Running head: THEORY

Martha Rogers: Nursing Theorist Heatha Rohr, Kaylee Sullivan, & Katherine Peterson Ferris State University

Running head: THEORY Abstract

The purpose of this paper is to evaluate the Nursing Theory of Science of Unitary Human Beings created by Martha Rogers. The paper will include focus information inclusive of her motivations and influences for creating this nursing model, her philosophies regarding nursing care and how this model correlates with the four global concepts of nursing (human being, environment, health and nursing). Additionally, the paper will provide an evaluation of how Martha Rogers Nursing Theory relates to nursing practice.

Running head: THEORY Martha Rogers: Nursing Theorist

Martha Rogers contributed to nursing practice with a profound desire for learning and an insatiable quest of leadership. These characteristics motivated her career and her contributions to the nursing profession all of her life. According to Gunther (2010) Rogers worked from 1933 until 1994 in a wide range of nursing and educational roles prior to the final development of her nursing theory Unitary Human Beings, published in 1970. The primary premise of her theory is the concept of interconnectedness that exists between human beings and the environment represented in elemental terms such as energy exchanges that occur on every level of existence and in every conceivable dimension (Gunther, 2010). Rogers explains best in the following statement: 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 environment fields for realization of maximum health potential (Rogers, 1970, as cited in Gunther, 2010, p. 242). Rogers theory included four pillars which provided the foundation of interconnectedness: energy fields, universe of open systems, pattern and pandimesionality. Each of these concepts provides a working definition on how and when people and the environment interact (Gunther, 2010). Origins of Nursing Model According to Gunther (2010) Rogerian nursing focuses on concerns with people and the world in which they live a natural fit to nursing care, as it encompasses people and their environment (p. 245). Based on Rogers background and experience, it is no surprise that her nursing theory would be science based, academic in tone and demonstrative of the importance of

Running head: THEORY relationships and environment. In an article by Hektor (1989) she depicts three influential

factors that possibly contributed to the development of Rogerian nursing philosophy. First, there is Rogers appreciation and love of family. Being the oldest of nine siblings, born in 1914, she came from a large upper class family of which provided her with the financial security and support to pursue her educational desires without limitations unlike most people (and specifically women) of her time (Hektor, 1989). This familial support afforded Rogers self confidence which she utilized throughout her career in a time when it was necessary to challenge social norms to achieve academic and professional success within the nursing field. Second, she had an appreciation and passion for learning with an aptitude for math and science (Hektor, 1989). Most of her career was in pursuit of higher education with an ultimate accumulation of degrees from a variety of Ivy League Universities such as Johns Hopkins, Columbia and New York University (Hektor, 1989). Roger's constant pursuit of education with an aptitude to science is present throughout Rogerian nursing theory. It is reflective of a science based theory, abstract in construct requiring a strong educational background for both understanding and implementation. Third, Rogers had a need to help people (Hektor, 1989). Most of the work she participated in while obtaining her Master and Doctorial Degrees focused on Public Health Nursing; participating in nursing activities such as program development, community education and home visitation (Hektor, 1989). There is evidence of how nursing, human beings, and environment are present in all of her personal work experience up until the time she published her initial theory. In review of her background it is possible to extrapolate that Rogers was an avant-garde scholar in her time and valued what education and experience could bring to the nursing field both in terms of nurses as caregivers as well as nurses as leaders and role models for maximizing

Running head: THEORY health. The influence of her public health nursing experience, love of science and math, and constant acquisition of knowledge are the philosophic values which seemed to motivate the development of Rogerss Science of Unitary Human Beings Nursing Philosophy. Content of Nursing Model As described by Kearney-Nunnery (2008) there is a metaparadigm in nursing that

establishes key components universal to all nursing practice models and theories; nursing, health, environment and human beings. They are defined as follows: Human being represents the individual, family, group, or community receiving care, each with unique characteristics The environment comprises the physical, social, cultural, spiritual, and emotional climate or setting(s) in which the person lives, works, plays and interacts. Health is the focus for the particular type of nursing and specific care provisions needed. Nursing is defined by its activities, goals and services (p. 3).

Rogerian nursing theory incorporates each of these elements to achieve a theory that provides a foundation for nursing practice. Rogers defined learning as a learned professionboth a science and an art[that] exists for the care of people and the life process of humans (Gunther, 2010, p. 245). Her theory emphasizes that nursing incorporates more than taking care of the physical aspects of a persons state of health. Nursing, therefore is reflective in a continuum of care with a critical thinking process directing practice[that] can be divided into three components: pattern appraisal, mutual patterning and evaluation (Gunther, 2010, p. 248). As stated previously patterns are one of the four significant concepts of Rogerian theory which provides a means for interpreting and interacting (reciprocy) with changes (synchrony) in any given energy field. Patterns change and

