Mark Corson

By W. Gunock. Berry College. 2018.

Aesthetic Meleis (1997) states that the structural and knowing grounded in an explicit conception of nursing cheap premarin 0.625 mg amex. Fundamental patterns of knowing in nurs- are assumptions purchase premarin 0.625 mg on-line, concepts discount premarin 0.625 mg online, and propositions of the ing. Integrated knowledge de- nurse-client interactions, environment, and nurs- velopment in nursing (6th ed. The structure of nursing knowledge: Analysis care through self-awareness and reflection (pp. Parker Study of Theory for Nursing Practice A Guide for Study of Nursing Theory for Use in Practice Study of Theory for Nursing Administration Summary References Nurses, individually and in groups, are affected Theories and practices from related disciplines by rapid and dramatic change throughout health are brought to nursing to use for nursing purposes. Nurses practice in increas- The scope of nursing practice is continually being ingly diverse settings and often develop organized nursing practices through which accessible health The scope of nursing practice is continu- care to communities can be provided. Community ally being expanded to include additional members may be active participants in selecting, knowledge and skills from related designing, and evaluating the nursing they receive. This guide was tice in hospitals, an increasing number of nurses developed for use by practicing nurses and students practice elsewhere in the community, taking the in undergraduate and graduate nursing education venue of their practice closer to those served by programs. The guide may be used to to provide nursing often realize that they share the study most of the nursing theories developed at all same values and beliefs about nursing. It has been used to create surveys of nursing nursing theories can clarify the purposes of nursing theories. An early motivation for developing this and facilitate building a cohesive practice to meet guide was the work by the Nursing Development these purposes. This chapter offers guides for continuing study 1 How is nursing conceptualized in the of nursing theory for use in nursing practice. Because many nurses are creating new practice or- ganizations and settings, a guide for study of nurs- Is the focus of nursing stated? The first guide is a set of • What does the nurse think about when con- questions for consideration in study and selection sidering nursing? The second • What are illustrations of use of the theory to guide is an outline of factors to consider when guide practice? Responses to questions offered and points sum- • What do nurses do when they are practicing marized in the guides may be found in nursing lit- nursing? Subsequent chapters of this • Is the richness and complexity of nursing book offer such sources. Four main questions have been developed and re- • What is the range of nursing situations in fined to facilitate study of nursing theories for use which the theory is useful? What major resources are authoritative • How can interactions of the nurse and the sources on the theory? What are major theoretical influences on this • Is the theory used to guide programs of nurs- theory? What were major external influences on devel- • Has nursing research led to further theory opment of the theory? What are projected influences of the theory on 3 Who are authoritative sources for infor- nursing’s future? Who are nursing authorities who speak about, • In what ways has nursing as a professional write about, and use the theory? Nurses in group practice may seek to use a nursing theory that will not only guide their practice, but also pro- vide visions for the organization and administra- This chapter has presented a guide designed tion of their practice. A shared understanding of for nurses to study nursing theory for use in the focus of nursing can facilitate goal-setting and practice. The guide is intended to accompany achievement as well as day-to-day communication more general formats of analysis and evalua- among nurses in practice and administration. This guide provides Allison and McLaughlin-Renpenning (1999) de- additional evaluative components for nurses scribe the need for a vision of nursing shared by all who are focusing on nursing practice. These questions are in- strate that a theory of nursing can guide practice as tended to further guide the study of nursing well as the organization and administration. The following questions are derived from components of a nursing administration model References (Allison & McLaughlin-Renpenning, 1999). Nursing questions are intended to guide descriptions of the administration in the 21st century: A self-care theory approach. New • How can the range of nursing situations be de- York: National League for Nursing. A nursing administration perspective on use • What nursing and related technologies are re- of Orem’s self-care nursing theory. Parker Introduction Why Evaluate Resources for Nursing Inquiry and Research Theory as a Guiding Framework for Evaluation How Do You Know What You Know? And if one begins, can the information that is often “here today and Never in human history have such vast quantities of gone tomorrow” be relied upon as accurate and information been so easily available. How can the information be evalu- brief space of a few decades, the acquisition, stor- ated? Given the complexity of data now available, age, and retrieval of information has been trans- can nursing theory resources even be evaluated formed from the realm of a labor-intensive manual across various types of media? Will the process be process to that of a digital, multidimensional vir- congruent with the theory and the values of the re- tual medium. The guide for evaluation of theory Nursing exists on the cusp of continual change, resources presented within this chapter moves to- with interfacing technological revolutions taking ward a realistic appraisal by the researcher of the place in nursing education, practice, and research.

