The metaparadigm I chose is the environment. This concept of the metaparadigm focuses on the internal and external surroundings of the patient. A patient’s milieu is not limited to its physical surroundings but can include social interactions with others and the emotional impact on the patient’s health and wellbeing. “Environment typically refers to the external elements that affect the person; internal and external conditions that influence the organism; significant others with whom the person interacts; and an open system with boundaries that permit the exchange of matter, energy, and information with human beings” (McEwen & Wills, 2023). When a person has toxic relationships that cause stress, anxiety, and depression, then it can negatively affect that individual’s care. It is up to the nurse to advocate for the patient to ensure a calm, serene, and comfortable environment. “A homely environment emerged as a space with properties that nurture optimum mental health contrary to a hostile environment that precipitates mental disorders and prolongs recovery” (Atieno Wagoro & Duma, 2020).

In Jean Watson’s theory referred to as The Human Caring Theory, there is great significance in a nurse’s ability to provide quality of care in a healing environment. “A nurse is considered an external factor that can offer assistance and care to a person through the Ten Caritas Processes including love, empathy, trust, and teaching/learning experiences” (Nikfarid et al., 2018). Watson does not go into any further detail about the environmental surroundings of a patient. Sister Calista Roy perceived the environment as any and all situations that directly impact the behavior of the patient and Dorthea Orem believed the opposite. Orem described the person and the environment are in fact two separate institutions. “Orem presented a number of environmental features and classified them into four types: physical, chemical, biological, and social” (Shah et al., 2015). Roy goes on to explain how internal and external stimuli will be the precipitating factors for a patient’s beliefs, behavior, and overall experience. All viewpoints can be understood. I believe that Watson was on point when she stated it is the responsibility of the nurse to provide a healing environment. I am a big advocate for my patients. I have had to remove family members from my patient’s room or have them banned from our floor for the safety and wellbeing of my patient. I will always provide the utmost quality of care in a healing environment for my patients.

References:

Atieno Wagoro, M. C., & Duma, S. E. (2020). Nurses’ perspectives of an environment of Optimum Mental Health: A grounded theory study. Journal of Research in Nursing, 26(6), 557–571. https://doi.org/10.1177/1744987120965651

McEwen, M., & Wills, E. M. (2023). Overview of theory in nursing. In Theoretical basis for nursing(5th ed., p. 42). essay, Wolters Kluwer.

Nikfarid, L., Hekmat, N., Rajabi, A., & Vedad, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: a comparative study. Journal of Medical Ethics and History of Medicine, 11(6), 1–9. https://doi.org/ncbi.nlm.nih.govLinks to an external site.

Shah, M., Abdullah, A., & Khan, H. (2015). Compare and contrast of grand theories: Orem’s self-care deficit theory and Roy’s adaptation model. International Journal of Nursing Didactics, 4(1), 1834–1837. https://doi.org/10.15520/ijnd.2015.vol5.iss01.28.39-42

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