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Personal Nursing Philosophy: A Work in Progress

Catherine E Hubka

Faculty of Health Disciplines: Athabasca University

MHST/NURS 608: Philosophical and Critical Foundations in Nursing

Dr. Lisa Adams

November 28, 2023

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Abstract

This paper explores my personal nursing philosophy by establishing claims under ontology,

epistemology, and ethical views. A basic understanding of nursing philosophy is first reviewed. Fawcett’s

2022 revised metaparadigm with human beings, planetary health, global environment, and nursologist

activities inspired my philosophy. Various nursing theories and epistemologies were discussed in relation

to the nursing knowledge holarchy to apply my philosophy to practice. Carpers four ways of knowing,

Chinn and Kramer's emancipatory knowing, Watson’s caring of human science, Nightengales

environmental theory, Leininger's transcultural theory, and Roy’s adaptation model are all briefly

discussed in relation to how the 2022 metaparadigm are put into practice.
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Personal Nursing Philosophy: A Work in Progress

Philosophy is “a statement encompassing ontological..., epistemic…, and ethical claims” used to

explain what the writer “believe[s] to be true in relation to the phenomena of interest to ...[their]

discipline” (Fawcett, 2005b, pp. 11-12 as cited in Butts & Rich, 2018, p. 91). Ontological claims come

from the study of ontology, meaning studying what is reality or what it is to exist (Welch, 2020, p. 196).

Epistemic claims come from the study of epistemology, meaning the “study of knowledge” or what,

how, and where we know things (Welch, 2020, p. 196; Rega et al., 2017, p.78). In search of a personal

nursing philosophy, I inquired about my life philosophy, current philosophies of nursing, and the value of

establishing a nursing philosophy.

The way I grasp knowledge is primarily by understanding the origins of a phenomena to

acknowledge the context and value of it, therefore I need to take you, the reader, on the journey I went

on to better explain my inevitable stated nursing philosophy. I begin by ‘digging’ and as I ‘dug’ into

nursing philosophy, I discovered in the year 1962, Thomas Kuhn, a philosopher of science, presented a

revolutionary science using philosophical rationalism (see Appendix A) or simpler put, he theorized that

“scientific revolution occurs in a structured way” (Younas & Parsons, 2019, p. 248). This structure

included the term paradigm and explained how the paradigm can change over time. A paradigm being a

social phenomenon and “a comprehensive set of social, material, and intellectual tools such as ideas,

rules, methods, theories, experiments, laws, and standpoints that provide an approach to scholars of

any given discipline to solve problems or engage in normal Science” (see Appendix A; Younas & Parsons,

2019, pp. 246-247).

This revolutionary science theory disseminated to the discipline of nursing. After that, nursing

theorists like Fawcett (in 1984), and later Parse (in 1987) and Newman (in 1992), coined their own

nursing related paradigms (Younas & Parson, 2019, p.249). I found Fawcett's interpretation of a nursing

paradigm to be most relatable with the use of laymen terms of person, nursing, health, and
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environment (Fawcett, 2023). She coined these categories to be a metaparadigm indicating a broader

scope from the defined paradigm (Younas & Parsons, 2019, p. 249). In 2022, Fawcett responded to the

revolutions and expansions of the nursing discipline (Fawcett, 2023). She did so by changing the terms

and definitions in her metaparadigm to include human beings, nursologist activities, planetary health,

and global environment (Fawcett, 2023). This interpretation of a nursing paradigm is considered

Fawcett's evolving philosophies of nursing, and they help guide nursing practice and give the profession

an identity (Younas & Parson, 2019, p.249). Denehy (2001) indicated that establishing a nursing

philosophy can also “affirm that [the nurses] practice is in harmony with their value system” during the

struggle of increased workload demands and decreased work satisfaction (p. 1).

