1. Nursing Theorists: Watson & Newman Lindsay Parker Kimberly Wright Marissa Zingaro Sacred Heart University

2. Abstract Looking at two well known nursing theorists: Jean Watson and Margaret Newman Examining their theories and concepts Analyzing each theorist’s model of care Applying each theorist’s model in current practice

3. Health as Expanding Consciousness Margaret Newman

4. Background She cared for her mother who suffered from ALS which sparked her interest in nursing (McEwen & Wills, 2011, p. 189) Served as a faculty member at the University of Tennessee, NYU, Pennsylvania State University, and University of Minnesota ( McEwen and Wills, 2011, p. 189) Received many awards for her work

5. Newman’s Timeline of Theory 1962- Completed her Bachelor’s degree from the University of Tennessee 1964- Received her Master’s degree from the University of California 1971- Completed her Doctorate from NYU 1978- Newman spoke at a conference and became interested in theory 1979- Published a theory on health 1986- Published Health as Expanding Consciousness 1994- Health as Expanding Consciousness was revised for the first time 1999- Her previous work was revised for a second time 2008- Book: Transforming presence: The Difference Nursing Makes (McEwen and Wills, 2011,p. 188)

6. Influences on Newman’s Theory Martha Rogers Science of Unitary Health beings is the basis for Health as Expanding Consciousness (McEwen & Wills, 2011,p.189) Itzhak Bentov “Explanation of the concept of evolution of consciousness” (McEwen and Wills, 2011, p. 189) Arthur Young Pattern Recognition David Bohm Theory of implicate order

7. Assumptions “The human is unitary, that is, cannot be divided into parts, and is inseparable from the larger unitary field” (McEwen & Wills, 2011,p. 189) Humans are open energy systems that are in continuous contact with the environment (McEwen and Wills, 2011, p.189) “Humans are continuously active in evolving their own pattern of the whole and are intuitive as well as cognitive and affective beings” (McEwen and Wills, 2011, p. 189) “The person does not possess consciousness, the person is consciousness” (McEwen and Wills, 2011, p.189) Health includes illness and pathologic conditions can be manifestations of the pattern of the person (McEwen and Wills, 2011, p. 189) Changes occur simultaneously not linearly (McEwen and Wills, 2011, p. 189)

8. Concepts Health: An essential component that is “a process of developing awareness of self and the environment together with increasing the ability to perceive alternatives and response in a variety of ways” (McEwen & Wills, 2011, p.189) Newman used this meta-paradigmal concept. Nursing : “caring in the human health experience” (McEwen and Wills, 2011, p. 189). Newman used this met-paradigmal concept. Person: A vibrant pattern of energy and “an open system in interaction with the environment. Persons can be defined by their patterns of consciousness” (McEwen and Wills, 2011, p. 190) Consciousness: The capacity of the system to interact with the environment “thinking, feeling, and processing information embedded in physiologic systems” (McEwen and Wills, 2011, p. 190) Expanding consciousness: “increasing complexity of the living system…characterized by illumination and pattern recognition resulting in transformation and discovery”. This is health. (McEwen and Wills, 2011, p. 190)

9. Concepts Integration via movement: natural condition of living creatures. Newman believes consciousness is conveyed through movement. This reflects and communicates an individual’s “inner pattern and organization” (McEwen & Wills, 2011,p.190) Pattern: “relatedness, which is characterized by movement, diversity, and rhythm” (McEwen and Wills, 2011, p.190). This portrays person- environment interactions. A pattern is visible in how one talks, moves, and relates to others. Pattern recognition: The realization of the truth. It is vital for the process of evolving to a higher level of consciousness. It demonstrates the possibility for action. (McEwen and Wills, 2011, p. 190) Time and Space: “Temporal patterns that are specific to individuals and define their ways of being within their world” (McEwen and Wills, 2011, p.190)

10. Theory Analysis The theory of health as expanding consciousness: stimulated by concern for those for whom health as the absence of disease or disability is not possible (Newman, 2010). 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). “Consciousness is a manifestation of an evolving pattern of person- environment interaction” (Nursing Theories, 2012)

11. Relationships of the Theory Health and illness are simply “health” (McEwen & Wills, 2011,p.190) Health is a pattern. Newman believes a person should look at patterns instead of parts (McEwen and Wills, 2011, p.191) “Pattern recognition comes from within the observer” (McEwen and Wills, 2011, p. 191) Patterns develop over time and are not predicted with confidence. To provide care, one must understand “the meaning of relationships through pattern recognition” (McEwen and Wills, 2011, p. 191) Time, space, and movement are related. Time and space are complementary to each other while movement turns time and space into reality (McEwen and Wills, 2011, p.191) “Movement is seen as a reflection of consciousness, time is a function of movement, and time is a measure of consciousness” (McEwen and Wills, 2011, p.191) Individuals are continually changing. This movement through time and space leads to someone’s perception of reality.

