Bibliography
-Margaret Newman was born on October 10, 1933 in Memphis Tennessee.
In 1954 She earned her first Bachelors degree in Home Economics and English from Baylor University in Waco, Texas
-Margaret Newman felt a call to nursing for a number of years prior to her decision to enter the field.
-During that time she became the primary caregiver for her mother, who became ill with Lou Gehrig's Disease.
-Upon entering nursing at the University of Tennessee, Memphis, Dr. Newman knew almost immediately that nursing was right for her
Education
• In 1962 she received her Bachelors degree in Nursing from the University of Tennessee, Memphis.
• In 1964 she received her Masters Degree of Medical-Surgical Nursing and Teaching at the University of California in San Francisco.
• In 1971 she completed her Doctorate of Nursing Science and Rehabilitation at New York University
Employment
Ø 1971 to 1976- She completed her graduate studies at New York University. She also worked and taught alongside nursing theorist Martha Rogers.
Ø Rehabilitation Nursing stemmed her interest in health, movement & time.
Ø 1977- Professor in charge of graduate study in nursing at Pennsylvania State.
Ø 1984- Nurse theorist at the University of Minnesota.
Ø 1996- Retired from teaching.
HEALTH AS AN EXPANDING CONSCIOUSNESS
Newman's Health as Expanding Consciousness was influenced by Martha Rogers. Newman (2003) writes:
Newman’s theory of pattern recognition provides the basis for the process of nurse-client interaction. Newman suggested that the task in intervention is a pattern recognition accomplished by the health professional becoming aware of the pattern of the other person by becoming in touch with their own pattern. Newman suggested that the professional should focus on the pattern of the other person , acting as the “reference beam in a hologram”.
Relationship to the Metaparadigm Concepts
Newman has designated “caring in the human health experience” as the focus of nursing discipline and has specified the focus as the metaparadigm of the discipline.
Nursing
-to help clients get in touch with the meaning of their lives by the identification of their patterns of relating
-Intervention is a form of non intervention whereby the nurse’s presence assists clients to recognize their own patterns of interacting with the environment.
-facilitates pattern recognition in clients by forming relationships with them at critical points n their lives and connecting with them in an authentic way.
-The nurse-client relationship is characterized by “a rhythmic coming together and moving apart as clients encounter disruption of their organized predictable state.”
-Nurses are seen as partners in the process of expanding consciousness.
Person
-Person as individuals are identified by their individual patterns of consciousness.
-Persons are further defined as “centers of consciousness” within an overall pattern of expanding consciousness”
-The definition of person has also been expanded to include family and community.
Environment
-Environment is not explicitly defined but is described as being the larger whole, which is beyond the consciousness of the individual.
Health
-A fusion of disease and non-disease creates a synthesis that is regarded as health.
-Disease and non-disease are each reflections of the larger whole; therefore a new concept “pattern of the whole” is formed.
-Newman has stated that pattern recognition is the essence of the emerging health. Manifest health, encompassing disease and non-disease can be regarded as the explication of the underlying pattern of person-environment.
Essence of Margaret Newman's Theory:
• An individual person in each situation, no matter how disordered and hopeless, is part of the universal process of expanding consciousness.
• The expanding consciousness is a process wherein an individual becomes more of his real self, as he finds greater meaning in his life and the lives of those people around him.
• In his/her search for his/her real self, the individual's awareness expands to include the interests of those people around him and the rest of the world.
• Self-awareness may eventually lead to acceptance of one's self and one's circumstances and limitations.
• With self-awareness and self-acceptance, an in-depth understanding of one's condition may pave the way for a person to engage into activities leading to positive progression transcending
Supporting Theory
• The health of a human being is a unitary phenomenon, an evolving pattern of human-environment (Rogers, 1970).
• Life is a process of expanding consciousness. Consciousness is the informational capacity of the system and can be seen in the quality of interaction of the system with the environment (Bentov, 1978).
• The explicate order is a manifestation of the implicate order (Bohm, 1980).
Assumptions
1. Health encompasses conditions heretofore described as illness, or, in medical terms, pathology
2. These pathological conditions can be considered a manifestation of the total pattern of the individual
3. The pattern of the individual that eventually manifests itself as pathology is primary and exists prior to structural or functional changes
4. Removal of the pathology in itself will not change the pattern of the indivdual
5. If becoming ill is the only way an individual's pattern can manifest itself, then that is health for that person
6. Health is an expansion of consciousness.
Critique
Clarity
Semantic clarity is evident in the definitions, descriptions, and dimensions of the concepts of the theory.
Simplicity
The deeper meaning of the theory of health as expending consciousness is complex. The theory as a whole must be understood, nut just the isolated concepts. If an individual wanted to use a positivist approach, Newman’s original propositions would serve as guides for hypothesis development. However, researchers who tried that approach have concluded that it is inadequate to study the theory. As Newman have advocated in the 1994 edition of her book, Health as Expanding Consciousness, the holistic approach of the hermeneutic dialectic method is consistent with the theory and requires a high level of understanding the theory in praxis research.
Generality
The concepts in Newman’s theory are broad in scope because they all relate to health. The theory has been applied in several different cultures and is applicable across the spectrum of nursing care situations. This renders her theory generalizable.
Empirical Precision
In the early stages of development, aspects of the theory were operationalized and tested within a traditional scientific method. However, quantitative methods are inadequate in capturing the dynamic, changing nature of this theory.
