Theory-based Exemplar Paper (TEP)

Theory-basedExemplar Paper (TEP)

Theory-basedExemplar Paper (TEP)

Accordingto Newman (2000), theory and practice are directed by beliefs andvalues. In nursing, theory acts as a conceptual framework that guidesnursing practice (Endo et al., 2005). Research indicates that theoryassists in reframing nursing perceptions, and directs the employmentof techniques as well as ideas (Pharris, 2001). The utilization ofnursing theory in practice finds its basis on daily practice ofnursing staff. The importance of theory in nursing varies and itincludes generating knowledge, describing nursing and promotesevidenced based practice (McEwen &ampWills, 2011). The present paperexamines the application of the theory of Newman Health Model fortheory-based exemplar paper. The paper provides an overview of thetheory, exemplar and how the theory applies to the story. Theoutcomes of the report are expected to indicate how the chosen theoryapplied to how the patient in question was cared for during her stayin the healthcare sating.

Overviewof Theory of Health as Expanding Consciousness (HEC)

Theoryof Health as Expanding Consciousness (HEC) was authored by MargaretNewman. According to the theory, all individuals in allcircumstances, in spite of the state they may be at, are a componentof the general procedure of expanding consciousness (Pharris, 2001).It is a procedure of growing to be more of self, of searchingsuperior significance of being, and of realizing novel facets ofconnectedness with others as well as the world at large (Endo et al.,2005). The development of the model was driven by Newman’s desireto shift from the reductionist health model that defines health asthe deficiency of illness (McEwen &ampWills, 2011). She developed atheory that communicates the real meaning of nursing practice. In thedichotomy of disease, health is not an enthusiastically acknowledgednotion. Newman’s theory regards illness as a prospect for growthand consciousness. According to the theory, health care should notfocus on eliminating the disease, but rather on gaining knowledge ofoneself during the disease experience (Pharris, 2001).

Thetheory of HEC derives from the theory of unitary human beingsauthored by Rogers Endo et al., 2005). Rogers’ presuppositionsconcerning patterning of individuals in contact with the surroundingsare fundamental to the perception that consciousness is a sign of adeveloping pattern of individual-surrounding interaction (Witucki,2002). Newman (2002) defines consciousness as the informationalcapability of human being (system). To be precise, it is thecapability of the system to interrelate with the surroundings(Newman, 2002). Consciousness encompasses various aspects includingthe effective and cognitive awareness and the interconnectedness ofthe whole system. The latter entails the immune system, growthprocedures, as well as physiochemical maintenance (Endo, 2004).

Newman’smodel was inspired by concern for persons who term health as thedeficiency of disability or illness is impossible (Endo et al.,2005). Such persons are considered by nurses as facing debilitation,uncertainty, and ultimate death linked with illnesses. The theory ofHEC has expanded to incorporate the health of every one in spite ofthe existence or deficiency of disease. It has been evidenced thatnurses who practice in the realm of Newman’s model experience thehappiness of taking part in the developing procedure of their clients(Endo, 2004). They also discover that the experience transforms andimproves their own lives. Pattern acknowledgement is essential toboth practice and research, as it is a sign of a hermeneutic praxistechnique (Endo, 2004).

HECmodel does not focus on merely treating the illness, but instead onassessing how the present condition fits into the client’sdeveloping pattern of contact and how the client decides to moveahead (Pharris, 2001). It focuses on the entire being and experienceof a person while acknowledging life patterns. The theory providesknowledge both to a persons’ life pattern as well as pattern of thesociety interrelating with the person. It considers caring asnoninterventionist, nonjudgmental and engages being (Flanagan, 2009).According to Newman (2002), health professionals should centre on thepattern of their clients during the intervention process. A majorrecognition by the theorist is that space, movement, and time aresomehow interconnected as strictures of health. A number ofindividuals have acknowledged novel strengths unfamiliar to themprior to their diagnosis of chronic diseases (Endo et al., 2005).Newman’s theory is founded on various assumptions. They include:

  • Health includes conditions formerly considered as pathology

  • Pathology is a sign of the whole pattern

  • Eliminating the pathology does not modify it

  • A person’s pattern is manifested by illness

(Endoet al., 2000)

Newman’sHEC model has been used by most health professionals as a foundationfor their practice (Flanagan, 2009). It has acted as a source ofinteraction with their clients while shaping their nursing care ofindividuals suffering from chronic diseases, violence, personalitydisorders, HIV/AIDS and sexual abuse among others (Pharris, 2001).

