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226 UNIT III Nursing Conceptual Models

framework for the emergent artistic application of The Rogerian model provides a challenging and
nursing care (Rogers, 1970). innovative framework from which to plan and imple-
Within Rogers’ model, the critical thinking pro- ment nursing practice, which Barrett (1998) defines
cess directing practice can be divided into three as the “continuous process (of voluntary mutual pat-
components: pattern appraisal, mutual patterning, terning) whereby the nurse assists clients to freely
and evaluation. Cowling (2000) states that pattern choose with awareness ways to participate in their
appraisal is meant to avoid, if not transcend, reduc- well-being” (p. 136).
tionistic categories of physical, mental, spiritual,
emotional, cultural, and social assessment frame- Education
works. Through observation and participation, the Rogers clearly articulated guidelines for the education
nurse focuses on human expressions of reflection, of nurses within the Science of Unitary Human Beings.
experience, and perception to form a profile of the Rogers discusses structuring nursing education pro-
patient. Mutual exploration of emergent patterns grams to teach nursing as a science and as a learned
allows identification of unitary themes predominant profession. Barrett (1990b) calls Rogers a “consistent
in the pandimensional human-environmental field voice crying out against antieducationalism and de-
process. Mutual understanding implies knowing par- pendency” (p. 306). Rogers’ model clearly articulates
ticipation but does not lead to the nurse’s prescribing values and beliefs about human beings, health, nursing,
change or predicting outcomes. As Cowling (2000) and the educational process. As such, it has been
explains, “A critical feature of the unitary pattern used to guide curriculum development in all levels of
appreciation process, and also of healing through nursing education (Barrett, 1990b; DeSimone, 2006;
appreciating wholeness, is a willingness on the part Hellwig & Ferrante, 1993; Mathwig, Young, & Pepper,
of the scientist or practitioner to let go of expecta- 1990). Rogers (1990) stated that nurses must commit
tions about change” (p. 31). Evaluation centers on the to lifelong learning and noted, “The nature of the prac-
perceptions emerging during mutual patterning. tice of nursing (is) the use of knowledge for human
Noninvasive patterning modalities used within betterment” (p. 111).
Rogerian practice include, but are not limited to, Rogers advocated separate licensure for nurses
acupuncture, aromatherapy, touch and massage, prepared with an associate’s degree and those with a
guided imagery, meditation, self-reflection, guided baccalaureate degree, recognizing that there is a dif-
reminiscence, humor, hypnosis, dietary manipula- ference between the technically oriented and the
tion, transcendent presence, and music (Alligood, professional nurse. In her view, the professional nurse
1991a; Jonas-Simpson, 2010; Larkin, 2007; Levin, must be well rounded and educated in the humani-
2006; Lewandowski, et al., 2005; Malinski & ties, sciences, and nursing. Such a program would
Todaro-Franceschi, 2011; Siedliecki & Good, 2006; include a basic education in language, mathematics,
Smith, Kemp, Hemphill, & Vojir, 2002; Smith & Kyle, logic, philosophy, psychology, sociology, music, art,
2008; Walling, 2006; Yarcheski, Mahon, & Yarcheski, biology, microbiology, physics, and chemistry; elec-
2002). Barrett (1998) notes that integral to these mo- tive courses could include economics, ethics, political
dalities are “meaningful dialogue, centering, and science, anthropology, and computer science (Barrett,
pandimensional authenticity (genuineness, trustwor- 1990b). With regard to the research component of the
thiness, acceptance, and knowledgeable caring)” curriculum, Rogers (1994b) stated the following:
(p. 138). Nurses participate in the lived experience of
health in a multitude of roles, including “facilitators Undergraduate students need to be able to identify
and educators, advocates, assessors, planners, coor- problems, to have tools of investigation and to do
dinators, and collaborators,” by accepting diversity, studies that will allow them to use knowledge for
recognizing patterns, viewing change as positive, and the improvement of practice, and they should
accepting the connectedness of life (Malinski, 1986, be able to read the literature intelligently. People
p. 27) These roles may require the nurse to “let go with master’s degrees ought to be able to do
of traditional ideas of time, space, and outcome” applied research. . . . The theoretical research, the
(Malinski, 1997, p. 115). fundamental basic research is going to come out of