Derivable Consequences
The focus of Newman’s theory of health as expanding consciousness provides an evolving guide for all health-related disciplines. In the quest for understanding the phenomenon of health, this unique view of health challenges nurses to make a difference in nursing practice by the application of this theory.
Margaret Newman UPOU N207_09_groupF
Case Study/ Application
Alice is an 80-year old widow who has lived alone in a low-income apartment complex in a small rural town since her husband’s death 8 years ago. She has one surviving family member, a granddaughter who lives 30 miles away. Alice has never learned to drive and depends on her granddaughter for all transpiration to physician appointments, shopping and getting medications. Her income is $824 monthly, and she requires several expensive prescriptions for arthritis, hypertension, and cardiac problems. She has osteoarthritis in her knees and requires a quad cane for support and safety when getting around her apartment. A visiting nurse stops by weekly to check her blood pressure and give her an injection for her arthritis. The visiting nurse notes that Alice’s BP is elevated, and Alice states that she has been unable to get her medication because her granddaughter’s car is broken. Alice also mentions that she is running low on food in the apartment because she can’t go out to shop.
Alice admits that she hardly knows or speaks to her neighbours despite having lived there for 8 years, and she still feels like a stranger and doesn’t want to “push myself in.” She says that she hates to bother people and “won’t hardly unless I just have to.” She says that sometimes she gets lonely for “her people” who are all deceased.
The visiting nurse, in working with Alice, recognized the current situation as a choice point, with potential for increased interaction with other and increased interaction with others and increased consciousness. The old ways no longer work for Alice and new ways relating are necessary. The nurse incorporates the elements of Newman’s method to assist Alice in pattern recognition for the purpose of discovering new potentials for action. As the nurse has Alice relate her story, through dialogue and interacting with Alice, she helps Alice recognize past patterns of relating and how present circumstances have changed those patterns. Alice talks about how she and her husband lived for 56 years in a rural mountain cabin with few neighbours except for two sisters and their sole daughter. They were very self-sufficient, grew large gardens, had their own livestock, and rarely went to town. All these family members are now deceased except the granddaughter, who insisted that Alice leave the cabin and move into town after the death of her husband. It is apparent that Alice’s past patterns have been those of independence and limiting social contact mainly to family members.
The nurse shares her perceptions with Alice and verifies the pattern identification. Alice states, “I just don’t know long I am going to manage by myself anymore.” The nurse helps her explore sources of help, besides the granddaughter, that will help Alice remain in her apartment as independently as possible. Alice relates that there is one man, a few doors away who has stopped several times to ask if she needed anything from the grocery store, but she hadn’t asked him because she hates to bother him and doesn’t want to be “beholden.”
After further discussion, she decides that she will ask him to pick up staples and medications for her and pay him back by baking some bread saying, “I just love to bake anyway and haven’t had anyone much to bake for.”
In subsequent weekly visits, Alice and the nurse explore the possibility of getting medications at a reduced price through the local nurse-managed clinic. Alice states that she might try getting to know some of her neighbours. The nurse helps Alice make arrangements to be picked up by the Senior Van for physician appointments. As Alice begins to build her own support system, she finds that she relies on the nurse less for help with maintain her independence and they resume their previous pattern of simply checking her BP and giving her injections weekly.
Alice admits that she hardly knows or speaks to her neighbours despite having lived there for 8 years, and she still feels like a stranger and doesn’t want to “push myself in.” She says that she hates to bother people and “won’t hardly unless I just have to.” She says that sometimes she gets lonely for “her people” who are all deceased.
The visiting nurse, in working with Alice, recognized the current situation as a choice point, with potential for increased interaction with other and increased interaction with others and increased consciousness. The old ways no longer work for Alice and new ways relating are necessary. The nurse incorporates the elements of Newman’s method to assist Alice in pattern recognition for the purpose of discovering new potentials for action. As the nurse has Alice relate her story, through dialogue and interacting with Alice, she helps Alice recognize past patterns of relating and how present circumstances have changed those patterns. Alice talks about how she and her husband lived for 56 years in a rural mountain cabin with few neighbours except for two sisters and their sole daughter. They were very self-sufficient, grew large gardens, had their own livestock, and rarely went to town. All these family members are now deceased except the granddaughter, who insisted that Alice leave the cabin and move into town after the death of her husband. It is apparent that Alice’s past patterns have been those of independence and limiting social contact mainly to family members.
The nurse shares her perceptions with Alice and verifies the pattern identification. Alice states, “I just don’t know long I am going to manage by myself anymore.” The nurse helps her explore sources of help, besides the granddaughter, that will help Alice remain in her apartment as independently as possible. Alice relates that there is one man, a few doors away who has stopped several times to ask if she needed anything from the grocery store, but she hadn’t asked him because she hates to bother him and doesn’t want to be “beholden.”
After further discussion, she decides that she will ask him to pick up staples and medications for her and pay him back by baking some bread saying, “I just love to bake anyway and haven’t had anyone much to bake for.”
In subsequent weekly visits, Alice and the nurse explore the possibility of getting medications at a reduced price through the local nurse-managed clinic. Alice states that she might try getting to know some of her neighbours. The nurse helps Alice make arrangements to be picked up by the Senior Van for physician appointments. As Alice begins to build her own support system, she finds that she relies on the nurse less for help with maintain her independence and they resume their previous pattern of simply checking her BP and giving her injections weekly.
