MARGARET NEWMAN

THE LIVING LEGEND OF THE AMERICAN

ACADEMY OF NURSING

Health As Expanding
Consciousness
MARGARET NEWMAN

• Born on October 10, 1933.

• Bachelor’s degree in Home Economics &
English – Baylor University in 1954
• Bachelor’s degree in Nursing - University
of Tennessee in 1962
• Master’s degree in Medical-Surgical
Nursing and Teaching - University of
California in 1964
• Doctorate of Nursing Science and
Rehabilitation- New York University in
1971
MARGARET NEWMAN
• Employment 

 1971 to 1976- She completed her graduate studies at

New York University. She also worked and taught
alongside nursing theorist Martha Rogers. 
Rehabilitation Nursing stemmed her interest in
health, movement & time
• . 
1977- Professor in charge of graduate study in
nursing at Pennsylvania State. 
•
1984- Nurse theorist at the University of Minnesota. 
•
1996- Retired from teaching. 

2008 – The American Academy of Nursing

recognized Newman as Living Legend
 THEORETICAL SOURCES
-
Martha Rogers Theory of Unitary Human Beings
• The main basis of the development of Newman’s theory.
• The health of a human being is a unitary phenomenon,
an evolving pattern of human-environment (Rogers,
1970).

Itzhak  Bentov – The concept of evolution of consciousness

• “Life is a process of expanding consciousness.
Consciousness is the informational capacity of the
system and can be seen in the quality of interaction
of the system with the environment” (Bentov, 1978).
• Arthur Young – The Theory of Process
• A person moves through stages of consciousness involving the loss of
freedom in the development of self-identity until a turning point is
reached when the ‘old rules’ don’t work anymore. The life task is to
discover the ‘new rules’ and move toward increasing freedom and
higher consciousness (Young, 1976).

• David Bohm – The Theory of Implicate

• The explicate order is a manifestation of the implicate order. (Bohm,
1980)

• Prigogine – Theory of Dissipative Structure

• A system fluctuates in an orderly manner until the occurrence of a
disruptive event, at which time the system moves in seemingly
random, disorderly ways until it chooses a new direction at a higher
level of organization (Prigogine, 1976).
• The theory of health as expanding consciousness was
stimulated by concern for those whom health as the
absence of disease or disability is not possible.
Nurses often relate to such people: people facing the
uncertainty, debilitation, loss and eventual death
associated with chronic illness. (Newman, 2010).
 USE OF EMPIRICAL EVIDENCE
• Evidence for the theory of health emanated from Newman’s
early personal family experiences. Her mother’s struggle with a
chronic illness and her dependency on Newman sparked an
interest in nursing. From that experience evolved the idea that
“illness reflected the life patterns of the person and that what
was needed was the recognition of that pattern and acceptance
of it for what it meant to that person.”

• Research has been conducted on the theoretical sources used.

MAJOR CONCEPTS
AND DEFINITIONS
 What is Health?
• Is not only the absence of disease and illness but also
includes the manifestation of the pattern of interactions
between a person and their environment.
• Is the “pattern of the whole” of a person and includes
disease as a meaningful manifestation of the pattern of
the whole, based on the premise that life is an ongoing
process of expanding consciousness.
• Is a transformative process to more inclusive
consciousness.
 PATTERN
• Is information that depicts the whole and understanding of the
meaning of all of the relationship at once.
• It is conceptualized as a fundamental attribute of all there is, and it
gives unity in diversity.
• Is what identifies an individual as a particular person.
CONSCIOUSNESS

• defined as the informational capacity of the system (in this case,

the human being); that is, the ability of the system to interact with
the environment (Bentov, 1978).  Consciousness includes not only
the cognitive and affective awareness normally associated with
consciousness, but also the interconnectedness of the entire living
system, which includes physiochemical maintenance and growth
processes as well as the immune system.  This pattern of
information, which is the consciousness of the system, is part of a
larger, undivided pattern of an expanding universe.
Three Correlates of Consciousness:

• MOVEMENT
• TIME
• SPACE
• The relevance of movement, time and space was part of the original
explication and has re-emerged in the evolving patterning of unfolding
consciousness.
To see health as the pattern of the whole, one needs to see
disease not as a separate entity but as a manifestation of the
evolving pattern of person-environment interaction. The
paradigm shift is:

• From treatment of symptoms to a search for pattern.

