Rosemarie rizzo parse human becoming theory

Theory Critique

Rosemarie Rizzo Parse’s Human becoming Paradigm

Nursing Theory

Master of Nursing

Sami AlShammari

ID 20190372

Supervised by : Dr.Richard Dayrit

Outlines

Brief background of the theorist

Sociopolitical context during the time the theory was formulated

Theory Description

Theory critique

References

Rosemarie Rizzo Parse 1. background

Educated at Duquesne University in Pittsburgh, Pennsylvania & earned her master’s & doctoral degrees from the University of Pittsburgh.

Member of the faculty of the University of Pittsburgh, Dean of the Nursing School at Duquesne University.

Professor & Coordinator of the Center for Nursing Research at Hunter College of the City University of New York (1983-1993)

Professor & Niehoff Chair at Loyola University in Chicago, Illinois (1993-2006).

Fellow in the American Academy of Nursing

Consultant & Visiting scholar at the New York University College of Nursing

Founder & current editor of Nursing Science Quarterly

President of Discovery International Inc.

With two Lifetime Achievement Awards

(Midwest Nursing Research Society and

Asian Nurses’ Association)

Rosemarie Rizzo Parse Scholarship at the Henderson State University School of Nursing.

Published 10 books and more than 300 articles and editorials about matters pertinent to nursing .

Outstanding contributions to the profession of nursing through her progressive leadership in nursing theory, research, education, and practice.

2. Context of the theory

The human becoming theory was developed as a human science nursing theory in the tradition of Dilthey, Heidegger, Sartre, Merleau-Ponty, and Gadamer and Science of Unitary Human Beings by Martha Rogers.

The assumptions underpinning the theory were synthesized from works by the European philosophers, Heidegger, Sartre, and Merleau-Ponty, along with works by the pioneer American nurse theorist, Martha Rogers.

The Human becoming Theory methodology looks at the nurse to person and nurse to group situations, the participant and locations as contexts.

The goal of the discipline of nursing “is to enhance the quality of life from the person’s, family’s, and community’s perspective. The goal of the human-becoming nurse it to be truly present with people as they enhance the quality of their lives.”

3. Theory Description

Parse's Theory of Human becoming is focused on quality of life. Parse’s Theory of Human becoming is a theory that many nurses' utilize in practice daily. It is a grand theory that focuses on life and human dignity. “From the human becoming perspective teaching-learning is a journey of giving-receiving in coming to know.”

Theory of Human becoming focuses on the human quality of life. It has three major themes or principles being meaning, rhythmicity and transcendence.

The theory is structured around three abiding themes: meaning, rhythmicity, and transcendence.

Parse believes the true presence includes coming-to-be-present by being gracefully present with your patient and being attentive. You embrace the moment given to you to immerse and have genuine conversation with the patient.

The nurse listens not just hears the patient, without interrupting. She believes face-to-face conversations are an opportunity to initiate discussion and engage in dialogue.

The nurse should restate or make clarifications for validation of listening. The silent immersion still includes body language as “silent immersion is true presence without words.”.

A lingering presence includes glimpses of recalling a moment, or attempting to glimpse with greater meaning of the other person’s perspective of the situation.

Parse’s Theory of Human becoming when exemplified is a vital way to develop an effective relationship with your patient especially given the short period of time you are with them. The human becoming theory develops trust and mutual understanding of care; relieves stress and facilities healing all of which are the foundation holistic care and nursing.