12. Testability “Newman’s theory has been the basis for an impressive number of doctoral dissertations” (McEwen and Wills, 2011, p. 191). “Most of the research done for this theory was qualitative” ( McEwen and Wills, 2011, p. 191). “The theory has been used with sudden deaths in children as well as with children cancer survivors” McEwen and Wills, 2011, p. 192)

13. Usefulness “Newman (1994) believed that theory must be derived from practice and theory must inform practice” (McEwen and Wills, 2011, p. 191). Examples: 1. Nursing practice with families 2. Direct practice among case manager 3. Older husbands who were caring for wives with dementia 4. Women with multiple sclerosis or menopause (McEwen and Wills, 2011, p. 191)

14. Theory Application Margaret Newman’s theory “…can be applied in any setting” (McEwen & Wills, 2011, P. 193). Numerous articles use Newman’s theory for a variety of patients a caring process that reflects the whole person and transforms all of us and all that we do” (Weingourt, 1998, p. 30).

15. Theory Evaluation Newman’s theory states “…a person’s life is constantly evolving toward a higher consciousness or unitary wholeness. Recognizing life patterns is an essential component in moving toward wholeness” (Predeger & Mumma, 2004, p.14). Patterns need to be recognized before therapeutic treatment can begin

16. Theory Evaluation (cont.) Newman’s theory was used in a prison to examine the patterns of incarcerated women who had young children on the outside waiting for them Newman’s theory was applied and the nurse was able “to establish a greater level of trust” (Hayes & Jones, 2007, p.66).

17. Advanced Practice Application Newman envisioned nursing in 2050 to be more proactive with nurses being “full partners” in treatment Newman and Watson both emphasize compassion and caring as the foundation of their theories. Nurses need to form a connection with the patient to have effective healing- physical, mental or spiritual, occur

18. References DeNisco, S., & Barker, A. (2013). Advanced Practice Nursing: Evolving Roles for the Transformation of the Profession (2nd ed.). Burlington, MA: Jones & Bartlett Learning. Hayes, M. & Jones, D. (2007). Health as Expanding Consciousness: Pattern Recognition and Incarcerated Mothers, a Transforming Experience. Journal of Forensic Nursing, 3(2), p.61-66. McEwen, M., & Wills, E. M. (2011). Theoretical Basis for Nursing (3rd ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Nursing Theories, (2012). Retrieved from http://currentnursing.com/nursing_theory/Watson.html http://currentnursing.com/nursing_theory/Watson.html

19. References (cont.) Nursing Theories, (2012). Retrieved from http://currentnursing.com/nursing_theory/Newman_He alth_As_Expanding_Consciousness.html http://currentnursing.com/nursing_theory/Newman_He alth_As_Expanding_Consciousness.html Pilkington, F., (2007), Envisioning Nursing in 2050 Through the Eyes of Nurse Theorists: Katie Eriksson and Margaret Newman. Nursing Science Quarterly, 20 (3), p. 200. doi: 10.1177/0894318407303099. Predeger, E., & Mumma, C., (2004). Connectedness in Chronic Illness: Women’s Journeys. International Journal for Human Caring, 8(1), p. 13-19.

20. References (cont.) Wade, G. & Kasper, N. (2006). Nursing Students’ Perceptions of Instructor Caring: An Instrument Based on Watson’s Theory of Transpersonal Caring. Journal of Nursing Education, 45(5), 162-168. Watson Caring Science Institute. (2007). Caring Science. Retrieved from http://watsoncaringscience.org/about- us/caring-science-definitions-processes-theory/# Weingourt, R., (1998). Using Margaret A. Newman's Theory of Health with Elderly Nursing Home Residents. Perspectives in Psychiatric Care,34(3), p. 25-30.