Martha Rogers The Science of Unitary & Irreducible Human Beings

1. Martha RogersThe Science of Unitary & Irreducible Human Beings Denise Barger, BSN, RN Pat Schlagel, BSN, RN Lisa Thielke, BSN, RN Minnesota State University Moorhead Nursing 600

2. Grand Nursing Theorist Martha Rogers1914-1994 retrieved from: http://www.nurses.info/nursing__theory__person__rogers__martha.htm

3. Origins • Rogers was one of the first nurse scholars to explicitly identify the person (unitary man) as the central phenomena of nursing concern • 1970 – Science of Unitary Human Beings (SUHB) • Rogers realized there had to be something to know in nursing that required increased education for its transmission (Fawcett interview, n.d.)

4. Purpose • SUHB theory offers a new look at nursing, providing a framework for practice, education and research that moves away from the traditional medical model approach to the delivery of nursing care (Fawcett interview, n.d.) • To promote human-environment field patterning and the nursing process (n.a., 2009, para. 11)

5. Evolution Over Time • Radical • Difficult to understand • Greatly influenced all facets of nursing (n.a., 2009, para. 7)

6. Science of Unitary Human Beings • Five basic assumptions underlay Rogers' conceptual framework: 1. Wholeness 2. Openness 3. Unidirectionality 4. Pattern and Organization 5. Sentience and Thought (Rogers as cited in Barrett, 2009, para. 4)

7. Science of Unity Human Beings • There are four main topics (metaparadigms) that are addressed by nursing theorists: 1. People 2. Environment 3. Health 4. Nursing (Rogers as cited in Barrett, 2009, para. 5)

8. Application to Health • Individually defined • Multicultural dimensions • Influenced by health behaviors • Goal of nursing: health promotion

9. Application to Nursing • Promote health • Positive optimistic approach • “The study of unitary, irreducible, indivisible human & environmental fields: people and their world.” (Rogers as cited in McEwen & Wills, 2007, p.204)

10. Application to Environment • Continually exchanging energy with the unitary human being • Constant state of change • Helix • Represents environment energy field • Co-existing & interactive with unitary human

11. INTERACTION BETWEEN HUMAN AND ENVIRONMENT • Environment • Energy Field Human Being Energy Field

12. Application to Person • Unitary energy system • Whole entity – sum of the parts • Continually exchanging energy with the environment • “These energy fields may be described as open systems, with each person having his/her own unique pattern of energy which constitutes the person’s identity.” (Tettero, Jackson, & Wilson, 1993, p.777)

13. Examples of Application to: • Nursing Practice • Education • Research

14. Application to Nursing Practice

15. Application to Research • Model is abstract & testable in principle • Study humans as individuals & groups • Challenges traditional thinking

16. THE FLOW OF ENERGY Energy is constant and ever flowing

17. Application to Education • “Nursing aims to assist people in achieving their maximum health potential” Martha Rogers – 1970 (as cited by Wright, 2007, p. 65) • Rogers stated nurses must commit to lifelong learning and noted, “the nature of the practice of nursing (the use of the knowledge for human betterment)”.Martha Rogers – 1990 (as cited by Tomey & Alligood, 2006, p. 252)

18. Critique of the Theory Clarity Simplicity Generality Empirical precision Derivable consequences Specific examples

19. Clarity • Major elements of Rogers’ work: • 5 key definitions • 3 principles of homeodynamics • 6 assumptions • This approach appears simplistic • But is difficult for nurses to understand • Too abstract • Parsimony: moderately (McEwen & Wills, 2007)

20. Simplicity • “Ongoing studies and work within the model have served to simplify and clarify some of the concepts and relations. However, when the model is examined in total perspective, some still classify it as complex” • More work is required: use in practice, research and education needed • May determine that the model is simple (Tomey & Alligood, 2006)

21. Rogers’ Nursing Theory Implementation • 1981 at San Diego Veteran’s Medical Center (SDVMC) • Review the process SDVMC nursing applied to arrive at this nursing model • Process took 8 years to implement