Ina nutshell, the theory of HEC contributes greatly in nursing. Tostart with, it assists clients in understanding the significance oftheir lives. It is achieved through the recognition of their patternsof interrelating. Through interventions, the presence of nurses helpsclients to identify their patterns of interrelating with thesurroundings (Flanagan, 2009). Additionally, nurses formrelationships with their clients at specific points and connect withthem in a genuine way. Nurses are also considered as associates inthe procedure of expanding consciousness (Endo, 2004).

Exemplar:My Encounter with Mrs. Jones

Thefollowing exemplar shows the application of Newman’s HEC modelthrough a case study of a family experience with cancer. Mrs. Jones,a 46 years old female, was hospitalized after she was diagnosed withovarian cancer. The client was diagnosed with cancer in 2014, and shehas been undergoing treatment. However, things were not going well asMrs. Jones was brought into the emergency room. As a nursepractitioner in the room at the moment, I realized that her eyes werefull of apprehension. During my stay in the room, I concentrated onmaking the client feel appreciated and considered a whole being. Atsome point in time, I realized that the client was not only concernedwith her physical wellbeing, but there were other things, whichoccupied her mental welfare. I recognized that each encounter wouldbe enclosed into the pattern of the client’s developing liferelations. This was a key component of transformation. While I wasattending to Mrs. Jones, my words and body attended to generating aspace, wherein the client contemplated on that which is significant.I engaged the patient by asking her a few questions in order torecognize the entirety of her experience. Such questions included herother concerns apart from her physical wellbeing and how she had beenfairing at home. Although I asked Mrs. Jones such questions, the mainintention was to get open to her concerns. Mrs. Jones explained to methat she is married with three teenage children. She is employed, andtogether with her husband they are able to provide for the needs ofher family. However, since she was diagnosed with the illness, shehas been in and out of job, until her employment was terminated. Withlow wages, it has become difficult for her husband to provide bothfor the family and take care of her health problem. She was filledwith emotions and wept as she reflected on the surrounding concerns,her chronic sickness, loss of job, and fear of dying and leaving herchildren without a mother. She felt isolated as she deemed caring forher children was the most essential thing.

Atthis point, I recognized that the major concern of the client was nother physical illness, but the people surrounding her. I contemplatedhow the patient could modify her concerns about the personssurrounding her and focus on getting better. I provided a number ofuseful resources at such transformative stage in life. Certainly,attending to the entire experiences of the patient and theprobability of transformation involves both the physical body andother concerns impacting the being in a negative way. Thiscomprehension helped the client feel more exposed and gave moreattention on her physical wellbeing. It is different from merelyattending to the patient by starting the IV, monitoring thehypotension and giving medications, which implies that physicalhealth, is all that matters. The interaction with Mrs. Jonesindicated that the only concern was not only the physical illness,but moment of spiritual growth as well. Through this, I was able totreat the disease and promote health simultaneously. It was revealedin how the patient changed after the conversation. The feeling ofterror disappeared from her eyes, and she afforded to smile.

Asdays went by, I realized that Mrs. Jones has generated a positiveoutlook regarding her condition. She was fairing well as far as herwellbeing was concerned. Her worries and concerns had subsided,having build a positive mind-set and concentrating all her energy ingetting better. During her stay at the hospital, we built a strongerrelationship, which helped me understand the patient better, thustake effective measures in helping her get better in allcircumstances.

Applicationof Theory of HEC

Itis important for nursing to discover effective ways to care forpatients. They should include holistic ways, which cover the entirebeing, rather than a part of it (Endo et al., 2000). In reality,illness and health are signs of a greater whole. It is in contrastwith some scholars who argue that health is the reverse of disease,that is, the absence of illness (Witucki, 2002). Newman has pointedout that individuals can be health In spite of the presence of achronic illness provided that they sustain a positive sense of self,healthy state of mind, engage in social support and be devoted totreatment just to mention a few (Endo et al., 2000).

