MARTHA ROGERSThe Science of Unitary Human Beings

Angeli Lagasca, RN BSN CCRNColumbia University, Teachers College

October 9, 2015

Martha Rogers(1914-1994)

EDUCATION

-1931: Studied science at University of Tennessee

-1936: Nursing diploma, Knoxville General Hospital

-1937: BS, George Peabody College, Nashville, TN

-1945: MA, public health nursing supervision, Columbia University Teachers College, New York, NY

-1952: MPH, Johns Hopkins University, Baltimore, MD

-1954: ScD, Johns Hopkins University, Baltimore, MD

Martha Rogers(1914-1994) NURSING CAREER

Practice: Rural public health, MI Visiting nurse, CT

Management: Visiting nurse supervision/education, CT Est’d VNS of Phoenix, AZ

Academia: Professor/Head of Nursing Division, NYU

Professor Emerita, NYU Published 3 books, >200 articles

Theory: Published An Introduction to the Theoretical Basis of Nursing (1970), described conceptual model for nursing

Rogers’ Science of Unitary Human Beings

“The study of the moving, intuitive experience of nurses in mutual process with those they serve”

(Rogers, 1970, p. 9).

Rogers’ Science of Unitary Human BeingsTheoretical Sources: Multidisciplinary

ANTHROPOLOGY PSYCHOLOGY SOCIOLOGY ASTRONOMY

RELIGION PHILOSOPHY HISTORY BIOLOGY

PHYSICS MATHEMATICS LITERATURE NIGHTINGALE

Rogers’ Science of Unitary Human BeingsTheoretical Sources: Nightingale

“FOUNDATION FOR THE SCOPE OF MODERN NURSING”(Rogers, 1970, p. 30)

Re: Relationship of human being and environment

Rogers’ Science of Unitary Human BeingsTheoretical Sources: Science

Abstract concepts: unable to be tested using measurable empirical evidence.

Instead, Rogers’ work builds on theoretical concepts of multiple disciplines:

QUANTUM PHYSICS GENERAL SYSTEMS THEORY ELECTRODYNAMICS Einstein von Bertalanffy Burr & Northrop

Rogers’ Science of Unitary Human BeingsTheoretical Sources: Eastern PhilosophyHanchett (1992) identifies Buddhist concepts as predecessors for Rogerian assertions:

THE SENTIENT BEING- An organism which experiences the totality of living, and thus, is capable of enlightenment- Composed of matter, sensation, perception, mental formations and consciousness

EMPTINESS- Openness, capacity for perception of the abstract- Boundless reality void of space, time

DEPENDENT ARISING, KARMA- Chain of causes which contribute to rebirth

Major Concepts and DefinitionsBuilding Blocks

PATTERN PANDIMENSIONALITY

UNIVERSE OFOPEN SYSTEMSENERGY FIELD

Major Concepts and DefinitionsBuilding Blocks: Pandimensionality

PANDIMENSIONALITY:The unitary whole is...

PANDIMENSIONALITY is an attribute of the unitary whole.

INFINITE

NONLINEAR

SPACELESS TIMELESS

LIMITLESS

Major Concepts and DefinitionsBuilding Blocks: Pattern

PATTERN

Represents characteristics which DEFINE an ENERGY FIELD:

PATTERN is a varying, single wave only perceivable via manifestations (ex: sense of self, degree of well-being, fast or slow perception of time, degree of pragmatism vs. imaginativeness), which are unique to the individual energy field.

Continuously changes in innovative and unique ways

Varies constantly, thereby giving identity to the Energy field.

Manifests as a result of interaction between human & environment (integral fields)

Major Concepts and DefinitionsBuilding Blocks: Universe of Open Systems

UNIVERSE OFOPEN SYSTEMS

Energy fields are…INFINITE

Energy fields are…OPEN

Energy fields are…INTEGRAL

The HUMAN FIELD and ENVIRONMENTAL FIELD interact continuously within a UNIVERSE OF OPEN SYSTEMS.

Major Concepts and DefinitionsBuilding Blocks: Energy Field

ENERGY FIELD

FUNDAMENTAL UNIT of living and nonliving things, including: (1) human being (2) environment

Exists in a UNIVERSE of OPEN SYSTEMS: change is dynamic, continuous, creative,

unpredictable, and infinite

Is identifiable by PATTERN:Identity changes with changes in pattern

Is PANDIMENSIONAL:Exists as an infinite, indivisible, irreducible

entity unbound by time or space

Major Concepts and DefinitionsBuilding Blocks: Energy Field

ENERGY FIELD

HUMAN FIELD ENVIRONMENTAL

FIELD

The Human Field and Environmental Field are in a process of continuous mutual change. They are integral to each other, and influence each other in ways that may be unquantifiable or imperceptible.

