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A REVIEW OF THE THEORY AND PARADIGM, MODELING AND ROLE-MODELING:

WHAT WE KNOW TODAY AND DON’T KNOW

HELENERICKSON,PHD,RN,AHN-BC,FAANAT

NURSINGTHEORY:A50-YEARPERSPECTIVEPASTANDFUTURE

MARCH21-22,2019CLEVELAND,OH.

©HELENERICKSON,MARCH2019NOTTOBEREPRINTEDWITHOUTPERMISSIONOFAUTHOR

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ReprintedwithpermissionfromH.Erickson,ParadigmChoicesinH.Erickson(2010).Exploringtheinterfacebetweenthephilosophyanddisciplineofholisticnursing.ModelingandRole-Modelingatwork,p.45

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I.UNDERLYINGPHILOSOPHCALASSUMPTIONSANDRELATEDILLUSTRATIONS

A.Allthingsareconnected,universe,soul,spirit,humanformandhumantohuman,andhumanwithinself. Energy,space,time1.1Humanprocesses1.2MRMlogoandlevelsof Humanenergyfield4Synchronizedenergyfields4 consciousness2,3

B.HUMANSAREHOLISTICWITHBIOPHISICALPSYCHOSOCIAL,SPIRITUALINTERACTIONS2,1Holism2.2,5 Wholism2.2,5 Mind-Brain-Body6 Affiliated-Individuation1,2.3Soul-SpiritHeart7

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C.Self-carehasthreecomponents:Self-careKnowledge,Self-careResources,Self-careActions2,1

RelationsamongSCK,SCR,SCA8Self-careknowledgefactorsofdailylife9

II.THEORETICALCOMPONENTSOFMODELINGANDROLE-MODELING2.4,1A.Humanshaveinherentholisticabilitiesneededtocope,grow,develop,self-actualize.

1.Stress,effectedbystressors,isapartofeverydaylife2.Ourabilitytocopeandadaptdeterminesourabilitytomobilizeresourcesneededtoworkthroughepigeneticdevelopmentaltasks.3.Theresourcesneededtocopearecreatedbyrepeatedneedssatisfaction.4.Attachmentobjects,thosethingsthatrepeatedlymeetourneeds,areassociatedwithdevelopmentaltasks.5.Lossofattachmentobjectsisbothnormalandsituationalandresultsinagriefprocess.6.Unresolvedattachment-loss-attachmentresultsinmorbidgrievingandaffectsneedsstatus7.Astasksareresolved,theresidualthatremainsaffectsfuturetaskresolution

AbilityToCopeDependsonResources(APAM)10,11AdaptivePotential10,11 APAMStatePhenomena10,11

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Healthyresolutionofepigeneticdevelopment,12Resourcesarederivedfromneed13 Needsaremetbyattachmentobjects&13

Relatedtasks,outcomestrengthsandvirtuessatisfaction age/stagerelated

Normaldevelopmentallosses14 Commongriefresponses14 Relationsamongconcept14

III.PRACTICEPARADIGM2.5

Categoriesofinformation1.Adescriptionofthesituation,expectationsforthefuture,resourcepotential,andgoals(immediateandlong-term).2.Theclientisalwaystheprimarysourceofinformation,significantother(s)aresecondary,andotherprofessionalsarethird.3.Dataareanalyzedwithincontextoftheoreticalpremises4.Interventionsarea.Basedoncopingabilityandaffiliated-individuationstatus,andb.Framedwithinthecontextofsixaims:

•Nursesself-preparationneededtocreatesacredspaceandinitiateperson-centeredholisticcaring.•Establishatrusting,functionalrelationship.•Promoteapositiveorientation••Promoteasenseofperceivedcontrol•Affirmandpromotestrengths•Sethealthdirected,mutualgoals

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• PreparingSelf:Presence,intent,2.5Majorconstructs2.5 Datacollectioncategories2.5Aims,principles,&goals1,2focus.2.5

Evidence-InformedPractice:15 ClientreportedA-IExperience16KnowledgePriorities

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REFERENCESBook1:Erickson,Tomlin,Swain(1983/2009)ModelingandRole-Modeling:ATheoryandParadigmforNursing.UnicornsUnlimitedBooks:CedarPark,TX.Book2:Erickson,H.(Ed)(2006)ModelingandRole-Modeling:Aviewfromtheclient’sworldview.UnicornsUnlimitedBooks:CedarParkTX.Book3.Erickson,H.(Ed)(2010).Exploringtheinterfacebetweenthephilosophyanddisciplineofholisticnursing:ModelingandRole-Modelingatwork.UnicornsUnlimitedBooks:CedarParkTX.NOTES1.1CopyofcoveronBook2Designedtoshowhumanenergyfieldacrosstimeandspace,withinvaryinglevelsofconsciousness.1.2.CopiedfromBook2withpermission.Showsincreasinglevelsofconsciousnessandrelateddiscoveries.1.3.CopiedfromBook2withpermission.ShowsA-Iwithenergeticconnectionsbetweentwopeople,p.xxiii.2.1CopiedfromBook1(MRMlogodesignedtodepict:

a)Thehumanneedforaffiliated-individuation®(theneedtofeelenergeticallyconnectedtoanotherhumanatthesametimeasperceivingasenseofindividuation,auniqueself.)b)Thenurseshownasahand,isafacilitatorandnurturerofinherenthumanabilities(notafixerordo-toothers);c)Thenurseslongarmshowsthepotentialforlong-termeffectonthewell-becomingandwell-beingofanotherhumanbeing;d)ThecirclesshowthattheminimumlevelsofconsciousnessneededtopracticeMRMisthespirituallevelasdescribedbyBentov,I.(1979);