The five views are summarized as follows: The agent view incorporates not only discrete de- liberate actions to achieve foreseen results and the The view of person buy premarin 0.625 mg cheap. Individual human beings are structure of processes to do so purchase premarin 0.625 mg on line, but also the powers viewed as embodied persons with inherent and capabilities of persons who are the agents or rights that become sustained public rights who actors premarin 0.625mg cheap. The internal structure, the constitution, and live in coexistence with other persons. A mature the nature of the powers of nursing agency and self- human being “is at once a self and a person with care agency are content elements of nursing sci- a distinctive I and me... The structure of the processes of designing viable rights and able to possess changes and and producing nursing and self-care is also nursing pluralities without endangering his [or her] science content. Individual human beings are tial in understanding the nature of interpersonal viewed as persons who can bring about condi- systems of interaction and communication be- tions that do not presently exist in humans or in tween nurses and persons who seek and receive their environmental situations by deliberately nursing. The age and developmental state, culture, acting using valid means or technologies to and experiences of persons receiving nursing care bring about foreseen and desired results. The beings are viewed as persons who use symbols ability of nurses to be with and communicate effec- to stand for things and attach meaning to them, tively with persons receiving care and with their to formulate and express ideas, and to com- families incorporates the use of meaningful lan- municate ideas and information to others guage and other forms of communication, knowl- through language and other means of commu- edge of appropriate social-cultural practices, nication. Individuals are viewed as uni- what persons receiving care are endeavoring to tary living beings who grow and develop ex- communicate. Nurses also has been a handicap in nurses’ communications may need to help individuals under nursing care to about nursing to the public as well as to persons take these views about themselves. They know that they have rights as persons and as They are embodied persons, and nurses must be nurses and that they must defend and safeguard knowing about their biological and psychobiologi- these personal and professional rights; their powers cal features. Viewing human beings as organisms of nursing agency must be adequate to fulfill re- brings into focus the internal structure, the consti- sponsibilities to meet nursing requirements of per- tution and nature of those human features that are sons under their care; they must know their the foci of the life sciences. Knowing human beings deficiencies, act to overcome them, or secure help as agents or users of symbols has foundations in bi- to make up for them; they must be protective of ology and psychology. Understanding human or- their own biological well-being and act to safeguard ganic functioning, including its aberrations, themselves from harmful environmental forces. Taking the object view carries with it a re- quirement for protective care of persons subject to The previously described nursing-specific views of such forces. The features of protective care are un- individual human beings are necessary for under- derstood in terms of impending or existent envi- standing and identifying (1) when and why indi- ronmental forces and known incapacities of viduals need and can be helped through nursing; individuals to manage and defend themselves in and (2) the structure of the processes through their environments, as well as in the nursing- which the help needed is determined and pro- specific views of individuals that nurses take in duced. These broad views point to the sciences Such knowing is foundational to model making and disciplines of knowledge that nurses must be and theory development in nursing. For example, knowing in, and have some mastery of, in order to Louise Hartnett-Rauckhorst (1968) developed be effective practitioners of nursing. Establishing models to make explicit what is involved physiolog- the linkages of nursing-specific views of human be- ically and psychologically in voluntary, deliberate ings to the named broader views is a task of nurs- human action, including motor behaviors. Orem’s Self-Care Deficit Nursing Theory 147 • A basic psychological model of action with three of self-care agency, a process with a specified submodels: structure. The first model, self-care operations, is The personal frame of reference of the basic