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Embracing the Four Metaparadigms: A Personal Philosophy and Exploration of Nursing Theories

Embracing the Four Metaparadigms: A Personal Philosophy and Exploration of Nursing Theories

The core objective of nurses is to deliver high-quality and compassionate care to each client. Therefore, the general philosophy of nursing care should be based on holistic care and guided by the four meta-paradigms of nursing practice. These meta paradigms are the core principles of nursing and include a person being cared for, the environment within which care occurs and the person exists, the health-illness continuum, and nursing activities supposed to promote health and recovery. During daily practice, every nurse tends to develop the own professional philosophy. This process is influenced by individual beliefs and values, professional nursing guiding principles, and the need to have a personal guiding framework to promote professionalism and development. Therefore, this paper presents a personal overview of the nursing meta paradigms, a description of my nursing philosophy, and a discussion of the theories compatible with the philosophy. The appropriate nursing philosophy and application of compatible nursing theories as guiding frameworks are principal for ensuring the delivery of quality care, accountability, professionalism, and individual growth as a nurse.

Personal Thoughts, Feelings, and Beliefs about the Nursing Metaparadigms

The four nursing meta-paradigms form the basis for delivering high-quality nursing care to patients and their families. Nursing theories and philosophies are used in clinical practice as a basis for rational judgments and justifying actions. Consequently, my philosophy includes the four nursing meta paradigms, and I have always referred to them in a dilemma.


Under the meta paradigms, the person is regarded as the individual receiving care and can be referred to as a patient, family member, and sometimes, the entire community. I believe nursing is associated with support and care for every person. It is important to ensure that care is delivered to meet the individual needs of each care recipient. Providing care to the patient as the central figure of the healthcare delivery process ensures a holistic approach to nursing care. It pays attention to all aspects of patient well-being, including the psychosocial and physical components. Moreover, research has demonstrated that optimum attention to patient factors is vital to improving healthcare outcomes when planning patient care. Therefore, my philosophy highlights the patient as the most important participant, whose features and associated factors should be considered to ensure holistic care and improved health outcomes.


The environment within which care takes place and where the patient lives is significant in nursing practice. It is an integrated care component within a specific space and place. The environment may refer to the immediate patient surrounding and may include bedding used by the patient, quality of air in the room, lighting, food, and even personal hygiene. Therefore, the environment is a critical component that affects patients’ comfort and attitude to healthcare interventions.


It is widely acknowledged that being healthy does not necessarily mean the absence of illness but suggests living in harmony with oneself and the environment. A person can be described as healthy if the individual has an optimum and desired quality of life. Patients cannot optimally enjoy life during disease, as numerous factors negatively affect their physical and psychological state. Thus, the focus of providing healthcare interventions is ensuring that individuals can enjoy life, as nurses consider the patient’s preferences, modify the environment appropriately, and perform health-promoting activities.


As highlighted, the nurse should perform only those interventions that promote patient well-being. Nursing activities should be carried out compassionately, concerning the patient with the right to agree or disagree with the treatment plan. Nurses should engage in activities that promote wellness or help in a peaceful transition to death, where inevitable. To ensure that these activities are carried out most humanely, nurses should care for the patient in the way they would prefer.

Relevant Nursing Theories

Given my nursing philosophy, Nightingale’s environmental theory and Sister Callister Roy’s adaptation model are the most compatible. Nightingale’s theory recognizes the person as the individual benefitting from nursing care. In addition, Nightingale advocated for the provision of holistic care by assessing and identifying all issues associated with care for the patient. The author also recognizes external and internal environmental factors affecting care outcomes. Nightingale believed that their manipulation was an effective method to promote patient recovery. According to Masters, Nightingale defined health as being well and able to use willpower. Moreover, Nightingale’s theory also focuses on providing health promotion and education to the affected and healthy persons. Lastly, Nightingale’s theory highlights the nursing interventions that should be implemented to alter the environment to achieve a better outcome.

According to Callista Roy’s theory, the person constantly interacts with the environment and can adapt. Therefore, the environment provides stimuli and includes any conditions or circumstances that affect an individual. In addition, Roy’s theory notes that health results when harmony between an individual and the environment. Finally, Sister Roy notes that nursing activities should promote adaptation, improve health, enhance life quality, and settle harmony between the individual and the environment.

Compatibility of My Philosophy with the Nursing Theories

My nursing philosophy suggests that the person is the most significant figure. Both the discussed nursing theories have the same approach and identify the patient as the major participant in the healthcare delivery process, and all the activities should be adjusted to meet his/her needs. For example, Roy’s theory states that the person constantly interacts with the environment, and hence, all nursing care activities should promote harmony in this process. The environment should be safe and promote both physical and emotional healing, which is possible in case of ensuring harmony in an individual’s interaction with it. Roy’s theory suggests that all internal and external environmental factors should be addressed, which is also reflected in Nightingale’s theory. Therefore, my philosophy is compatible with the adaptation theory by Roy and Nightingale’s theory to the meta paradigms of person and environment.

Meanwhile, the two theories, which have similar principles to my personal view, also contain contrasting elements. Nightingale acknowledges that health is beyond merely being sick, while Roy highlights it as a state of harmony, which agrees with my philosophy. Roy’s adaptation theory states that health results from how well an individual can adapt, while Nightingale believed that health promotion and education help improve wellness. It is demonstrated in my philosophy that seeks to empower the patient through health education to adapt effectively and improve life quality. Both theorists have emphasized nursing activities that promote well-being and improve an individual’s ability to adapt to the environment as measures to enhance recovery and promote life quality. Equally, my philosophy has emphasized the performance of nursing activities humanely, aimed to promote recovery. As such, there is no doubt that the two leading nursing theorists greatly influence my philosophy.


An appropriate personal nursing philosophy ensures quality care, accountability, professionalism, and individual growth. Having a personal nursing philosophy is important for guiding nursing activities and justifying actions in complex situations. My nursing philosophy encompasses the patient as the main focus of nursing practice, and the other three paradigms should be manipulated to meet his/her needs. It ensures effective meeting of patient’s needs and more efficient recovery of the person. Every nurse should have a personal philosophy, and the meta paradigms of nursing are the great basis for its development.

📎 References

1. Arora, S. (2015). Integration of nursing theories in practice. International Journal of Nursing Science Practice and Research, 1(1), 8-12.
2. Jarrin, O. F. (2012). The integrality of situated caring in nursing and the environment. Advances in Nursing Science, 35(1), 14. https://doi.org/10.1097/ANS.0b013e3182433b89
3. Masters, K. (2015). Nursing theories: A framework for professional practice (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
4. Mughal, F. B., & Ali, B. H. I. (2017). Enhancing patient well-being: applying environmental theory in nursing practice. Annals of Nursing and Practice, 4(3), 1085.
5. Weiner, S. J., Schwartz, A., Sharma, G., Binns-Calvey, A., Ashley, N., Kelly, B.,. & Harris, I. (2013). Patient-centered decision making and health care outcomes: An observational study. Annals of internal medicine, 158(8), 573-579. https://doi.org/10.7326/0003-4819-158-8-201304160-00001
6. Ursavaş, F. E., Karayurt, Ö., & İşeri, Ö. (2014). Nursing approach based on Roy adaptation model in a patient undergoing breast conserving surgery for breast cancer. The journal of breast health, 10(3), 134–140. https://doi.org/10.5152/tjbh.2014.1910