How philosophies can integrate into nursing practice is through nursing theories and models

(Butts & Rich, 2018). As I learn more about grande and middle-range theories and conceptual and

framework models (see Appendix A), I am not alone as a new graduate nurse, who struggles to

understand the different terms and abstract thoughts of nursing epistemology (p.87) and theory (Butts

& Rich, 2018, p.97). Furthering my search for understanding, Fawcett in 2005, presented a nursing

knowledge holarchy (or model of hierarchy involving nursing concepts) to demonstrate the most

abstract to the most concrete nursing knowledge (see Appendix B; Butts & Rich, 2018, p. 88). Having a

grasp of these concepts and how they unfold into direct nursing practice is pivotal in understanding how

my own nursing philosophy translates to my nursing practice in administration for Calgary, Alberta,

Canada’s Home Care program. In this paper I will describe my nursing philosophy (ontological,

epistemic, and ethical claims) inspired from Fawcett’s 2022 revised metaparadigm and how it relates to

my practice using differing nursing theories, models, and epistemologies.

Ontological Claim

The idea of what it means to exist is an abstract thought. Within a previous paper (Hubka, 2023),

I delved into what influences my ontological stance of nursing. At that time, I did not connect with the
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metaparadigm, recognizing it was an overarching understanding of nursing that I did not directly relate

to my practice, not like nursing theories do at least. As I have described in previous paragraphs, I have

grown to understand exactly what a metaparadigm is and now hold more value towards it. Fawcett’s

2022 metaparadigm describes the influences I associate with. The use of the word human being as

opposed to person describes the understanding that not all cultures value the individual and they

acknowledge the community more (Fawcett, 2003, p.273). This is the case with some non-colonial

philosophies, placing value on the person being part of the community rather than an autonomous

being (Chinn, 2022). My ontological stance of being culturally competent is supported with the

promotion of communitarianism, defined as encompassing the community relationship to the individual

(Daniel, 2023).

Further relations with the 2022 metaparadigm, the nursologist term versus title of nurse refers

to the clear indication that nurses are their own discipline (Nursology, n.d.). An exciting shift I see as in

revolution stages following Kuhn’s revolutionary science theory (Younas & Parson, 2019, p.248),

nursology being its own study of nursing science. This change aligns with feminism's influence on my

nursing practice because radical feminism (“valuing women's experience without the imposed standards

of male ideology or systems”) is a view that helps honour and explore the professions foundations and

growth (Chinn & Wheeler, 1986, p.75). Nursology as its own discipline is being confident in it’s own

nursing knowledge and theories, and appreciates itself as a valuable member of the health care team.

The use of planetary health (Fawcett, 2023) aligns with my ontological view of social justice. Potter

(2021) describes planetary health as the health of humans and the planet are intertwined (abstract

only). While Kuehnert et al. (2022 as cited in Fawcet, 2022a) highlights “cultural, socioeconomic,

physical, and political” environments reportedly effect planetary health (p. 269). This view of everything

being interconnected, including political environments, reflects communitarianism (Daniel, 2023). This

impacts my nursing practice with the knowledge that the persons health is greatly affected by their
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community (Daniel, 2023; Schim et al., 2007 p. 76). Lastly the view of global environment indicates

“local, regional, national, and worldwide cultural, social, political and economic conditions [are]

associated with human beings health” (Fawcett, 2022a). I must consider a person's environment while

addressing their care needs (Schim et al., 2007).

To describe how my ontological view translates to practice, I must first clarify that I consider

myself a nurse, now to be referred to as a nursologist. I do not consider it simply as a career, so I do not

box myself into the current work I am doing. My ontological view relates to more than the current role I

am encompassing in the health care system. It relates to previous and future roles as well. My

ontological claim as a nursologist is to remain open, inquisitive, non- judgmental, and flexible in a caring

manner to promote culturally competent, non-bias, socially just care. A nursologist is to ensure they

advocate at every level of health care because of global and planetary influences on human beings'

health (Fawcett, 2023). I do this through work meetings, advocating for marginalized individuals needing

decreased barrier to access care. I remain open and non-judgmental during phone calls with both clients

and peers while collaborating to formulate a plan of care to address the person's needs.

I view my ontological stance as utilizing the Jean Watson’s human caring theory in which the

major concepts are categorized by Fawcett's metaparadigm of person, nurse, health, and environment

(Kandula, 2019, p. 30). The theory places clients in relation to their community and culture (Kandula,

2019, p.30) which have been established as clear commitments in my ontological stance. Some of

Watson’s primary carative factors include understanding the self-view of interpersonal relations,

fostering faith and hope, striving for sensitivity and authenticity, establishing trust with empathy and

warmth, non-judgmental supportive listening, and utilizing scientific method for safety (Kandula, 2019,

p. 29).

