Margaret Newman Health as Expanding Consciousness Newman 2011

Margaret Newman Health as Expanding Consciousness (Newman, 2011 a, p. 1)

Brought to you By Group #2 Group Members: Andrea Bengston Jessica Stewart Joseph Urbanski

(Jones, 2007, p. 306)

I like being on time. I wish everyone did. My time in my life, My consciousness. The time experienced In a moment Expands or diminishes With Consciousness. If I am fully present There is No time. Only consciousness. (Newman, 2008. p. 225) Margaret Newman “Nurses have told me that coming to know the meaning of health as expanding consciousness has brought them home. It has brought them full circle from their original intent in becoming a nurse through the instrumentality of medical intervention to the place where they have be striving to be. ” (Newman, 2010, p. 203)

Historical Evolution 1978 was the year that Margaret Newman first offered thoughts on a theory of health “During this time, she was also pursuing research on the relationship of movement, time, and consciousness and was expanding development of theory of health as expanding consciousness” (Marriner-Tomey, & Alligood, 2010, p. 480).

Historical Evolution Many other theorists helped to form Newman’s Health as Expanding Consciousness

Historical Evolution Rogers Hegel Bentov Bohm Young Moss Prigogine (Marriner-Tomey & Alligood, 2010, p. 484)

Historical Evolution Newman’s Health as Expanding Consciousness was also developed due to personal experiences within her life Newman had to take care of her mother due to her mother having Amyotrophic Lateral Sclerosis (Newman, 2008, p. 225). While taking care of her she had the idea that “illness reflected the life patterns of the person and what was needed was the recognition of that pattern and acceptance of it for what it meant to that person” (Marriner-Tomey, & Alligood, 2010, p. 486).

Metaparadigms Person Environment Health Nursing

Person Refers to: Individual Family Community

Person The Following Terms are seen in Newman’s work: v v v Client Patient Person Individual Human Being (Marriner-Tomey & Alligood, 2010, p. 482) The patient is a participant in expanding their consciousness, which can be seen as a pattern that evolves throughout their lives. (Endo, 2004, p. 111)

Environment Although not clearly defined in Newman’s work, environment is “Described as being the larger whole, which contains the consciousness of the individual” (Marriner-Tomey & Alligood, 2010, p. 483). Let’s look at Newman’s definition of consciousness in order to better understand this concept.

Consciousness Bentov defined Consciousness as the “Informational capacity of the system” in 1978 (Newman, 2011 c, para. 2) Newman uses this definition, with the term “human being” (in place of system) to state that consciousness is the ability of the human being to “interact with the environment” (Newman, 2011 c, para. 2). Cognitive awareness Affective awareness Physiochemical maintenance Growth processes Immune System Direct wording from (Marriner-Tomey &Alligood, 1010. p. 485)

Health Let’s look at the title of Newman’s Theory: Health as Expanding Consciousness What does this tell us from what we have learned thus far?

v Life experiences v Wholeness “Health is a unitary pattern of the whole and encompasses both disease and non-disease” (Newman, n. d. , slide 2). v Patterns “Pattern identifies the evolving human-environment process and is characterized by meaning” Newman, n. d. , slide 2). Health “Health encompasses disease and non-disease and is a manifestation of the underlying pattern of person-environment” (Newman, 1994, p. 11)

Pattern A pattern may be seen by looking at the person as a whole. The pattern of one’s life defines them as an individual. Alligood, 2010. p. 485 Newman’s theory relies on the basis that the patterns of interactions between the individual and the environment is what makes up one’s health.

Pattern Newman Order + Disorder = Life pattern believes that individual life patterns move “through peaks and troughs, variations in order-disorder that are meaningful for the person. ” (Marriner-Tomey & Alligood, 1010, p. 485)

Nursing That’s what we do, after all…

Nursing Nurses that use this theory help their patients to come to a better understanding of their lives and what it means to them. This unique coming together of nurse and patient often occurs in critical times of the patient’s life. By reflecting on the whole, the patient is able to expand their consciousness.