Thenurse at the emergency room employed the components of Newman’smodel to help Mrs. Jones in pattern recognition. Through this, theclient was able to comprehend novel opportunities for action, forinstance, in the presence of disease there is a space for health(Endo et al., 2005). It is certain from the case that the nurse triedto understand the patient’s concerns outside her physical health.This is advocated by the theory of HEC, which considers health as notbeing the reverse of illness. The theory states that individuals canstill be healthy even in the presence of disease. For Mrs. Jones, itwas clear that her other concerns at home was what aggravated thewhole condition.

Bygenerating a nurse-patient relationship, interacting with the patientand trying to understand everything surrounding her was crucial inthe intervention process. Expanding consciousness surrounding thepatient’s physical condition assisted her in recognizing that shecould still benefit from facets of health (Flanagan, 2009). It istrue to say that the presence of disease in Mrs. Jones life was partof the pattern of her life. It did not just take place. The caseevidenced various elements of a transformative process. For instance,the client demonstrated boosted openness, acceptance andconnectedness in caring linkages. During the nurse-patientinteraction, the nurse was able to grasp the pattern of the client inentirety and experienced the significance of caring. Nursingintervention and pattern recognition was significance in thetransforming procedure in the nurse-patient contact Endo et al.,2005). Time is valuable for patients suffering from cancer. It meansthat they have a choice of making optimum use of it in order torealize maximum returns. This can be achieved if the patients makereasonable goals founded on life expectancy (Endo et al., 2000).Having greater knowledge into the significance of their health andexperience can be attained when the nurse and the patient unite inthe novel responsibilities in health during intervention (Endo etal., 2005). The key characteristic of Newman’s model is that itoffers emphasis both to hospital and home-based care. It means thatthe patient can continue with the healing process even afterdischarge as long as she considers her interaction with the nurse.

Accordingto the theory of HEC, it is important for the patient to recognizethe problem before the health practitioner takes any action.Acceptance and acknowledgement results in a novel magnificentconsciousness, where in assistance can find its way into the client’slife (Flanagan, 2009). It means expanding consciousness where, thenurse engages the patient in the whole nursing care plan (Endo etal., 2000). Newman’s theory points out that, nurses should makedeliberative observations concerning patient and make a reflection onthe same. Through this, patients are motivated to talk about theirconcerns and subtle needs. As evidenced in the case of Mrs. Jones, itis certain that this process was helpful. The patient was willing tocreate interconnectedness with self in a holistic way to attaingreater sense of wellbeing. This implies that getting the patientscategorize their objectives and offer them with appropriateinstruments to accomplish such objectives there is a highprobability of the patient continuing to assist themselves andsurpass their current condition (Newman, 2002).


Innursing, theory plays a significant role in the intervention process.Most nursing researchers have evidenced that theory acts as atheoretical framework that guides the nursing process. Against thisbackground, the current paper has discussed the application ofNewman’s theory of health as expanding consciousness in a patientsuffering from cancer. According to the theory, all individuals inall circumstances, in spite of the state they may be at, are acomponent of the general procedure of expanding consciousness. It isa procedure of growing to be more of self, of searching superiorsignificance of being, and of realizing novel facets of connectednesswith others as well as the world at large. Through self-awareness,individuals are able accept their self and conditions they are in ata specific point of time. The theory offers a foundation for theprocedure of nurse-patient relationship. Nursing interventioninvolves pattern recognition wherein, the health practitioneracquires knowledge of the client’s pattern. Individuals are wholebeings, who cannot be sub-divided into pieces.

Thetheory also acknowledges health as key and it is a procedure ofboosting awareness, both for the environment and for oneself. Consciousness has been defined as a manifestation of a developingpattern of the interaction between an individual and the generalenvironment. Besides, it is a continuing process. As a result, it canbe said that Newman’s theory of HEC is a standard model that isapplicable to nursing intervention for cancer patients. The case usedin the current paper promotes the utilization of the theory byreinforcing it practicality and usability. The relationship createdbetween the nurse and the client was effective in enhancing theintervention process. This makes it a great resource in the entirenursing practice.


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