Newman’s theory of Health as Expanding Consciousness

Margaret A. Newman (1933–Present)

Margaret A. Newman was born on October 10, 1933, in Memphis, Tennessee.
She earned a bachelor’s degree in home economics and English from Baylor
University in Waco, Texas, and a second bachelor’s degree in nursing from the
University of Tennessee in Memphis (M. Newman, curriculum vitae, 1996). Her
master’s degree in medicalsurgical nursing and teaching is from the University
of California, San Francisco. She earned her doctorate in nursing science and
rehabilitation nursing in 1971 from New York University.

Health is the “pattern of the whole” of a

person and includes disease as a
manifestation of the pattern of the whole,
based on the premise that life is an
ongoing process of expanding consciousness
Pattern is information that depicts the
whole and understanding of the meaning of
all of the relationships at once. It is
conceptualized as a fundamental attribute
of all there is, and it gives unity in
diversity. Pattern is what identifies an
individual as a particular person.
Consciousness is both the informational
capacity of the system and the ability of
the system to interact with its
environment. Newman asserts that
understanding of her definition of
consciousness is essential to understanding
the theory. Consciousness includes not only
cognitive and affective awareness, but also
the “interconnectedness of the entire
living system which includes
physicochemical maintenance and growth
processes as well as the immune system”
Newman emphasizes the primacy of relationships as a
focus of nursing, both nurse–client relationships and
relationships within clients’ lives. During dialectic
nurse–client relationships, clients get in touch with the
meaning of their lives through identification of
meanings in the process of their evolving patterns of
relating.
Clients are viewed as participants in the transformative
process. Persons as individuals are identified by their
individual patterns of consciousness ) and defined as
“centers of consciousness within an overall pattern of
expanding consciousness”.
Although environment is not explicitly defined, it is
described as being the larger whole, which contains the
consciousness of the individual. The pattern of person
consciousness interacts within the pattern of family
consciousness and within the pattern of community
interactions

Movement-Space-Time Newman emphasizes the

importance of examining movement-space-time is the major concept of Newman’s theory of health as
together as dimensions of emerging patterns expanding consciousness. A fusion of disease and
of consciousness rather than as separate nondisease creates a synthesis regarded as health
concepts of the theory
 Nursing, for Parse, is a science, and the performing art of nursing is
practiced in relationships with persons (individuals, groups, and Person, Environment, Health
communities). Parse set forth the following set of fundamentals for Viewed as Humanuniverse,
practicing the art of nursing: • Know and use nursing frameworks and Humanbecoming, and Living
theories. • Be available to others. • Value the other as a human Quality As mentioned
presence. • Respect differences in view. • Own what you believe and previously, Parse views the
concepts human and universe
be accountable for your actions. • Move on to the new and untested.
as inseparable and irreducible.
• Connect with others. • Take pride in self. • Like what you do. • To emphasize this
Recognize the moments of joy in the struggles of living. • Appreciate inseparability, she specified
mystery and be open to new discoveries. • Be competent in your humanuniverse and
chosen area. • Rest and begin anew. humanbecoming as one word

“configuring rhythmical patterns is “cotranscending with

“Structuring meaning is the
the revealing-concealing and possibles is the powering and
imaging and valuing of languaging”
enablinglimiting of connecting-separating” originating of transforming”

Imaging Paradoxes: Explicit–Tacit and Paradoxes: Pushing–Resisting,

Reflective–Prereflective - is an
individual’s view of reality. It is the
shaping of personal knowledge in
explicit and tacit ways
Paradox: Confirming–Not Confirming
- concept is about how
persons confirm and do not confirm
beliefs in light of a personal
perspective or worldview Persons are
continuously confirming–not
confirming beliefs as they are making
choices about how to think, act, and
feel. These choices may be consistent
with prior choices, or they may be
radically different and require a
shifting of value priorities
Paradoxes: Speaking–Being Silent and
Moving–Being Still
concept that is visible
and relates to how humans symbolize
and express their imaged realities and
their value priorities. When
languaging is visible to others, it is
expressed in patterns that are shared
with those who are close. Family
members or close friends often share
similar patterns, such as speaking,
moving, and being quiet.
Paradox: Disclosing–Not Disclosing
is the way persons
disclose and keep hidden the persons they
are becoming with the becoming visible–
invisible becoming of the emerging
now.There is always more to tell and more
to know about self as well as others.
Paradox: Potentiating–Restricting
Enabling–limiting
is related to the
potentials and opportunities that surface
with the restrictions and obstacles of
everyday living. Every choice, even those
made prereflectively, has potentials and
restrictions. It is not possible to know all
the consequences of any given choice;
therefore people make choices amid the
reality of ambiguity.
Paradox: Attending–Distancing
This concept
relates to the ways persons create patterns
of connecting and separating with people
and projects. Patterns created reveal value
priorities. Connecting– separating is about
communion–aloneness and the ways
people separate from some to join with
others. Connecting– separating is also
about the paradox attending–distancing
and explains the way two people can be
very close and yet separate. S
Affirming–Not Affirming, Being–
Nonbeing
is a concept that conveys
meaning about struggle and life and
the will to go on despite hardship and
threat. Parse (1981, 1998, 2012b,
2014) describes powering as pushing–
resisting that is always happening and
that affirms being in light of the
possibility of nonbeing.
Paradoxes: Certainty–Uncertainty,
Conforming–Not Conforming
holds the following two
paradoxes: (1) certainty–uncertainty
and (2) conforming– not conforming.
People strive to be like others, yet
they also strive to be unique. Choices
about originating occur with the
reality of certainty–uncertainty. It is
not possible to know all that may
come from choosing to be different or
from choosing to be like others.
Paradox: Familiar–Unfamiliar
Transforming is about the
continuously changing and shifting
views that people have about their
lives as they live what is becoming
visible to them with the invisible
becoming of their emerging now.
 Ten Caritas Processes

