Margaret Newman's Theory

Margaret Newman's Theory Nurses utilize a wide range of theoretical perspectives to guide their actions during education and practice. Nursing theories have numerous benefits in practice since they inform nurses on the basis for practice together with additional tools to improve the delivery of care.

Furthermore individual and nursing theories serve as a framework for nursing schools. One of the theories that have been used extensively in nursing education and practice is the Margret Newman’s theory of health as expanding consciousness and caring partnership.

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Margaret Newman is an American nurse and a prominent nursing theorist. The American Nursing Academy considers her a living legend due to her contribution to nursing (Ayiera, 2016). The Newman’s theory was selected for this paper since it is considered a grand nursing theory. This theory describes the process of finding greater meaning in life in addition to becoming oneself and reaching novel dimensions of connectedness with the people (Kamau et al., 2015). This theory also has the potential to assist nurses to generate answers to many of the nursing issues besides increasing their autonomy in practice.

Description of the Theorist Margaret Newman has been recognized as a prominent nursing leader and theorist. She was born in 1933 and raised in Memphis in a Christian family (Snowden, Donnell, & Duffy, 2014). The family and Christian values under which she was brought up contributed to her decisions to join missionary service. During her missionary activities, she realized that she could not address the spiritual needs of the people without taking care of their health needs. However, she did not select major nursing upon completing high school. She was frequently requested by her roommate who was a nursing student to assist the people who were injured during a huge tornado. This was the first time Newman started thinking over a career in nursing. Her mother was later on diagnosed with amyotrophic lateral sclerosis, an irreversible condition that kept her confined in bed (Why I Want to Be a Nurse.org. 2014). At this point, Newman decided to be her mother’s primary caregiver. She critically though over her mother’s conduction and concluded that the presence of a chronic condition does not make one unhealthy. She formulated that even though the chronic condition confined her mother, it did not define her life (Parker & Smith, 2010). While taking care of her mother, she started experiencing alterations in space, time, movement, and consciousness that led to the development of greater connectedness. She and her

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mother came to know and understand each other better than before (Parker & Smith, 2010). This marked the turning point for Newman as she decided to become a nurse.

The Category Under Which the Theorist Falls The theory of health as expanding consciousness falls under the grand nursing theory since it has a broad scope and presents general concepts and propositions. The grand nursing theories reflect and offer insights relevant to practice but are not designated for empirical testing.

The fact that grand nursing theories are not designed for empirical testing limits their application for directing, predicting and explaining nursing in certain situations (Smith & Parker, 2015).

Margret Newman's theory is categorized as a grand nursing theory since it is intended to be pertinent to all aspects of nursing. It consists of conceptual frameworks that define broad perspectives for nursing practice.

Assumptions Underlying the Theory Newman’s theory is based on several assumptions including that health is a composition of conditions described as diseases or pathology in medical terms. According to Newman illnesses are considered as manifestations of the wholeness or the total pattern of an individual (Butts, Bandhauer, & Rich, 2013). The theory also assumed that the pattern of every individual patient with time expresses itself as an illness exists before structural and functional changes (Butts et al., 2013). Another assumption of the Newman's theory is that the removal of an illness cannot change the pattern of an individual (Endo, 2017). The theory has it that if the presence of an illness is the only way the patter of an individual can manifest itself, then that typifies the health of the person. Health, as posited in the theory of health as expanding consciousness, is an expansion of consciousness (Butts et al., 2013).

Major Concepts of the Theory

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One of the major concepts of the theory of health as expanding consciousness is that health is not simply the absence of a disease. This theory was formulated to incorporate the health and care for people, whom the absence of illness or disability is not possible (Endo, 2017).

The theory recognizes the role of the nurse in providing care for individuals presenting with debilitating conditions that increase their uncertainty, debilitation and the risk of death (Newman, 2011). The theory was expanded to integrate the health of all people irrespective of the presence or absence of disease. The theory considers that all people in all situations despite how hopeless or disordered they may appear are part of the universal process of expanding consciousness.

Human beings, according to Newman (2011), are directly involved in the process of becoming more united and finding a superior significance of life besides reaching novel dimensions of connectedness with others and the world.