3.1. Structural Components Assumptions:

Parse’s (1981) original nine assumptions are the following:

1. Man is coexisting while co-constituting rhythmical patterns with the environment.

2. Man is an open being, freely choosing meaning in situation, bearing responsibility for decisions.

3. Man is a living unity continuously co-constituting patterns of relating.

4. Man is transcending multi dimensionally with the possible.

5. Health is an open process of becoming, experienced by man.

6. Health is a rhythmically co-constituting process of the man-environment interrelationship.

7. Health is man’s pattern of relating value priorities.

8. Health is an inter-subjective process of transcending with the possible.

9. Health is unitary man’s negentropic unfolding .

Using Parse’s 1992 language revision, the original nine assumptions now read as four assumptions concerning humans & five assumptions concerning becoming. They are:-

Human:

1. The human is coexisting while co-constituting rhythmical patterns with the universe.

2. The human is an open being, freely choosing meaning in situation, bearing responsibility for decisions.

3. The human is a living unity continuously co-constituting patterns of relating.

4. The human is transcending multi dimensionally with the possible.

BECOMING

5. Becoming is an open process, experienced by the human.

6. Becoming is rhythmically co-constituting process of the human-universe interrelationship.

7. Becoming is the human’s pattern of relating value priorities.

8. Becoming is an inter subjective process of transcending with the possible.

9. Becoming is human unfolding.

PRINCIPLES of the theory

The three themes in Parse’s assumptions are:

meaning, rhythmicity & contranscendence.

1. Structuring meaning multidimensionality: is cocreating reality through the languaging of valuing & imaging.

A. IMAGING: An infertile couple believes there are many children in need of loving homes and plan to adopt .

B. VALUING: An older woman putting her health first as her children have all moved out of the house .

C. LANGUAGING: A man diagnosed with terminal cancer finds the words and the strength to talk to his family about it.

2. Cocreating rhythmical patterns of relating: is living the paradoxical unity of revealing-concealing and enabling-limiting while connecting separating.

A. REVEALING-CONCEALING: A pregnant youth must reveal her secret to her parents.

B. ENABLING-LIMITING: A patient chooses to refuse a treatment.

C. CONNECTING-SEPARATING: Parents want more aggressive treatment for their palliative care daughter; her husband disagrees straining the relationship.

3. Contranscending with the possibles: is powering the unique ways of originating in the process of transforming.

A. POWERING: Parents learn to be strong and move on with life after losing their youngest child in an accident.

B. ORIGINATING: A woman raises money for breast cancer research to honor her grandmother.

C. TRANSFORMING: An elderly man finally accepts outside help as he is no longer able to care for his wife.

3.2. Functional Components “PARSE'S NURSING PARADIGMS”

Person:

Open being who is more than and different from the sum of the parts.

A holistic view of person is utilized for viewing patients. Humans are greater than the sum of their parts, and so medical knowledge of how the body and organs function and dysfunction does not necessarily give understanding for what will happen to a patient or how the patient will present.

Environment

Everything in the person and his experiences

The environment and the person are connected and cannot be separated. The patient creates and coexists with their environment , so the nurse is interacting just as much with the environment as the patient.

Health

Open process of being and becoming. Involves synthesis of values.

Healing involves an openness to presence and the person and environment. At the center of this is real relationships between nurses and patients. A closeness emotionally, physically and spiritually is necessary .

Nursing

A human science and art that uses an abstract body of knowledge to serve people.

The act of nursing is heavily reliant on true presence. The nurse must wholly be with the patient in order to care for them and assist them to health within their environment. This would involve, in simpler terms, opening oneself completely to the patient and the patient's needs.

Application of the theory

Nursing Practice

A transformative approach to all levels of nursing.

Differs from the traditional nursing process, particularly in that it does not seek to “fix” problems.

Ability to see patients perspective allows nurse to “be with” patient and guide them toward desired health outcomes.

Nurse-person relationship cocreates changing health patterns.

Research

Enhances understanding of human lived experience, health, quality of life and quality of nursing practice.

Expands the theory of human becoming.

Builds new nursing knowledge about universal lived experiences which may ultimately contribute to health and quality of life.

Example of Application in Nursing

Application of Parse’s Theory of Human Becoming can be found in many nursing specialties. However, the one specialty that stands out the most would be Hospice Nursing.

