In her article, “The evolution of the new environmental meta-paradigms of nursing”, Dorothy Kleffel explores nurses’ views of the environment and how they have differed widely over time. Kleffel has examined the egocentric, homocentric, and ecocentric environmental paradigms. The three levels of paradigms allow us not just to define the scope of nursing, but also to understand it (Kleffel, 2006). Early nursing leaders such as Florence Nightingale and Lillian Wald had comprehensive perspectives of the environment and later on, their viewpoints on the impact of the environment of an individual helped to shape the nursing profession. Florence Nightingale’s work incorporated egocentric, homocentric and ecocentric viewpoints. Her egocentric ideas were mainly concerned with managing the surroundings of an individual. For example, she advocated for pure water, clean air, cleanliness, efficient sewage, light, good nutrition, and warmth as necessary in order for individual patient healing to occur. On the other hand, her homocentric ideas were concerned with the plight of the environment surrounding the community and how it affected members of such a community. For example, she was concerned about the need for a clean water supply, proper waste and sewage disposal, improved housing, and alleviation of overcrowding. Nightingale’s ecocentric ideas were concerned with the need to address the broader economic, political and social elements of the environment and how this impacted the health of individuals.
Like Nightingale, Wald was also concerned about the impact of the environment on the health of individuals. Based on these viewpoints, the scope of nursing could be defined as encompassing the egocentric, homocentric and ecocentric dimensions. In the 18th century, there was a lot of overcrowding and pollution in the cities and as a result, social amenities were not sufficient to cater for the rising population owing to rural-urban migration (Kleffel, 2006). This led to disease outbreaks, increased infectious diseases, and deaths. By the 1930s, the trend had changed largely due to the work of the early nurses such as Florence Nightingale and Lillian Wald that sought to address the environmental conditions that affected the health of the individuals. By this time, immigration had declined markedly, and infectious diseases had been replaced by chronic degenerative diseases. Owing to these changes, public health services were no longer in high demand. The scope of nursing had to change as well because nursing was moving from the community to hospitals (Andrist, Nicholas & Wolf, 2006). In addition, the patient’s environment was now confined to his/her hospital room. By the 1950s, nursing education was already on its way from hospitals to the universities, and this gave birth to nurse theorists. Many of the nurse scholars began exploring environmental thoughts in the 1980s and 1990s. In the 21st century, many nursing scholars have become increasingly aware of the need to extend their focus on the individual from the egocentric paradigm to include the ecocentric and homocentric paradigms. This has been necessitated by the depletion of natural resources, increased world hunger, desertification, global warming and wars, all of which have caused untold misery to the human race, not to mention an increase in the complexities and nature of diseases, and deaths.
To this day, the early nursing comprehensive views continue to shape the nursing profession. Nursing professionals have realised that there is need to care for the individual, his/her family, and even for the community. Most problems and deaths facing the human race today are as a result of the enormous environmental degradation and as such, there is need to care for the environment in order to reverse the trend. Based on the foregoing arguments, the transpersonal caring-healing model is slowly replacing nursing’s traditional theories and practices. This model endeavours to create a symbiotic relationship between technology, nature, humans, as well as the larger universe. There is the indication of an evolving and expanding metaparadigm on the environment and by embracing it nurses are bound to educate research and practice in the global arena with a view to confronting the major health issues facing the human race today.
Throughout history, the nursing profession has mainly been influenced by egocentric, homocentric, and ecocentric environmental paradigms. However, this trend has changed over the years owing to changes in the environment such as global warming and desertification. This has resulted in the emergence of newer diseases that warrants a different form of caring compared to the infectious disease to which the nursing profession had been exposed to. In addition, chronic degenerative diseases have also become increasingly common. Communities have changed as well and this has seen the nursing profession being relegated to the hospital setting. Newer theories have also emerged that have sought to study the health of individuals on a case study basis, as opposed to an entire community.
Andrist, L. C., Nicholas, P. K., & Wolf, K. (2006 ). A history of nursing ideas. Sadbury, Mass: Jones & Bartlett Learning
Kleffel, D. (2006). The evolution of the new environmental meta-paradigms of nursing. In Andrist, L. C., Nicholas, P. K., & Wolf, K. (Ed.), A history of nursing ideas. Sadbury, Mass: Jones & Bartlett Learning