modeled on deliberate action. The study of these and other general theoretical Models of categories of constituent care requisites models of deliberate action stimulated some mem- within the demand (universal, developmental, and bers of the Nursing Development Conference health deviation types) were developed as well as a Group to investigate and formalize the conceptual model to show the constituent content elements of structure of self-care agency, conceptualizing it as a therapeutic self-care demand and their derivation the developed power to engage in a specific kind of (Orem, 1995). The goal of these efforts was the ements of an action system to meet a specific self- construction of models to identify types of relevant care requisite particularized for an individual was information and to aid in the development of tech- developed as an example of what actions must be niques for collection and analysis of data about performed to meet each of the self-care requisites self-care agency. A model of self-care operations, and estimative, the conceptual entity therapeutic self-care demand. The therapeutic self- volved with and enabling for performance of care demand models represent what is to be known self-care operations. A model of human capabilities and dispositions self-care agency or met for them when required by foundational for: reason of self-care agency limitations. The models are offered as a means toward un- The adequacy of the theories should be ex- derstanding the reality of the named entities in plored. Despite the di- to be general models of nursing can be versity of these models, they are all directed toward adequate or deficient in their scope as related knowing the structure of the processes that are op- to expressing why people need and can be erational or become operational in the production helped through nursing or in describing of nursing systems, systems of care for individuals and explaining the structure of nursing or for dependent-care units or multiperson units processes. In any practice field, a general model or For information about models and scientific theory incorporates not only the what and growth involving development of knowledge in in- the why, but also the who and the how. The dividual scientists, see Wallace (1983) and Harré adequacy of a general theory comes into (1970). Black’s Models and Metaphors (1962) was question when there is omission of any one the source first used by the writer. The validity and specificity of theories referred to as nursing theories are in question when there is no ref- erence to the human condition that gives rise to needs for nursing on the part of individu- The use of specific views of human beings by als, to the presence and the powers of persons nurses or persons in other disciplines does qualified as nurses, to the structure of not negate their acceptance of the unity, the processes of production of nursing, and to oneness of each individual man, woman, or the results sought. In human sciences, specific views of What comes first, the view of humankind human beings identify the domain and or the view of nursing in the cognitional boundaries of the science within the broad processes of theorists, is a moot question. In nursing, The writer’s position is that a theorist’s life for example, the views of human beings ex- experiences in and accumulated knowledge pressed in Self-Care Deficit Nursing Theory of nursing practice situations support the identified the proper object of nursing and recognition and naming of nursing-specific were enabling for the development and views of human beings. A valid comprehen- relevant to all the health services or even to sive theory of nursing has as its reality base human existence. Such general views include individuals who need and receive nursing the view of human beings as energy fields, as care and those who produce it, as well as the living health, as culture-oriented, or as caring events of its production. Such general views, however helpful human societies and is something produced in understanding humankind or in identify- by human beings for other human beings ing approaches to data collection, do not and when known conditions and relationships cannot support viable nursing science, theo- prevail. Contemporary Nursing Knowledge: Analysis and evaluation of nursing models and theories. Development of a theoretical point of view, the role of nursing in society is to en- model for the identification of nursing requirements in a selected able individuals to develop and exercise their self- aspect of self-care. Concept for- themselves the amount and quality of care re- malization in nursing: Process and product (2nd ed.

