Margaret Newman’s theory, Health as Expanding Consciousness, “was stimulated by concern for those for whom health as the absence of disease or disability is simply not possible” (Nursing theory, 2016). Newman’s theory “asserts that every person in every situation, no matter how disordered and hopeless it seems, is part of the universal process of expanding consciousness” (Nursing theory, 2016). Newman expressed that removing pathology will not change the pattern of the individual pattern (Nursing theory, 2016).
Newman expressed that “nurse client relationships often begin during periods of disruption, uncertainty, and unpredictability in patients’ lives” (Smith & Parker, 2015, p. 288). Majority of the time patients who are in the hospital are there due to unexpected events that occurred and now they are hospitalized. Some patients suffer such traumatic injuries and develop lifelong complications that will affect everything and everyone around them. As nurses, we tend to evaluate each and every patients situation, and at times we are more concerned and relate to the patients situation. Working in a rehabilitation hospital, I use theory very often, I would say probably on a day to day basis in my practice.
There are many stories I could share with the experiences I have had with some patients, however, I am going to share my experience I had with a patient that stayed in the hospital for about 2 months. He was a 66 year Old man, who had fallen off a tree, while trying to get the family cat from the tree, and suffered a major spinal cord injury. He was paralyzed in his lower extremities with very limited movement in his upper extremity. He spent a lot of time in an acute hospital, before he came to our facility for rehab. Each day I spent taking care of him, I learned something new about him every day. I learned about his family, what he did for a living, about his kids, and soon we developed a relationship where we would joke around and laugh and talk about his progress in therapies. He was a very sweet and kind man. He was the provider of his family, he was independent and was just not ready to give up. His wife and daughter came to visit him every day. Even though he joked around and was happy we knew that deep down inside he was suffering.
The day case management met with the family and patient about discharge planning, the wife told them she would not be able to take care of him, he needs a nursing home. The tears just rolled down the patient’s eyes. The process of discharge continued because the patient did not have the best insurance so finding placement was not very easy, but our case managers were wonderful and kept getting him more time in the rehab hospital. From nursing, to therapy, to case management, and almost every department knew his story and everyone just adored and loved him. The wife and daughter started to come visit less and less, and the one day the patient just broke down and said “I am useless, I am burden to my family, I cannot even take care of myself, I don’t blame my wife, I am nothing but a body, I just wish I would die”. I had to hold back tears. This is the person who provided for his whole family, and now that same family is unable to provide for him. As days went on he became less active, more quiet, depressed and ill. He stopped eating and drinking, he just wasn’t himself.
One day I went into change him, and we talked about therapy and the weather, my nursing tech helped me roll him over, and all of the sudden she said “I don’t think he is breathing”. His eyes rolled to the back of his head, we called a code and CPR was started and 911 was called. He had a PE, went into cardiac arrest and never came back. One of the saddest experiences of my life and probably of all the staff that had the pleasure of taking care of such a special man. As a healthcare team, we provided him with the best care, he developed relationships with all his nurses, nursing techs, therapist and doctors.
We build relationships with majority of our patients. Sometimes we are the only family these patients have. When life throws unexpected twists and turns at them, they are scared, angry and feel hopeless, and they turn to us for answers and that little bit of hope and confidence. I can say with confident that this patient knew and trusted us, even though he knew he would not be the same as before.
Health as Expanding Consciousness. (2016). Nursing theory. Retrieved from http://www.nursing-theory.org/theories-and-models/newman-health-as-expanding-consciousness.php
Smith, M.C. & Parker M.E. (2015). Nursing theories and nursing practice (4thed.). Philadelphia, PA: F.A. Davis.