N491 Concepts and Theories in Nursing-JMRY 8- Module 7_ Parse, Erickson, Tomlin _ Swain
Parse’s Human Becoming Theory
N491 Concepts and Theories in Nursing
Jimmy A. Reyes, DNP, AGNP, RN, FRE
Parse’s Human Becoming Theory
Nursing care focuses on improving the quality of life for patients. This is especially the case for terminally ill patients receiving end-of-life care. Unfortunately, how nursing perceives patients places a restriction on the care that can be provided. In fact, the predominance of biomedical model (with mechanistic approaches) has restricted nursing approaches as patients (human beings) are considered as ‘operating machines’ that need to be fixed when an illness occurs. Parse’s Theory of Human Becoming seeks to reverse this perception by considering human beings as unitary beings that are involved in the process of living their lives as co-authors and co-participants so that nursing care does not necessarily have to fix a problem. Parse’s novel approach to nursing allows for a more client-centered nursing care approach with a focus on improving quality of life (Smith & Parker, 2015). The focus of this paper is to explore end-of-life nursing care guided by Human Becoming Theory as applied in a case study to improve a patient’s quality of life.
Actualize Parse’s Theory
Based on the case study, the nurse would actualize Parse’s theory of Human Becoming by shifting away from trying to heal the patient as this is an end-of-life care scenario. Instead, the nurse would focus on seeing the perspective of the patient and guiding the patient towards achieving the desired outcomes. To be more precise, the nurse would approach health as a lived experience with the patient choosing the specific meaning. Besides that, health would be perceived as the unique experience of Ann, not fixed but continuously changing and dynamic. This implies that the value priorities set by Ann and Ben would be considered in the care approach. At the core of this perspective is the understanding that nursing care should improve the quality of life. As such, the nurse would express true presence in becoming a witness to the changing health patterns that the patient experiences, and providing the required support in terms of incorporating the patient’s values and principles. In essence, the nurse would exhibit true presence through intentional and deliberate reflections that are founded on a strong, scientific knowledge base. With this approach, the nurse would bear witness to the patient’s lived experiences in the pursuit of good quality of life (Smith & Parker, 2015).
Human becoming Strengths and Weaknesses
The theory considers each person as a combination of spiritual, sociological, psychological and biological factors, and the existence of each person is based on mutual, continuous interactions with the environment. The theory identifies three characteristics of a human becoming nurse. Firstly, meaning characteristic that focuses on allowing each patient to freely choose a personal meaning in any situation so that the patient’s values are subjectively prioritized. In this case, the patient develops his/her reality by giving meaning to the lived experience of nursing care or disease progression. Secondly, rhythmicity characteristic that focuses on enabling each patient to co-create rhythmical patterns of relating in mutual processes with the environment, to include the language used, values and image. Thirdly, transcendence characteristic that focuses on enabling the patient to co-transcend multidimensionality by considering all possibilities, even emerging possibilities, while reaching out and exceeding previously set limits so that the patient is constantly transforming (Butts & Rich, 2018).
The theory presents some strengths and weaknesses. It presents five strengths. The first strength is that it provides a framework that guides inquiry into other nursing theories. The second strength is that it provides research methodologies for enhancing human understanding and building new nursing knowledge. The third strength is that it is useful in nursing education. The fourth strength is that it provides useful guidelines for nursing practice. The fifth strength is that it differentiates nursing discipline from other disciplines. In addition, the theory presents four weakness. Firstly, it is not applicable to nursing care delivery in acute, emergent care situations. Secondly, it requires experience and is not accessible to novice nurses. Thirdly, it does not apply nursing processes. Fourthly, it does not produce quantifiable results thus making it difficult to compare patients (Butts & Rich, 2018).
Challenges to Parse’s Approach
There is a significant challenge is applying Human Becoming Theory in daily nursing activities. The challenge is on how to allocate the scare resources, particularly when considering the excessive biomedical needs that patients have, nursing shortage and financial crises facing health care organizations. Organizations are making a concerted effort to reduce expenses by reducing costs in areas such as staffing, especially in nurse staffing. This has resulted in nurse staff downsizing that has effectives the ratios of patients to nurses so that nursing shortage has been reported, as well as increase nurses’ workload that makes it more difficult for nurses to spend more time with the patients at the bedside. This implies that nurses do not have enough time to apply the Human Becoming Theory in exploring the perceptions and values of patients. This makes nurses more inclined towards applying the biomedical model in delivering care to their patients. As such, switching to the Human Becoming Theory would require that organizations employ more nurses so that nurses are not overworked and they are able to spend more time with patients at the bedside (Helming, Shields & Avino, 2020).