Brazil premarin 0.625mg visa, China and Nepal have conservation programmes buy cheap premarin 0.625 mg on-line, but India and Pakistan still harvest from the wild discount 0.625mg premarin with mastercard, and little is known of the ecological impact of such trade. Climate changes As well as the direct threat to plants from humans through their actions on the habitat or by exhausting the plant stock, there are other more natural factors such as climate, although it has to be said that this may well have been changed as a result of human action also. Scientific tests at Canberra’s Australian National University have proved a link between stunted plant growth and higher ultraviolet radiation caused by depletion of the earth’s protective ozone layer. Changes in climate from global warming as a result of the greenhouse effect are also important. However, it is unclear how long-term changes in the composition of the mix of atmospheric gases, soil structure, or pest and disease patterns will affect the capacity of plants to manufacture the impor- tant active principles for which we currently rely on them. There are some successes; after the increased use of natural gas and low-sulphur fuels, the amount of sulphur dioxide in the atmosphere has fallen. Arnica montana usually grows in alpine regions, but has been known to flourish in milder climates too. At the same time, ammonia concentrations have risen, with the effect of changing the pH of rootwater and directly affecting the chances of plants to survive in some habitats. Evelyn’s Sylva published in 1664, became the tree growers’ handbook for two centuries. The greatest number of endangered species (38) are those of lowland pasture, open grassland and other natural open habitats. Working with local population Perhaps the most important way to conserve resources is to work closely with the people who live in and use the forest, the indigenous population, rubber tappers, ranchers, loggers, etc. Finding alternative uses for crops is one solution – the town of Aukre in Brazil is making money harvesting Brazil nut oil for the Body Shop set up by the late Anita Roddick. A total of 332 plants were either listed or proposed for listing, under the latter, from 1985 to 1991. It has been suggested that companies should fund forest protection schemes by putting cash up in exchange for exploitation rights. However, the costs are enormous, running into billions of dollars just to preserve resources solely for the pharmaceutical industry. Other agri-environment schemes make payments for the adoption of agricultural practices to conserve wildlife habitats, and historical, archaeological and landscape features, and to improve opportunities for countryside enjoyment. Plant alternatives Chemical synthesis would cut down the amount of plant material consumed in extraction processes. Ideally, pharmaceutical companies require novel, single, active molecules that can be made in a laboratory. Although this may be possible for some allopathic drugs, the activity of most crude extracts can seldom be attributed to a single molecule, but is usually the result of several compounds acting in synergy, making production of synthetic copies extremely difficult. Medical herbalists are obliged to use the original source material to protect this unique mix of active principles. Furthermore, the holistic principles of herbal medicine suggest that the relative concentrations of useful plant chemicals achieved by mixing different species together in individualised prescriptions are important in treating patients despite the general lack of standardisation. We know little about the interactive abilities of naturally occurring chemicals, much to the consternation of our orthodox colleagues whose demands are for purified, fully characterised medicines given in regulated doses. Homoeopaths need to use naturally occur- ring source materials too, complete with any inherent impurities, so that modern drug pictures can be assumed to match exactly with Hahnemann’s own work. There is also the possibility of creating a problem of another kind by following the synthesis strategy. The isolation of the chemical diosgenin, from the Mexican Dioscorea species in the 1940s, led to a booming steroid 20 | Traditional medicine industry in that country. As sophisticated isolation, separation and elucida- tion techniques developed, the requirement for this particular raw material fell away completely and with it went the accompanying industry, causing widespread local social deprivation. There is some irony in the fact that the largest pharmaceutical compa- nies in the world are scouring the South American rainforests increasingly, seeking natural sources for drug products. The chances of finding active plant extracts is greatly increased by studying the use of plants by various cultures, and the disci- pline of ‘ethnobotany’ is growing slowly. The tree has survived in cultivation because of its valuable fruit and wood and possibly because it was planted in temples. It was introduced to Europe from its native China in 1730 and was heading for extinction until fortuitous intervention saved it. Extracts are used in Chinese herbalism under the name baguo to treat hypertension. It would be unforgivable if future generations were to suffer because remedies disap- peared due to the actions of others. Gesundheitsberichte Bundes – Heft 9 Inanspruchnahme Alterna- tiver Methoden in der Medicin (Health Report by the Federal Government Issue 9 – Use of Alternative Methods in Medicine). Use and expenditure on complementary medicine in England: a population based study. Conference for the Midterm Review of the Decade on African Traditional Medicine (2001–2010), Yaounde, Cameroon, 31 August 2008. In: Bodeker G, Burford G (eds), Traditional Complementary and Alternative Medicine Policy and Public Health Perspectives. Influence of ammonia and sulphur dioxide on the growth and competitive ability of Arnica Montana and Viola canina. Over the last 500 years and more, medicine has been defined largely by who has practised it, rather than its theoretical basis or efficacy.

