Running head: NURSING PARADIGM ONE VERSUS MANY 1

Nursing Paradigm One versus Many:

An Analysis of its Importance on the Advancement of the Nursing Discipline

Mae Geraldine E. Dacer

Silliman University
NURSING PARADIGM ONE VERSUS MANY 2

The nursing profession has been a subject of debate and controversies over the years as it

grow as a discipline and a profession. Many questions have been raised like does health or caring

indeed represent the focus of the discipline. Are the knowledge gained from various research

identified as nursing knowledge? Which paradigm should guide nursing science? Should there be

one ultimate paradigm that will guide nurse scientist in the development and testing of theories?

This paper will try to bring the light of what is the relevance of paradigms to nursing in the point

of view from the different philosophers, nurse scholars, educators, and researchers and how

philosophy become the epicenter of a nurses life and practice. As the larger society grapples

with the meaning of quality of life accompanied by the objectification of the healthcare world,

the need to examine issues of what it means to know, what truth is and what can we learn that

will be vital in the advancement of the profession. Porlifroni and Welch (1999) strongly suggest

that it is of vital for nurse scholars to gain an understanding of the diverse scientific and

philosophic traditions that have influenced the development of nursing knowledge in order to

further develop and enhance the nursing discipline and the nursing profession and how it affects

the lives of nurses.

This article will showcase the summary of their work, their defining characteristics, their

similarities, their points and how they differ from one another. Each paper has different views,

uses different terms on how to address the issue being presented and their own analysis but it all

boils down to one main goal, the development of nursing as a profession. Before we discuss the

articles lets us answer the basic questions first. What is a paradigm? There has been a constant

confusion of how to define a paradigm. Even Kuhn who popularized the term has failed to

precisely define it.

NURSING PARADIGM ONE VERSUS MANY 3

Monte and Tingen (1999, p. 65), who presented the nature of paradigm in their paper,

cited Websters definition as an overall concept accepted by most people in an intellectual

community, as a science, because of its effectiveness in explaining a process, idea, or set of

data. To avoid confusion Kuhn later on provided a much stronger definition of a paradigm.

Monte and Tingen (1999) coined the term disciplinary matrix from Kuhns definition. A

disciplinary matrix is an ordered element accepted and used by the practitioners of the discipline.

Thus, paradigms are set of ideas accepted by those who practice the profession to guide

in the development of new knowledge and theories for the advancement of the discipline.

The Articles

The articles presented different nursing paradigms of nursing science. Silva and Rothbart

(1984) compared logical empiricism and historicism as a nursing paradigms to guide nursing

theory and testing. Newman, Sime, and Corcoran-Perry (1991) described 3 (three) paradigms

namely particulate-deterministic, interactive-integrative, and the unitary-transformative. Cody

(1995) claimed in the plethora of paradigms there are only two in nursing. He cited Parses two

paradigms in nursing as totality and simultaneity. Monte and Tingen (1999) in their paper

classified two nursing paradigms as empiricism and interpretative.

Silva and Rothbart (1984) pointed out that nursing as a profession is in a state of

transition. During their time, even now, the profession is in a state of divergent, contradictory and

confusing points of view that prompt in the analysis on the changing trends in the profession.

Based on their analysis Silva and Rothbart have made four recommendation which the author

find still very relevant. First, since nursing is a varied discipline, there should be a liaison to

bridge the different departments of nursing to keep track with the changing trends in the
NURSING PARADIGM ONE VERSUS MANY 4

profession despite the diversity. Second in the formation more closer relationship among nurse

clinicians, nurse educators, and researcher having only one goal, the advancement of the

profession. The third is the search for an effective way for theory development and testing. And

lastly, the emphasis on courses on theory development using the interrelationship of the

philosophy of science, different theories and knowledge gained from different theories.

