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Newman's Theory of Health as Expanding Consciousness: A Personal Evolution

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Science Quarterly

Newman's Theory of Health as Expanding Consciousness: A Personal Evolution

Gina C. Bateman and Lyn Merryfeather
Nurs Sci Q 2014 27: 57
DOI: 10.1177/0894318413509725

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509725
research-article2013
NSQXXX10.1177/0894318413509725Nursing Science Quarterly 27(1)Bateman / Article

Article

Nursing Science Quarterly

Newman’s Theory of Health as Expanding

2014, Vol 27(1) 57­–61
© The Author(s) 2013
Reprints and permissions:
Consciousness: A Personal Evolution sagepub.com/journalsPermissions.nav
DOI: 10.1177/0894318413509725
nsq.sagepub.com

Gina C. Bateman, RN,1

and Lyn Merryfeather, RN; PhD2

Abstract
In this article, the authors demonstrate the value of using Newman’s theory of health as expanding consciousness for nurses
and the clients they serve. A review of the conception and evolution of the theory and its link to spiritual ideology provides a
multi-dimensional perspective of Newman’s ideas. Additionally, an exploration of the central concepts of the theory offers an
in- depth view of the philosophical and practical tenets on which the theory is based. The authors also chronicle one nurse’s
journey and evolution as a healthcare provider whose practice is rooted in Newman’s theory.

Keywords
Newman’s theory, nursing, spiritual

Newman’s theory of health as expanding consciousness not by spiritual tenets, but by her own experiences and by the
(1994) provides a perspective of nursing that recognizes and ideas of other scholars who focused on the melding of the
honors clients’ histories, unique attributes and experiences, mind, body, and spirit in an effort to define and improve
desires and goals, and life journeys. It is important for the human health (Newman, 1994; 2008).
nurse to be fully present and attend to the patterns that exist Newman’s grand theory contains many of the assertions
in clients’ lives in order to create a safe environment for cli- of spiritual philosophers. The certainty and importance of
ents to adapt to and cope with life’s redirections (Newman, personal evolution through expanded consciousness in the
2008). I am a nurse who strongly believes that health is an process of life (Bentov, 1978; Chessick, 2004; Holmes,
expression of life, however it may manifest. Newman’s the- 1998); the healing that may occur when someone is fully
ory both validates my perspective and inspires my work. My present with another person (Guenther, 2011); the relation-
role as a nurse is to develop connections with my clients that ship between history, thoughts, perceptions, and present
inspire them to authentically explore their life patterns so experiences (Chessick, 2004; Dalai Lama & Hopkins, 2002;
that they may experience the quality of life that they desire. I Holmes, 1998); the effects of intention on personal experi-
have witnessed the success of using this strategy in my own ences and physical and emotional environments (Dalai Lama
life and in the lives of others. Historically, my nursing prac- & Hopkins, 2002; Holmes, 1998; Meixner, 2006); and the
tice reflected the essence of Newman’s ideology in various power of self-reflection on health and personal evolution
ways. In achieving a greater understanding of the theory of (Chessick, 2004; Dalai Lama & Hopkins, 2002; Holmes,
health as expanding consciousness, my nursing practice has 1998) are poignant ideas that cross the borders of nursing,
intentionally become rooted in this framework. It is both an medicine, and spiritual ideologies. It appears that universal
honor and pleasure to discuss the conception and implemen- truths related to human existence transcend the limits and
tation of Newman’s theory of health as expanding conscious- boundaries of original thought and unique disciplines.
ness, and to reveal my evolution and transformation as a The theory of health as expanding consciousness is deeply
person and as a nurse whose practice is rooted in Newman’s thoughtful and filled with intricacies that may make it more
conceptual framework. difficult to comprehend than some other theories. However,
Individuals have the ability to rise above their perceived when understood and embodied, the concepts depicted in the
limitations and evolve in ways that not only improve their ontology have the power to transform nurses to accomplish
circumstances, but also afford them a greater understanding exactly what the theory avows, which is to expand the con-
of their existence (Newman, 1994). Nurses who anchor their sciousness of both nurses and patients. Nurses realize that
practice in the concepts proposed by Newman (1994) would
support the idea that the responsibility of a nurse is to facili- 1
Alberta Health Services, Child and Adolescent Mental Health, Alberta,
tate the revelation of meaningful patterns that unfold in clients’ Canada
lives. Newman claimed that her proposed theory was inspired 2
Instructor, University of Victoria

