JOYCE FITSPATRICK Life Perspective Rhythm Model

y y y y y y

born in 1944 BSN - Georgetown University MS in psychiatric-mental health nursing - Ohio State University PhD in nursing - New York University and an MBA from Case Western Reserve University. Fellow in the American Academy of Nursing 1981 Presently, Elizabeth Brooks Ford Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.

INTRODUCTION y y Life Perspective Rhythm Model is a nursing model developed by Joyce J Fitzpatrick. She conceptualized her model from Martha Rogers' Theory of Unitary Human beings.

MAJOR ASSUMPTIONS y y y y "The process of human development is characterized by rhythms that occur within the context of continuous person-environment interaction." Nursing activity focuses on enhancing the developmental process toward health. A central concern of nursing science and the nursing profession is the meaning attributed to life as the basic understanding of human existence. The identification and labeling of concepts allows for recognition and communication with others, and the rules for combining those concepts permits thoughts to be shared through language.

CORE CONCEPTS Rhythm Model includes four content concepts and they are: y y y Person Health wellness-illness and

METAPARADIGM. y PERSON

Person includes both self and others. Person is seen as an open system , a unified whole characterized by a basic human rhythm. The model recognizes individuals as having unique biological, psychological, emotional, social, cultural, and spiritual attitudes.

HEALTH

Health is a dynamic state of being that results from the interaction of person and the environment. 'a human dimension under continuous development, a heightened awareness of the meaningfullness of life. Optimum health is the actualization of both innate and obtained human potential gathered from rewarding relationships with others, goal directed behavior, and expert personal care. y WELLNESS-LLNESS

Professional nursing is rooted in the promotion of wellness practices. y NURSING

"A developing discipline whose central concern is the meaning attached to life (health) Primary purpose of nursing is the promotion and maintenance of an optimal level of wellness.

CONCLUSION Life Perspective Rhythm Model is a complex nursing model which contribute to nursing knowledge by providing taxonomy for identifying and labeling nursing concepts to allow for their universal recognition and communication with others.

ANNE BOYKIN & SAVINA SCHOENHOFER NURSING AS CARING: A Model for Transforming Practice

ANNE BOYKIN y Grew up in Kaukauna, Wisconsin. y The eldest of six children y She began her career in nursing in 1966,graduating from Alverno College in Milwaukee, Wiscon y She was a dean and professor of the Christine E. Lynn College of Nursing at Florida Atlantic University. y Also a director on the said College which is housed in College of Nursing. y Boykin s scholarly work is centered on caring as grounding for nursing. SAVINA O. SCHOENHOFER y She was born the second child and eldest daughter in a family of nine children. y She has a daughter, Carrie,and grand daughter, Emma y She spent 3 years in Amazon region of Brazil, working as a volunteer in community development. y Her initial nursing study was at Wichita University. y She introduced the caring as a substantive field of nursing study.

MAJOR CONCEPTS AND DEFINITIONS FOCUS AND INTENTION OF NUSING y Disciplines of knowledge are described as communities of scholars who develop particular perspective on the world and what it means to be in the world. Each disciplinary community holds in a common a value system that is expressed in its unique focus on knowledge and practice. y From the perspective of Nursing as Caring, the focus of nursing is nurturing person living and growing in caring. The general intension of nursing is to know persons as caring and to support and sustain them as they live caring. y Caring is an e expression of nursing and a the intentional and authentic presence of the nurse with another who is recognized as a living in caring and growing in caring y Sensitivity and creating unique and effective ways of communicating caring are developed through intention to care. PERSON y Is recognized as an individual living caring and growing in caring. y Through the lens of Nursing as Caring, persons are complete and whole i9n the moment: There is no deficit, deficiency, insufficiency, or brokenness. y The encounter person as less than whole is not to encounter person.

