In the past the standard of health was thought to be the absence of disease and disability (Smith & Parker, 2015). Being sick meant that a person had a disease or disability. Margaret Newman noted that this past thinking and theory was inaccurate, since it did not include the population of patients with chronic disease (Smith & Parker, 2015). Her theory asserts that every person in every situation is part of the universal process of becoming oneself of greater meaning in life. With this concept the individual is reaching new dimensions by expanding consciousness. She felt very strong that people with chronic disease could be labeled as healthy. She introduced a new way of thinking and advanced common healthcare models by adding on the theory of health. Sometimes, circumstances where an individual patient is in, seem hopeless or disorganized. Nurses who followed Newman’s ideas could lead chronically ill patients to a better place. She mentioned in her theory that individuals are constantly interacting with different energies in the universe (Smith & Parker, 2015). These interactions within the universe involve each individual’s unique pattern as a whole.
Patterns are described as genetics, social interactions, development, physical changes, life experiences, routines, conceptions and even death (Smith & Parker, 2015). Throughout someone’s period of life, disease could manifest itself through the person’s evolving patterns. A person could be unaware of the negative effects on their health. An example of this could be the presents of cancer cells. Other times a person may be aware of a negative effect or pattern, such as not allowing a child to attend school because of the present of an immune suppressive disease. In that situation the family is aware that their chronically ill child is suffering from a lack of social interactions with peers, but afraid that the child is leaving the safe place of his home environment.
In my personal experience while working with pediatric patients, I always work with their parents or caregiver together to accomplish healthcare goals. While working with pediatric patients nurses always encounter a so called “gate keeper” in practice (Wheeler, 2014). The so called guardian may be a parent or caregiver who is the protective person of the pediatric patient.
At the beginning of the school year my chronically ill pediatric patient and his family went through a very difficult period of uncertainty. Families often experience a very challenging time by allowing their chronically ill child to leave the secure environment (Wheeler, 2014). It could be a frightening step as the child leaves the safety of a family’s home for most of the day. My pediatric patient was homeschooled for a majority of his life due to his renal disease and immunosuppression.
The family and my pediatric patient experienced a phase of disruption and disorganization with the change from being homeschooled to now attending public school. Through good communication with the family and patient we were able to recognize the pattern. I sat together with the patient alone to gain an inside understanding on the negative influencing factors. Through dialogue we discovered that the patient was suffering from isolation, as he was not experiencing any peer interactions besides his siblings. The family and patient also stated the fear of not being at the family home and becoming sick with the possibility of germs within the school setting. As the nurse, I was successful to help them to identify problematic patterns. From there we were able to turn things around to focus on positive outlooks.
Newman’s hypothesis points out that the individual person is always connecting with other people and the world, such as family, community, work, religion education, and genetics (Smith & Parker, 2015). Culture, government, environment, and healthcare are influences on someone’s health. We were able to develop a mutually supportive care team for the patient that includes the school nurse, teachers, the school psychologist and even the special needs bus driver. The patient and family had to discover a new approach of decision making. They had to learn to live with the uncertainty by trusting others. They were able to find a new medium of relating to family, friends, nurses, teacher, bus drivers and the school psychologist by expanding their consciousness.
With the help and support of these named individuals the patient and family was able to move on to a phase of reorganization. The family and the pediatric patient had to learn during the time of reorganization to gain control of the new situation. As the patient and family learned to live with this new situation, they were thankful that they went forward with this big step of attending a public school in their son’s journey. The patient was in a much happier mood because he met a lot of friends at school. He felt safe and confident in his new environment. The parents stated how cooperative the teachers were by even providing safety measure like adequate handwashing. The patient reported that he loved his friends and the school.
Since the school enrollment, I see a big difference in the mood of the patient. He is overall a lot happier and even become more independent since he started school. Just as Newman ones stated, coping with chronic disease is about learning to live in balance (Smith & Parker, 2015). It is very important for nurses to be always positive and supportive around the patient. This tactic helped my pediatric renal patient who found a healthy place in his consciousness. For now, he is able to live to his fullest potential in the chaos of his life as a renal patient.
Smith, M.C. & Parker M.E. (2015). Nursing theories and nursing practice (4thed.). Philadelphia, PA: F.A. Davis.
Wheeler, G. (2014). Heart of Development: Early and Middle Childhood (1sted.). New York City, NY: Gestalt Press.
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