Experiencing Rogerian Theory from a baccalaureate perspective: a nursing student's window to well-being.
Abstract: The purpose of this paper is to describe the acquisition of emerging knowledge of Rogerian Theory from one baccalaureate student's perspective. The learning process regarding nursing theory and its correlation to evidence-based practice will be discussed, and the importance of exposure to nursing theory at an undergraduate level will be explored. Personal examples of nursing practice from a Rogerian perspective and its impact on patient well-being will be highlighted.

Key words: "nursing theory", "baccalaureate", "theory-based, "Martha Rogers", Science of Unitary Human Beings
Subject: Nursing education (Curricula)
Nursing students (Education)
Author: Lodics, Danielle N.
Pub Date: 01/01/2011
Publication: Name: Visions: The Journal of Rogerian Nursing Science Publisher: Society of Rogerian Scholars Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 Society of Rogerian Scholars ISSN: 1072-4532
Issue: Date: Jan, 2011 Source Volume: 18 Source Issue: 1
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 272167871
Full Text: Introduction

Current research indicates that in order for nursing to complete its move from vocation to practice, theory needs to be taught at an undergraduate level (Flanagan & McCausland, 2007). Students in a profession as diverse and complex as nursing need to be taught in a theory-based manner in order to prepare for the intellectual challenges that will be faced in practice (Flanagan & McCausland). The author of this paper completed the Baccalaureate Degree in Nursing at Cedar Crest College in Allentown, Pennsylvania in December 2008. Curriculum content included not only instruction in clinical competency and content mastery, but also nursing theory and its practical application. While nursing theory was not taught as a specific class, concepts relating to nursing theory were interspersed throughout the author's educational process. It was during this process that the author conceptualized the foundation of Rogerian theory. Because it is a personal story, I will report the rest of my experience in the first person.

Timeline of Learning Process

The first two years of my four year education consisted of pre-requisite classes. These classes were required to complete the degree, but were not part of the nursing curriculum. When these classes were completed, access to nursing courses was granted. The introductory course of the nursing program provided an overview of the nursing profession including its history, education, ethical and legal concerns, and cultural issues. During this course, students were assigned to groups that would research a specific topic then write a paper and present it to the class.

Students were then exposed to the process of nursing research, including the functions of the professional nurse in designing and conducting research. Knowledge obtained through prior course work and life experience was incorporated to enhance comprehension and application of nursing research as an essential facet of nursing practice. Students critiqued a sample of nursing research for statistical and functional validity, formulated research questions and performed comprehensive literature searches. During the clinical component, each student nurse was assigned placement in an on-going research study with an experienced nurse preceptor. My work, under the supervision of the nurse preceptor, was continued during the Leadership in Nursing class, which emphasized the management process of the professional nurse in the delivery of healthcare.

In addition to mandatory assignments, students were encouraged to further develop and present projects initiated during the educational process. Again, students worked in small groups. My group partner and I were given the opportunity to present a report of the baccalaureate dissemination of the research explored throughout the educational process. The presentation took place at the Health and Wellness Conference on campus. The work was further refined and submitted as a poster presentation at the 20th Rogerian Nursing Conference at Case Western Reserve University in Cleveland, Ohio. (see Figure A). Process

My emerging knowledge of Rogerian Theory and its application was gained through a gradual process which spanned the two-year nursing portion of the curriculum of baccalaureate preparation (see Figure A for the flow of course work). During the introductory concepts course, students were group-assigned various topics relevant to the nursing profession. The topic assigned to my group was nursing theory. Each participant in the group selected one theory and expounded on it during the presentation to the class, and also prepared a paper on their topic to turn in at the end of the semester. Although Rogers' Theory was not selected at this time, understanding of the importance of nursing theory and its applications to nursing care was gleaned from writing this paper. This early experience laid the foundation for the introduction of Rogerian Theory, because it demonstrated to me that the nursing profession is built upon a theoretical framework.

The next step in the process of acquiring knowledge regarding Rogerian Theory occurred when I was completing the curriculum's research component. I learned how to analyze research findings to determine validity, as well as how to perform a literature search. These skills were subsequently employed when I participated with a faculty preceptor on a nursing research project. The project to which I was assigned involved data collection at Cedar Crest College using Gueldner's Well-Being Picture Scale (Gueldner et al., 2005). In addition to compiling data, I was afforded the opportunities to develop a site-specific consent form and to contact the Institutional Review Board for permission to obtain the data on campus. In order to complete this assignment, rudimentary understanding of Rogerian Theory was essential.

In my senior year of the baccalaureate program, during the Leadership in Nursing class, I was approved to continue working with a faculty advisor (preceptor) on the Well-Being Picture Scale I should just note that the theme of the conference was well-being, which coincided very well with the presentation). It was at this point that I began to explore Rogerian Theory at a deeper level. Leadership students were encouraged to participate in the college's annual Health and Wellness Conference and a classmate and I developed a power point presentation on the Well-Being Picture Scale. In order to understand the conceptual base of the scale, I found it necessary to study the theoretical framework from which it was derived, which is based on the tenets of Rogerian Science. Being able to connect Martha Rogers' Science of Unitary Human Beings (Rogers, 1992) with the Well-Being Picture Scale gave the concepts of the theory new depth and clarity, and I began to consider health as a multi-dimensional dynamic process. Rogers' principles of helicy, resonancy, and integrality became easier to grasp when applied to patient assessment using the picture scale.