• From viewing disease and disruption as negative to viewing them
as part of the self-organizing process of expanding consciousness.
• From viewing the nursing role as addressing the problems of
disease to assisting people to get in touch with their own pattern
of expanding consciousness.
 MAJOR ASSUMPTIONS

1. Health encompasses conditions heretofore

described as illness or, in medical terms
pathology…
2. These “ pathological” conditions can be
considered a manifestation of the total pattern
of the individual…
3. The pattern of the individual that eventually
manifests itself as pathology is primary and
exists prior to structural or functional changes…
4. Removal of the pathology in itself will not
change the pattern of the individual… 

5. If becoming ill is the only way an individual's

pattern can manifest itself, then that is health
for that person… 

 
NURSING PARADIGMS
NURSING
-to help clients get in touch with the meaning of their
lives by the identification of their patterns of
relating 

-Intervention is a form of non intervention whereby

the nurse’s presence assists clients to recognize their
own patterns of interacting with the environment. 

-facilitates pattern recognition in clients by forming

relationships with them at critical points n their lives
and connecting with them in an authentic way. 

-The nurse-client relationship is characterized by “a

rhythmic coming together and moving apart as
clients encounter disruption of their organized
predictable state.” 

-Nurses are seen as partners in the process of

expanding consciousness. 
Nurse and patient coming together and moving apart in process
recognition, insight, and transformation.
PERSON/HUMAN
• “The human is unitary, that is
cannot be divided into parts, and
is inseparable from the larger
unitary field”
• “Persons as individuals, and
human beings as a species are
identified by their patterns of
consciousness”…
• “The person does not possess
consciousness-the person is
consciousness”.
• Persons are  “centers of
consciousness” within an overall
pattern of expanding
consciousness” 
ENVIRONMENT

• Environment is described as a
“universe of open systems”
• Environment is not explicitly
defined but is described as being
the larger whole, which is beyond
the consciousness of the
individual. 
HEALTH
-A fusion of disease and non-
disease creates a synthesis that is
regarded as health. 

-Disease and non-disease are each

reflections of the larger whole;
therefore a new concept “pattern of
the whole” is formed. 

-Newman has stated that pattern

recognition is the essence of the
emerging health. Manifest health,
encompassing disease and non-
disease can be regarded as the
explication of the underlying
pattern of person-environment. 
“The theory has progressed to include the health of all
persons regardless of the presence or absence of
disease. The theory asserts that every person in every
situation, no matter how disordered and hopeless it
may seem, is part of the universal process of expanding
consciousness – a process of becoming more of oneself,
of finding greater meaning in life, and of reaching new
dimensions of connectedness with other people and the
world” (Newman, 2010).
• Humans are open to the whole energy system of the universe
and constantly interacting with the energy. With this process of
interaction humans are evolving their individual pattern of
whole.

• According to Newman understanding  the pattern is essential.

The expanding consciousness is the pattern recognition.

• The manifestation of disease depends on the pattern of

individual so the pathology of the diseases exists before the
symptoms appear so removal of disease symptoms does not
change the individual structure.
• According to  her nursing is the process of recognizing the
individual in relation to environment and it is the process of
understanding of consciousness.

• The nurse helps to understand people to use the power within

to develop the higher level of consciousness.

• Thus it helps to realize the disease process, its recovery and

prevention.
• Newman also explains the interrelatedness of time,
space and movement.

• Time and space are the temporal pattern of the

individual, both have complementary relationship.