Newman, Sime, and Corcoran-Perry (1991) talk about the paradigms that should guide in

the focus of the nursing discipline. They have pointed out that any professional discipline should

have a shared social and service commitment. They have claimed that while the profession had

identified the 4 (four) metaparadigms in nursing (person, environment, nursing, health), although

it may narrow its focus there is still a need for more clear connection and social relevance to

fully describe the field of study in nursing. They have also cited from the article made by

Johnson (1974) and Donaldson and Cowley (1978) that the focus any professional discipline is

defined by the professions shared social and service commitment. The social mandate and

service identity are depicted in the nurses commitment to caring as a moral imperative. They

have also noted that this concept is not associated with any nursing theory. The authors have

concluded in their article that the focus of the nursing discipline is the study of caring in the

human health experience. They cited Pender (1990) who described illness as an occurrence in the

whole human health experience.

It is also briefly discussed in the article the different perspective in existence in the

nursing literature used to explain the effect of a paradigm in the development of nursing

knowledge. These perspective are the following: particulate-deterministic, interactive-

integrative, and unitary-transformative.

NURSING PARADIGM ONE VERSUS MANY 5

It is pointed out that the explication of nursing knowledge is based on what is the

perspective of the one making it. They view the unitary-transformative perspective as important

to fully explain what is caring in the human health experience.

Cody (1995) in this paper predicted that there will be changes in the nursing perspective

in the coming years. Feasibly according to Cody there will be emerging knowledge that will

abolish the reductionist, natural science model of nursing. He views that in time there will be a

middle ground in the nursing profession.

Monti and Tingen (1999) in their paper gave a very comprehensive comparison of two

paradigms, empiricism and interpretative. It is a grouping into two the different accepted nursing

paradigms used in the profession. It incorporates the works of different nurse scholars,

researchers and theorists like Silva and Rothbart, Watson, Leininger to name a few. They have

classified it in a way easier to be understood by beginner nursing students.

Conclusion

The discussion of having multiple paradigms and having one grand theory has been a

subject of debate since time in memorial. It is believed that this argument came out from the

discussion on having a single or multiple conceptual frameworks.

It is claimed by Retsas (1994) that in relation to nursing knowledge and practice

development, it is a time of crisis. Nurses are attempting to explain the ontological dimensions of

nursing. In other words, there has been a philosophical shift, as suggested by Rutty (1997). It has

been debated that nursing is simply a knowledge borrowed from another discipline such as

natural and human sciences (Donaldson & Cowly, 1978). This statement is presented since
NURSING PARADIGM ONE VERSUS MANY 6

nursing discipline doesnt use one single paradigm to guide the profession basing on the criteria

given by Kuhn.

Different nursing scholars and researchers may use different terms, different views, have

different ways but the goal still remains the same, the advancement of the profession. The ability

to analyze, reason, and evaluate is important in the modern health service to provide care based

on the best available evidence (Holt & Clarke, 2000). Hence, there is a need to let future nurses

think on their own, examine assumptions presented, and provide reasoned arguments to support

ideas and judgment. It is suggested that to acquire this skill one must be introduced to the

philosophical methods to provide a means for thinking about questions about reality, about truth

and about meaning. Philosophy has helped nurses think more critically and reflect on how their

own values influence their practice and the way of being (Bruce, Rietze, & Lim, 2014). Nursing

as a profession is very diverse. We have nurses in the different clinical area like pediatrics or

surgery, we have nurses as educators, nurses as managers, and nurses as businessmen, to name a

few, that is why it is impossible to make one grand theory or one major paradigm to be used as

the guide in the profession. Therefore, the debate of having a single paradigm or

multiparadigmism wont be easy.

Because of its diversity, nurses have slowly embraced the changing trends in nursing

science. Nurses now are slowly accepting the facts that multiparadigmism is an approach in the

nursing profession with greater chances in the development of nursing knowledge than having

one major theory. Rogers (1992) emphasized that we truly cannot push back the frontier of

knowledge until we approach it. I agree that we have to dig deeper on the foundation of this

knowledge in order to move forward in the improvement of the profession. We must dig deeper

to the very foundation of our existence and that is caring in the human health experience.
NURSING PARADIGM ONE VERSUS MANY 7

And so, nursing knowledge needs to consider and reflect on the uniqueness of nursing and

welcome pluralism in its practice. The inference that the scientific field in isolation is extremely

limiting and restrictive to thoroughly explore, describe and predict the nature of nursing and its

practice, leads to nurses needing to explore knowledge from a combined art and science standpoint:

inextricably linked in such a way that the whole is more than the sum of the two (Rose & Parker,

1994).

