The faculty of TCNJ gratefully acknowledges the works of Martha Rogers, Jean Watson and Patricia Benner. The study of their writings has reaffirmed for us the joy, wonder, and excitement of the profession of nursing as art and science. From their theories, observations, and ideas we have derived many of our ideas, philosophical explanations and definitions.
The organizing framework is comprised of four basic concepts – Human Beings, Environment, Health and Nursing. These concepts form the metaparadigm of nursing and are the basis of the program of study. Systems Theory is used to examine the continuous mutual process between human beings and the environment.
Within human beings the pervasive concepts are holism and growth and development in the life span. Holism includes the biological, psychological, social, cultural, spiritual, and intellectual dimensions. The client systems are progressive in that students work first with individuals, then families, and finally, the community as client. At the graduate level the client is defined as the family.
Environment is believed to be the context or landscape and geography of the human social experience and relations. Environment is viewed throughout the curriculum to include personal, social, national, global, and beyond global dimensions. The physical, psychosocial, ethical/moral, legal, cultural, historical, developmental, economic, and political aspects are considered within each dimension.
Health, a dynamic process, is the synthesis of wellness and illness and is defined by the perception of the client across the life span. The pervasive concepts are the lived experience of wellness or congruence between one’s possibilities and one’s realities based on caring and feeling cared for and the lived experience of illness or loss/dysfunction that can be mediated by caring relationships. The concepts of stress and coping further explicate the wellness/illness experience of the client.
Stress is the disruption of meaning, understanding, and smooth functioning so that harm, loss or challenge is experienced and sorrow, interpretation, or new skill acquisition is required. Coping is what people do when personal meanings are disrupted and smooth functioning breaks down. The goal of coping is the restoration of meaning and is not a series of strategies that people choose from a list of unlimited options. Coping is always bounded by the meanings and issues inherent in what counts as stressful to each individual.
Nursing is seen as a process that links the nurse to others. The pervasive concept is caring. At the undergraduate level critical thinking is seen to move progressively through the curriculum and includes Nursing process, clinical and ethical decision-making, and the research process. Cognitive function progresses from description and identification, to application, to synthesis and praxis. Locus of decision-making progresses from dependent, to shared, to independent, to interdependent, to collaborative. Clinical decision-making progresses from context independent to context dependent.
The development of the student nurse is considered and seen to progress through the study and experience of nursing roles. These humanitarian roles which include moral/ethical and aesthetic, cognitive, intellectual and interpersonal dimensions are learner, clinician and leader.
The Learner role includes student, scholar (expert learner), researcher and scientist. The Clinician role of care giver includes critical thinker, teacher, collaborator, and user of nursing theory as the professional nurse develops from novice to expert clinician. The Leader role includes manager and coordinator of care, change agent and role model.