Parse’s understanding of transcendence explains that every person co-transcends multidimensionally with emerging possibilities. This implies always being open to the impossible and making an effort to reach out and go beyond the personal limits in the process of transformation. To be more precise, transcendence would guide the nurse through helping Ben in coming to reality with the death of Ann as he accepts that she is gone and he needs to plan changes in his life. In addition, the nurse would mobilize transcendence in helping Ben to move towards transformation as he appreciates the fact that he is an agent of and responsible for his health and wellbeing. Besides that, the nurse applies the understanding of transcendence to help Ben through the process of going beyond the significance of the moment of Ann’s death to a life that is yet to become without Ann. With this understanding, Ben would be able to focus on dreaming about life’s possibilities and plan to achieve these new dreams to include planning changes in health standards and focusing on visualizing new possibilities in life (Yoost & Crawford, 2020).
Additional Plan and Theories
In addition to Parse’s Human Becoming Theory, Roy’s Adaptation Theory would be applicable to the case study. The two theories encourage patients/clients to positively adapt to the changes in their lives through conscious awareness, self-reflection and making good life choices. They (the two theories) concede that an individual is a spiritual, sociological, psychological and biological being that is in constant interaction with the environment, and should constantly adapt to match the changing environment. Applying the two theories would involve a three-step nursing care plan. The first step is to assess Ben. This involves identifying meanings, patterns of living and interactions with others, and how he interprets Ann’s death. Also, it would involve identifying his value priorities, how he would live through Ann’s death, and how he would handle living without Ann. The second step is to present a nursing diagnosis and intervention for Ben. This involves presenting an interpretation for the assessment, such as he expresses trepidation about living without Ann, he has regrets about unrealized dreams and hopes, and expresses grief over tragic loss of loved ones. It is important to note that nursing intervention for Ben would not seek to fix a problem, rather it would seek to see Ben’s perspective and guide him towards the desired health outcomes even as he adapts to the changes in his life. The final step is to conduct an outcome evaluation in terms of Ben’s lived experiences and how he achieves good quality of life depending on his perceived meaning, live paradoxes and moving forward with his life (Butts & Rich, 2018).
In hospice care nurses must apply learned methods and theories to patient and family needs for care and spiritual support. The patient and family experiencing grief, loss, and emotional shifts the nurse can apply Parse’s human becoming theory to bridge the gap between factual medicine and holistic patterns. The hospice nurse applied Parse’s strengths and weakness during cares so that they arrived in a personal meaningful way for Ann and Ben. The nurse shared the art of human becoming to meet Ann’s and Ben’s needs at the moment it was most needed to support their wishes and desires.
Butts, J., & Rich, K. (Eds.) (2018). Philosophies and Theories for Advanced Nursing Practice (3rd ed.). Jones & Bartlett Learning, LLC.
Helming, M., Shields, D., & Avino, K. (2020). Dossey & Keegan’s Holistic Nursing: A Handbook for Practice (8th ed.). Jones & Bartlett Learning, LLC.
Smith, M. C., & Parker, M. E. (2015). Nursing Theories and Nursing Practice (4th ed.). F.A. Davis.
Yoost, B. L., & Crawford, L. R. (2020). Fundamentals of Nursing: Active Learning for Collaborative Practice (2nd ed.). Elsevier.
Health professionals will also be involved in the policy. Health professionals are involved in helping the addicts to overcome their situations and lead healthy lives in the long run. The healthcare professionals will be drawn from different areas of the profession to contribute their expertise in managing the situation and providing positive outcomes in the policies being undertaken (Bhatt & Arespacochaga, 2017). They will also be used in research about the subject matter to achieve positive outcomes in the process. Government agencies will also be stakeholders in the program. The government will be involved in different capacities in the project. For example, the government will be involved in financing the programs so that the resources required will be readily available to the stakeholders involved in eliminating the crisis (Bhatt & Arespacochaga, 2017). Furthermore, the government will also be a stakeholder in creating policies that will facilitate the elimination of the opioid crisis, such as proposing laws that will lead to research and development of more effective pain management medications that are less addictive. Also, the government will be involved in developing different approaches whereby instead of punishment, the addicts will be rehabilitated.
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