The power point presentation on Gueldner's Well-Being Picture Scale was well-received at the conference. In fact, my faculty advisor recommended that a poster based on the power point presentation be constructed and submitted for presentation at the 2008 Society for Rogerian Scholars Conference at Case Western Reserve University in Cleveland, Ohio. The abstract was accepted, and during the poster presentation at Case Western, I had the opportunity to discuss Rogerian Theory with nursing experts from diverse backgrounds and specialties. This experience fostered further understanding of Rogers' Science of Unitary Human Beings, as well as adding an important theoretical dimension to my professional and personal growth.

The exploration of nursing theory from my perspective as a baccalaureate nursing student took place during each course, in a different way. According to Chickering and Gamson, high quality undergraduate education urges students to become active participants in the progression of intellectual development (1987). The American Association of Colleges of Nursing (AACN) holds that baccalaureate students need to understand the correlation between theory, practice and research (AACN, 2008). For me, hands-on involvement was a cornerstone in each step of the learning process. By participating in nursing research and presenting both my experience and the findings of that research in different forums, I was able to recognize the connection of various concepts and the application of those concepts to nursing practice. The AACN has also stated that critical thinking and reasoning are essential to high-quality evidence-based nursing practice, suggesting that a nursing education which includes theory can help foster these skills (2008). For me, being exposed to nursing theory and seeing its practical application as an undergraduate student was an exercise in critical thinking. Reflections on Homeodynamics: Nursing from a Rogerian Perspective

Rogers' concepts of helicy, resonancy and integrality provided a multi-faceted framework for my pursuit of the concept of well-being both personally and professionally. According to Rogers, helicy is defined as an on-going, progressive process within the human and environmental field pattern that is evidenced as increasing diversity (1992). Helicy has been noted to correspond with moving toward and fulfilling an individual's potential (Gueldner et al., 2005). For me, the journey of nursing education and the genesis of a nursing career have produced multiple interfaces within the human and environmental energy fields that have elicited progression toward fulfilling my individual potential. I now think of well-being as an experience that is impacted by more than just physical condition and essential knowledge.

Resonancy is defined as the ebb and flow of energy in human and environmental fields, with amplification of the flow of energy being tantamount to enhanced well-being (Gueldner et al.). In my personal experience, low (negative) energy and high (positive) energy have impacted my well-being at many points throughout my still-evolving life process. At times, fatigue and fear of failure have resulted in depression, lower productivity, and an ensuing decline in well-being. Conversely, encouragement, positive personal interactions and relaxation techniques such as communing with nature and practicing breathing exercises have resulted in a higher state of well-being.

Integrality describes the process as one and whole (Rogers, 1992). To me, the quintessence of this concept can be stated as the whole being different than the sum of its parts. It was not one experience, individual, or class that lead me down this path. Rather, it was the summation of all and the dynamics of the connecting and communing energy fields that wove the tapestry that has become my life experience to this point.

Coming to "know" Rogerian Theory has had an influence on the author's nursing practice in many ways. I currently work on a medical/surgical intensive care unit. The environment in a critical care unit can often be cold and impersonal. Because of my exposure to Rogerian Theory and specifically, the Rogerian-based conceptualization of well-being, I am able to perform my nursing care in a more holistic manner. When ventilated patients appear agitated, I use relaxation techniques such as soft music and lighting, in conjunction with medication. When unstable patients are experiencing a crisis, I attempt to exude calm, positive energy while reacting, in order to increase the patient's feeling of well-being. In my work, I sometimes have the opportunity to provide comfort care to dying patients. At these times, therapeutic touch and spiritual care seem especially helpful.

Conclusion

Perhaps grasping the concepts of Rogerian Theory cannot be achieved at a baccalaureate level by taking one class in nursing theory. Inclusion of nursing theory in each course of the undergraduate program has the potential to assist students in understanding the often obscure theoretical concepts and in improving critical thinking skills. Not all of my nursing classmates were afforded the opportunity to study nursing theory for independent projects; therefore, my educational experience with Rogerian Theory was the culmination of a fortunate chain of events. This chain of events has resulted in my deeper understanding of Rogers' homeodynamics and how they can impact one nurse's personal and professional growth. Because of my unique experiences as a baccalaureate student, Rogerian-based theory has become a part of my daily nursing care. I would have liked to have met Dr. Rogers in person.

References

American Association of Colleges of Nursing. (2008, October 20). The essentials of baccalaureate education for professional nursing practice (American Association of Colleges of Nursing). Washington, DC: Author.

Chickering, A., & Gamson A. (1987). Seven principles for good practice in undergraduate education. AAHE Bulletin, 39(7), 3-7.

Flanagan, N. A., & McCausland, L. (2007, November 1). Teaching around the cycle: Strategies for teaching theory to undergraduate nursing students. Nursing Education Perspectives, 310-314.

Gueldner, S.H., Michel, Y., Bramlett, M.H., Liu, C.F., Johnston, L.W.,Endo, E. et al. (2005). The well-being picture scale: A revision of the index of field energy. Nursing Science Quarterly,8, 42-50.

Rogers, M.E., (1992). Nursing science and the space age. Nursing Science Quarterly, 5, 27-34.

Danielle N. Lodics, BSN, RN

Cedar Crest College
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