Epistemic Claim
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Continuing my philosophy of nursology with my epistemological stance, I can now relate the

2022 metaparadigm to Carpers four ways of knowing and Chinn and Kramer’s emancipatory knowing as

influenced from White’s sociopolitical knowing (Thorne, 2020, p. 3). Carpers four ways of knowing

include empirics (scientific based), aesthetics (the “art” of nursology), personal (interpersonal contacts

and self-awareness), and ethics (including moral and principles; See Appendix C; Carper, 1978).

“Nursologists activities are directed toward human beings and planetary health within the context of the

global environment” (Fawcett, 2023). With this said, I incorporate what I claim through human being,

planetary health, and global environment to be involved in my epistemic claim to the activities of

nursology.

Reflecting on the paradigm of human beings, I use ethical knowledge and Leininger's culture

care theory to ensure cultural preferences and values are advocated for (Fawcett, 2018). With aesthetic

knowledge, I am sensitive with verbal and non-verbal language while inquiring about Leininger's cultural

factors influencing the person and communities, including technological, religious, social, political,

economic, and educational factors (Fawcett, 2018). A work example of ethical knowledge in relation to

cultural care is when a client with capacity is choosing to live at risk to stay home longer with family or

alone, I ensure the risks are made known to the client and documented as I support the client with their

informed decision.

Within planetary health I understand the empirical knowledge and empirical indicators noted

from the knowledge holarchy (see Appendix B), are required to complete safe and competent care. I

follow Clinical Care Topics and standard procedures set out by my employer as these are evidence-based

tools for my practice (AHS, n.d.). I am an established resource for peers to discuss complex client needs

or workload concerns. I frequently converse with Home Care educators to confirm the most recent

evidence-based updates and annually review the registered colleges standard of practices to maintain

my practice (CRNA, 2023). Florence Nightengale’s theory of environment helps steer my assessments
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with altering the client's environment to affect the client's health, including temperature, hygiene,

nutrition, social support, adequate shelter, and mental health (Selanders, 2010, p.84). I demonstrate

aesthetic knowledge while implementing these practices and standards with the use of humour, silence,

or therapeutic touch when culturally appropriate (Perry, 2009).

For the global environment paradigm, I incorporate emancipatory knowing with understanding

that a human being's environment and community directly affects their health (Fawcett, 2022a). The

complexities of society and political barriers and interactions that the community, client, and nurse all

face are related to emancipatory knowing as well (Thorne, 2020). During collaboration with the client, I

practice aesthetic knowledge with active listening, empathy, and maintaining a nonjudgmental approach

(Carper, 1978). Roy’s Adaptation Model assists in assessing the client’s whole environment through

recognizing stimulus effecting the client and understanding the client's views of their role, personal

values, surrounding community, social supports, and physical health (Masters, 2015, pp. 130-131).

Personal knowing or the understanding that I am simply a human interacting with another

human (Carper, 1978, p.28), is reflected in the entire metaparadigm through my personal philosophy. To

demonstrate my personal knowing and what it can bring to the forefront of my nursing philosophy, I will

share it here. Be authentic because life is too short not to be. Be brave and stand up for what you believe

to be right in this complex world. Trust in your own self and validate your feelings. Share your gifts and

interest in this world so others can share in them too. Strive to contribute because no matter

how small the contribution, you will make a difference in this world. To say this difference is good

or bad is up to you. So, choose to be kind. Your perception of the world is your own, do not try to

compare. You cannot possibly understand fully what another is going through. Therefore, choose

empathy and patience, while staying true to you, your values and morals using healthy

boundaries. Try to be curious and inquire about others and yourself. Explore the spiritual side of

life and do not impose what you find on others. This world can leave you reeling, so find
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something to believe in.

Ethical Claim as a Scholar

Establishing my personal philosophy has assisted in articulating the impact I want to make as a

nursologist. Aligning my personal values with my nursing values, I can establish my goals for professional

growth and being a “good role model” in various settings (Denehy, 2001, p. 1). An ethical claim is a

statement that includes a future tense describing how you plan to make something better, not what the

current state of that something is (Wesleyan University, n.d.). To reflect upon an ethical claim, I

searched further into a current revolutionary stage of nursology, that is decolonization of nursing.

