For someone like Margaret Newman, nursing was not only a profession but a more of a calling. She knew, long before she stepped into formal nursing education, that nursing would become her life’s fulfillment. Prior to attaining formal nursing education, she became the primary caregiver to her mother who was diagnosed with amyotrophic lateral sclerosis. Dr. Newman took up a degree on nursing at the University of Tennessee, Memphis.
In her stay in the University, she was intrigued with the human experience and the complexity of health and illness. This challenged her to greater heights in intellectual capacity and fueled her more to reach for higher levels of education. After attaining a degree in Nursing, she then pursued a graduate level degree and majored in medical-surgical nursing at the University of California, San Francisco. In her studies in California, she was honored with a master’s degree in 1964. Before she resumed her graduate studies, she jointly served as the director of nursing in a clinical research center and also contributed in the academe as the assistant professor of nursing at the University of Tennessee.
For the next ten years, Margaret Newman furthered her search for knowledge by pursuing further study in the graduate level and taking a doctorate level at 1971 (Margaret Newman: A Nurse Theorist). She also taught from 1971 to 1977 at New York University. In 1977, she was appointed as the professor-in-charge of the graduate study for Nursing at Penn State. In addition, she assumed a position as a nurse theorist at the University of Minnesota in 1984. It was only in 1996 that she finally passed the torch and retired from education potential nurses.
Dr. Newman has been included in Who’s Who in American Women since 1983 and was appointed to Who’s Who in America in 1996. Lastly, the Zeta Chapter of Sigma Theta Tau International established a scholarship program named aptly for Margaret Newman, the Margaret Newman Scholar award to support doctoral students whose research contributes to Dr. Newman’s theories (Professional biography of Margaret Newman).
The Health as Expanding Consciousness (HEC) theory arose from the concern for people facing the debilitation, uncertainty, loss or even loss of life associated with chronic illness, which Nurses relate to. Moreover, HEC has emerged from a nursing paradigm based on three elements particularly a unitary or dynamic view, pattern that determines or identifies the wholeness and transformative unfolding as the process of change (Health as Expanding Consciousness).
The theory assumes that every person regardless of disorder is part of the universal process of expanding consciousness – a process of becoming more of oneself and of reaching new dimensions of being intertwined with other people. HEC incorporates disease as pattern of the whole and assumes that health is not separate from disease as compared to existing medical models. Nurses who utilize this kind of practice or mindset experience the how it is to participate in the expanding process enhancing lives and transforming them (Overview of the Theory).
During her research, Dr. Newman observed that patients that were confined in hospitals described time as dragging. This was confirmed by extant studies that indicated the degree of physical mobility as well as state of health was related to the perception of time rather than a more focused attention to ones health. There are four concepts, particularly movement, space, time and consciousness that supply an ample framework to view health. However Newman placed more weight and attention on consciousness, describing it as expanded consciousness (Engle, 1983).
HEC is based on several existing theories that will be briefly explained the succeeding paragraphs. HEC stems from Rogers’ theory of unitary human beings. His human pattering assumptions and how they interact with the environment are the essential building blocks to the perspective that consciousness is a manifestation of an evolving pattern of interactions between a person and the environment.
Consciousness not only encapsulates cognitive and affective awareness that is normally associated with it but also how the entire living system is interconnected with each other that can include physiochemical maintenance and growth processes as well as the immune system. Roger’s assertion that health and illness are related and are simply the manifestations of rhythmic fluctuations in life process is essentially the building block for seeing health and illness as a unitary process moving through variations in order and disorder.
With this in mind, a medical practitioner can no longer see health and illness in the dichotomous manner as prescribed by medical science, moreover health in the absence of disease or health as a continuum from illness to wellness. Both the evolving pattern of consciousness and Health are the same.
In order to effectively utilize this theory, one has to effectively change his/her paradigm in dealing with patients/people. In order to see health as the pattern of the whole, one should understand that disease is not a separate entity but rather it is a manifestation of interactions between the person and the environment. The paradigm shift is moving away from merely treating symptoms but rather searching for patterns and from viewing disease as negative and taking them as a part of the self-organizing process that would lead to a much higher state of consciousness.
One of the theories supporting HEC is David Bohm’s theory of reality as undivided wholeness. Bohm’s theory of reality states that disease is considered a manifestation of a whole of an underlying pattern and should be seen as a separate entity. HEC is a health and medical perspective that requires a non-pragmatic worldview. Wellness and illness are simply different points in a single stick of reality. Unless seen in a fragmentary point of view, they cannot and should not be separated from the whole.
Another supporting theory is that of Both Gregory Bateson (1979) and Arthur Young (1976) that emphasized the job of learning how things work in a nurse-patient atmosphere, determine the new rules of engagement and medical assistance and to move on to a new level of being and understanding in this medical field/profession. It is the crux of situations in which nursing can assist people in their search for understanding of the evolving pattern of their lives. The nurse-client relationship facilitates this kind of transformation and discovery.
People continually move through periods of consciousness involving the loss of freedom in the development of self-identity until the maximum point of discovery or transformation is reached. In this case, the things, methods or ideas that had previously been accepted don’t work anymore. The task now is to learn the new rules, which the patient is enclosed. There is a realization then of a person’s self-limitation prior to the transformation that makes it possible for one to go beyond in expanding his/her own consciousness.
Lastly, Ilya Prigogine’s theory of change is one of the supporting theories in accordance to HEC. The theory of change asserts that naturally occurring fluctuations of deterministic processes work together with chance events to usher in a bigger fluctuation that can actually thrust the system into another level of organization and functionality. Disorder is resisted by the structure as it places a strain on the existing structure. The action induced at the fluctuation’s vital point has the potential to drive into several and varying directions, and it is impossible to identify its path. It is at some point a single direction takes over the system and a new order is established with new rules created and applied upon.
This occurring movement through stages of disruption, ambiguity and disorganization is made easier and possible by the presence of a caring other. Extant research has continued to impress on the importance of a nurse’s role to partake a supportive role and partnership with the patient in order for the process expanding consciousness to unfurl (Newman, M.).
By considering dealing with patients using the HEC framework, although there is a considerable possibility for nurse-patient affinity, it is more likely that treating patients with HEC the underlying diseases affecting the patients can easily be determined. By identifying a patient’s pattern, we can then identify the pattern of the environment upon which the patient is interconnected because the pattern of the patient reflects the pattern of the environment. This evolving pattern of order and disorder includes patterns that can be identified as health and disease (Exemplars).
Newman, M. Overview of the Theory. Retrieved February 19, 2007, from http://www.healthasexpandingconsciousness.org/overview/overview.html.
Newman, M. Health as Expanding Consciousness. Retrieved February 19, 2007. from http://www.healthasexpandingconsciousness.org/.
Professional biography of Margaret Newman. Retrieved February 19, 2007, from
Newman, M. Health as Expanding Consciousness (PowerPoint Presentation). University of Minnesota.
Newman, M. Exemplars. Retrieved February 20, 2007. From http://www.healthasexpandingconsciousness.org/exemplars/exemplars.html
University of Tennessee Health Sciences Library and Biocommunications Center. Margaret Newman: A Nurse Theorist. Retrieved February 20, 2007. From http://library.utmem.edu/exhibits/newman/
Engle, V.F. (1983). Conceptual models of nursing: Analysis and application. Newman’s model of health. In: J. Fitzpatrick & A. Whall (Eds.). 263-73.