Major Propositions of the Theory The main proposition of Newman's theory is the view that health and the presence of disease are synthesized as health (Ayiera, 2016). This proposition applies the Hegelian dialectical logic which has it that thought occur through contradiction and recognition of the contradiction. In Newman's case, the theorists proposed that the state of the presence of disease unites with the state of absence of disease leading to a synthesis of the two (Ayiera, 2016). The two antithetical concepts fuse bringing forth what is termed as health. The basis of comprehending Newman's theory of health is based on the proposition that health should be perceived as a progressing pattern of the whole (Ayiera, 2016).

Application of the Theory Margaret Newman's theory can be applied in the care of patients presenting with a wide range of health conditions. Kamau et al. (2015), for instance, described the application of this

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theory in the care of patients presenting with HIV/AIDS. Individuals who are diagnosed with this condition experience a feeling of hopelessness and devastation. The emotional, spiritual and social aspects of the patient are also negatively affected since the patient feels that his/her selfimage, sexuality, and reproductive capacity of the patient have been destroyed. Kamau et al.

(2015) noted that nurses use the Newman's theory to reassure the patients that their life is precious and is not defined by their present moment. Nurses also use this theory to fight stigma and inform patients that the presence of disease does not make them unhealthy.

Integration Of Newman's Theory into Practice The Newman's theory can be integrated into clinical care in geriatric care settings to improve delivery of care to patients presenting with debilitating health conditions. A step by step case-approach action plan can be used to facilitate the application of the theory as a foundation of care. This plan involves an assessment of the patient to identify the level of hope, devastation and perception of life due to the presence of a chronic condition. Another crucial step in the integration process is mutual goal setting. The goal setting is aimed at helping patients and care providers to work collaboratively to achieve a projected outcome. The goal setting will improve the patient’s participation in the process of care. The third step will involve the identification and implementation of a practical intervention. Only evidence-based interventions that can improve the health and restore the hope of a patient shall be implemented. The final step will be the evaluation of the care provided to the patient.

An example of a case whereby the Newman's theory can be applied is the care of elderly persons with stroke. Stroke is a debilitating condition that severely affects the ability of a person to participate in activities of daily living. The patients can be assigned a nurse who will stand by them throughout their hospitalization. The nurse is required to use high-level interpersonal skills

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to interact with the patient. This interaction is aimed at increasing the patients hope in life and assuring him/her that the presence of stroke does not mean that the person is unhealthy (Endo, 2017). An evaluation of the integration process can be performed to determine whether the anticipated benefits were achieved. Various individual aspects including the meaning of life, level of hope, and satisfaction with care will be evaluated.

Conclusion Nurses utilize theoretical perspectives to guide their actions during education and practice. These theories have numerous benefits in practice since they offer nurses with a ground for practice together with additional tools to improve the delivery of care. The application of Newman's theory has the potential to transform the care of terminally ill patients. This theory allows nurses to not to base their interaction with the patients on the presence or absence of disease. The theory was expanded to integrate the health of all people irrespective of the presence or absence of disease.

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Ayiera, F. (2016). The theory of health as expanding human consciousness. Margaret Newman’s contribution to nursing theory and practice. New York, NY: GRIN Publishing, Butts, J., Bandhauer, D., & Rich, K. (2013). Philosophies and theories for advanced nursing practice. New York, NY: Jones & Bartlett Publishers Endo, E. (2017). Margaret Newman's theory of health as expanding consciousness and a nursing intervention from a unitary perspective. Asia Pacific Journal of Oncology Nursing, 4(1), 50–52. doi: 10.4103/2347-5625.199076 Kamau, S., & Rotich, R., & Mwembe, D. J. (2015). Applying Margaret Newman’s theory of health as expanding consciousness to psychosocial nursing care of HIV infected patients in Kenya. American Journal of Nursing Science, 4. 6-11. 10.11648/j.ajns.s.20150401.12.

Newman, M. (2011). Health as expanding consciousness. Retrieved from http://currentnursing.com/nursing_theory/Newman_Health_As_Expanding_Consciousne ss.html Parker, M., & Smith, M. (2010). Nursing theories & nursing practice. Philadelphia, PA: F.A Davis Company Smith, M. C., & Parker, M. E. (2015). Nursing theories & nursing practice. Philadelphia, PA : F.A. Davis Company Snowden, A., Donnell, A., & Duffy, T. (2014). Pioneering theories in nursing. London, UK: Andrews Why I Want to Be a Nurse. (2014). Margaret Newman. Retrieved from http://www.whyiwanttobeanurse.org/nursing-theorists/margaret-newman.php