Re‐conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice

Abstract

Jacqueline Fawcett's nursing metaparadigm-the domains of person, health, environment, and nursing-remains popular in nursing curricula, despite having been repeatedly challenged as a logical philosophy of nursing. Fawcett appropriated the word "metaparadigm" (indirectly) from Margaret Masterman and Thomas Kuhn as a devise that allowed her to organize then-current areas of nursing interest into a philosophical "hierarchy of knowledge," and thereby claim nursing inquiry and practice as rigorously "scientific." Scholars have consistently rejected the logic of Fawcett's metaparadigm, but have not yet proposed a substantially agreed-upon alternative. Through an analysis of articles introducing and critiquing Fawcett's metaparadigm, I argue for a re-conceptualized metaparadigm that articulates nursing's ontology. What exists for the nursing discipline are not already-demarcated metaparadigm domains, but rather interdependent, dynamic relations that constitute people, including nurses, in their health/environment circumstance. The nursing discipline aims to skillfully access this dynamic relationality as the basis for action and reflection to produce both positive health trajectories and knowledge that facilitates future action and reflection. Further inquiry into the onto-epistemology of nursing will produce a more robust understanding of nursing practice, science, and philosophy, and clarify its unique contribution to health and healthcare.

Nursing and spirituality: A discussion paper on intertwining metaparadigms

“…The so‐called nursing metaparadigm has been a central topic in nursing scholarship since Margaret Hardy (Hardy, 1978) first introduced the concept in the field and Jacqueline Fawcett (Fawcett, 1984) proposed her new articulation. Recently, Miriam Bender (Bender, 2018) has offered a history of the paradigm trajectory and has argued for the need to reconceptualize the metaparadigm by articulating a philosophical ontology of the nursing discipline. This nursing ontology tries to produce a more solid framework to nursing management, practice and education, a much better evaluation of the nursing role in the big picture of health care science.…”

Reconciling nursing's art and science dualism: Toward a processual logic of nursing

“…It is a language that aligns with enduring nursing concepts and can be used to articulate the logic of how they fit together and why, to what purpose, and with what products or achievements. This was the original goal of the efforts to develop a nursing metaparadigm, which failed for reasons described elsewhere (Bender, 2018b; Bender & Feldman, ). We believe process philosophy provides a cohesive language to articulate the way nursing already thinks and acts the world, or as Thorne and colleagues have beautifully put it, ‘understanding how it is that skilled nurses routinely make excellent clinical decisions under conditions of infinite variation [and] that they do so from a wide range of educational backgrounds and theoretical frameworks’ (Thorne, Henderson, McPherson, & Pesut, , p. 212).…”

Nursing’s metaparadigm, climate change and planetary health

“…We suggest this delay may have been influenced by two important theoretical pieces that guide nursing work: nursing's professional mandate and nursing's generally accepted metaparadigm (Fawcett, 1984). While Fawcett's (1984) metaparadigm has received much criticism and several authors have debated its usefulness (Allen, 2004(Allen, , 2014Bender, 2018;Litchfield & Jónsdóttir, 2008;Morse, 2016;Risjord, 2010;Thorne et al, 1998), it remains a significant historical influence on the nursing discipline and thus the nursing profession. (Ryback & Decker-Fitts, 2009).…”