466734
734Nursing Science QuarterlyLee, Fawcett
2013
NSQXXX10.1177/0894318412466
Essays on Nursing Science
The Influence of the Metaparadigm
of Nursing on Professional Identity
Development Among RN-BSN Students
Rebecca C. Lee, RN; PhD1 and Jacqueline Fawcett, RN, PhD; FAAN2
Abstract
This paper is a report of an interview about the metaparadigm of nursing and the influence of the metaparadigm on the
professional identity development of students enrolled in an online RN-BSN program.
Keywords
metaparadigm of nursing, nursing education, RN-BSN students
The Institute of Medicine (IOM) (2011) has recommended
that 80% of all nurses hold a minimum of a bachelor of sci-
ence degree in nursing (BSN) by 2020. This recommenda-
tion should increase the incentive for healthcare organizations
to require nurses who do not yet hold a baccalaureate degree
in nursing to enroll in a registered nurse to baccalaureate
degree (RN-BSN) program. Creating a supportive learning
environment for these nurses is crucial if the IOM recom-
mendation and healthcare organization requirements are to
become reality.
Although many students entering RN-BSN programs
already have a strong sense of clinical competence and a
variety of diverse practice-based experiences, many enroll
without a clear understanding of nursing as a professional
discipline and what it means to be a member of a profes-
sional discipline. Therefore, a challenge for nurse faculty
who teach this particular group of students is to design learn-
ing activities that establish linkages between the students’
previous clinical experiences and more abstract knowledge
to facilitate both their transition to baccalaureate education
and their professional identity development. One potential
way to meet the challenge is to facilitate students’ under-
standing of the implications of the metaparadigm of nursing
for professional identity development.
The purpose of this paper is to report the influence of the
metaparadigm of nursing on the professional identity devel-
opment of students enrolled in one online RN-BSN program.
The paper includes the edited transcript of an interview of
Jacqueline Fawcett by Rebecca Lee, and Dr. Lee’s students’
responses to the interview content.
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Nursing Science Quarterly
26(1) 96­–98
© The Author(s) 2013
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DOI: 10.1177/0894318412466734
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Background
An interview with Dr. Fawcett was conducted in July 2011
as part of a larger learning activity integrated throughout the
first required course in the online RN-BSN program at a
Midwestern university. In this course, Transition to
Professional Nursing, students engage in a discussion of the
philosophy undergirding professional nursing and the theo-
retical foundations of nursing practice, research, and other
scholarly activities. One topic is the metaparadigm of nurs-
ing, a topic that is new to most of the students. Several years
of student feedback about the topic revealed that understand-
ing the concepts and propositions of the metaparadigm of
nursing can be a bridge from practical to abstract thinking
and appreciation of nursing discipline-specific knowledge. It
was thought that an interview with Dr. Fawcett might
amplify and clarify the contents of publications about the
nursing metaparadigm.
The Interview
Rebecca Lee (RL): Would you please share with the stu-
dents your own educational pathway to nursing?
Jacqueline Fawcett (JF): I earned a baccalaureate
degree in nursing in 1964, a master’s degree in
1
Assistant Professor, College of Nursing, University of Cincinnati
2
Professor and Chairperson, Department of Nursing, University of
Massachusetts Boston
Lee, Fawcett 97
parent-child nursing with a minor in nursing education
in 1970, and a PhD in nursing in 1976.
RL: What originally inspired you to develop the
metaparadigm concepts?
JF: I was asked to present a paper, “The What of The-
ory Development,” at a conference sponsored by
the National League for Nursing in 1977 (Fawcett,
1978). Viewed through the lens of Kuhn’s (1970)
work on the structure of scientific revolutions,
Dubin’s (1969) idea of the central concepts of a dis-
cipline became nursing’s central concepts, which
evolved into the concepts of the metaparadigm of
nursing (Fawcett, 2005).
RL: How did these concepts influence the discipline
of nursing, both at the time of creation and in the
years since?
JF: The metaparadigm concepts, indeed the very idea
of a metaparadigm of nursing, influences nurses’
understanding of what nursing is, and especially
their understanding that nursing is an intellectual
discipline and not only skills used in the care of
people who are sick. I believe that a consider-
able amount of nurse burnout could be reduced if
nurses took the time to step back from their con-
crete clinical practice activities and examine their
practice from an abstract theoretical perspective.
One theoretical perspective is the concepts of the
metaparadigm of nursing. I think that in doing
so, nurses will begin to realize that nursing is an
intellectual enterprise that encompasses clinical
practice activities that are guided by theoretical
rationale. Thinking in this way requires nurses to
embrace change, which can be scary! But all of us
must be willing to take the risks that are inherent
in change to grow.
RL: How have your original metaparadigm concepts
evolved over the years?
JF: The central concepts I included in my 1978 paper
(Fawcett, 1978) were man, society, health, and nurs-
ing. Later, I changed man to person in the interests
of gender-neutral language, and I changed society to
environment in the interests of a broad perspective of
the surroundings of nurses and nursing participants.
