The term "care" has been used in the nursing profession for more than a century to characterize the essence of the nursing process or metaparadigm. Since the beginning of modern nursing in the mid-1860s, with the publication of Florence Nightingale's book, Notes on nursing: What it is and what it is not, nursed have been charged to care for patients as "whole persons" (Leininger, 1984). Nightingale not only emphasized the concept of care in her work and writing; she also emphasized health and the proper use of environmental resources. This statement will offer an overview of Nightingale's metaparadigm or model of nursing, along with an observed case analysis of the metaparadigm in action. A following section will include the beliefs and values I observed in this case and how they relate to my philosophy of nursing.
Cristy (1976), a nurse historian, has written that Florence Nightingale viewed the practice of nursing as more important than practicing medicine, since when the "physician cannot diagnose he cannot care." In Nightingale's metaparadigm of nursing, honed by her years of experience in the field and hospital settings, care for the patient is positioned at the core of the nursing process from a practical standpoint, while recognition of the patient as more than a symptom, condition, disease or injury establishes a holistic approach to care in general (Nightingale, 1946). Nutting and Dock (1935) argued that one of the underlying values in Nightingale's theory is a focus on restoration of health and well being over illness amelioration.
The case observed with respect to this model consists of providing hospice care for a dying AIDS patient. The patient, "Charles," is in the final stages of AIDS; he is debilitated, suffering pneumonia and Karposi's sarcoma. A return to any state resembling health and wellbeing is not possible, give the terminal nature of the presenting problems. Orem
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