The outstanding faculty of the CSUB Department of Nursing has designed the departmental philosophy and curriculum around the Nursing metaparadigm concepts of client, environment, health and the nurse.

We assume nursing is a scientific discipline and as a discipline makes a distinctive contribution to the maintenance and promotion of health.  This contribution is achieved through facilitating maximum functional health status by collaborating with individuals, families, groups and the community.  Activities to accomplish nursing goals are viewed as congruent with society’s expectations and needs.

Professional nursing draws upon the related disciplines of natural and social sciences, humanities and nursing science for its theory as a foundation for practice.  In addition, nursing continues to develop and refine its knowledge base through scientific inquiry into its theory and practice.  Critical thinking, progressive inquiry, and decision-making skills are emphasized through the use of the nursing process, which is directed toward achievement of maximum functional status for the client.  The use of this process results in complex independent judgments based on accurate data and knowledge.  We believe that the ability to engage in this process necessitates a baccalaureate level of nursing education. Such education is the essential preparation for beginning professional nursing practice.

Client

The client of nursing is the recipient of nursing care and may include the person across the lifespan, family, group or community.  The faculty believes in the integrity, dignity, and worth of the person as an open, goal-directed, humanistic being.  We assume each person as an open system includes distinct, but integrated physiological, psychological and socio-cultural systems.  The person as an open system actively engages in interchange of energy with the environment and tends to achieve a balance among the various forces operating within and upon it.  As an open system, the individual attempts to achieve balance with respect to these forces by utilizing, conserving, and replenishing energy in order to function effectively and efficiently.  The motivating energy underlying this interchange with the environment is assumed to be present from conception through the lifespan.  Developing through the process of adaptation, each person is engaged in modification through interaction with the environment.  Effective adaptation during development can be defined as momentary periods of balance and maximum functional status.  Genetic endowment, spiritual orientation, education, occupation, and cultural/ethnic group membership influence individualized development.  Although individuals strive to achieve balance and maximum functional status, they also actively seek new experiences that may disturb their balance at least temporarily.  These new experiences may require variable behavioral modifications to re-establish balance.  Further, we believe that individuals are rational, ever-changing, and capable of making critical choices.

Within our philosophical framework, the person across the lifespan, as an open system, interacts with, is part of, and influences other systems.  The family is a dynamic social system which responds to the needs and desires of its members and the community in which it is located.  As the primary reference group for the individual, the family serves to protect, educate, and nurture.  Individuals or sub-populations sharing a common purpose or problem are the group/aggregate clients of nursing.  A community, also a client of nursing, interacts with individuals, groups and institutions for their mutual protection and common good.  Because we believe in the value of relationships, linking people to each of the above social systems, we view the individual not in isolation, but as an integral part of the larger whole.  These relationships are significant because they influence the individual’s development, systems stability, functional status and health.

Environment

The environment may be defined as a composite of all the conditions and elements that make up the internal and external surroundings and influence the development of individuals.  Additionally, the environment may be conceptualized as human, social, political, economic, geographic and physical factors influencing each other.  We view society as the network of dynamic relationships that links individuals to other systems such as family, other individuals, group/aggregates, community, nation and the universe.  The individual and society are linked to and part of the environment.  Further, individuals, society, and the environment mutually influence each other through exchange of energy.  One aspect of the interaction of these multiple factors is their influence on health.

Health

Health can be defined as a state of maximum wellness/functional health status at a given point in time.  The concept of maximum wellness has been classically defined as an “integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable within the environment where he is functioning” (Dunn, 1959, p. 18).  Hence our belief that health consists of the ability to function optimally within an ever-changing environment and that health influences one’s growth and development.  Health is composed of multiple factors, some of which include the presence or absence of a disease state and the ability to adapt to internal and external stressors.  The definitive parameter of health is defined by specific societies.  Personal responsibility for an individual’s health is defined by specific societies.  Personal responsibility for an individual’s health is assumed by virtue of the individual’s ability to make free choices.

Nurse

We believe the professional nurse works autonomously and collaboratively with others to promote the health of individuals, families, and communities.  Nurses are individually accountable to the public they serve.  As a patient advocate and change-agent, the nurse works with others to facilitate growth and needed changes in the healthcare delivery system by evaluating and utilizing research findings.  The professional nurse not only interacts with patients/clients during the provision of care but also supervises and coordinates the care given by others.  Advanced communication, education, leadership, research and clinical skills are used to carry out these nursing functions.

Professional nurses provide nursing services to individuals of all ages and to families in a wide variety of healthcare settings where they function with various degrees of independence and complexity.  Increasingly, evolving nursing roles in the healthcare delivery system will require even greater independent decision-making, accountability, and autonomy of practice.  Scientific and technological advances necessitate commitment to life-long learning and may include higher education.  While ensuring the welfare of the public, the nurse also has the added responsibility to enhance the welfare of the profession of nursing.  This is accomplished by being actively involved with political and social forces impacting upon the profession.

Updated 2-06