The Human Field and Environmental Field are each identified by wave patterns whose changes are manifested in the whole.

Major Concepts and DefinitionsNursing Metaparadigm

NURSING METAPARADIGM

NURSING

PERSON HEALTH

ENVIRONMENT

Major Concepts and DefinitionsNursing Metaparadigm

PERSON

A unitary human being is...

...an “irreducible, indivisible, pandimensional energy field identified by

pattern and manifesting characteristics that are specific to the whole” (Rogers, 1992,

p. 29).

...an open system or human field

...in constant process with the environment

...more than the sum of his or her parts

Major Concepts and DefinitionsNursing Metaparadigm

ENVIRONMENT

An environmental field is...

...irreducible, infinite, pandimensional.

...specific to its human field.

...more than the sum of its parts.

...subject to innovative, unpredictable change.

...characterized by increasing diversity.

Major Concepts and DefinitionsNursing Metaparadigm

NURSING

Nursing is an empirical science. It becomes an art when used creatively for human betterment.

Its focal concern is people, the world they live in, and the life process, which causes them to change.

Its purpose is to advance health and well-being on a large scale.

It aims to promote harmony between human field and environmental field in a way which optimizes well-being.

Major Concepts and DefinitionsNursing Metaparadigm

HEALTH

“Health” is a value term.

it is defined by the individual or group based on manifestations that are considered to have high value (“health”) or low value (“illness”).

“Wellness” refers to the activity of an individual’s energy field.

Dynamic change represents movement along the wellness continuum. In an energy field, wellness is manifested in rhythmic consistency, higher frequency, and increasing pattern diversity.

Iatrogenesis & hypochondriasis are the major health problems in the US.

These indicate discord in the process between human field and environmental field-- specifically, between patient and healthcare environment.

Theoretical AssertionsDefinitions & Evolution, 1970-1992

H E L I C Y(EVOLUTION)

R E S O N A N C Y(CHANGE INTENSITY)

I N T E G R A L I T Y(WHOLENESS)

Continuous and nonrepeating: essential properties of change

Intensity of the evolution of an energy field, i.e. its wave pattern

Presence of a continuous mutual process of exchange between energy fields

From probabilistic, became unpredictable

Came to specify a change from lower to higher wave frequency

Evolved from the concepts of synchrony, reciprocy

H O M E O D Y N A M I C S(QUALITIES OF CHANGE)

The principles which describe the nature of the intrinsic change occurring in wave patterns, energy fields and the universe as a whole:

Theoretical AssertionsFive Supportive Assumptions

4. P A T T E R N :“Pattern and organization identify man and reflect his innovative wholeness”(p. 54)

5. S E N T I E N T B E I N G :“Man is characterized by the capacity for abstraction and imagery, language and thought, sensation, and emotion” (p. 73)

1. E N E R G Y F I E L D : “Man is a unified whole possessing his own integrity and manifesting characteristics more than and different from the sum of his parts” (p. 47)

2. I N T E G R A L I T Y :“Man and environment are continuously exchanging matter and energy with one another” (p. 54)

3. H E L I C Y : “The life process evolves irreversibly and unidirectionally along the space-time continuum” (p. 59)

(Rogers, 1970)

Acceptance by the Nursing Community

NURSING COMMUNITY

RESEARCH

EDUCATION

PRACTICE

Acceptance by the Nursing CommunityNursing Practice

CONCEPT: Existence is a totality of experienceAPPLICATION: Focus on continuum of care vs. episodic illness

C: Nursing is theoretical knowledge translated into creative actionA: Act using the intellectual, the abstract, AND the human; unify theory and practice

C: Wellness, not health, is the goalA: Do not target change that is traditionally valued as a “healthy,” favorable outcome; evaluate outcomes based on change in perception (observable pattern of human field)

C: Pattern manifests characteristics of the wholeA: Address disturbances using a holistic critical thinking process:(1) Pattern appraisal, (2) mutual pattern exploration, (3) evaluation of emerging perception

Acceptance by the Nursing CommunityNursing Practice: Rogerian Patterning Modalities

E X A M P L E S

ACUPUNCTURE AROMATHERAPY TOUCH / MASSAGE

GUIDED IMAGERY

GUIDED REMINISCENCE

HUMOR HYPNOSIS DIETARY MANIPULATION

MEDITATION SELF-REFLECTION

TRANSCENDENT PRESENCE

MUSIC

Acceptance by the Nursing CommunityNursing Practice: Rogerian Patterning Modalities (Cont’d)

