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(Marcin) #1

A hallmark of a maturing scientific practice dis-
cipline is the development of specific practice and
research methods evolving from the discipline’s ex-
tant conceptual systems. Rogers (1992) asserted
that practice and research methods must be consis-
tent with the Science of Unitary Human Beings in
order to study irreducible human beings in mutual
process with a pandimensional universe. Therefore,
Rogerian practice and research methods must be
congruent with Rogers’ postulates and principles if
they are to be consistent with Rogerian science.


Practice


The goal of nursing practice is the promotion of
well-being and human betterment. Nursing is a
service to people wherever they may reside.
Nursing practice—the art of nursing—is the cre-
ative application of substantive scientific knowl-
edge developed through logical analysis, synthesis,
and research. Since the 1960s, the nursing process
has been the dominant nursing practice method.
The nursing process is an appropriate practice
methodology for many nursing theories. However,
there has been some confusion in the nursing liter-
ature concerning the use of the traditional nursing
process within Rogers’ Nursing Science.
In early writings, Rogers (1970) did make refer-
ence to nursing process and nursing diagnosis. But
in later years she asserted that nursing diagnoses
were not consistent with her scientific system.
Rogers (quoted in Smith, 1988, p. 83) stated:


[N]ursing diagnosis is a static term that is quite inap-
propriate for a dynamic system...it [nursing diagno-
sis] is an outdated part of an old worldview, and I
think by the turn of the century, there is going to be
new ways of organizing knowledge.

Furthermore, nursing diagnoses are particular-
istic and reductionistic labels describing cause and
effect (i.e., “related to”) relationships inconsistent
with a “nonlinear domain without spatial or tem-
poral attributes” (Rogers, 1992, p. 29). The nursing
process is a stepwise sequential process inconsistent
with a nonlinear or pandimensional view of reality.
In addition, the term “intervention” is not con-
sistent with Rogerian science.Interventionmeans
to “come, appear, or lie between two things”
(American Heritage Dictionary, 2000, p. 916). The


principle of integrality describes the human and
environmental field as integral and in mutual
process. Energy fields are open, infinite, dynamic,
and constantly changing. The human and environ-
mental fields are inseparable, so one cannot “come
between.” The nurse and the client are already in-
separable and interconnected. Outcomes are also
inconsistent with Rogers’ principle of helicy: that
expected outcomes infer predictability. The princi-
ple of helicy describes the nature of change as being
unpredictable. Within an energy-field perspective,
nurses in mutual process assist clients in actual-
izing their field potentials by enhancing their
ability to participate knowingly in change (Butcher,
1997).
Given the inconsistency of the traditional nurs-
ing process with Rogers’ postulates and principles,
the Science of Unitary Human Beings requires the
development of new and innovative practice meth-
ods derived from and consistent with the concep-
tual system. Over the last decade, a number of
practice methods have been derived from Rogers’
postulates and principles.

BARRETT’S ROGERIAN PRACTICE METHOD
Barrett’s two-phase Rogerian practice methodology
for health patterning is the accepted alternative to
the nursing process for Rogerian practice and is
currently the most widely used Rogerian practice
model. Barrett’s (1988) practice model was derived
from the Science of Unitary Human Beings and
consisted of two phases: pattern manifestation ap-
praisal and deliberative mutual patterning. Barrett
(1998) expanded and updated the methodology by
refining each of the phases, now more appropri-
ately referred to as “processes.” Each of the
processes have also been renamed for greater clarity
and precision.Pattern manifestation knowing is
the continuous process of apprehending the
human and environmental field (Barrett, 1998).
“Appraisal” means to estimate an amount or to
judge the value of something, negating the egalitar-
ian position of the nurse, whereas “knowing”
means to recognize the nature, achieve an under-
standing, or become familiar or acquainted with
something.Voluntary mutual patterningis the con-
tinuous process whereby the nurse assists clients in
freely choosing—with awareness—ways to partici-
pate in their well-being (Barrett, 1998). The change

168 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration

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