Tilson 25 Statistical Principles and Application in Biopharmaceutical Research 313 Dan Anbar 26 Data Management 345 T buy premarin 0.625 mg line. Fox 33 The Development of Human Medicines Control in Europe from Classical Times to the Year 2000 415 John P purchase premarin 0.625mg with visa. Fox 43 Organizing and Planning Local generic premarin 0.625 mg with amex, Regional, National and International Meetings and Conferences 575 Zofia Dziewanowska and Linda Packard 44 Drug Withdrawals from the Market – Causes and Consequences 579 Ronald D. Fletcher 46 Pharmaceutical Medicine and the Law 595 Sarah Croft and Timothy Pratt 47 Pharmaceutical Product Liability 605 Han W. Graham Hughes 51 Advertising and Marketing 653 Jonathan Belsey 52 Middle East, India, China and the Far East: Pharmaceutical Medicine in the East 665 Gamal Hammad 53 Financial Aspects of Clinical Trials 689 R. Wells Appendix: Useful Internet Links 745 Index 749 Preface to the First Edition Pharmaceutical medicine is a relatively new, but rapidly growing, academic discipline. As editors, we would like to thank our contributors for their expertise, their dedication, and their vision. We would also like to thank and acknowledge the enormous help, encouragement, and patience of the team at John Wiley & Sons, Inc. Lastly, we would like to thank our families, and friends, who have withstood the frequent telephone calls, e-mails, and meetings, often late into the night. Indeed, to all who made this project possible, both authors and non-authors, we thank you. We are certain that this specialty, and our patients, even though we may help them vicariously, will benefit because of your contributions. Andrew Fletcher Lionel Edwards Tony Fox Peter Stonier Preface to the Second Edition Since the first edition of this book, pharmaceutical medicine has only become more diverse and has also become widely accepted as a recognized medical specialty, for example, with its first graduates of specialist training in the United Kingdom, to add to those of Switzerland, and Mexico. This has been accompanied by pharmaceutical medicine’s rapid progress toward specialty recognition within the European Community, and many changes in the pharmaceutical environment. There are new chapters on European regulations, risk management, the Middle East, Asia and other topical subjects in pharmaceutical medicine. Those chapters that did appear in the first edition have all been brought up to date. But this book is for all those working in pharmaceutical medicine, regardless of their degrees, titles or affiliations. Although it comprehensively covers the internationally harmonized syllabus for the Diplomas in Pharmaceutical Medicine that are awarded in Belgium, Switzerland and the United Kingdom, this book will also usefully serve those teaching other types of certificates and (usually Master’s) degrees in this field, as well as being a vade mecum for those who are not undertaking academic courses. Hannah Bradley got this second edition started, but then went off on a tour around theworld; the editors strenuously deny that they are the reason why. Lucy Sayer and Juliet Booker have since piloted the ship to the dock-side, successfully cajoling us into getting this edition done before its second decade. Not least, we would like to thank you, the reader, for your continued support and suggestions. Edwards has been involved in all aspects of clinical trials for over 33 years on many different research drug and devices in 10 therapeutic areas. Previously, he was Vice President of Clinical Research at Bio- Technology Pharmaceutical Corporation, a small biotechnology firm operating both in the United States and internationally. Edwards is a Fellow of the Faculty of Pharmaceutical Medicine and an Adjunct Professor at Temple University Graduate School of Pharmacology. He has taught for the Pharmaceutical Education & Research Institute for over 12 years and was on the teaching faculty of the National Association of Physicians. He teaches pharmaceutical medicine, bioethics and medical and scientific writing at Temple University’s School of Pharmacy. He is a founder member and former trustee of the Academy of Pharmaceutical Physicians and Investigators (formerly the American Academy of Pharma- ceutical Physicians). He has also been a clinical and regulatory Vice President within a small pharmaceutical company. His publications span several areas of pharmaceutical medicine, for example, regulation, pharmacology, clinical trials, pharmacovigilance, analgesics, migraine, genotoxicology, and metabolism, and he is named as inventor on several patents. He is on the editorial boards of several journals, and serves in a more senior capacity for two of them. Tony is proud to be an Essex man, researches the history of that County, and has been elected as