The most recent change, from person to human
beings, was in response to the critique that person
is not recognized in some cultures. I described these
changes in detail in my book, Contemporary nurs-
ing knowledge: Analysis and evaluation of nursing
models and theories (Fawcett, 2005). In that book,
I also present other versions of the metaparadigm
concepts offered by several nurse scholars There
has been some discussion as to whether “nursing” is
a tautological concept within the metaparadigm of
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nursing. However, I have maintained that the inclu-
sion of nursing as a distinct metaparadigm concept
is necessary to capture the notion of the definition,
goals, and processes of nursing.
RL: Would you please discuss the relevance of the
metaparadigm concepts to the profession of nursing
in 2011, and beyond?
JF: The concepts of the metaparadigm of nursing,
whether my version or another version, are as rel-
evant today as at any other time in nursing’s his-
tory, because they are a way to identify what are the
boundaries and scope of the knowledge of nursing.
Specifically, the metaparadigm concepts identify
the global areas of knowledge needed for nursing
at the bedside and in administration, education, and
research. Individuals who might dismiss the idea of
a metaparadigm of nursing as dated should consider
their position carefully. For if people do not accept
that there is a body of knowledge that constitutes
nursing that is distinctive and different from other
disciplines, then they do not have the right to say
that they are practicing a profession or that they are
members of a professional discipline. Instead, they
are functioning as trades people.
RL: Could you share with us your own vision for the
future of professional nursing?
JF: I regret that I am not optimistic. Too often, we
behave as if we are members of a trade rather
than of a professional discipline by ignoring the
metaparadigm of nursing and by denying the utility
of nursing’s discipline-specific knowledge. Instead,
we willingly assume tasks and functions given to
us by physicians who would rather not bother with
certain tasks and functions. See, for example, Sand-
elowski’s (1999) seminal paper about the history of
intravenous nursing.
RL: In closing, do you have any advice for my students
as they embark on their educational journey?
JF: Keep going! Don’t be afraid to envision pos-
sibilities in your own future. That takes courage!
You will no doubt reach a point at which you want
more education, so it is best to pursue that educa-
tion while you are used to being a student. Above
all, have the faith of your convictions and don’t be
afraid of being alone.
Student Commentary
One assignment for the Transition to Professional Nursing
course is for students to develop a personal philosophy of
nursing based in part on personal meanings related to the
nursing metaparadigm concepts of human beings, environ-
ment, health, and nursing that incorporate exemplars taken
98 Nursing Science Quarterly 26(1)
from the students’ clinical experiences. The metaparadigm
concepts guide students’ examination of their own practice
from a theoretical perspective, allowing them to reflect on
the meaning of being members of the professional discipline
of nursing.
Students enrolled in the course were asked to provide
feedback after listening to the interview, which was uploaded
as an audio file to the course web site. Analysis of the stu-
dents’ feedback revealed three themes: Envisioning nursing
as a profession, developing a professional identity, and
embracing change.
Envisioning Nursing as a Profession
Students indicated that after listening to the interview, they
could begin to think about nursing as a professional disci-
pline. One student commented, “After listening to the con-
versations in the interview and reading other students’
comments, I am left wondering why it is such a struggle and
challenge to consider nursing as a profession. I’ve come to
the conclusion that perhaps it is the attitude of nurses them-
selves that makes nursing a profession or will cause us to
lose our place.” Another student noted, “In order for nurses
to be given the respect afforded members of a profession,
they have to look at what they do as just that–a profession.”
Students indicated that they felt inspired by the dialogue
with Dr. Fawcett, and eagerly accepted her challenge to
shape the future of the profession. A student declared,
“Thank you for inspiring us to take the challenge of
strengthening our profession!”
Developing a Professional Identity
Each of the students noted the relevance of the metapara-
digm concepts as a guide for reflective examination of
their unique views of what it means to be a nurse and a
member of the profession. One student stated, “I had never
heard of the metaparadigm of nursing before this course
and this activity. But hearing about it and thinking about
the concepts in relation to my own philosophy of nursing
and experiences as a nurse makes me feel more connected
with the profession.” Another student commented, “It is
truly hard to examine the whole nursing picture when you
perform the same clinical practice(s) each day. You lose
sight of the role you play in the larger profession of nurs-
ing. But I truly believe it is up to each of us to keep nursing
going as a profession.”
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Embracing Change
Students recognized the need for acceptance of changes. One
student declared, “In order to continuously develop as a pro-
fession, you must have the capacity to embrace change and
learn and grow from it.” Another student noted, “It was a
very scary step for me to return to school, as I was comfort-
able with my routine. People get set in their ways, [so] they
sometimes don’t welcome change. But if you’re not chang-
ing, then you’re not growing, and you’ll get left behind.”
Conclusion
In summary, it is crucial to the continuous development of
the professional discipline of nursing that members embrace
not only their role as members of the professional discipline,
but also embrace continuous changes in self, others, and the
knowledge and practice of the discipline. However, it is
important that in the rush toward innovation not to fail to
build on the past. The concepts and propositions of the
metaparadigm of nursing can provide a sound foundation for
baccalaureate education for registered nurses transitioning
from clinically-based practice to more theoretically informed
reasoning.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
References
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