Characteristics of Nurse/Client Interaction Nurse Client Appears “authentic” Lets go of the “need to direct the relationship or fix things” Does not “manipulate or control” the partnership (Endo, 2004, p. 111) Views relationship as “partners” Able to focus on patterns in their life Views nurse as “caring” Able to move through process of “recognition, insight, and transformation”

Nursing Evolving Pattern of the Nurse-Client Process From “Health as Expanding Consciousness With Families With a Child With Special Healthcare Needs” by S. K. Falkenstern, S. H. Gueldner, and M. A. Newman, 2009, Nursing Science Quarterly, 22, p. 271. Copyright 2009 by The author (s).

Unique Concepts: Nursing Praxis

Nursing Praxis-What Newman has to Say. “If you want to know nursing, you engage in nursing practice. ” “Nursing praxis integrates theory, research, and practice. It is art, science, and practice. ” “A person comes into a higher stage of being known. The nurse becomes the means whereby clients emerge as a transformation of themselves. ” (Newman, 2002, p. 3)

Concepts Unique to Health as Expanding Consciousness Research as Praxis Protocol Phenomenon of Interest The Interview Transcription Development of the Narrative: Pattern Recognition Diagram: Pattern Recognition Follow-up: Pattern Recognition Application of the Theory of Health as Expanding Consciousness

Research as Praxis Protocol Lets take a look at what the Praxis Protocol is! Click on the arrow below!

Research as Praxis Protocol Phenomenon of Interest: “The process of expanding consciousness” (Kearney-Nunnery, 2008, p. 68) The Interview: The interview process is where the nurse and the client meet via similar patterns and develop trust in each other where they can expand into a higher level of consciousness. The nurse would then explain what the study is about and the client agrees to be part of it. The nurse would then ask certain questions pertaining to the client, listening and clarifying as the interview goes along. The interview would usually last about an hour, and usually recorded via tape for future review by the nurse. (Kearney-Nunnery, 2008, p. 68)

Research as Praxis Protocol Transcription: The transcription process is the part of the praxis protocol where the nurse reviews the tape recording of the client, noting important life patterns that the client has said. Development of the Narrative: Pattern Recognition: The nurse then would take all important data pertaining to the client’s life pattern and put them into chronological order emphasizing the most significant events or people in the clients life. “The data remains the same except in the order of presentation. Natural breaks where a pattern shift occurs are noted and form the basis of sequential patterns” (Kearney-Nunnery, 2008, p. 68)

Research as Praxis Protocol Application of the Theory of Health as Expanding Consciousness: “The nurse evaluates the nature of the sequential patterns of interaction in terms of quality and complexity, and interprets the patterns according to the study participant/client’s position on Young’s spectrum of consciousness” (Kearney-Nunnery, 2008, p. 69).

Let’s take a look at key works for transformation using Praxis Protocol: Fear, shock, surprise Depression, helplessness, uncertainty Accepting, hoping, praying, dealing, advocating, information seeking Letting go, confidence, connecting, trusting, reaching out, blessings, future Audio quote (Newman, 2007, p. 204)

Use of Health as Expanding Consciousness in Clinical Practice “Emphasis on time in the discipline of nursing has followed the trajectory of moving from physical, linear time to the synchronization of time in interpersonal relationships to the instantaneous flow of information in each center of consciousness. It is time to opt for practice that reflects this dimension. ” (Newman, 2008, p. 227).

Use of Health as Expanding Consciousness in Clinical Practice Health is the major concept of Newman's theory of expanding consciousness. A fusion of disease and non-disease creates a synthesis that is regarded as health (Newman, 1979, 1991, 1992). Newman’s view on health was that health is not something that can be “lost” or “gained” but that it is a reflection of a persons “wholeness” Therefore, health and evolving pattern of consciousness are the same. Specifically, health is viewed “as transformative process to more inclusive consciousness” (Newman, 2008, p. 16).