2.2.CopiedfromBook1;depictsdifferencesbetweenholismandwholism,(p45-46).2.3.Affiliated-IndividuationwasfirstcoinedanddescribedinBook1,pp.68-69,laterdiscussedmorefullyinBook2,pp.182-207,andthroughouttheBook2,andstudiedbyActon,Timmerman,andothers.2.4.PresentedinBook1,pp.39-97&Book2,pp.97-269.2.5.PresentedinBook1,pp.99-232&Book2,pp.SectionIIITheHealingProcess.3.ThenursesarmextendedbeyondthespirituallevelandintoUniversalConsciousnessdepictsthepotentialfornursestoconnectwithUniversalKnowing,andbydoingso,abilitytobringUniversalWisdomtoclientsbybeing-withthem.4.CopiedfromBook2,Chapter2EnergyTheories:ModelingandRole-ModelingwrittenbyBrekke,M&Schultz(p.51).Thefirstimageshowsasinglehumanenergyfield;thesecondshowtwohumanswithsynchronizedenergyfields,necessarytocreateasacredspaceandfacilitateinherenthealingabilities.5. Erickson, H. (2007) Philosophy and theory of holism, Nursing Clinics of North America, Vol. 42 (2), pp.139-163. 6.CopiedwithpermissionfromBook2,Benson,D.Adaptation:Copingwithstress,p.244).7.CopiedwithpermissionfromBook2,Kinney,C.Heart-to-heartnurse-clientrelationshipsp.289.ThisdocumentwasagifttoKinneyasthisclientconcludedtheirtherapeuticrelationship.Shestatedthatit

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8.FirstdescribedthroughoutBook1(pp.83-84)andincludedintheQAsection,p.241.TheillustrationwascopiedwithpermissionfromBook2,Hertz,JandBaas,L.Self-careknowledge,resourcesandactions,p.98.9.Self-careknowledgewasvalidatedthroughresearchinErickson,H.(1984).Self-careknowledge:Relationsamongtheconceptssupport,hope,control,satisfactionwithdailylifeandphysicalhealthstatus.Unpublisheddissertation,TheUniversityofMichigan,AnnArbor,MI.10.Firstconceptualizedandtestedin1976:Erickson,H.Identificationofstatesofcopingutilizingphysiologicalandpsychologicaldata.LaterpublishedbyErickson,H.&Swain,MA,(1982).Amodelforassessingpotentialadaptationtostress.ResearchinNursingHealth,5(93-101).LaterstudiedbyBarnfather,J(1987,1989,1990).11.APAMintegratedintoMRMtheoryinBook1,pp.75-83.12.FirstdiscussedinBook1,pp.56-68.LaterexpandeduponinBook2:Erickson,M.Developmentalprocesses,pp.121-181;Erickson,H.Facilitatingdevelopment,pp.346-390;Erickson,H.Taxonomyofdevelopmentalattributes,pp.486-488.13.FirstdiscussedinBook1,pp.52-55.LaterexpandeduponinBook2:Erickson,H.,Erickson,M.,&Jensen,B.,pp.182-207;discussedthroughoutSectionIIITheHealingProcess,pp.275-443.TaxonomyonhumanneedsinBook2,pp484-485.14.FirstdiscussedinBook1,pp.88-91.LaterexpandeduponinBook2,Erickson,M.Attachment-Loss-Reattachment,pp.208-240.15.IllustratesrelationshipsamongthetripartitedimensionsofEvidence-informedholisticnursingpractice.16.Drawnbyaclientasagiftforhernurseuponconclusionoftheirtherapeuticrelationship.Shestatedthatitillustratedthehealingprocesssheexperienced.SheisdepictedasRandhernurseasC.Aftershedrewit,shedecidedthatitwasagoodexampleofAffiliated-Individuation;Iwouldagree.Notethedifferencesinsizeofeachindividualsinillustrations1andthenfollowitthroughtotheend,watchwhathappensasshegrows,andhowtheyendup.Imightaddthatthiswomanwasfunctioningfairlywellinsociety,butwashavingseriousproblemswithpersonalrelationshipswhenshestarted.Sheisahealthy,happymemberofsocietytoday,20yearsaftershecompletedherworkwithmycolleague.ThiscaseisdescribedinBook2,277-299.Considerwhatittooktohelphermovefromaninsecureaffiliationandover-individuatedpatternofrelationshipsthatshebroughttothenurse-clientrelationship.Itwasstep10beforeshebegantotrusttherelationshipandwhathappenedthereafter.Thisiswhyitissoimportanttomaintaintheenergeticconnectionbetweenselfandother;whenpeoplehavedevelopedsufficientresourcestheydowhatisnatural—theyhealandgrow.