V I T A L C O M P O N E N T S

MEANINGFUL DIALOGUE

CENTERING PANDIMENSIONAL AUTHENTICITY

GENUINENESS

TRUSTWORTHINESS

ACCEPTANCE

KNOWLEDGEABLECARING

Acceptance by the Nursing CommunityNursing Practice: Rogerian Patterning Modalities (Cont’d)

FACILITATORS EDUCATORS ADVOCATES

ASSESSORS PLANNERSCOORDINATORS/ COLLABORATORS

N U R S E S ‘ R O L E S

ACCEPTDIVERSITY

RECOGNIZEPATTERNS

VIEW CHANGEAS POSITIVE

ACCEPT THE CONNECTED-NESS OF LIFE

QUESTION TRADITIONAL

VALUES

WHILEACTING

AS

Acceptance by the Nursing CommunityNursing Education

ASSERTIONS

SEPARATE LICENSURE

CURRICULUM

RESEARCH COMPETENCIES

Nursing is a SCIENCE and a LEARNED PROFESSION.Nurses must commit to LIFELONG LEARNING.Nursing uses KNOWLEDGE for HUMAN BETTERMENT.

Associate’s Degree Nurse (technically oriented)Bachelor’s Degree Nurse (professionally oriented)

Professional Nurses should be WELL ROUNDED:educated in humanities, sciences, and nursing

Bachelor’s: Identify problems Use knowledge to improve practice Read research intelligently Master’s: Conduct applied research Doctoral: Conduct theoretical, fundamental research

Acceptance by the Nursing CommunityNursing Research: Emerging Theories

ROGERIAN MODEL

GRAND THEORY

NEWMAN:Health as

Expanding Consciousness

PARSE:Human

Becoming

MIDRANGE THEORY

HOMEODYNAMICS SELF-TRANSCENDENCE, ENLIGHTENMENT,

SPRITUALITY

TURBULENCE AND DISSONANCE AGING

INTENTIONALITY

UNITARY CARING

HUMAN FIELD MOTION

CREATIVITY, ACTUALIZATION,

EMPATHY

BARRETT (2010), BULTEMEIER (2002),

FLOYD (1983) REED (2003), MALINSKI (1994), SMITH (1994)

ALLIGOOD & MCGUIRE (2000), BUTCHER (2003)

UGARIZZA (2002), ZAHOUREK (2005)

WATSON & SMITH (2002)

FERENCE (1986)

ALLIGOOD (1991)

BUTCHER (1993), BULTEMEIER (2002)

Acceptance by the Nursing CommunityNursing Research: Approach

PURPOSE:Examine unitary human being as

integral with environment

Examine and understand

the phenomenon

Develop patterning activities

TYPES OF DATA:

QUALITATIVE:Appropriate. Descriptive, experiential, acknowledges diversity, universality, patterned change, demonstrates value of perception/sentient awareness

QUANTITATIVE:Less appropriate. Seeks to prove causal relationships, thereby oversimplifying causality

METHODS:

Instruments and practice tools derived from the

Rogerian model

Used to measure human-environmental field activity, interaction,

manifestation

Critique

CLARITY - Principles are difficult to understand- Lack of operational definitions- Inadequate tools of measurement- Applied for development of nursing science- Clear implications for nursing research

SIMPLICITY - Complex upon first inspection- Study / use uncovers “elegant simplicity” (Alligood, 2013, p. 230)- Few major concepts/assumptions, offers comprehensive theory

GENERALITY - Abstract model = broad in scope- Provides a framework for grand or middle-range theories

ACCESSIBILITY - Deductive: no immediate empirical support- Rogerian science has yielded testable theories, measurement tools

IMPORTANCE - Supports nursing’s developing identity as a science- Contains many suggestions for future studies- Utility for nursing practice, education, administration, research

Thank you for your attention!Questions?

References

Gunther, M. E. (2013). Unitary Human Beings. In M. R. Alligood (Ed.), Nursing Theorists and Their Work (220-239). Missouri: Mosby Elsevier.

Hanchett, E. S. (1992). Concepts from eastern philosophy and Rogers’ Science of Unitary Human Beings. Nursing Science Quarterly, 5(4), 164-170.

Rogers, M. E. (1970). An Introduction to the Theoretical Basis of Nursing. Philadelphia: F. A. Davis.