Use of Health as Expanding Consciousness in Clinical Practice Cont. Newman’s theory had much influence on further research of patients problems during clinical practice. At first Newman’s theory of health was useful in the practice of nursing because it contained the concepts of movement and time that are used by the nursing profession and intrinsic to nursing interventions such as range of motion and ambulation (Marriner – Tomey & Alligood, 2010, p. 490) In addition to Newman’s practices of movement and time many others conducted research about time, space, or movement. Newman and Gaudiano (1984) focused on the occurrence of depression in the elderly and decreased subjective time (Marriner – Tomey & Alligood, 2010, p. 490) Mentzer and Schorr (1986) used Newman’s model of duration of time as an index to consciousness in a study of institutionalized elderly. (Marriner – Tomey & Alligood, 2010, p. 490) Newman states that her research over time assisted not only clients who participated, but she and fellow researchers were also assisted. (Marriner – Tomey & Alligood, 2010, p. 490)

Patient Assessment In Newman’s view, the responsibility of professional nurses is to establish a primary relationship with the client for the purpose of identifying meaningful patters and facilitating the client’s action potential and decisionmaking ability (Marriner – Tomey, 2010, p. 489). The task of nursing is not to try to change the pattern of another person, but to recognize it as information that depicts the whole and relate to it as it unfolds (Marriner – Tomey, 2010, p. 490).

Patient Assessment By utilizing the Theory of Health as Expanding Consciousness in our daily practice, we can help make a difference in the lives of our patients. Instead of merely treating the patient for current symptoms, we can help the patient to reach a “higher stage of being known” (Newman, 2002, p. 3) Let’s look at an example of how Newman’s theory has defined the way one nurse cares for her patients, shall we?

From Margaret Dexheimer Pharris, Minneapolis, Minnesota, USA: Newman’s HEC theory has been the basis of my nursing practice over the past decade. It has served as a basis for my interactions with my BSN and graduate nursing students. It has shaped my nursing care of adolescents experiencing violence, survivors of sexual assault and abuse, and people presenting to the local trauma center for emergent care. I have found its greatest power in working with people who have been labeled with the diagnosis of borderline personality disorder, in that the process of pattern recognition focuses on the interaction between the person and her or his environment. As pattern recognition unfolds, the person is able to see what was a manifestation of who they are at the core of their being, and what was a manifestation of their environment, the people around them as they were growing up. This insight is often transformative, pointing to a different way of interacting with others. (Newman, 2011 b, para. 3) Listen first after reading: Listen second: Newman, 2011 b, para. 4 -5

Patient Assessment-The Bigger Picture As you can see, this theory is not merely concerned with objective data. We need to look at the bigger picture, and focus on the patient as a whole. By assessing the whole, the nurse is able to aid in the patient’s transformation of themselves.

Use of Newman’s theory, Health as Expanding Consciousness in Nursing Education Newman’s theory should be presented in nursing education to help students identify patterns. Her theory in school will help strengthen the teacher-student interaction. Teaching her theory will help students view illness and health as a whole.

Nursing Education This theory will help students to become authentic nurses. It will help students to recognize the importance of forming a partnership with their patients. This theory will also teach students to look at the big picture, beyond physical symptoms and at the meaning of the patient’s situation, because they can make a difference in the lives of their patients.

Current Research of Health as Expanding Consciousness Newman continues to do research about her theory. She recently wrote a book in 2008 called Transforming Presence: The Difference That Nursing Makes. Researchers are using Praxis Protocol in order to better serve their clientele. Nursing Praxis have been used to help people with special needs, mental illness, terminal diagnosis, and so on.

Health as Expanding Consciousness Strengths Health and the evolving pattern of consciousness are the same. The essence of the emerging paradigm of health is recognition of pattern. Newman (1994) sees the life process as a progression toward higher levels of consciousness (Marriner – Tomey & Alligood, p. 484). Once a person is able to embrace becoming healthy or being healthy then they can achieve health. As one begins to see the “bigger” picture on what health really consists of and can expand on the idea of health it will strengthen that persons state of health.

