Evolution of your personal approach to your nursing practice
Students agree that by taking this course all required papers or other written work may be subject to submission for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted papers will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such papers. Students who do not want their work submitted to this plagiarism detection service must, by the end of the second week of class, consult with the instructor to make alternate arrangements (which could include submission of bibliographies, writing samples, research outlines, or other materials).
This assignment is completed in two stages and is designed to help you critically analyze the evolution of your personal approach to your nursing practice.
1.a Part I:
Length: 4-6 pages, not including cover page or reference list
This personal reflection paper is a ‘work-in-progress’, designed to build upon each week’s learning, and to facilitate reflection and analysis of your current approach to practice. The purpose is to identify how you describe each of the nursing metaparadigm concepts at the beginning of the course; why you describe each as you do; and to analysize which paradigm your thinking represents. This paper is to be submitted to Turnitin by midnight on the date prior to the due date for submission.
- At the conclusion of Module 1, and using your own ideas (i.e. no formal references), define/describe each of the four concepts of the traditional nursing metaparadigm (person; environment; health; nursing) – what do each of these concepts mean to you? Provide a clear example from your own practice to support your description for each concept.
- By the end of Module 2, review your description of each metaparadigm concept and expand your on-paper discussion to include the reasons why you described each concept as you did. Using Mezirow’s framework for reflective practice, describe what influenced your thinking about each of the concepts. This answers the question: Why did I write what I wrote?
- By the end of Module 3, review your work-in-progress to date. Based on your descriptions of each of the metaparadigm concepts and your reasons for describing them as you did, i) determine which world view (paradigm) your thinking represents and ii) explain why, using Parse’s framework for paradigm analysis. This constitutes the analysis component of this assignment.
- Your instructor will provide you with information about how to submit this paper for grading and how it will be returned to you.
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Experience has demonstrated that students who do not complete the assignment as identified above (on a weekly basis) do poorly in that assignment. It is recommended that you do not start the weekly assignment until after the weekly class discussion so that you have a more understanding of the relevant content that you will need to complete each weekly component of this first written assignment. Prior to beginning week 1’s assignment, download the grading rubric for this particular assignment. As you proceed in the completion of the assignment from weeks 1 through 4, refer regularly to the grading rubric so that you understand exactly what is being asked for in terms of what is to be included in the assignment and what marks are allotted to each component of that assignment.
Module 2’s assignment asked you to, first, review the 4 metaparadigm concept definitions you wrote out after the first week. Ensure that you know what you mean by the words you used in your definitions – in other words, ‘dig down’ to the root definitions of the various words you use in your definitions. For example, if you wrote that health is the ‘well-being’, what does ‘well-being’ mean? If you wrote that nursing is ‘caring’, what does ‘caring’ mean? If you said that person is a ‘human being’, what does this ‘human being’ look like?
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Let’s say that you defined ‘person’ as a ‘human being’. What is a ‘human being’? Is it an individual with a mind, a body and a soul? In other words, when you think of ‘person’, do you think of someone who has a psychological, physical and spiritual component? Or do you think of ‘person’ as a being that is so complex that you can’t break that ‘person’ into parts? In other words, is ‘person’ so complex that it is something that is greater than the sum of its parts? Review all your concept definitions (what you wrote for each of the metaparadigm concepts: person, environment, health and nursing). Review last week’s instructions related to the writing of these definitions* to assist you in ‘drilling down’ so that your concept definitions are clear. *NOTE: The instructions can be found in Module 2 under Reviewing what you’ve done this past week – Assignment. Another thing that you’ll want to do is use consistent terminology between your definitions. For example, you might have said that ‘person’ has a mind, body and soul. You might have defined ‘health’ as the balance of ‘person’s’ physical, psychological and spiritual self. This would be consistent (that is, if ‘person’ has these three parts, then ‘person’s’ health should reflect these three parts as well – in other words, if ‘person’ has a body, there needs to be some consideration of ‘person’s’ health related to ‘person’s’ bodily part). However, try and use the same words between concept definitions. In this example, therefore, if you think that ‘health’ is the balance of ‘person’s’ physical, psychological and spiritual parts, then, in your definition of ‘person’ use the same words: ‘person’ has physical, psychological and spiritual components (rather than saying that ‘person’ has a body, mind and soul).