Watson (1995) describes this postmodernism idea unfolding from attempts to understand the

“human experience and beyond, into hermeneutics..., to feminism, language and semiotics, to

deconstruction, to constructivist thinking and onward, toward the disownment of theory” (p.62).

Watson (1995) discusses the now classic works of Parse (theory of human becoming), Rogers (science of

unitary human beings), Newman (theory of health as expanding consciousness), and her own (theory of

transpersonal human caring) to be inviting of “shared themes of what might be considered a redefining

of nursing knowledge from the modern” (p. 63). I agree with Watson (1995) that the expansion of

knowledge of the human condition beyond the physical and the “awakening of nursing’s moral

consciousness and compassion” are “hallmarks” of this revolutionary stage (p.63). Deconstruction

“without critique can lead to a void and moral confusion” (Watson, 1995, p.61) which is particularly how

I first felt after learning about decolonization through Suárez-Baquero (2023) and Chinn (2022). Where

do I go from here? This brings me to my ethical claim based off the revised 2022 metaparadigm which

has already helped establish my ontological and epistemological claims.

In relation to human beings, I commit to the continuous active process of self-reflection, as I

implement current nursing theories. I recognize current nursing theories to be crucial in understanding

the persons culture and what they value. I recognize that nursing theory has been used to establish
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health policies therefore policies are to guide my practice (Fawcett, 2022b). I acknowledge that policy,

society, and culture influence my “implicit” or subconscious bias towards the person(s) and I will strive

to correct this bias to promote acceptance of the paradigm of human being (Wei et al., 2023). For

planetary health, I will continue to use evidence-based practice for the safety of myself and clients. I will

question standards of practice and address required revisions or updates with management and the

quality education program within Home Care. Health is always evolving, and policies and standards will

require updating (Younas & Parsons, 2019). I recognize the implications that health does not mean

optimal wellness but rather the entire health experience which includes dying with dignity and comfort

(Fawcett, 2003). I will continue practices of reducing waste and encourage workplaces to implement

reduction of waste programs as the health of the planet is interconnected with the health of the human

being (Potter, 2021, abstract only).

Global environment is reflected in cultural, socioeconomic, physical, and political environments

(Fawcett, 2022a). This indicates that as a nursologist, I must consider climate change and advocation for

political reform a part of caring for my clients (Fawcett, 2022a). I will strive to promote and listen to “the

stories of all indigenous people, peoples of colour, and peoples with diverse gender identities and sexual

orientations” (Fawcett, 2022a, P. 269). Within nursologist activities, I will openly share my knowledge as

I mentor new nurses or students. I will encourage the use of nursing theory in practice to ensure

culturally sensitive and holistic thinking. I will use a critical lens when reading any scholarly works, from

well-established to new revolutionary works (Thorne et al., 1999). I will avoid labeling the ideas of my

peers so I can accept the value their ideas bring to nursing knowledge, even when these ideas do not

appear to align with my own (Thorne et al., 1999). I will continue to grow in my emancipatory

knowledge and strive to establish a long-term goal of mine, a volunteer program at a local homeless

shelter. Lastly, I understand that this nursing philosophy is and always will be a work in progress because

health and the world is forever changing (Denehy, 2001; Thorne et al., 1999).
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Conclusion

With my ontological, epistemic and ethical claims based off Fawcett’s 2022 metaparadigm, I was

able to establish a working nursing philosophy. Fawcett’s metaparadigm consisted of person, nurse,

health, and environment, however with revolutionary changes to nursology, she proposed a new

metaparadigm in 2022 as human beings, nursologist activities, planetary health, and global environment

(Fawcett, 2023). I utilized this new metaparadigm to explore my ontological stance with the concepts of

cultural competence, communitarianism, social justice, and feminism while implementing these

concepts with Watson’s theory of human caring. With my epistemological stance I claimed Carper’s four

ways of knowing and Chinn and Kramer’s emancipatory knowing. These epistemologies were utilized in

practice with nursing theories of Leininger's cultural care theory, Nightengale’s environmental theory,

and Roy’s adaptation model. I reflected on my life philosophy to help establish what personal knowing

contributed to my nursologist philosophy and practice. Finally, I established ethical claims for my future

nursologist activities that included advocating for decolonizing nursing with political reform, establishing

a critical and non-judgmental lens, self-reflection on use of nursing theory and implicit bias, and

ensuring I am expanding my knowledge while being open to my personal and nursing philosophies

forever changing.
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References

