Discussion: Nurse Client Relationships

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Discussion: Nurse Client Relationships

Discussion Question:

Newman pointed out that “nurse client relationships often begin during periods of disruption, uncertainty, and unpredictability in patient’s lives” (Smith & Parker, 2015, p. 288). Discussion: Nurse Client Relationships

Explore what she means by this statement. Then, reflect on a patient that you cared for that you could apply her theory to. Provide details of the interaction and outcomes.

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Leininger, Newman, and Watson Discussion

Margaret A. Newman developed the theory of Health as expanding consciousness after working with Martha Rogers and affirming Rogers’ theory with her experience in caring for her mother earlier in life. Rogers’s work, The Science of Unitary Human Beings, is a well-known nursing model due to its assumption that man is a unified whole, possessing integrity and manifesting characteristics that are more than and different from the sum of his parts (Edwards-Maddox et al., 2021).

Rodgers viewed health as a unitary and transformative process. From this understanding, Newman embraced the unitary and transformative paradigm of nursing. In this discussion, I will explore what Newman meant when she pointed out that nurse-client relationships often begin during periods of disruption, uncertainty, and unpredictability in a patient’s life. I will share a reflection on a patient care situation where I could apply her theory and the details of the interaction and outcomes.

Newman’s health as expanding consciousness theory is based on the assumptions that health is an evolving unitary pattern of a whole, consciousness is the informational capacity of the whole, revealed in the evolving pattern, and the pattern identified in the person-environment process, which is characterized by meaning.

According to Mitsugi (2019), Newman believed health and illness evolve in a pattern, and pattern changes enfold and unfold based on the patient’s interaction with the environment. Therefore, at some point, the patient’s life may be orderly (health), then through interaction with the environment, their life becomes difficult and chaotic (illness presence). The orderly and disorderly phases in the patient’s life are parts of expanding consciousness.

By pointing out that nurse-client relationships begin during a period of uncertainty, disruption, and unpredictability in a patient’s life, Newman meant the point at which the pattern has evolved into disorder. At this point, the patient has interacted with the environment, and their pattern has evolved, leading to a disorderly phase; the illness has struck.

The patient is usually in chaos, confused, disrupted, and needs assistance to get their life back in order. Mitsugi, Endo & Ikeda (2020) note that the nurse-client relationship begins as a nursing intervention that Newman defined as a caring partnership in the nurse-client relationship. Both parties mutually recognize the pattern, determining a course of action, and therefore evolve together in consciousness, leading to achieving health and order in the patient’s life.

As an oncology nurse, I cared for a patient with breast cancer, and I applied Newman’s theory in our interaction. When she came to the clinic, she had just been diagnosed with breast cancer, at stage two, and decided to seek specialized care services. At this point, her life was in disorder, unpredictable, and with a lot of uncertainty. At the nurse-client relationship’s initiation phase, the patient lost hope.

It took effort to comfort her and convince her to participate actively in our interaction. We worked together to mutually recognize the pattern and actions we would take to contribute to health. The actions taken were biologic, chemo, and radiation therapies. We evolved in the pattern together in consciousness, as an improvement would be seen at every follow-up. The patient had positive health outcomes since she had fully recovered by the end of the 18th month.

Newman’s health as expanding consciousness theory is a widely applied nursing theory that guides the nurse-client relationship, emphasizing working in partnership to recognize the pattern and evolve together in consciousness. Nurse-client relationships are initiated when the patient’s life is in chaos, and through the interaction, they work together to restore health, hope, and order.                              

References

Edwards-Maddox, S., Cartwright, A., Quintana, D., & Contreras, J. A. (2021). Applying Newman’s theory of health expansion to bridge the gap between nursing faculty and Generation Z. Journal of Professional Nursing, 37(3), 541-543. https://doi.org/10.1016/j.profnurs.2021.02.002

Mitsugi, M. (2019). A transforming process based on Newman’s caring partnership at the end of life. International Journal for Human Caring, 23(1), 40-50. https://doi.org/10.20467/1091-5710.23.1.40

Mitsugi, M., Endo, E., & Ikeda, M. (2020). Recognizing One’s Own Care Pattern in Cancer Nursing and Transforming toward A Unitary Nursing Practice Based on Margaret Newman’s Theory. Asia-Pacific Journal Of Oncology Nursing, 7(2), 225–228. https://doi.org/10.4103/apjon.apjon_1_20