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58 Nursing Science Quarterly 27(1)

health may include illness, even death (Newman, 2008). surgery or the previously prescribed medical interventions
Further, explanations of the theory’s ideas foster the under- (Newman, 2008).
standing that health is enhanced when a client’s “pattern of The medical model’s definition of health as the absence
the whole” (Newman, 2008, p. 7) is uncovered in the safety of disease is shortsighted and it does not serve people well.
of a caring and accepting nurse-client relationship (Newman, For people to discover the meaning of their lives and to have
1994; 2008). rich experiences, a paradigm shift was in order (Newman,
1994). Nursing practice rooted in the unitary- transformative
theory of health as expanding consciousness focuses on cli-
Conception of Health as Expanding
ents’ wholeness; allows people to explore and express them-
Consciousness selves genuinely; recognizes that individuals’ states of health
As a child, Margaret Newman was encouraged to consider are important indicators of areas of personal growth; and
life from a philosophical standpoint by her father who taught fuses the internal and external environments of clients and
his daughter about the power of perception and inner resolve nurses to allow for mutual self-actualization (Newman,
(Pharris, 2010). Newman first felt a pull toward the profes- 1994; 2008).
sion of nursing when she realized that she could not effec- The goal of nursing from the tenets of Newman’s theory
tively participate in missionary work without attending to is to guide clients in a process of pattern recognition so that
both the spiritual and physical needs of the people whom she they may know themselves more intimately and gain the
would serve (Pharris, 2010). Further to this discovery, insights that support their evolution (Newman, 2008). This
Newman’s experience as a witness to her mother’s journey purpose is achieved through the development of an authentic
through a debilitating illness that eventually claimed her connection between the nurse and the client that is encour-
mother’s life deepened Newman’s understanding of health, aged by the nurse’s full presence in the client’s unfolding
and inspired her scholarly pursuit of nursing (Newman, health experience. As the meaning of the client’s life experi-
2008; Pharris, 2010). ences is explored, both the nurse and the client gain a more
In addition to her life experiences, Newman credited profound understanding of themselves and the other within
Martha Rogers for inspiring her to further her nursing studies the vast, universal environment that is the field of all possi-
in graduate school (Newman, 2008, p. xv). According to bilities (Newman, 2008, p. 9-10).
Newman, Rogers asserted that the process of life is charac-
terized by the ebb and flow of changing states of health that Implementation of Health as Expanding
occur on a continuum. In addition, Rogers claimed that well-
ness and illness are not distinct entities to be considered or
Consciousness
managed separately, but are informational tools that may be Newman described the nurse-client relationship as a mutual
used by individuals to understand themselves more deeply engagement for the purpose of discovering the unfolding pat-
(Newman, 2008, p. xv). terns that influence the client’s health (Newman, 1994; Pharris,
Newman also acknowledged the significant influence of 2010). It is imperative that the nurse be completely present and
Bentov’s ideas on the development of her nursing theory non-judgmental as the client reveals personal information
(Newman, 1997; 2008, p. 3). Incorporating Bentov’s belief (Newman, 1994; Pharris, 2010). The nurse’s actions are char-
that the process of life is one of expanding consciousness acterized as “caring in its deepest and most respectful sense”
with Rogers’ concepts became the underpinnings of the the- (Pharris, 2010, p. 303), focusing on the aspects of the client’s
ory of health as expanding consciousness (Newman, 1997). life that the person identifies as most relevant. A nurse must be
In addition to her major influences, Newman (2008) noted prepared for and willing to accept a period of ambiguity, chaos
the influence of the works of other scholars, such as Bohm and imbalance while a client forges a new life path (Pharris,
(p. 7), who discussed the effect of implicate and explicate 2010). The result of the nurse-client relationship throughout
order and Ferguson (p. 11), who viewed pain and illness as their journey together is the uncovering of patterns for both
informational sources that assist in the revelation of people’s parties (Newman, 1994; Pharris, 2010).
intrinsic patterns. From a unitary-transformative perspective (Cowling &
As Newman was pursuing graduate studies, she wit- Chinn, 2001), clients who are facing health crises and who
nessed a demonstration of these scholarly insights in action are seeking the assistance of healthcare professionals are rec-
with the unfolding of her friend’s experience with hyperthy- ognized as demonstrating readiness to some degree, to move
roidism. As proponents of the medical model prepared to through a process of transformation (Pharris, 2010). It is at a
remove her friend’s thyroid gland in an effort to manage her point of chaos in a client’s life when the nursing actions pro-
condition, the woman explored the possible reasons for the fessed in the theory of health as expanding consciousness are
occurrence of the issue and discovered the patterns within most helpful to the client (Pharris, 2010). The intention of
herself that likely contributed to her physical condition. nursing practice is to assist the client to achieve a level of
Using this knowledge, Newman’s friend consciously recon- self-awareness and self-reliance whereby the client, at some
figured her life. Subsequently, her over-active thyroid gland point in time, may continue the wellness journey indepen-
regulated itself to the degree that she no longer required dent of the nurse (Pharris, 2010).