AHS (n.d.). Clinical Care Topics [webpage]. Alberta Health Service. Retrieved November 11, 2023, from

https://www.albertahealthservices.ca/cgv/Page16657.aspx#:~:text=Clinical%20Care%20Topics

%20(CCTs)%20are,with%20evidence%2Dbased%20clinical%20guidance

Butts, J.B. & Rich, K.L. (2018). Components and levels of abstraction in nursing knowledge. In

Philosophies and Theories for Advanced Nursing Practice, (3rd ed., pp.87-105). Retrieved from

https://samples.jbpub.com/9781284041347/9781284041347_ch05_pass02.pdf

Carper, B.A. (1978). Fundamental patterns of knowledge in nursing (Chapter 3). ANS, 1

(1), 23-32. Jones & Bartlett Learning. Reprinted from Aspen Publishers, Inc.

https://samples.jbpub.com/9780763765705/65705_ch03_v1xx.pdf

Chinn, P. (2022). Decolonizing nursing knowledge. Nursing Philosophy, 23(4). e12410.

https://doi.org/10.1111/nup.12410

Chinn, P.L. & Wheeler, C.E. (1986). Feminism and nursing- can nursing afford to remain

aloof from the women's movement? [Kango] Japanese journal of nursing, 38(1). 115-124.

CRNA (College of Registered Nurses of Alberta) (2023). Practice standards for registrants

(pp.1-13). https://nurses.ab.ca/media/1mkkxvxi/practice-standards-for-registrants-2023.pdf

Daniel, B. (2023). Communitarianism [webpage]. The Stanford Encyclopedia of Philosophy, Edward N.

Zalta, E.N & Nodelman, U. (eds.). Retrieved October 9, 2023, from

https://plato.stanford.edu/archives/fall2023/entries/communitarianism/

Denehy, J. (2001). Articulating your philosophy of nursing. Journal of the School of Nursing, 17(1), 1-2.

Fawcett, J. (2003). Critiquing contemporary nursing knowledge: A dialogue. Nursing Science Quarterly,

16(3), 273-276. https://doi.org/10.1177/0894318403016003022

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Fawcett, J. (2018). Leininger’s Theory of Culture Care Diversity and Universality [webpage]. Nursology.

https://nursology.net/nurse-theories/leiningers-theory-of-culture-care-diversity-and-

universality/

Fawcett J. (2022a). Thoughts about environment. Nursing Science Quarterly, 35(2), 267-269.

https://doi.org/10.1177/08943184211070578

Fawcett, J. (2022b). Thoughts About Health Policies. Nursing Science Quarterly, 35(3), 378–382.

https://doi.org/10.1177/08943184221092444

Fawcett, J. (2023). Thoughts about the metaparadigm of nursing: Contemporary status

and recommendations for evolution. Nursing Science Quarterly, 36(3). 303-305.

https://doi.org/10.1177/0894318423116977

Hubka, C.E. (2023). Nursing Ontology Stance: Being a Nurse Through Caring Advocacy.

Kandula, U.R. (2019). Review article: Watson human caring theory. JNPE, 5(1), 28-31.

https://www.researchgate.net/publication/338621474_Watson_Human_Caring_Theory

Lindell, D. & Chinn, P. (2022, October 27). Patterns of knowing [webpage]. Nursology.

https://nursology.net/patterns-of-knowing-in-nursing/#:~:text=In%201978%2C%20Barbara

%20Carper%20published,personal%2C%20ethical%2C%20and%20aesthetic.

Markie, P. (2021, September 2). Rationalism vs. Empiricism [webpage]. Standford

Encyclopedia of Philosophy. https://plato.stanford.edu/entries/rationalism-empiricism/

Masters, K. (2015). Roy adaptation model: Sister Callista Roy. Nursing Theories: A

Framework for Professional Practice (2nd edition, pp. 113-126). Johns & Bartlett Learning.

https://books.google.ca/books?id=sd0-BAAAQBAJ&printsec=frontcover#v=onepage&q&f=false

Merriam-Webster. (n.d.). Rationalism. In Merriam-Webster.com dictionary. Retrieved