Health as Expanding Consciousness Strengths Can be used in any healthcare setting Broad Her enough for theory development theory helps with patient-client interactions to give better interventions, understand how the client is feeling, and helps the client to achieve a higher consciousness

Health as Expanding Consciousness Limitations The theory is based on abstract. The metaparadigm environment is not clearly defined. It is highly important to theory, but is not addressed in terms of what environment entails. Complex- must be able to understand theory as a whole, not just the concepts Multi-dimensional

Health as Expanding Consciousness Overall The concepts in Newman's theory are broad in scope because they all relate to health. Application of theory is universal in nature. The broad scope provides a focus for future theory development. Newman’s theory changed over time by process of trial and error. Patterns showed that expanding consciousness was related to quality and connectedness of relationships (Marriner – Tomey & Alligood, 2010, p. 494). The theory of health as expanding consciousness, along with the research as praxis method, has been used extensively in nursing practice with a variety of individuals, family, and community situations. Nursing education, and practice models and nursing research in the United States and several other countries. Newman continues to write, consult, and lecture, advancing her work (Marriner – Tomey & Alligood, 2010, p. 494).

Questions?

Questions? 1. After viewing our presentation, can you think of a situation where someone was ill, but accepted the illness and reached a higher level of consciousness? 2. Have you ever used Newman’s theory, Health as Expanding Consciousness? If not, would you now? 3. What is your view of health? How do you feel about Newman classifying health as a developing pattern of interaction between person and environment, which includes both disease and non -disease?

References Endo, E. (2004). Nursing praxis within Margaret Newman’s theory of health as expanding consciousness. Nursing Science Quarterly, 17(2), 110 -115. doi: 10. 1177/0894318404263260 Falkenstern, S. k. , Gueldner, S. H. , & Newman, M. A. (2009). Health as expanding consciousness with families with a child with special healthcare needs. Nursing Science Quarterly, 22(3), 267 -279. doi: 10. 1177/0894318409337015 Jones, D. A. (2007, October). Tribute to theorists: Margaret. A. Newman over the years. Nursing Science Quarterly, 20(4), 306. doi: 10. 1177/0894318407307134

References Kearney Nunnery, R. (2008). Advancing your career: Concepts of professional nursing. (4 th ed. ). Philadelphia, PA: F. A. Davis. Marriner-Tomey, A. , & Alligood, M. R. (2010). Nursing theorists and their work (7 th ed. ). St. Louis, MO: Elsevier. Newman, M. A. (n. d. ). Health as expanding consciousness [powerpoint presentation]. Retrieved from: http: //healthasexpandingconsciousness. org/home/images/sto ries/hecpresentation. pdf

References Newman, M. A. (2002). The Pattern that connects. Advances in Nursing Science, 24(3), 1 -7. Retrieved from Newman, M. A. (2204). Health as expanding consciousness (2 nd ed. ). New York: National League for Nursing Press. Newman, M. A. (2007, July 3). The Power of one: Confidence in our evolving future. Nursing Science Quarterly, 20(3), 203 -204. doi: 10. 1177/0894318407303435 Newman, M. A. (2008). It’s About Time. Nursing Science Quarterly, 21, 225 -227. doi: 10. 1177/0894318408320154

References Newman, M. A. (2011 a). Health as expanding consciousness; Margaret Newman’s biography [photograph]. Retrieved from http: //healthasexpandingconsciousness. org/home/index. php? opti on=com_content&task=view&id=12&Itemid=26 Newman, M. A. (2011 b). Health as expanding consciousness; Examplars. Retrieved from http: //healthasexpandingconsciousness. org/home/index. php? opti on=com_content&task=view&id=18&Itemid=34 Newman, M. A. (2011 c). Health as expanding consciousness; Overview. Retrieved from http: //healthasexpandingconsciousness. org/home/index. php? opti on=com_content&task=view&id=5&Itemid=6