NURSING SITUATION y Nursing takes place in the nursing situation. The idea of the nursing situation is conceptualized as the shared, lived experience in which caring between nurse and nursed enhances personhood and is the locus of all that is known and done in n nursing. y Nursing situation is a construct in the mind of the nurse and is present whenever the intent of the nurse is to nurse . y The practice of nursing, and thus the practical knowledge of nursing, is situated in the relational locus of person-with-person caring in the nursing situation. y The nursing situation involves the expression of values, intentions, and actions of two or more persons choosing to live a nursing relationship. STORY AS METHOD FOR KNOWING NURSING y As the repository of all nursing knowledge, any single nursing situation has the potential to illuminate the depth and complexity of the experience as lived, that is, the caring that takes place between the nurse and the one nursed. y Nursing situation ia5re best communicated through aesthetic media such as storytelling, poetry, graphic arts, and dance to preserve the lived meaning of the situation and the openness of the situation through text. y Nursing situation as a unit of knowledge and practiced is recreated in narrative or story. y Story is a method for knowing nursing through which the content of nursing knowledge...is generated, conserved and known through the lived experience of nursing situation and the medium for all forms of nursing inquiry. y Nursing stories embody the lived experience of a nursing situation involving the nurse and nursed. y Story as method re-creates and represents the essence of experience, making the knowledge of nursing available for further study. PERSONHOOD y Personhood is understood to mean living grounded in caring. y Is the universal human call. y This implies that the fullness of being human is expressed in living caring uniquely day to day and enhanced through participation in caring relationship. y Is a process of living caring and growing in caring and implies being authentic, demonstrating congruence between beliefs and behaviours, and living out the meaning of one s life. DIRECT INVITATION y Opens the relationship to truly caring between. The nurse risk entering the other s world and directly invites the one nursed to share what matters most in the moment. What matters most to you in this moment, at this time? And How might I nurse you in ways that are meaningful to you? are communicated in the personal language of the nurse and call forth responses for mutual valuing in the beauty of the caring between. CALL FOR NURSING y A call for nursing is a call for acknowledgement and affirmation of the person living caring in specific ways in the immediate situation y Calls for nursing is a call for nurturance to which the nurse responds uniquely with a

deliberately developed knowledge of what it means to be human. CARING BETWEEN y When the nurse enters the world of other person with the intention of knowing the other as a caring person, the encountering of the nurse and the one nursed gives rise to the phenomenon of caring between, within which personhood is nurtured. CARING RESPONSE y Ass an expression of nursing, Caring is teh intentional and authentic presence of the nurse with another who is recognized as living caring and growing in caring y In responding the nursing call call, the nurse enters the nursing situation with the intention of knowing the other person as caring. This knowing of person clarifies the call for nursing and shapes the nbursing response, transforming the knowledge brought by the nurse to the situation in general,to the particular and unique.

SIX MAJOR ASSUMPTIONS THAT REFLECT A SET OF VALUES 1. 2. 3. 4. 5. 6. Persons are Caring by Virtue of Their Humanness Persons are Whole and Complete in the Moment Persons Live Caring, Moment to Moment Personhood is Living Life Grounded in Caring Personhood is enhanced through Participating in Nurturing Relationships With Caring others. Nursing is both a Discipline and Profession

MARGARET NEWMAN HEALTH AS EXPANDING CONSCIOUSNESS y y y y She was born on October 10, 1933, in Memphis, Tennessee. She earned her first bachelor s degree in home economics and English from Baylor University. She found it restrictive and not consistent with the paradigm from which the theory was drawn The theory of health as a expanding consciousness, along with the research as praxis method, has been used extensively in nursing practice with variety of client and family situations.

MAJOR CONCEPTS AND DEFINITION HEALTH y Health encompasses disease and nondisease. y Health can be regarded as the evolving pattern of the person and the environment. y Health is viewed as a process of developing awareness of self and environment together with an increasing ability to perceive alternatives and respond in variety of ways. y Health is viewed as the pattern of the whole of a person and is further described as including disease as a meaningfully manifestation of teh patter of teh whole, based on the premise that life is an ongoing process of expanding consciousness. PATTERN y Pattern is seen as information that depicts the whole, and understanding of the meaning of all of the relationships at once. y It is conceptualized as a fundamental attribute of all there is, and Newman sees it as giving unity in diversity. y Pattern is what identifies an individual as a particular person. CONSCIOUSNESS y Is defined as both the informational capacity of the system and the ability of the system to interact with its environment. y Newman asserted that an understanding of her definition of consciousness is essential to understanding the theory. y 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 MOVEMENT-SPACE-TIME y Newman states that it is important to examine movement-space-time as dimensions in emerging patterns of consciousness, not in isolation as separate concepts of the theory, like in the old paradigm. y Therefore, movement, space, and time, are no longer considered major concepts of the theory as they were in earlier works.

METAPARADIGM NURING y Is to help clients get in touch with the meaning of their lives by identification of their patterns of relating. y Facilitates pattern recognition in clients by forming relationships with them at critical points in their lives and connecting with them in an authentic way. y The nurse-client relationship is characterized by a rhythmic coming together and moving apart as clients encounter disruption of their organized, dictable state PERSON y Throughout Newman s work, the terms client, patient, person, individual, and human being are used interchangeably. Persons as individuals are identified by their individual patterns of consciousness. Persons further defined canters of consciousness within an overall pattern of expanding consciousness ENVIRONMENT y Environment is not explicity defined but is described as being the larger whole, which is beyond the consciousness of the individual. y The pattern of consciousness that is the person interacts within the pattern of consciousness that is the family and within the pattern of community interactions. HEALTH y Is the major concept of Newman s theory of expanding consciousness y A fusion of disease and nondisease creates a synthesis that is regarded as health. y Disease and nondisease are each reflections of the larger whole:therefore, a new concept, pattern of the whole , is formed.

JOSEPHINE PATERSON