of any health care system The purpose of nursing services is health promotion Characteristics of nursing personnel The administrators should hold higher degrees in nursing and licensed Leaders must be visionary and willing to embrace innovative and creative change Leaders should be able to identify the patterning to ensure the integrated behaviors for client and employees Management strategies and administrative policies Administrative policies foster an open and supportive administrative climate that enhances staff members self esteem , actualization, and freedom of choice and provide opportunity for staff development and continuing education The ultimate goal is the clients well-being Rules for independent practitioner guided by Rogerian model Nursing is an independent science Nurse assumes the role of potentiater of care She proposes the independent role in various setting like school, industry, community, space (by 2050AD) Independent practitioner is an advanced practice registered registered nurse who focus on well-being or mutual patterning of individual, family, community across the life span ,at risk for developing dissonance/illness Rules for nursing practice guided by Rogerian theory Areas of Rogerian model application SETTINGS All spheres of life School Industry Family Community Space SPECIALITIES Pediatrics Psychiatry Oncology Burns Geriatrics Neurology Cardiology Rehabilitative medicine SPECIALIZED AREAS OF PRACTICE Neonatal ICU Pediatric ICU Post operative unit Pre operative unit Palliative care unit Rehabilitation center Burns unit Adult ICU’s Old age homes Neuropsychiatric units AREA WHERE ROGERIAN MODEL IS NOT APPLICABLE Operation theaters Purpose of nursing practice To promote well-being for all persons, wherever they are To assist both the client and nurse to increase their awareness of their own rhythm Setting for practice From community to hospital to outer space Legitimate participants People of all ages both as individual human energy fields and group energy fields Nursing process- Health patterning practice method Assessment Voluntary mutual patterning Evaluation For the nurse Pattern appraisal Mutual patterning of human and environmental fields Evaluation For the patient Self reflection Patterning activities Personal appraisal Nursing process Assessment Areas of assessment Simultaneous states of the individual and the environment Total pattern of events at any given point in space –time Rhythms of life process Supplementary data Categorical disease entities Subsystem pathology Pattern appraisal It is a comprehensive assessment of: Human field patterns of communication, exchange, rhythms, dissonance Environmental fields pattern of communication, rhythms, dissonance, harmony Intuitive reflection of self Validation of the appraisal Validate with self Validate with the client Mutual patterning of human and environmental field Sharing knowledge Offering choices Empowering the client Fostering patterning Evaluation Repeat pattern appraisal Identify dissonance and harmony Validate appraisal with the client Self reflection for the client Pattern appraisal include appraisal of multiple lifestyle rhythms such as: Nutrition Work/leisure activities Exercise Sleep / wake cycles Relationships Discomfort or pain Fear /hopes Patterning activities for the client  Meditation  Imagery  Journaling  Modifying the surroundings Clinical case study of Radha using Rogerian conceptual Model Radha is a 22years old female admitted in a psychiatry unit with severe depression secondary to diagnosis of ovarian malignancy. She becomes tearful during history taking. Radha is accompanied with her husband and 1year old child. Her husband appeared anxious but supportive and attentive …………he is working as an accountant in their native place. Radha was diagnosed with ovarian cancer 2 months back and underwent bilateral salphingio oopherectomy and hysterectomy………30days ago. She is undergoing chemotherapy due to its Metastatic pattern…….. From past 3 weeks Radha started sitting lonely, decreased ADL, repeated crying spells, decreased talks, neglects hygiene, muttering to self, decreased sleep , appetite, neglecting her child care, complaints of severe pain in the body,………….3 days back 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….cries inconsolably …on repeated asking expressed sadness of mood. Nursing care of Radha with Rogers model With rogerian model, the process of caring Radha begins with pattern appraisal Nursing care involve pattern appraisal, mutual patterning, and evaluation Pattern appraisal This visible rhythmical pattern is a manifestation of evolution towards dissonance Radha has pattern manifestation of dissonance……..depression with suicidal ideation, ovarian malignancy, pain Radha has a low educational background A pattern activity of healing is noted through reports of a positive operative course Patterning has to be directed towards reduction in perceived dissonance with her personal and environmental field Pain is a manifestation of perceived dissonance Decreased environmental energy transfer is visible by decreased talking and crying Radha has manifestation of fear…….her self knowledge 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 Appraisal can be grouped into exchanging patterns, communication patterns, and relating patterns Time between nurse and Radha is needed to foster her healing During the process nurse must rely on personal intuition and insight regarding the emerging pattern All this pattern forms the unitary pattern of Radha Mutual patterning The process is mutual between the nurse and Radha The surgery performed, medication she is receiving are patterning modalities Patterning activities planned by the nurse for Radha ……..therapeutic touch, humor , meditation, imagery Radha needs to be assessed fully regarding her ability to understand and agree with different patterning modalities Therapeutic touch can be introduced to Radha Touch is introduced and incorporated into the management of pain, helps in energy transmission for healing and …….helps in developing trust in the nurse Teach her how to center the energy and channel her energy to the area of pain Use humor for increasing socialization and developing self confidence and developing worthiness Human environmental patterning needs to involve the other individual who share her environment including husband and son Options are introduced relating to increase communication and hygiene patterns The entire family is involved in power as knowing participation in change Evaluation The evaluation process centers on the perceptions of dissonance that exist after the mutual pattern activities The appraisal process is repeated Manifestation of worry, pain, fear, sadness of moos has to be appraised with family members A summary of the dissonance and/or harmony that is perceived is then shared with Radha, and mutual patterning is modified or instituted ad indicated based on the evaluation Summary Biographical sketch of Martha Rogers Overview of Rogerian concepts Rogerian terminologies Rogerian theories Nursing concepts, nursing process Perspectives of nursing education, administration, nursing practice Contribution to nursing knowledge Clinical example References George B. Julia , Nursing Theories- The base for professional Nursing Practice , 3rd ed. Norwalk, Appleton & Lange. Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.