Margaret Newman’s Health as Expanding Consciousness is one of the major grand theories of modern nursing practice. It has broad applicability, and any nurse in any practice field can use it as the basis or framework for his or her practice in understanding the nurse-patient relationship and interaction that are meant to bring comfort and health in ways that go beyond polypharmacy or by treating symptoms and disease as manifestations of nonhealth. The basic assumptions surrounding the theory are these: A) illness is a part of what we would describe as health, and is not necessarily a manifestation of nonhealth
B) illness or pathological conditions should rightly be seen as a manifestation of the patterns of an individual’s life, C) the individual pattern of the person that manifests itself as illness is primary and leads to structural changes or functional changes in the individual, D) removing the pathology without consideration of the person to whose life pattern and belongs will not result in any changes in that pattern, E) illness may be the only way a person’s pattern can manifest explicitly, and in that case, the expression of the illness can be considered health for that individual, and F) health should rightly be seen as expansion of consciousness (Current Nursing, 2013).
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"Nursing Grand Theory".
Shields (2011) asserts that Newman’s theory can be used as a basis for the ways in which mindfulness can be taught to nursing students to reduce their stress and to care for themselves by increasing their self-awareness in positive ways. The theory, according to Shields, “supports the idea that the nurse needs to be fully present within the nurse-client relationship” (p. 9). Dyess (2011) asserts that through the nursing encounter, the nurse has an opportunity to understand the uniqueness and thought in an individual’s belief pattern and what holds meaning for the patient and how that meaning is a part of how the patient responds in a situation that we would term illness. Faith, she asserts, evolves, in the same way that consciousness evolves. Quigg (2011) discusses the issue of persistent pain in the elderly, and asserts that the formation of close and long-lasting therapeutic relationships helps us to improve the management of persistent pain in the elderly.
Clearly, Newman’s theory has applicability across a range of situations and patients with different presenting problems. As a framework for nursing, and as a nurse manager, it describes the worldview or perspective from which nursing practice can manifest itself with patients, as well as in the nurse-nurse management relationship as it evolves over time.