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Bateman / Article 59

There is no particular physical environment required for Born to European immigrant parents, I grew up in an envi-
nurses to function from this theory. From what Newman ronment in which higher learning and personal evolution
(1994) explained, it is the nurse’s use of presencing and the was not only undervalued, but was completely misunder-
demonstration of unconditional positive regard that fosters the stood. My family of origin was riddled with issues of paren-
therapeutic environment in which the client may learn to func- tal discord, neglect, abuse, addiction, and mental health
tion at higher levels to improve health. The obstacles for challenges. I grew up experiencing poverty, hate, and aban-
nurses who practice from this perspective may come from donment. However, I believe that the universe does not
other healthcare providers who believe that the proof of accept a vacuum. Opportunities to balance my fate were cre-
improvement in a client’s condition must be swift and obvious ated by Spirit. In an attempt to move our family out of the
to the observer. Physical settings are much more important to watchful eyes of concerned neighbors, my father relocated
nurses, doctors, and other healthcare practitioners who believe my mother, two brothers, and me to a community where
that outside influences are stronger than internal states. Being middle class, cohesive families were living honest existences
cared for in healthcare environments such as acute care and with a strong sense of togetherness as families and as a
residential treatment settings in which a client’s responsibili- community.
ties and relationships differ from real-life situations, may pro- I went to school with others who lived in what appeared
vide inaccurate examples of a person’s level of functioning. to be loving families. Observing the lives of my peers, I
Facilitating the enhancement of a client’s internal strengths could see what was right and just. I was determined to emu-
and personal awareness allows the person to improve func- late what I noted to be better ways of living. Fortunately for
tioning independent of the environment. me, my mother divorced my father. Unfortunately for me,
There are real life demonstrations of the positive out- my mother had her own issues that prevented her from being
comes from the use of Newman’s theory. An exemplar a loving and nurturing parent. At the time, my brothers were
offered by an emergency room/intensive care nurse demon- affected by drugs and involved in delinquent activities. I was
strated that Newman’s theory could be used effectively in trying to find a way of being that differed from the experi-
busy, physical-health focused environments. The nurse pro- ences of my family members.
viding the example stated that, while attending to clients’ Consequently, I spent time with friends, studied hard, par-
physical needs, she explored what was meaningful to them in ticipated in sports and kept in touch with Spirit. I cannot
their everyday lives and what concerned them about their explain how I knew that these measures would propel me
current experiences. In taking this approach, the nurse stated into experiences filled with quality and meaning, except I
that she connected with her clients on a deeper level and that observed that these practices benefitted the lives of others.
she was able to note patterns that emerged as clients related My future hardships, though painful, became teaching tools
their personal stories. More importantly, the clients’ true and opportunities for growth. Before I decided to live pur-
needs were identified and the nurse was able to serve the posefully and consciously, I was fearful, emotionally numb,
individuals more effectively (Newman, 2008). and often portrayed myself as a hard-hearted individual.
Another example of incorporating Newman’s ideas into However, I came to believe that it is unwise to blame other
caring for a client provided evidence that use of the theory people for being themselves and living out their destinies. I
was effective in time-constrained situations. A nurse practi- learned that my internal environment directed and com-
tioner described her interaction with a client on a day when manded my life and that my point of power existed in my
the nurse was stressed for time and felt rushed. As she took choices in the present moment.
the opportunity to center herself and ensure that she was My decision to go to nursing school was the result of my
fully present by taking deep breaths and reciting a mantra keen observation of other people. As a young adult, I met a
before entering the room, she prepared for a mutually benefi- woman whom I came to know and greatly admire. She
cial interaction with her client. In her discussion with the cli- appeared to be the epitome of an exemplary woman. I could
ent, the nurse ensured that she heard all that the client was see that she was highly respected by others. That woman
saying and noted the emotional weight of the client’s account. happened to be a nurse. Although I never saw her in action in
In being fully alert to the clients overall presentation, the her profession, she possessed the qualities that I wanted to
nurse was able to respond compassionately and appropri- embody. I wanted to be like her, so I entered nursing school.
ately and to assist the client in creating an action plan that Even though my journey as a nurse had a rough start and
could be initiated immediately. The nurse accomplished her I actually left the profession for 10 years, I remained true to
goal of being a responsible care provider to the client in my endeavor to be the kind of person I believed the exem-
15 minutes, demonstrating that caring from this perspective plary woman to be, and I continued my journey of self-
can be efficient as well as effective (Newman, 2008). discovery. That journey eventually led me back to the
discipline of nursing and to the quality of life I always
My Evolution as a Nurse believed that I deserved. On the tumultuous road that carried
me out of my internal and external prisons, I constructed a
I entered the profession of nursing apparently on a whim. strong emotional skeleton, grounded myself in what I felt
However, I have learned that in life there are no accidents. was the truth of human existence and broke the cycle of

