Person

It may seem obvious that person refers to the patient himself or herself,
but in this metaparadigm, the person can refer to more than one person,
including the patients family members and friends. The nurses goal when
dealing with the person is to nurture the patient and empower him or her
to manage their own health to the best of his or her abilities. Nurses should
make their patients feel like they truly care about their health and well-being.

Health
The next part of the metaparadigm of nurse theory construction is health.
This refers to the patients wellness as well as his or her access to
healthcare. Patients health refers to a large variety of aspects of the
persons wellbeing such as genetic factors, and also includes less obvious
factors such as the patients intellectual, emotional, and spiritual wellness.

It is important to note that when assessing a patients health, health is not

an absolute term, but a relative one. For instance, an 80 year old man who
can do 5 pushups is likely considered to be in great health, where as an 18
year old man who can only do 5 pushups would typically be viewed as being
less healthy compared to the average man his age.

Environment
The environment refers to everything around patients that impacts their
illness and recovery. Environment in this instance is not limited to external
factors and includes internal and social factors such as mental state,
geographic location, culture, and personal relationships. It is very important
for the patient to be in an environment that is conducive to his or her
recovery.
Nursing

The final component in the metaparadigm of nursing is nursing. Nursing

refers to all of the special skills that an individual must acquire to become a
nurse including medical knowledge, technical skills, and any hands-on
nursing care. While applying these skills, nurses must be sure to show
compassion for their patients. A lack of empathy for patients will likely have
a detrimental effect on the their health and recovery.

Environment:

The environment plays a very large and significant role in maintaining health and
promoting recovery from illness. There exist five environmental components which are
all essential to an individuals health. These are known collectively as the health of
houses, and outline factors of the physical environment which must receive attention
(Nightingale, 1860). The underlying principle of maintaining health of houses is to put
the patient in a condition which is best for nature to act upon him or her. An
environment that promotes health allows the patient to retain their energy, or vital
powers for use towards self healing (Nightingale, 1860).

Person:

In Florence Nightingales theory, the Person, one of the elements in the four
metaparadigms, is the individual receiving care (Selanders, 2010).. Nightingales
perception of the Person is that the person is a multidimensional being, that includes
biological, psychological, social and spiritual components (Selanders, 2010). The
biological component is addressed by the use of medicine and nursing to address
various diseases (Selanders, 2010). The psychological and social components consists of
self-concept, feelings, thought-processes and social interactions (Selanders, 2010). The
component of spirituality is intertwined with Nightingales own spiritual beliefs; that the
person is valued (Selanders, 2010). Lastly, Nightingale theory of the Person is based on
holism. Holism is the concern of integrating the biological, social, psychological and
spiritual with its environment (Selanders, 2010).

Health:

Health is viewed as the combined result of environmental, psychological and physical

factors, not just the absence of disease (Parker, M. E., 2005). Nightingale states that
health is not only to be well, but to be able to use well every power we have.
(Selanders, 2010) This is consistent with our perception of health today, where one does
not have to be disease free to be healthy but to maximize their potential to be in a
healthy state. Florence Nightingale (1860) also states that We know nothing of the
principle of health, the positive of which pathology is the negative, except from
observation and experience. Disease is portrayed as dys-ease, or the absent of comfort.
Disease was seen as a reparative process of the body to correct a problem. Symptoms
would alert one to the presence of a disease and allow appropriate interventions to be
applied (Selanders, 2010). Nightingale isolated 5 factors essential in securing an
individuals health; these include pure air, pure water, efficient drainage, cleanliness
and light (Parker, M. E., 2005).

Nursing:

Nightingales view on nursing is one that is largely intertwined by factors pertaining to

the environment. The goal of nursing is strictly different from that of medicine as the
goal of the former is to place the patient in the best possible condition for nursing to
act or to facilitate a healing process by placing the patient in the best possible
environment for nature to influence health(Nightingale, 1860). Nightingale believed
that many of the symptoms and sufferings of patients were not directly related to their
disease or ailment, but rather consequences of poor environmental conditions. The
duties of nursing include providing essentials such as fresh air, warmth, light,
cleanliness, quiet and a proper diet. By helping to control environmental influences,
nurses can aid in the maintenance of health of their patients. Only then is it possible to
see the true ailments of a disease, and not just the effects the absence of essentials
(Nightingale, 1860).

Nursing

Nursing is different from medicine and the goal of nursing is to place the patient in the best possible condition for
nature to act.

Nursing is the "activities that promote health (as outlined in canons) which occur in any caregiving situation. They
can be done by anyone."

Person

People are multidimensional, composed of biological, psychological, social and spiritual components.

Health

Health is not only to be well, but to be able to use well every power we have.

Disease is considered as dys-ease or the absence of comfort.

Environment

"Poor or difficult environments led to poor health and disease".

"Environment could be altered to improve conditions so that the natural laws would allow healing to occur."

A metaparadigm is a concept that is extremely general, one that serves to define an entire world
of thought. "Meta" means "that which is behind," in Greek, and refers to that which under-girds
something else, serving as a conceptual basis. In her seminal (1984, cited in Slevin) work,
"Analysis and Evaluation of Conceptual Models of Nursing," Jacqueline Fawcett developed the
basic four metaparadigms of nursing. More recently, these have been revised by Basford and
Slevin (2003) and serve to underpin the entire conceptual universe of the nursing profession. In
the United States, the nursing metaparadigm has been widely used to describe four spheres of
nursing knowledge that reflect beliefs held by the profession about nursings context and
content (Myers Schim, Benkert, Bell, Walker, & Danford, 2007, p. 73).
Metaparadigms define a discipline and set the boundaries with other disciplines. It gives the
discipline a global perspective which is useful for the practitioners of the discipline to observe
phenomena within their parameter (Van Wyk, 2005). In most cases it comprises a range of major
concepts which act as its defining elements. These concepts within a metaparadigm act as
limitations or boundaries of the discipline. Again, metaparadigm not only defines a discipline but
also outlines its concerns. For instance in nursing metaparadigm we have four concepts which
include environment, person, nursing and health. These concepts in general help to define
nursing metaparadigm and set it apart from other disciplines or professions for that matter. A
clear line is therefore able to be drawn between nursing and physician practice. This is possible
because of the different metaparadigms.

Person

As a nurse, we are primarily dealing with people who are in dire need of help. It is
the nature of our profession to deal with different types of person and it is our
obligation to deal with them in a holistic manner without prejudice and bias. As a
nurse, the biggest challenge that we have in meeting different kind of people is how
to establish rapport and obtain their trust as a health care provider. We are often
dealing with the illness and health aspect of our patients but the important thing to
remember is we have to look at them in a holistic way where