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The key takeaways are that nursing care should address the physical, mental, and spiritual aspects of the patient as a whole person within their environment. The four domains of nursing - person, environment, health, and nursing - overlap and together define patient care.

The four domains of the nursing metaparadigm are person, environment, health, and nursing.

According to Watson, health is defined as 'unity and harmony within the mind, body, and soul'. She believes healing involves addressing the whole person - body, mind, and soul.

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Nursing Philosophy

Axel Rodriguez Martinez

Benjamin Leon School of Nursing, Miami Dade College

NUR2811C: Professional Nursing Leadership

Professor Annette Brown & Takenya McDonald, RN

December 07, 2021


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The Nursing Metaparadigm

The Nursing Metaparadigm is a set of concepts and theories that provide the structure of

nursing discipline. These are centered around person, environment, health, and nursing. These

focus on the quality and wellness of patients. These domains overlap with each other and

together define the conditions and address the patient as a whole. Throughout this paper, I will

further elaborate on these domains, on their approach by different theorists, and on my own

interpretation of them. I will then compare the philosophies of Miami Dade College’s Benjamin

Leon School of Nursing to that of another institution.

The Four Domains

The four domains of the Nursing Metaparadigm include person, environment, health, and

nursing. The domain of the person is centered around the patient. This domain elaborates on the

aspects of the patient’s life. These include spirituality, culture, family, and friends. Furthermore,

the domain of the environment focuses on both internal and external aspects around the patient.

Mainly, it describes on how the patient interacts with their surroundings and how these

surroundings affect the patient. Moreover, the domain of health refers to the patient’s well-being.

Furthermore, this also includes factors that may influence the patient’s well-being, such as the

patient’s access to health care. Finally, the fourth domain is nursing. This domain focuses on the

person providing the care for the patient. It encompasses on how the nurse will use their

competencies and attributes in the care of the patient (Alligood,2018). Many nursing theorists

have developed their own approaches to these concepts that would further define the approach to

nursing care.
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Margaret Jean Harman Watson was an American nurse and theorist that began practicing

as a nurse during the 1960s. Watson obtained a master’s degree in Psychiatric-Mental Health

Nursing and a doctorate degree in Education Psychology and Counseling. Watson’s approach to

health focused on much more than just curing illnesses. Furthermore, she describes healing in a

holistic manner, approaching the patient’s body, mind, and soul as one. Watson defines health as

“unity and harmony within the mind, body, and soul” (Alligood,2018). Furthermore, she

believed that a caring environment played a role in the patient’s ability to heal.

Florence Nightingale, the founder of modern nursing, was an Italian nurse that began

practicing in the year 1851. Her theory focused on the environment, using the term surroundings

in her writing. Furthermore, she believed that the surroundings were essential to providing

nursing care and maintaining health (Alligood,2018). In her writings, the nurses performed tasks

and were in control of the patient’s environment. This was done with the intent to improve

recovery. Nightingale, believed the environmental factors that influenced a patient’s healing

were ventilation, warmth, quiet, diet, and cleanliness. (Alligood,2018) Today, these concepts

remain as part of nursing care.

Personalized Definitions of Domains

The four domains can be viewed from different perspectives that result in a different

manner of approach to patient care. I believe the person should be viewed as mind, body, and

soul. These are uniquely important in their own way but should be viewed as part of a whole. I

define health as a spectrum of quality of life. Physical and mental circumstances can have a

negative impact on functionality, comfort, and happiness. Therefore, conditions such as illnesses

and situations that impact mental health can decrease quality of life. Moreover, the person and

the environment are in constant interaction. Therefore, the environment is part of the
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circumstances that impact quality of life. Finally, I believe nurses should function within their

competency and scope of practice in a manner that maximizes positive outcomes that improve

quality of life.

Analysis of Two Institutions

Miami Dade College believes that environments are constantly changing, and patient

health states are dynamic. They have a focus on developing and creating nurses that can provide

care in a variety of healthcare settings. Their discipline focuses on providing a safe and effective

care environment. Furthermore, they believe that nursing education should prepare students to

assess, plan and act on changes based on patient and community needs. (Miami Dade College

[MDC], 2019) Jackson Hospital believes in nursing as a discipline that incorporates knowledge,

critical thinking, and caring. They believe the nurse-patient relationship is based on respect and

care, recognizing their patient’s individual values, disabilities, sexual orientation, nationality,

religion, and cultural beliefs. Their level of care is guided by a single high standard ensuring

safe, culturally competent, and patient focused care. Both Miami Dade College and Jackson

Health Hospital emphasize on the importance on the delivery of safe patient care. However,

Miami Dade College focuses on creating new nurses and Jackson Health focuses on maximizing

their potential through growth and experience.

Summary

Safety, respect, and genuine care are crucial to the delivery of nursing care. These

concepts promote physical and mental well-being. Furthermore, focusing on these principals

when providing nursing care will minimize negative outcomes and promote positive outcomes. I

believe that having this mindset may improve the quality of life of patients. Therefore,
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institutions should continue to focus on developing safe, competent, respectful, and caring nurses

that will maximize positive outcomes for patients.

Reflection

The four domains of nursing demonstrate that patient care encompasses more than just

curing a patient. Nurses should be equipped with the knowledge necessary to assist the patient in

a complete form of care. I believe nurses should pay as much attention to external factors as to

internal factors when providing care. Nursing care should tend to both mental and physical

health equally. Furthermore, the patient and environment are constantly interacting, and these

circumstances should always be included in patient planning and outcomes. This philosophy will

assist me in utilizing my nursing clinical knowledge to work within my scope of practice to

maximize quality of life in patients.


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References

Alligood, M. R. (2018). Nursing theorists and their work. Elsevier.

Jackson Health Systems. (n.d.) Nursing Excellence Report


https://storage.googleapis.com/jackson-library/annual-reports/nursing-annual-report-2009.pdf

Miami Dade College. (n.d.) Associate of Science in Nursing Student Handbook 2019
https://www.mdc.edu/nursing/docs/ASN-Student-Handbook.pdf

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