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60 Nursing Science Quarterly 27(1)

dysfunction that was my birth-family’s legacy. I planned so I believe that the design of the program contributed to the
that my children and I could have and be anything and every- clients’ failures to maintain sobriety and achieve their goals.
thing we desired. While confronting family secrets and the When I consider a substance abuse treatment program
dysfunction in my own marriage, I joined a spiritual center anchored in the theory of health as expanding consciousness,
and I explored the ideas of insightful mystics and scholars in I can imagine outcomes more aligned with clients’ objec-
order to achieve a greater understanding of my place and tives to manage their lives differently. It is interesting that
purpose in the universe. According to Newman (2008), com- the nurses in the health services department who operated
prehending health and quality of life from a more enlight- from Newman’s perspective were challenged and negatively
ened perspective and assisting clients to do the same is the judged by the addictions’ counselors. It became clear to me
ultimate goal of nursing. Similarly, realizing the divine influ- that viewing clients as intelligent, insightful, and experts in
ence in my life and the lives of others was the spiritual jour- their own lives was not the common practice in that setting,
ney on which I embarked. so I chose to leave with the intention of finding work that
I can confidently say that I am still learning and growing was more aligned with my understanding of appropriate cli-
as a nurse and a person. Demonstrations of kindness still ent care.
sometimes make me cry. Watching or hearing about children Since learning more about Newman’s theory I realized
suffering, even in fictional works, always makes me cry. As how much my personal opinions and professional practice
a result of my personal experiences, I understand many aligns with this theory. I believe in the unlimited potential of
dichotomies of human experiences – pain and pleasure, sor- individuals no matter what may be evident in the present
row and joy, chaos and calm, and hate and love. As a result, moment. In my daily practice, I behave in ways that support
I believe that as a nurse, I not only approach client interac- the highest good for all persons involved. I have been known
tions from a clinical understanding, but from personal knowl- to challenge colleagues who have self-serving practices or
edge of pain, suffering, endurance, and transcendence. harmful biases. I do this because I believe in their abilities to
Exploring nursing theories in a baccalaureate degree pro- move beyond their restrictive thinking and behaviors to be
gram is allowing me to gain more insight into the relevance better care providers to their clients.
and impact of my nursing practice. Higher learning is a For my clients, I set a daily intention to be considerate,
unique achievement in the history of my family. No one in compassionate, and supportive. When I allow my biases or
either of my parent’s families obtained a university degree. frustrations to get the best of me, I refocus by reminding
My three boys and I will be the first ones to accomplish this myself of my intentions. I attend to my inner dialogue and my
scholarly goal and we are in a race to see who finishes first. responsibilities as a nurse more frequently since learning
Newman’s theory of health as expanding consciousness about and exploring Newman’s theory and concepts related to
(Newman, 1994) reinforces what I know to be true about my caring (Newman, 1994; Pharris, 2010). Lately, I have been
responsibility to my clients. I have found that learning about devoting myself to using the Ho’oponopono Cleaning Tools,
and practicing spiritual philosophies is similar to discovering (Vitale and Len, 2007) about which I learned at the spiritual