• Humans are constantly changing through time and

space and it shows unique pattern of reality.
 ACCEPTANCE BY THE
NURSING COMMUNITY
 PRACTICE
• Newman’s model of Health is useful in the practice of
nursing because it contained concepts used by the
nursing profession. Movement and time are an
intrinsic part of nursing intervention, that is, range-of-
motion, ambulation, turning, coughing, and deep-
breathing. These parameters are used each day by the
nurse in practice.
 EDUCATION

• Newman did not advocate one model as the sole basis

for curriculum. Rather, students should have the
opportunity to study various approaches to health and
nursing and to choose what is relevant to them in their
practice and research.
• Some researchers have attempted to test Newman’s propositions of time,
space, and movement.

*A negative correlation was found between depression and subjective time –

findings do not support an increasing level of consciousness with age.

• Cooperative inquiry or interactive, integrative participation - Newman

stated that research should center around “participatory investigations in
which subjects (clients) are our partners, our core-searchers, in our
search for health patterns.”
 PUBLICATIONS AND REFERENCES

• Newman, M. A. (1972). Nursing's theoretical evolution. Nursing Outlook,

20(5), 449-453.
• Newman, M.A. (1979). Theory development in nursing. Philadelphia:
F.A. Davis.
• Newman, M. A. (1982). Time as an index of expanding consciousness
with age. Nursing Research, 31(5), 290-293.
• Newman, M. A. (1984). Nursing diagnosis: Looking at the
whole. American Journal of Nursing, 84(12), 1496-1499.
• Newman, M.A. (1986). Health as Expanding Consciousness. St. Louis:
Mosby.
• Newman, M. A. (1987). Aging as increasing complexity. Journal of
Gerontological Nursing, 13(9), 16-18.
• Newman, M. A. (1997). Evolution of the theory of health as expanding
consciousness.Nursing Science Quarterly, 10(1), 22-25.
• Newman, M. A. (1999). The rhythm of relating in a paradigm of wholeness.
Image:Journal of Nursing Scholarship, 31(3), 227-230.
• Newman, M. A. (2002). Caring in the human health
experience. International Journal for Human Caring. 6(2), 8-12.
• Newman, M. A. (2002). The pattern that connects. Advances in Nursing
Science, 24(3), 1-7.
• Newman, M. A. (2003). A world of no boundaries. Advances in Nursing
Science, 26(4), 240-245.
• Newman, M. A. (2008).  It's about time. Nursing Science Quarterly, 21(3).
225-227. 
• Newman, M. A. (2008). Transforming Presence/ The Difference That
Nursing Makes.  Philadelphia: F. A. Davis. 
• Newman, M. (2010). Health as expanding consciousness. Retrieved on
November 13, 2010, from health as expanding consciousness:
http://www.healthasexpandingconsciousness.org/home/
• Newman, M.A. (1990). Newman's theory of health as praxis.  Nursing Science
Quarterly, 3(1), 37-41
• Newman, M. A. (1990). Toward an integrative model of professional
practice. Journal of Professional Nursing, 6(3), 167-173.
• Newman, M. A., Lamb, G. S., & Michaels, C. (1991). Nurse case management: The
coming together of theory and practice. Nursing & Health Care, 12(8), 404-408.
• Newman, M. A., Sime, A. M., & Corcoran-Perry, S. A. (1991). The focus of the
discipline of nursing. Advances in Nursing Science, 14(1), 1-6.
• Newman, M. A. (1992). Prevailing paradigms in nursing. Nursing Outlook, 40(1),
10-14.
• Newman, M. A. (1994). Health expanding consciousness (2nd ed.). New York:
National League for Nursing.
• Newman, M.A. (1994). Theory for nursing practice. Nursing Science Quarterly,
7(4), 153-157.
• Newman, M. A. (1995). A developing discipline: Selected works of Margaret
Newman.New York: National League for Nursing.
• Newman, M. A. (1997). Experiencing the whole. Advances in Nursing Science,
20(1), 34-39.
THANK YOU!