Parse’s Theory of Human Becoming relates in many ways to the key elements of Hospice Nursing. Holistic care, or whole person care, is fundamental in hospice and palliative care.

Quality of life in the dying patient is always taken into account when planning care for that patient. Parse’s Theory of Human Becoming runs parallel to this belief, stating that quality of life should be measured by the person living the experience.

A hospice nurse can apply Parse’s theory into her nursing practice by bearing witness to the dying process, and honoring the reality of the experience. In turn, the patient has an easier transition from life to death.

Theory of Human Becoming & Nursing Process

ASSESSMENT & NSG DX

Assessment & Dx do not fit with this theory as Parse states the nurse-client interaction is not limited by prescriptions.

PLANNING

Nurse is a guide, not a decision maker.

Interaction is evolving.

IMPLEMENTATION

Nurse serves as a guide to illuminate meaning-guides Mrs. James to identify the personal meaning of the situation to her; to synchronize rhythms -lead Mrs. James to recognize the harmony within her existence; & to mobilize transcendence -guide Mrs. James to move from the present to what is not yet, to dream of the possibles for her.

EVALUATION

Because the interaction is not limited to prescription, standards of evaluation cannot be created. Essentially the nurse can evaluate if Mrs. James has identified personal meaning, recognized harmony, & dreamed of the possibles.