and using the concepts of nursing theories such as the ideas center that I attend, to elevate my ability to be of service to my
proposed by Newman (1994). As I intentionally interact with clients. Before interacting with an individual, I focus my
clients in meaningful ways to assist them in achieving their attention on that person and silently offer these words, “I love
wellness goals, I become more self-aware, advancing to you, I’m sorry, please forgive me, thank you.” My belief is
higher levels of consciousness with the knowledge that my that by extending the healing vibrations of these statements,
evolution is a life-long venture. my clients may experience deep, energetic transformations. It
is my mantra that allows me to focus on my professional and
personal obligations to the people whom I serve.
Using Newman’s Theory
In an effort to be a better nurse, I have challenged the
When I was working at a residential substance abuse treat- voice in my head that values productivity over quality of
ment facility, I was struck by how often clients stated that interactions with others. This shift in my practice has resulted
they were afraid to leave once the three-week program ended. in being more present with people, and subsequently, in cli-
It was also disconcerting that most of the clients, upon leav- ents telling me that they appreciated my caring nature and
ing the program, relapsed and either requested further inter- assistance. I have experienced tangible results since I
vention or returned to a level of functioning in their lives that changed my focus. I owe the majority of the shift to the focus
was detrimental to their health. It appeared to me that there that learning about nursing theories and philosophies has
was a great deal of information being presented to the clients afforded me. I am truly grateful for the nurse scholars who
about what may have contributed to their substance abuse devoted their careers to paving the way for meaningful and
issues, and what they needed to do to change their experi- purposeful nurse-client experiences.
ences. However, there were few opportunities offered to the Finally, attending to patterns in my life and changing the
individuals to process their experiences or to practice new elements of my existence that do not serve me well has
ways of functioning. increased my effectiveness as a nurse. I have become more

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 Bateman / Article 61

aware of my effect in this world, and I feel a greater respon- understanding crosses ideological barriers of nursing theories
sibility to extend myself to others to benefit humanity. In and spiritual philosophies melding commonly held beliefs
becoming more conscious of my history and emerging pat- that may be used in the pursuit of the meaning and purpose of
terns and in taking steps to create a better experience for life. It is with great wisdom that nurses embrace the tenets of
myself, I learned that change can be difficult, that support nursing theory and build professional practices in the spirit of
offered during challenging times is comforting, and that the ideologies that resonate with their inner knowing.
rewards that result from exploring personal patterns are
worth the work. I believe that truly understanding what evo- Declaration of Conflicting Interests
lution feels like and the effort required to expand one’s con- The authors declared no potential conflicts of interest with respect
sciousness allows me to be a more caring nurse. to the authorship and/or publication of this article.

Conclusion Funding
The future of the world and of human existence is uncertain. The authors received no financial support for the authorship and /or
With the effects of global warming and social insensitivity publication of this article.
inspired by technological advancements that make it easy for
people to avoid engaging in genuine, connected, and caring References
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