Nursing at this times need to scrutinize and reflect on their philosophical stance, supply

and unclouded, comprehensive strategy for nursing with tangible and positive long-term goals,

ensure that knowledge for nursing is advance from not only scientific paradigms but aesthetic,

personal and ethical knowledge, utilizing both the scientist and the logical artist, and finally

acquire a united standpoint (Rutty, 1997). This makes the nursing discipline unique from another

discipline. We take care of people, It has always been a belief that no two people are alike, hence

we try all the possible paradigm we can use giving the most effective service we can give to our

clienteles. An improved understanding of philosophy is not only relevant in the lives of nurses but

also significant in the discipline and the practice of the nursing profession.
NURSING PARADIGM ONE VERSUS MANY 8

References

Bruce, A., Rietze, L., & Lim, A. (2014). Understanding philosophy in the nurse's world: what,

where and why. Nursing and Health, 65-71.

Cody, W. K. (1995). About all those paradigms: Many in the universe, two in nursing. Nursing

Science Quarterly, 144-147.

Donaldson, S. K., & Cowly, D. (1978). The discipline of nursing. Nursing Outlook, 113-120.

Gortner, S. R. (1999). Nursing values and science: Toward a Science Philosophy. In C. E.

Polifroni, & M. Welch, Perspectives on Philosophy of Science in Nursing (pp. 25-31).

Philadelphia: Lippincott Williams & Wilkins.

Holt, J., & Clarke, D. (2000). Philosophy and nursing a useful transferable skills. Nursing

Philosophy, 76-79.

Johnson, D. E. (1974). Development of theory: A requisite for nursing as a primary health

profession. Nursing Research, 372-377.

Monti, E. J., & Tingen, M. S. (1999). Multiple paradigms of nursing science. Advances in

Nursing Science, 64-80.

Newman, M. A., Sime, A., & Corcoran-Perry, S. A. (1991). The focus of the discipline of

nursing. Advances in Nursing Science, 1-6.

Newman, M. A., Sime, M. A., & Corcoran-Perry, S. A. (1991). The focus of the discipline of

nursing. Advance nursing science, 1-6.

Parse, R. R., Coyne, A. B., & Smith, M. J. (1985). Nursing research: Qualitative Method. Bowie,

MD: Brady.

Pender, N. J. (1990). Expressing through lifestyle pattern. Nursing Science Quarterly, 115-122.
NURSING PARADIGM ONE VERSUS MANY 9

Polifroni, C. E., & Welch, M. (1999). Nursing and philosophy of science: Connections and

disconnections. In C. E. Polifroni, & M. Welch, Perspectives on philosophy of science in

nursing (pp. 1-11). Philadelphia: USA: Lippincott Williams and Wilkins.

Polifroni, C. E., & Welch, M. (1999). Perspectives on Philosophy of Science in Nursing.

Philadelphia: Lippincott.

Retsas, A. (1994). Knowledge and practice development: Towards an ontology of nursing. The

Australian Journal of Advanced Nursing, 20-25.

Rogers, M. E. (1992). Nursing science and the space age. Nursing Science Quarterly, 5.

Rose, P., & Parker, D. (1994). Nursing: An integration of art and science within the experience of

the practitioner. Journal of Advanced Nursing, 1004-1010.

Rutty, J. (1997). The nature of the philosophy of science, theory and knowledge relating to

nursing and professionalism. Journal of Advanced Nursing, 243-250.

Silva, M. C., & Rothbart, D. (1984). An analysis of the changing trends in philosophies of

science on nursing theory development and testing. Advances in Nursing Science, 1-13.