The second thing you needed to do in last week’s assignment, once you reviewed and revised (if necessary) your concept definitions, was think about why you defined each of the concepts the way you did. That part of the assignment was geared toward the identification of your meaning perspectives. This part of the assignment is all about answering the following questions: Why did I write what I wrote? Where did those ideas come from? What influences formulated/created/etc. those ideas? This is usually a particularly challenging exercise. We rarely take the time to critically reflect on the basic components that define our practice (that is, why we define ‘person’ the way we do; why we think about the ‘environment’ the way we do; why we describe ‘health’ the way we do; why we think nursing is what we say it is?). This critical reflection requires that we look back on our lives and our experiences – how we were socialized and what we learned. Remember, critical reflection requires us to critically think about our past.
|Facilitate your own learning: Let’s say that you define ‘person’ as a physical, psychological and spiritual being. |
Here is a plausible meaning perspective discussion that would explain why you defined ‘person’ as having physical, psychological and spiritual parts: When I was a child, I had a twin brother. I’m a girl. Early on I learned that his body and my body were different. He was very smart in school while I struggled for every mark. The teachers used to compare us but my mother would say to me: ‘You are the sensitive, compassionate one – you have other talents that you put your mind to.’ He was very popular with our school friends while I was more quiet and introverted. Every day I would pray to God to make people like me as much as they liked my brother. So, let’s look at this. Discovering that girls are built differently than boys would explain how you would know that ‘person’ has a physical part. Being told that you had a mind and feelings (for example, compassion) would explain the psychological part of ‘person’. And praying would explain the spiritual part of ‘person’. However, in this meaning perspective discussion, consider the notion of ‘mother’, ‘brother’ and ‘friends’. ‘Mother’, ‘brother’ and ‘friends’ are social constructs. So, if these social constructs are included in your meaning perspective discussion, you must also believe that ‘person’ has a social component. Therefore, you would need to adjust your ‘person’ definition to include this component (that is, ‘person’ is a being with physical, psychological, spiritual and social parts). You can see from the example above that your meaning perspective discussion for each of the metaparadigm concepts does not have to be long. However, it does have to explain why you include whatever you do in each of your concept definitions (that is, in the example above, the inclusion of all the components of ‘person’ are explained). Let’s stick with this example we’re using and try one more of the metaparadigm concepts – ‘health’. Let’s say that you define ‘health’ as a state of balance. The first question is: balance of what? So, you tighten this up to say that ‘health’ is a state of balance between ‘person’s’ physical, psychological and spiritual components. Okay, well, at least this is consistent with how you originally defined the ‘person’ (that is, ‘person’ has three parts and ‘health’ is the balance of these three parts + you’re using the same words, for example, physical versus body). But, based on the above meaning perspective discussion, you’ve identified that there is also a social component to ‘person’ (and you adjusted your person definition accordingly). Now you have to ask yourself: if there is a social component to ‘person’, is there social health? If so, then you need to adjust your ‘health’ definition to include this (that is, health is the balance between the person’s physical, psychological, spiritual and social parts). If you don’t believe that there is social health, you would need to explain why. Make sure that all your concepts definitions are explained – that the meaning perspective discussions that explain why you define the 4 metaparadigm concepts the way you do address all the aspects of your concept definition. Make sure that you use the same terminology throughout your concept definitions. Make sure that your definitions are consistent.
Take a look at your work on the 4 concepts of the nursing metaparadigm that you have been working on over the past weeks. Focus on your concept definitions and, for each, determine whether your definition represents the totality or simultaneity paradigm and explain why, using the criteria that differentiates the totality from the simultaneity perspective.
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Let’s start with the metaparadigm concept ‘person’.