THEORY CRITIQUE

CRITERIA UNITS OF ANALYSIS CRITIQUE ARTICLE NO. 1 (Rosemarie R. Parse Human Becoming theory critique using The Chinn and Kramer model) MY VIEWPOINT
(3.1) Relationship between structure and function (3.1.1) Clarity -Clear Clear and simple
(3.1.2) Consistency -Presents clear relationships that are consistent with the logical precision research methodology to the theoretical structures. Consistent all through
(3.1.3) Simplicity / Complexity -Complex, simplicity is achieved through the differentiation of simultaneity and totality paradigms, the creation of nine assumptions. Simple assumptions and relationships
(3.1.4) Tautology / Teleology -The familiarity of terminologies makes concepts clearer to the reader. -Appropriate Tautology with low Teleology.
(3.2) Diagram of Theory (3.2.1) Visual and Graphic Presentation Three main assumptions (meaning, rhythmicity, &transcendence) linked clearly. -Clear and simple Graphic Presentation
(3.2.2) Logical Representation -The definition of the four paradigms was clear; nursing, environment, health and person. Logical representation. -Research considered to be in a “closed circle”
(3.2.3) Clarity -Clear. Concepts are related to each other by theoretical principles. -Clear Diagrams
(3.3) Circle of Contagiousness (3.3.1) Graphical origin of theory and geographical spread. -Borrowed from the principles and concepts of Roger and the phenomenon of existence. -Originated from other previous theories, e.g. Rogers.
(3.3.2) Influence of theorist versus theory -Offers alternatives to bio-psycho-social-spiritual and conventional bio-medical approaches of other theoretical frameworks of nursing -Provides framework to guide inquiry of other theories (grief, hope, laughter, etc.)
CRITERIA UNITS OF ANALYSIS CRITIQUE ARTICLE NO. 1 (Author of Critique) MY VIEWPOINT
(4) Usefulness (4.1) Practice (4.1.1) Direction (4.1.2) Applicability (4.1.3) Generalizability (4.1.4) Cost Effectiveness (4.1.5) Relevance -Views the role of nurses as facilitation of healthcare decision making following the current situation and health. -Useful in all levels of practice. -Not seek to fix problems; a character that differentiates it from the traditional nursing process. -It allows nurse practitioners to practice according to the perspectives of the patient. -Esoteric utility. -Provides guidelines of care of patients in hospitals. -Does not utilized the nursing process/diagnoses. -Useful in Hospice and Palliative care. -Not applicable to acute, emergent care. -Nurse must subscribe to this world view to truly use it.
(4.2) Research (4.2.1) Consistency (4.2.2) Testability (4.2.3) Predictability -Presents clear relationships that are consistent with the logical precision research methodology to the theoretical structures. -Reflects generalizability. -Provides research methodologies -Provides framework to guide inquiry of other theories (grief, hope, laughter, etc.) -Rarely quantifiable results - Difficult to compare to other research studies, no control group, standardized questions, etc.
(4.3) Education (4.3.1) Philosophical Statement (4.3.2) Objectives (4.3.3) Concepts -Human Becoming theory presents a transformative approach to all nursing levels. -clear and consistent philosophy. -Useful in Education. -Provides theoretical framework for nursing research and scholars.
(4.4) Administration (4.4.1) Structure of Care (4.4.2) Organization of Care (4.4.3) Guidelines for Patient Care (4.4.4) Patient Classification System -Applicable to all human beings since its focus is on the unitarily of humans and their lived experiences . -Useful in Hospice and Palliative care. -Provides guidelines of care and useful administration -Not applicable to acute, emergent care.
CRITERIA UNITS OF ANALYSIS CRITIQUE ARTICLE NO. 1 (Author of Critique) MY VIEWPOINT
(5) External Components of Theory (5.1) Personal Values (5.1.1) Theorist implicit/ explicit values -Human is open, freely choosing meaning in situation, bearing responsibility for decisions. -The human is unitary, continuously co-constituting patterns of relating and the human is transcending multidimensional with the possibles. -Congruence with personal, professional and social values. -Congruence with personal values. -Nurse must subscribe to this world view to truly use it. -Makes a substantial difference in the lives of clients and nurses.
(5.2) Congruence with other professional values (5.2.1) Comlementarity (5.2.2) Esoterism (5.2.3) Competition -Not seek to fix problems; a character that differentiates it from the traditional nursing process. -Practitioners are guided by unfolding meaning, transcendence and synchronizing rhythms. -Congruence with other professional values -Not accessible to the novice nurse. -Differentiates nursing from other disciplines. -Exoteric foundations -Esoteric utility. -Complements and competes with other health care professionals’ values.
(5.3) Congruence with social values (5.3.1) Beliefs (5.3.2) Values (5.3.3) Customs -Developed to shift the perspective of a person to human science from the medical model. -Makes a relevant contribution to the lives of nurses and patients. -Negates the idea that each person engages in a unique lived experience. -Congruence with social values.
(5.4) Social Significance -Goal is to enhance the quality of life, based on the personal perspective of the patient. Nurses are able to guide individuals towards achieving the life they perceive as quality based on their experiences. -Important to nurse and patient. -Esoteric utility -Fulfills society’s expectations of nursing role. -High Social Significance. -Makes a substantial difference in the lives of clients and nurses.
References:

Hutchings, D. (2002). Parallels in practice: palliative nursing practice and Parse’s theory of human becoming. American Journal of Hospice & Palliative Care, 19(6), 408-414.

Karen L. Melnechenko. Parse's Theory of Human Becoming: An Alternative Guide to Nursing Practice for Pediatric Oncology Nurses. Journal of Pediatric Oncology Nursing, Vol. 12, No. 3, 122-127 (1995)

Kearney-Nunnery, Rose (2012). Advancing Your Career: Concepts of Professional Nursing. (5th ed.). Philadelphia, PA: F. A. Davis Company.

Melnechenko, K. (1995). Parse’s theory of human becoming: an alternative guide to nursing practice for pediatric oncology nurses…including commentary by Parse RR. Journal of Pediatric Oncology Nursing, 12(3). 122-128.

Parse, R. R. (2007). The Humanbecoming School of Thought in 2050. Nursing Science Quarterly, 20, 308-311.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.Wu, X. (2008). My nursing philosophy as viewed through nursing' metaparadigm. Illuminations, 17(2), 5-7.

Zyblock, D. (2010). Nursing presence in contemporary nursing practice. Nursing Forum, 45(2), 120-124. doi:10.1111/j.1744-6198.2010.00173.x