November 23, 2023, from https://www.merriam-webster.com/dictionary/rationalism

 14

Nursology. (n.d.). Nursology, nursing, nursologist, and nurse: An invitation to dialogue

about disciplinary term [Webpage]. Retrieved November 18, 2023, from

https://nursology.net/about/definitions/nursology-nursing-nursologist-and-nurse-an-invitation-

to-dialogue-about-disciplinary-terms/

Perry, B. (2009). More moments in time: Images of exemplary nursing. AU Press.

https://doi.org/10.15215/aupress/9781897425510.01

Potter TM. (2021). Planetary Health: An Essential Framework for Nursing Education and Practice

[abstract access only]. Creative Nursing, 27(4), 226-230. doi:10.1891/cn-2021-0017

Rega, M. L., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and

theoretical content of the nursing discipline in academic education: A critical interpretive

synthesis. Nurse Education Today, 57, 74–81. https://doi.org/10.1016/j.nedt.2017.07.001

Schim, S., Benkert, R., Bell, S., Walker, D., & Danford, C. (2007). Social justice: Added

metaparadigm concept for urban health nursing. Public Health Nursing, 24(1), 73-80.

https://doi.org/10.1111/j.1525-1446.2006.00610.x

Smith, M. (2022, December 20). The Focus of the Discipline of Nursing [webpage].

Nursology. https://nursology.net/2022/12/20/the-focus-of-the-discipline-of-nursing/

Suárez-Baquero, D. (2023). Breaking the chains: Decolonizing the language of Nursology.

Nursing Philosophy, 24(2), e12422. https://doi.org/10.1111/nup.12422

Thorne, S. (2020). Rethinking Carper's personal knowing for 21st century nursing.

Nursing Philosophy, 21,e12307, 1-7. https://doi.org/10.1111/nup.12307

Thorne, S. E., Kirkham, S. R., Henderson, A., & Thorne, S. (1999). Ideological implications of paradigm

discourse. Nursing Inquiry, 6(2), 123–131. https://doi.org/10.1046/j.1440-1800.1999.00016.x

Watson, J. (1995). Postmodernism and Knowledge Development in Nursing. Nursing Science Quarterly,

8(2), 60–64. https://doi.org/10.1177/089431849500800207

 15

Wei, H., Price, Z., Evans, K., Haberstroh, A., Hines-Marin, V., & Harrington, C.C. (2023).

The State of the Science of Nurses' Implicit Bias: A Call to Go Beyond the Face of the Other and

Revisit the Ethics of Belonging and Power. Advances in Nursing Science, 46(2). 121-136.

https://doi.org/10.1097/ANS.0000000000000470

Welch, S. (2020). Caring and Esthetics: An Argument for a Nursing Ontology and

Epistemology. International Journal for Human Caring, 24(3). 196-201.

https://doi.org/10.20467/HumanCaring-D-19-00062

Wesleyan University (n.d.). Ethics in society: “How do I think about ethics?” [webpage]. Retrieved

November 20, 2023, from

https://www.wesleyan.edu/ethics/teaching/media/classroom/question1.html#:~:text=Ethical

%20claims%20are%20evaluative%20or,the%20world%20can%20be%20better.

Younas, A., & Parsons, K. (2019). Implications for Paradigm Shift in Nursing: A Critical Analysis of Thomas

Kuhn’s Revolutionary Science and Its Relevance to Nursing. Advances in Nursing Science, 42(3),

243–254. https://doi.org/10.1097/ANS.0000000000000244
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Appendix A: Definitions

1. Communitarianism - “idea that human identities are largely shaped by different kinds of

constitutive communities (or social relations) and that this conception of human nature should

inform our moral and political judgments as well as policies and institutions” (Daniel, 2023).

2. Conceptual model - has its own distinct language of its concepts and propositions, and the

definition of each term and phrase is directly connected to the essence and meaning of the

conceptual model”. It is “abstract and represents the physical, psychological, and logical process of

the world”. (Butts & Rich, 2018, p.97)

3. Empirical indicators - concrete and specific information used for middle range theory concepts

or experimental instruments or tools for measuring middle range theory concepts (e.g. practice

standards; Butts & Rich, 2018, p.102)

4. Epistemic or Epistemology - The philosophical study of what knowledge is, how someone

obtains knowledge, and in what way they do (Welch, 2020, p. 196; Rega et al., 2017, p. 78).

