Personal Nursing Philosophy and the 4 Meta-Paradigms of Nursing Practice


Nursing as a concept is a multidimensional practice that cannot be holistically defined based on one concept or philosophy. However, each nurse has his/ her personal belief that guides practice. Personally, this belief, which I call my philosophy, is that every activity in nursing practice should be aimed at improving the quality of life of others. As such, I believe that my calling as a nurse is to serve others by identifying their areas of need and making efforts to work with others towards improving their quality of life. In doing this, I look at both patients and their families, and I focus on making life better for both parties. By ensuring that the patient consistently has good health and is capable of taking care of them holistically, I improve the quality of life of the patients’ families as they are freed of some of the time they use to take care of their kin.

The 4 Meta-Paradigms

McEwen and Willis (2014) provide a description of four concepts referred to as the meta-paradigms of nursing practice. These meta-paradigms include the person, environment, health and nursing. The concept of the person is described through a focus on the patient as the center of care. For me, this concept implies that any decision or action in nursing practice has to put into consideration the needs of the patient, their strengths and weaknesses, and emphasize on the intention to improve the well-being of the patient.

The second concept in the meta-paradigm is that of the environment, which is described as the internal and external factors which are related to the environment including their surroundings and the interactions they have with those who visit them (Branch et al., 2016). For me, the environment meta-paradigm means that the nurse has to put into consideration factors such as the quality of support that the patient gets from his/ her friends and family, the hygiene of the environment and its capacity to prevent re-infection and the role of the nurse in ensuring that the environment supports patient well-being. As a nurse, some of the roles in which one may be engaged in to foster the support of the environment are counseling activities, specifically for family members who may not know how to deal with the patient’s condition (Nikfarid et al., 2018). The concept of the environment is tied closely to that of health.

My perception of the concept of health as a nursing meta-paradigm focuses on the quality and quantity of healthcare service delivery to the patient. The nurse is mandated to provide healthcare that is free from harm and to ensure that the patient also has access to healthcare services. The fourth paradigm described as nursing refers to the actual practice of nursing, which is essentially how the nurse translates nursing knowledge into practice. The application of knowledge focuses on realizing the well-being of the patient as a whole.

My Addition to the 4 Meta-paradigms

While all the concepts are useful descriptors of the nursing care environment, I would add the concept of collaboration/ communication to the meta-paradigm. I feel that this concept is an inevitable one in nursing and would be used to describe the how and what of information dissemination among members of the inter-professional team as well as between the patient and the nurse. The concept of health, on the other hand, could be combined with that of nursing as they both target the objective of improving client well-being.

Concluding Remarks

Based on my philosophy, I have been able to stand firm in practice even where the circumstances were unfavorable to the patient and me. It is also because of my philosophy that I feel hurt when I am unable to help a patient because of reasons beyond my control. To some extent, I believe that my philosophy promotes the core concepts of the nursing meta-paradigm.


Branch, C., Deak, H., Hiner, C. & Holzwart, T. (2016). Four nursing metaparadigms. Nursing, 124-132. Retrieved from

McEwen, M., & Wills, E. M. (2014). Theoretical basis for nursing (4th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Nikfarid, L., Hekmat, N., Vedad, A. & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: A comparative study. Journal of Medical Ethics and History of Medicine, 11(6). Retrieved from