Running head: THEORY evolve (helicy) which is why nursing practice should continuously appraise, acknowledge and evaluate (resonancy) the energy fields with which they interact; specifically human beings and environment (Gunther, 2010). As stated by Kearney-Nunnery (2010) human beings are those individuals, families or communities that are receiving care (p. 3). Rogers breaks down each of those constructs (individuals, families and communities) into energy fields and open systems. First, humans and

the community are dynamic and unitary in that they are irreducible, indivisible, pandimensional energy field[s] identified by pattern and manifesting characteristics that are specific to the whole and that cannot be predicted from knowledge of the parts (Gunther, 2010, p. 244). In more simplistic terms relative to the direct practice of nurses, human beings or communities are a construct of each other. To interact as nurses with one is to consider the implications of the other. Second, recognizing that energy is an open system, nurses must comprehend human beings are unstable, changing entities across a continuum time. According to Rice (2009), unitary human beings experience time as passing, and involving the past, present and future (p. 8). Nurses must have an awareness of the human beings in their present state in order to have a successful, meaningful interaction to optimize health related interactions. Health for Rogers is not clearly defined but is implied as a value term defined by the culture or individual. Health and illness are manifestations of pattern and are considered to denote behaviors that are of high value and low value (Gunther, 2010, p. 246). Health as a pattern health may vary and manifest itself as disease or wellness as an idea; a barrier relative to a given human being or environment in a variety of situations. Health is for the nurse to determine as a pattern identified by those nursing activities of appraisal, identification and

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evaluation. According to Wright (2007) Rogers believed that nursing was in the center of health care because the primary purpose of health care is the promotion of health (p. 65). Environment for Rogerian Theory is identified in similar terms as human beings. The environment is an energy field and an open system. The value of the environment is not necessarily a physical location; it is the significant interacting energy field and open system with human beings. Each human field is specific to its given environmental field and energy flows between the two as a unifying force creating a whole component for evaluation (Gunther, 2010). Interpretations & Conclusions Martha Rogerss model for nursing practice is abstract in content which challenges nurses to think metaphysically about their patients and how nursing care should be provided with an emphasis on a more global approach to nursing and healthcare. It is a foundation for practice principals more than a how-to guide for nursing care implementation. Her philosophy is unique to nursing in that it incorporates facets of physics such as energy fields and pandimensionality unfamiliar to other nursing theorists during her time. The diverse content lends itself to having a broad scope for practice in all disciplines of nursing. Energy is a dynamic exchange regardless of the specific field of practice. The concepts of energy fields and open systems are adaptive regardless of the nursing discipline, development of programming, or education offering. Correlative to the theories abstract nature it has lent itself to the development of other nursing theorist such as Barretts (1998) health patterning; Butchers (1999) synthesizing health patterning and pattern appreciation; and Cowlings (2005) unitary appreciative nursing (Wright, 2007, p. 66), Newmans Health expanding consciousness and Parses human becoming (Gunther, 2010, p. 250).

Running head: THEORY There are a multitude of documented research instruments and practice tools that were derived from the Science of Unitary Human Beings. The following is a list selected from Gunther (2010) (p. 252-254): Nursing Process Format (Falco & Lobo, 1995) Assessment Tool for Postpartum Mothers (Tettero et al., 2993) Assessment Criteria for Nursing Evaluation of the Older Adult (Decker, 1989) Holistic Assessment of the Chronic Pain Client (Garon, 1991) An Assessment Guideline for Work with Families (Johnson, 1986) A Conceptual Tool Kit for Community Health Assessment (Hanchett, 1979)

Martha Rogers was a truly distinctive and innovative philosopher whose contributions have outlasted her 50 year career and extend into the 21st century for continued growth and development within the nursing field. According to Phillips (2010) Rogers view of energy freed us from the ideas of cell theory and field theory (p. 55), she created alternative ways to consider nursing interactions. To appreciate and understand the abstract nature of Rogerss theory a nurse must have as strong educational foundation and be willing to step outside of traditional thinking and open their views of the world through creative interactions. Her values of higher learning resonates throughout her theory and suggests that the ultimate provision of nursing care is accomplished in achieving the highest education possible to exchange scholarly ideas while remaining open to limitless possibilities of human and environment interactions.

Running head: THEORY References Gunther, M. (2010). Martha E. Rogers: Unitary human beings. In M. R. Alligood, & A. M.

Tomey, (Eds.), Nursing theorist and their work. (7th ed., pp. 242-264). Maryland Heights, MO: Mosby Elsevier. Hektor, L. M. (1989). Martha e. rogers: A life history. Nursing Science Quarterly, 2 (1), 63-73. doi: 10.1177/089431848900200205. Retrieved from: http://nsq.sagepub.com/content/2/2/63 Kearney-Nunnery, R. In Kearney-Nunnery, R. (Eds.), Advancing your career: Concepts of professional nursing. (4th ed., pp. 3). Philadelphia, PA: F.A. Davis Company. Phillips, J. R. (2010). The universality of rogers science of unitary human beings. Nursing Science Quarterly, 23(1), 55-59. doi: 10.1177/0894318409353795. Retrieved from: http://nsq.sagepub.com/content/23/1/55. Ring, M.E. (2009). An exploration of the perception of time from the perspective of science of unitary human beings. Nursing Science Quarterly, 22(1), 8-12. doi: 10.1177/8094318408329338. Retrieved from: http://nsq.sagepub.com/content/22/1/8 Wright, B. W. (2007). The evolution of rogers science of unitary human beings: 21st century reflections. Nursing Science Quarterly, 20(1), 64-67. doi: 10.1177/0894318406296295. Retrieved from: http://nsq.sagepub.com/content/20/1/64