1. All four of the metaparadigms related to nursing-person, health, environment, and nursing-are vital and significant to nursing practice, but the one that is most pivotal to the concept of nursing is health. Health is of special concern because through the many years since nursing began, the quest for and preservation of health as an integral part of nursing has largely become obscured and set aside. Instead, today's healthcare systems have focused on illness, medication, and intervention. These are all acknowledged to be essential for modern medicine, but not to the exclusion of health, which should be paramount in the conceptualization and practice of nursing.
The omission of health from modern nursing theory and practice is due to a fragmentation of the idea of the person in which the person is seen as a patient rather than as a person that is comprised of multiple dimensions beyond the symptoms that he or she exhibits. Health "cannot be conceptualized as anything less than a reflection of the whole person" (Thorne, Canam, Dahinten, Hall, Henderson, & Kirkham, 2004, p. 1261). Thus, a holistic concept of the person that includes not only his persona as a patient but also his spiritual self, his psyche, and the other dimensions of his being, is requisite for understanding and ministering to him as a whole person. Health is not just a collection of bodily functions; it is an infusion of joy, peace, optimism, and other whole-person attributes that give the individual a reason for living and a zest for life that contributes to overall health. Moreover, the concept of health "must be expanded to include the dynamic agency of a person within a dynamic institutional and societal environment," since the institutions of society can exert a potent impact on people's health (Schim, Benkert, Bell, Walker, & Danford, 2006, pp. 75-76). Whole-person health needs to be a keynote of nursing theory an
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