5. Framework model - a middle range theory model, are a “schematic diagram of theories, a

representation of testable theories, or a graphic representation that helps one to comprehend the

theory” and “they suggest and imply relationships” (Butts & Rich, 2018, p.97).

6. Grande theory - is an “abstract, broad theory consisting of concepts and propositions that are

less broad and abstract than a conceptual model but not as specific and concrete as middle range

theory” and can be referred to as macro theory and too broad to place into nursing practice (Butts &

Rich, 2018, p.99)

7. Knowledge holarchy - a geometric shape involving the hierarchy of concepts (Butts & Rich,

2018, p.88)

8. Metaparadigm- indicating a broader scope from the defined paradigm (Younas & Parsons, 2019,

p. 249)
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9. Middle range theories - are concrete, align with nursing practice, and strongly supported by

empirical data. They can be descriptive, predictive, explanatory, derived from conceptual systems or

models. They are presenting, building, confirming, or utilizing knowledge. Examples – Orlando

(deliberate nursing process), Peplau (interpersonal relations), Watson (human caring), King (goal

attainment), Tulman and Fawcett (adaptation during childbirth from RAM) (Butts & Rich, 2018, pp.

100-101)

10. Normal science- “a gradual process that takes place under a single paradigm” (Younas &

Parsons, 2019, p.252)

11. Nursologist- “Nursing isn’t the application of knowledge from other fields like medicine,

psychology, or public health to the care of people. Yes, nurses draw on this knowledge in their

practice, but nursing is a discipline, a professional discipline, with its own knowledge base distinct

from others “(Smith, 2022)

12. Ontological or Ontology - the study of existence, in nursing it involves questions like “disease,

power, moral judgements, and ‘what is’ concerning nursing” (Edwards, 2001, as cited in Welch,

2022, p.196).

13. Paradigm- a social phenomenon and “a comprehensive set of social, material, and intellectual

tools such as ideas, rules, methods, theories, experiments, laws, and standpoints that provide an

approach to scholars of any given discipline to solve problems or engage in normal Science” (Younas

& Parsons, 2019, pp. 246-247).

14. Paradigm shift - “a discipline achieves a scientific revolution” when “the existing paradigm fails

to accommodate new phenomena of a discipline” or when “the nature and details of the new

phenomena cannot be explained by the existing paradigm and require articulation of a new theory”.

“[Knowledge translation] is an example of paradigm shift because it is considered a complete

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science in itself rather than a combination of existing research approaches” (Younas & Parsons,

2019, p. 248).

15. Philosophy - “a statement encompassing ontological..., epistemic…, and ethical claims” used to

explain what the writer “believe[s] to be true in relation to the phenomena of interest to ...[their]

discipline” (Fawcett, 2005b, pp11-12 as cited in Butts & Rich, 2018, p. 91).

16. Postmodernism - “postmodern thought is defined by both the beginning and end of modernity”

or modern era thought (Watson, 1995, p. 60).

17. Radical feminism - “equality is not an issue. The critical feature of radical feminism is its starting

point-discovering, analyzing, and valuing women's experience without the imposed standards of

male ideology or systems. “(Chinn & Wheeler, 1986, p.75)

18. Rationalism - a philosophical thought that “sense experience allows us to acquire knowledge of

external objects” (Markie, 2021) and “reason is in itself a course of knowledge superior to and

independent of sense perceptions” (Merriam-Webster, n.d.).

19. Revolutionary science - “an abrupt change leading to a paradigm shift” (p.252) and “a

revolution refers to a noncomparable development based on the new paradigm that replaces an

older paradigm, in part or as a whole” (Younas & Parsons, 2019, p.248)

20. Revolutionary science theory - Kuhn's theory from 1962 that science revolutionizes and changes

in a structured way from “preparadigm, normal science, paradigm, problem-solving, anomaly, crisis,

revolution, [to] the paradigm shift” (Younas & Parsons, 2019, p. 245).
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Appendix B: The Nursing Knowledge Holarchy

“Holarchy of nursing knowledge” as described by Fawcett in 2005 (Butts & Rich, 2018, p. 89)
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Appendix C: Carper’s Four Ways of Knowing

(Note. From Lindell & Chinn, 2022, Nursology)