2. Being Authentically Present:

Enabling, Sustaining, and
Honoring the Faith, Hope, and
Deep Belief System and the Inner-
Subjective World of Self/Other.

4. Development and Sustaining a

Helping-Trust Caring Relationship

6. Creative Use of Self and All Ways

of Knowing as Part of the Caring
Process; Engage in the Artistry of
Caritas Nursing.

9. Administering Sacred
Nursing Acts of CaringHealing
by Tending to Basic Human
Needs.
 Orlando’s Nursing Process
Ida Jean Orlando-Pelletier (August 12, 1926 – November 28, 2007) was an
internationally known psychiatric health nurse, theorist, and researcher who
developed the “Deliberative Nursing Process Theory.” Her theory allows nurses
to create an effective nursing care plan that can also be easily adapted when
and if any complications arise with the patient

The function of Professional Nursing

the function of professional nursing is the organizing principle. This
means finding out and meeting the patient’s immediate needs for
help. According to Orlando, nursing is responsive to individuals who  Assessment
suffer or who anticipate a sense of helplessness  Diagnosis
 Planning
Presenting Behavior  Implementation
Presenting behavior is the patient’s problematic situation. Through the  Evaluation
presenting behavior, the nurse finds the patient’s immediate need for
help.
Distress- The patient’s behavior reflects distress when the patient
experiences a need that he cannot resolve, a sense of helplessness
occurs.

Immediate Reaction
is the internal response. The patient perceives objects with his or
her five senses.
Nurse Reaction-The patient’s behavior stimulated a nurse’s reaction, which marks
the nursing process discipline’s beginning. Orlando uses the concept of human as she
emphasizes individuality and the dynamic nature of
Nurse’s Action-When the nurse acts, an action process transpires. This action
process by the nurse in a nurse-patient contact is called the nursing process.
the nurse-patient relationship. For her, humans in
The nurse’s action may be automatic or deliberative. need are the focus of nursing practice.

Automatic Nursing Actions- are nursing actions decided upon for reasons
other than the patient’s immediate need.
Deliberative Nursing Actions- are actions decided upon after ascertaining a
need and then meeting this need.
In Orlando’s theory, health is replaced by a sense
of helplessness as the initiator of a necessity for
nursing. She stated that nursing deals with
individuals who require help.

 Deliberative actions result from the correct identification of patient

needs by validating the nurse’s reaction to patient behavior.
 The nurse explores the meaning of the action with the patient and
its relevance to meeting his need.
 The nurse validates the action’s effectiveness immediately after
completing it.
 The nurse is free of stimuli unrelated to the patient’s need when she
acts.
Orlando completely disregarded the environment
in her theory, only focusing on the patient’s
immediate need, chiefly the relationship and
actions between the nurse and the patient (only an
individual in her theory; no families or groups were
mentioned). The effect that the environment could
have on the patient was never mentioned in
Orlando’s theory.

Nursing Process Discipline

is the investigation into the patient’s needs
The action process in a person-to-person contact functioning
in secret.
The action process in a person-to-person contact functioning
by open disclosure
Orlando speaks of nursing as unique and
independent in its concerns for an individual’s need
for help in an immediate situation. The efforts to
meet the individual’s need for help are carried out
in an interactive situation and in a disciplined
manner that requires proper training.

Improvement
is the resolution to the patient’s situation. In the resolution, the nurse’s
actions are not evaluated. Instead, the result of his or her actions is
evaluated to determine whether their actions served to help the patient
communicate his or her need for help and how it was met.