22. Implementation of Rogers’ Nursing Theory (Heggie, Schoenmahl. Chang, & Grieco, 1989) CNS Committee Evaluation Process Review of nursing models and theories Review of nursing service philosophy and care standards Current care model was a medical model Determined focus a metaparadigm model Limitation to nursing practice 400 Nurse knowledge/attitudes survey Model needed to change focus Creating disequilibrium drove need for change Medical problems focus  individual focus Discussion groups validate conflict with present medical model framework CNS committee determined need for model change A

23. Implementation of Rogers’ Nursing Theory Staff attend classes on nursing theory models Leadership attend classes on Rogers’ Theory B Created openness and awareness of new ideas Classes included actual patient application Staff attend classes on Rogers’ Theory Survey results/nursing philosophy compared to nursing theories Rogerian Theory Expert visits to present application of Rogers’ Theory CHOSE ROGERS’ THEORY RATIONALE: Most congruent with hosp. philosophy and nursing staff beliefs Foundational for future oriented growth Holistic in nature Continued nursing staff education over 3 years Martha Rogers visited and addressed nursing staff

24. Generality • Rogers’ theory is a synthesis of phenomena • Important to nursing • Abstract, unified, and highly derived framework • Does not define particular hypotheses or theories • Instead provides a worldview • Nurses may derive theories and hypotheses and propose relationships specific to different situations (McEwen & Wills, 2007)

25. Rogers’ Theory Applied to ADN Program (Hellwig & Ferrante, 1993)

26. Empirical Precision • Early criticism identified major limitations • Difficult to understand principles • Lack of working definitions • Poor tools for measurement • Deductive in logic • Characteristic lack of immediate empirical support (Tomey & Alligood, 2006)

27. Derivable Consequences • Intends to assist in the understanding of human evolution and human potential • Organized in a manner that place nursing’s identity as a science • Focus is on the human and environmental connection as highly significant • Many have used the conceptual model for research (Tomey & Alligood, 2006)

28. Summary • To understand the Rogers’ Theory principles and concepts requires: • A general education base • A readiness to part from the traditional • Be imaginative in viewing our world • New and challenging theories are emerging to move the understanding of the unitary human being (Tomey & Alligood, 2006)

29. Discussion Questions • Let’s review the MSUM Graduate Program Nursing Theory • Is there a nursing theory that is followed at your place of work/practice?  • What nursing theories were your initial licensure and/or baccalaureate nursing program based on? • How do you view Roger’s Theory, complex or simple?  Why? • Do you think nurses are challenged by nursing theory?  Why?

30. References Fawcett, J. (n.d.). Interview of Martha Rogers nursing theory [Video file]. Retrieved from http://www.youtube.com/watch?v=V1XN3rPKndE Heggie, J., Schoenmehl, P., Chang, M., & Grieco, C. (1989). Selection and implementation of Dr. Martha Rogers' nursing conceptual model in an acute care setting. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 3(3), 143-147. Hellwig, S. & Ferrante, S. (1993). Martha Rogers’ model in associate degree education. Nurse Educator, 18(5), 25-27. McEwen, N. & Wills, E. (2007). Theoretical basis for nursing (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkin n.a. (2009). Martha Rogers. Retrieved from http://www.scribd.com/doc/17667393/NURSING-THEORIST-MARTHA-ROGERS

31. References Read, P., Shearer, N., & Nicoll, L. (2004). Perspectives on nursing theory (2nd ed.). Philadelphia, PA: Lippincott, Williams & Wilkin Tettero, I., Jackson, S., and Wilson, S. (1993). Theory to practice: Developing a Rogerian-based assessment tool. Journal of Advance Nursing, 18(5), 776-782. doi:10.1046/j.13652648. 1993.18050776.x Tomey, A. & Alligood, M. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby Elsevier. Wright, B. W. (2007). The evolution of Rogers’ s Science of Unitary/Human Beings: 21st century reflections. Nursing Science Quarterly, 20(1), 64-67.doi: 10.1177/089-4318406296295