a fellow of the Royal Geographical and the Royal Numismatic Societies. He is Medical Director of Amdipharm Plc, and of Medical Resource Provider Axess Ltd. His publications include edited works in human psychopharmacology, pharmaceutical medicine, clinical research, medical marketing, and careers in the pharmaceutical industry. Professor Stonier has been elected a Fellow of the Royal Society for the encouragement of Arts, Manufactures and Commerce. Fox Pharmaceutical medicine is unquestionably a strate efficacy, tolerability and purity in drug young medical specialty. The first university chair products (and their equivalents in diagnostics and in pharmaceutical medicine is less than 10 years old, devices), pharmaceutical medicine has become and there are no great buildings or institutions evidence based; it is interesting to note that the dedicated to it, unlike venerable medical specialties more venerable medical specialties are now imitat- such as chest medicine, neurology, physiology, ing the supposed ‘new kids on the block’ with the pharmacology and so on. Possibly because of its recent emphasis on evidence-based approaches to youth, this is a specialty that can be misunderstood the patient. Even among practitioners of It is therefore not surprising that the diverse and pharmaceutical medicine, there can be surprise overlapping discipline of pharmaceutical medicine when they consider their own diversity. There can be no doubt that today as the practice of pharmaceutical medicine clinical experience is always a good prelude to a have existed for a long time. But dental sur- cation of Digitalis purpurea as a treatment for what geons, medical practitioners, nurses, pharmacists, was then called ‘dropsy’ and the clinical trial of physiotherapists, psychologists and many other citrus fruit conducted by Lind are examples of drug members of the allied health professions have all discovery and investigation. For example, gen- shared with the fields of epidemiology and public eralpractitionersregularly workwith nurses, health health are obvious and also well established. Every visitors, administrators, hospital colleagues and prescription written in ordinary clinical practice is social workers; radiologists might add radiogra- a clinical trial of some sort, where n ¼ 1, because phers and physicists to this list and delete the health human beings are anisogenetic; this even applies to visitors and social workers.

Patterning manifestation searcher maintains observational purchase premarin 0.625 mg line, methodologi- knowing and appreciation occurs in a natural cal discount premarin 0.625mg with visa, and theoretical field notes effective 0.625 mg premarin, and a reflexive setting and involves using pandimensional journal. Any artifacts the participant wishes to modes of awareness during in-depth dialoguing. Unitary field pattern profile is a rich descrip- process section of the practice method are used tion of the participants’ experiences, percep- in this research method. All the tion and knowing is on experiences, percep- information collected for each participant is tions, and expressions associated with the synthesized into a narrative statement reveal- phenomenon of concern. The researcher also ing the essence of the participant’s descrip- maintains an informal conversational style while tion of the phenomenon of concern. Mutual processing involves constructing the thereby lifting the unitary field pattern por- mutual unitary field pattern profile by mutu- trait from the level of description to the level ally sharing an emerging joint or shared pro- of unitary science. Scientific rigor is main- file with each successive participant at the end tained throughout processes by using the cri- of each participant’s pattern manifestation teria of trustworthiness and authenticity. For exam- findings of the study are conveyed in a ple, at the end of the fourth participant’s Unitary Field Pattern Report. The joint construction (mutual Cowling (2001) recently explicated the processes unitary field pattern profile) at this phase of Unitary Appreciative Inquiry as a method would consist of a synthesis of the profiles of grounded in Rogerian science for “uncovering the the first three participants. After verification wholeness and essence of human existence to in- of the fourth participant’s pattern profile, the form the development of nursing science and guide profile is folded into the emerging mutual the practice of nursing” (p. Pattern manifes- may be used with individuals, groups, or commu- tation knowing and appreciation continues nities and includes appreciative knowing, partici- until there are no new pattern manifestations patory, synoptic, and transformative processes. If it is not possible to either share the dinary and extraordinary forces characterized by