Let’s say that you defined ‘person’ as a ‘unique being with physical, mental, spiritual and social components’. Looking at the criteria that differentiate the totality from the simultaneity paradigm, and comparing your definition to those criteria, what did you discover? Remember, the criteria for ‘person’ according to the totality paradigm is that the ‘person’ is defined as the sum of parts (a mechanistic point of view). The simultaneity paradigm criteria for ‘person’ are that the ‘person’ is greater than the sum of parts and can’t be reduced to parts (an organismic point of view). So, if your definition claims that ‘person’ is a ‘unique being with physical, mental, spiritual and social components, then clearly you have reduced the ‘person’ (the whole) to the sum of 4 parts: physical, mental spiritual and social. When you put all these parts together, you have a totality definition of ‘person’. The practice example that you included to demonstrate how you describe the person would, for example, speak to you doing an assessment that looked at the person’s physiological condition/symptoms (the physical part); you’d ask questions about her/his psychological status (the mental part); you’d inquire about what kinds of supports s/he has at home (the social part); and if the person has any religious needs/practices (the spiritual part). Let’s say that your definition of ‘environment’ includes words like ‘place where person lives’ or ‘surroundings’. Clearly, this puts your ‘environment’ definition into the totality paradigm because it meets the criteria for environment that reflects the totality paradigm – that the ‘environment’ is separate from the person. Let’s also say that your ‘environment’ definition also talks about how the ‘environment’ influences the person. Or, let’s say, that in your meaning perspective discussion, you talk about how you know that the ‘environment’ influences the person because, when you were small, you got stung by a bee and had an allergic reaction. The bee is in the ‘environment’. This example shows that you ‘reacted’ to your ‘environment’ – the bee (in the ‘environment’) stung you and that influenced your physical body – you had an allergic reaction. The totality criteria for ‘environment’ is not only that the ‘environment’ is separate from the person, but also that the person reacts to (is influenced by) her/his ‘environment’. So, your ‘environment’ definition reflects these totality criteria so it is a totality definition. We’ll try one more:
Let’s say that your ‘health’ definition said that ‘only the person knows what health means to them’. In this case, you are saying that the person (not the nurse) says what ‘health’ is. The simultaneity criteria for ‘health’ are that only the person and no other knows what it means to be healthy (for her/him). So this ‘health’ definition is a simultaneity definition. And, if the above is the case (that only the person knows what health looks like for her/him), then the ‘nurse’ cannot possibly be the expert – only the person can be the expert on her/his health matters. In the simultaneity paradigm, since only the person knows what health means, all the nurse can be is a knowledge broker – giving the person information (if s/he wants it) but in no way imposing the nurse’s own ideas about ‘health’ on the person. If your definition of ‘health’ is that only the person knows what health is to her/him (reflecting the simultaneity paradigm), then your definition of ‘nursing’ must also reflect the simultaneity paradigm.
This can be crazy-making! The best way to understand this is to look at your definition of each of the metaparadigm concepts; look at the criteria for the totality paradigm for each concept and see if your definition matches that criteria; look at the criteria for the simultaneity paradigm and see if your definition matches that criteria. If your concept definition matches the totality criteria, it is a totality definition. If it matches the criteria for the simultaneity paradigm, it is a simultaneity definition.
Remember, if your ‘person’ definition reflects the totality paradigm, then your ‘environment’ definition will also most likely reflect that same paradigm. If it reflects the simultaneity paradigm, then your ‘environment’ definition must also reflect the simultaneity paradigm because those 2 concepts tend to go together. Similarly, if your ‘health’ definition reflects the totality paradigm, then so will your ‘nursing’ definition. If it reflects the simultaneity paradigm, then so will your ‘nursing’ definition as these 2 concepts tend to go together.
You also need to remember that one paradigm is NOT better than the other!!!
Also, remember that the totality approach to nursing practice evolves from a logical empirical orientation to viewing the world in general. The simultaneity approach to nursing practice evolves from a historicist perspective of the world in general. When we think about philosophical orientations (ways in which we can interpret and navigate within the ‘real’ world), we think about logical empiricism or historicism. However – and this is IMPORTANT – when we’re talking about the way in which we approach our individual nursing practice – the paradigm we base our nursing practice on – we’re talking about totality or simultaneity.
As you begin to pull you first Reflective Analysis paper together, remembering that it is due in week 5 of the course,
- review the definitions of each of the metaparadigm concepts that you initially wrote after the first week of the course – are they consistent? are you using the same language to describe the four concepts?
- have you provided a practice example for each of your concept definitions that demonstrates your definition ‘in action’ (that is, a specific application of each of your definitions that demonstrates, in practice, why you defined each concept the way you did)?
- have you provided a meaning perspective discussion that demonstrates why you defined each of the concepts the way that you did?
- have you identified the paradigm that each of your concept definitions reflects and provided the rationale for your decision?
Format your work into a scholarly paper. Although this paper is intended to be a self-reflection in its entirety (and, therefore, written in the first person), if you have cited an author other than yourself, ensure that you have correctly used APA formatting for your paper. Remember: only actual citations that appear in your text (in your paper) are included on a reference list at the conclusion of your paper. Your paper is due Week 5 and must be submitted to Turnitin by midnight of the day preceding the submission deadline.