The metaparadigm concepts of nursing, person, environment, and health are structures upon which nursing practice is built. For some, these concepts are built upon a Christian worldview, but for others they are based in secularism. The worldview lens through which we view these concepts will have tremendous impact upon our nursing practice. For the purposes of this discussion, Christianity will be defined as traditional Judeo-Christian belief which has its roots in the Bible and the teachings of Jesus Christ. Secularism will be defined as “exclusion of religion and religious considerations” (Secularism, n.d.).
From some perspectives, the history of present-day American nursing is based in the Christian faith. Doornboos, Groenhout, and Hotz (2005) state that the “. . . Christian faith has qualified and shaped nursing practice nursing practice from its inception”. The Christian faith is based primarily in the teachings of Jesus Christ. He consistently encouraged his followers to love others, to care for those less fortunate, and to minister to the sick and dying. In fact, Doornboos et al. (2005) report that “Jesus specifically names caring for basic bodily needs as the service that is proper to those who would be his followers”. According to Rose (1959), real Christianity teaches “devotion to others, without hope of any sort of reward, but for the sincere love of God and a desire to be like him”. When a nurse approaches nursing from this Christian worldview, his or her acts of nursing service suddenly become an outpouring of devotion to Christ. The nurse understands that “. . . for the Christian nurse, even the most mundane activities can be experienced as participating in worship and gratitude and delight” (Doornboos et al., 2005). Nursing is a “practice whose internal goods such as health and care fit wonderfully well with a Christian vision of service to God” (Doornboos, Groenhout, & Hotz, 2005). A nurse with a secular worldview will cease to serve if the service becomes personally unsatisfying, but a nurse with a Christian worldview will continue to serve because his or her motivation comes primarily from serving God. A Christian worldview provides a springboard for the nurse to serve and love God, but it also provides a context within which the nurse can cope with pain and suffering. Unlike the secular nurse, the Christian nurse believes that there is a future life with God that will be free of pain and suffering. “[T]he Christian nurse acts out of a hope that is grounded in faith in the Creator and Sustainer of all that exists . . . [T]he Christian nurse knows that the suffering, pain, and dying that call for care are not the end of the story” (Doornboos et al., 2005).
Christian worldview has tremendous impact on the metaparadigm concept of person. “[T]he Christian nurse’s character is shaped in part by her or his commitment to the good of the other because the other is seen as bearing the image of God, and this adds a depth to her or his response to the other that is an important part of the Christian nurse’s character” (Doornboos et al., 2005). The idea that humans are created in the image of God is a concept that finds its roots in the Bible. For the Christian nurse, each patient is inherently precious because they have been created by God. The patient is deserving of the best care because they are made in the image of God, not because they are the most pleasant or loveable. “The nature of nursing is focused by an understanding of the client as a bearer of the image of God” (Doornboos et al., 2005). For a nurse from a secular perspective, worth can be easily based on how kind, receptive, or deserving the patient appears to be.
Christian thought and worldview play an important role in the environment where a patient lives, as well as the environment in which patient and nurse interact. A Christian nurse understands that the environment is important. Since the beginning of the world in Genesis, God has been creating environments for humanity to live and interact in. Doornboos et al. (2005) state that “ . . . we care about the environmental aspects of nursing because the environment is part of God’s good creation intended for universal flourishing” . Often a nurse will discover that his or her patient lives in an unjust environment that is not allowing them to flourish. This injustice can be in their socioeconomic setting, their psychological or spiritual needs, or their family environment. A Christian nurse will see this as an opportunity to provide justice to a beloved creature of God. “The call for justice extends to all Christians, including Christian nurses. Effective nurses are competent in the hands-on care they give and in their attentive assessments of the intersections between client health and the environment” (Doornboos et al., 2005). While this attentiveness can be seen by both secular and Christian nurses, the Christian nurse’s worldview teaches that he or she should seek to provide justice within the environments of others, much as Christ provided justice and made humanity right with God. Rose (1959) shares that those with a Christian worldview should desire to perform their duties “for the world’s betterment, bringing about greater physical comfort, moral cleanliness, and spiritual emancipation”.
Health is a concept that is particularly interesting to the nurse with a Christian worldview. Health is much more than just an absence of physical illness. “Health in the fullest sense is the complete physical, mental, and spiritual flourishing that allows us to fulfill our created purposes – and so give glory to our Creator and enjoy the relationships with our Creator and fellow creatures that are made possible by these purposes” (Doornboos et al., 2005). A nurse with a secular worldview cannot, according to the aforementioned definition of secularism, minister to the spiritual health needs of his or her patients. A Christian nurse, however, understands that spiritual needs are present in every individual and can seek to minister to those needs.
Alligood (2010) states that, “the way you think about people and about nursing has a direct impact on how you approach people in your nursing care”. This is true whether a nurse has a secular worldview or a Christian worldview. A strong Christian worldview will provide a rich and strong foundation upon which to base excellent nursing care.
Alligood, M. R. (2010). Nursing theory: Utilization & application (4th ed.). Maryland Heights, MO: Mosby Elsevier.
Doornboos, M. M., Groenhout, R. E., & Hotz, K. G. (2005). Transforming care: A christian vision of nursing practice. Grand Rapids, MI: Wm B. Eerdmans Publishing Company.
Rose, R. (1959). Christian vocation in general nursing. Brethren Life And Thought, 4(3), 30-37.
Secularism. (n.d.). In Merriam-Webster online. Retrieved from http://www.merriam-webster.com/dictionary/secularism