pattern profile with each participant or create unknowable mystery. The researcher and partici- a mutually constructed unitary field pattern pant are equals in a participatory mutual process profile, the research may choose to bypass the where outcomes are not imposed and change un- mutual processing phase. The unitary field pattern portrait is created by amines all pattern information synoptically by identifying emerging unitary themes from viewing all experiences, perceptions, and expres- each participant’s field pattern profile, sorting sions as interrelated in a way that reflects the inher- the unitary themes into common categories ent wholeness of a phenomenon or situation. The and creating the resonating unitary themes of elements of the approach in unitary appreciative human/environmental pattern manifestations inquiry (Cowling, 2001) include: through immersion and crystallization, which involves synthesizing the resonating themes 1. The scientist/practitioner seeks out to explore a into a descriptive portrait of the phenome- life situation, phenomenon, or concern from a non. Describe the endeavor with the aim of appreciat- and accurate aesthetic rendition of the univer- ing the wholeness, uniqueness, and essence sal patterns, qualities, features, and themes of the particular situation, phenomenon, or exemplifying the essence of the dynamic kalei- concern. Approach participants as partners in a coequal preted from the perspective of the Science of participative appreciative endeavor. Information is collected in the form of dialogue, evolutionary interpretation to create a theoret- discussion, interview, observation, or any prac- ical unitary field pattern portrait of the phe- tice that illuminates the underlying human life nomenon. Documentation of the experience, perceptions, retical structure of the phenomenon from the and expressions can be accomplished through perspective of Rogers’ nursing science. Engagement with participants is negotiated Rogerian science to practice and research. Construct a pattern profile using synopsis that disease and cellular biological processes, the meaningfully represents the person’s experi- Science of Unitary Human Beings focuses on ences, perceptions, and expressions of partici- human beings as irreducible wholes insepa- pants and captures the wholeness, uniqueness, rable from their environment. The profile may be created For 30 years, Rogers advocated that nurses by the scientist/practitioner, the participants, should become the experts and providers of or as a joint venture. If nursing ory by seeking universals that may exist across continues to be dominated by biomedical cases while acknowledging the individual frameworks that are indistinguishable from differences. If nurs- offers nursing a distinguishable and new ing’s content and contribution to the better- way of conceptualizing health events con- ment of the health and well-being of a society cerning human well-being that is congru- is not distinguishable from other disciplines ent with the most contemporary scientific and has nothing unique or valuable to offer, theories. Thus, nursing’s survival rests on its ability to make a difference in promoting References the health and well-being of people. Well-being and ing care is distinguishable from the services of high-risk drug use among active drug users. The consciousness nursing a distinguishable and new way of rainbow: An explication of Rogerian field pattern manifesta- conceptualizing health events concerning tion. Personalized nurs- human well-being that is congruent with the ing: A science-based model of the art of nursing. New York: National League for worldview, new terminology is needed to cre- Nursing. Unpublished dissertation, New York a new understanding of the experiences, per- University, New York. Crystallizing the processes of the unitary The relationship of human field motion and power. Nursing Science Quarterly, 9, porary society: Issues, trends, and transition to practice (pp. Instrument development and the meas- derings related to the power as knowing participation in urement of unitary constructs. Unitary perspectives on methodological prac- harmony: A theory of Rogerian nursing practice. Turbulent mirror: An illustrated Theoretical issues, methodological challenges, and research guide to chaos theory and the science of wholeness. Spirituality as integrality: A Rogerian Visions: The Journal of Rogerian Nursing Science, 11, 7–20. Spirituality: A pattern manifestation of doctoral dissertation, New York University, New York. The relationship of time experience, cre- Journal of Rogerian Nursing Science, 2, 12–18. Governing Council of the Society for the Advancement of Rogers: Her life and her work. Rogers: Her life and of dying, the experience of paranormal events, and creativity her work (pp.