The practice of nursing evolves daily from theories and philosophies that are proven by researchers, resulting in growth of the medical profession and advanced evidence based knowledge. PhilosophiesAccording to Alligood (2014b), philosophies are specific theories that focus on one or more metaparadigm concepts in a wide spectrum philosophical way (p. 43). For a person to understand philosophies it is required to understand the knowledge type, metaparadigms. MetaparadigmMetaparadigm is the vast perspective of a discipline and a way to describe a concern specifically to a profession or department (Alligood, 2014b, p.42). Nursing MetaparadigmThe metaparadigms in nursing knowledge are human beings, environment, health, and nursing.Nursing PhilosophyTherefore, a philosophy of nursing would be a broad statement that would generate general ideas about specific values or beliefs. Alligood (2014b) stated, “Philosophies present the general meaning of nursing and nursing phenomena through reasoning and logical presentation of ideas” (p. 42). For example, Notes on Nursing: What It Is and What It Is Not, where Nightingale answers the broad, yet complex, question, “What is nursing?” (Nightingale, 1946). Metaparadigm?The four metaparadigms of nursing include human beings or person, environment or society, health, and nursing. PersonChinn and Kramer (2015) define the metaparadigm of person aims on the recipient of care in the aspect of wholeness and the holistic view entirely. This includes a person’s culture, family, career or socioeconomic status, and even spirituality. Western cultures consider the whole equal to its sum of the parts and stress the interrelationships amongst the parts; compared to the Eastern culture who believes healthcare providers must take into consideration all aspects of the patient to properly treat them. Western cultures believe in treating a specific problem, for example a patient presents to the Emergency room with shortness of breath, cough for a week, fatigue, and pain in her chest and sides; the physician treats the patient for a sinus infection and discharges her home without evaluating the whole body. In the Eastern culture, a physician would evaluate the patient’s entire body, taking into consideration her history of COPD and current smoking status, including but not limited to socioeconomic background. The benefits of assessing the whole compared to its part could be the life-threatening diagnoses of Pulmonary Embolism versus an uncomplicated sinus infection. The Eastern culture philosophies could result in an increase in healthcare costs for unnecessary lab work, tests, and procedures(Chinn and Kramer, 2015, p. 46-47). EnvironmentAccording to Chinn and Kramer (2015) the metaparadigm environment or society refers to both dependent and independent factors that are directly significant to the patient and his or her care (p 47). For Nightingale environment was essential while conveying her perception of nursing. She believed all people involved in the care of a patient should maintain a therapeutic setting to heighten the comfort and healing (Alligood, 2014a, p. 65). On the other hand, Martha Rogers believes that humans and the environment are one and their manifestations derive from mutual developments. She also believes a person is a consolidated whole and cannot be observed by looking at its parts. Lastly, her philosophies are focused on the environmentalfield and human field coinciding (Alligood, 2014a, p.224). HealthThe metaparadigm health, according to Chinn and Kramer, is distinguished as the goal of nursing. Health is defined differently among nurse authors varying from the principle of nursing which is to assist ill patients while attaining the highest possible quality of health, to health being an influential process that alters with life circumstances and time. In other words, some authors view the process of health and environmentalcircumstances are reciprocals of each other and others believethe process of health derives from each individual. Several other nurse authors, including Myra Levine, often avoid the term health or illness and tend to refer to these terms as conserving wholism. This idea leads nurses to direct their attention to the entire patient situation and environment instead of the typical factors referred to by healthcare. NursingThe metaparadigm nursing refers to the interactions and helping process between a patient and the nurse. In addition, how the nurse attributes the plan of care and the knowledge he or she presents. From a medical framework, nursing follows the medical aspect like diagnosis, assessment, treatment, and medication administration. Contrary, the nursing framework describes interpersonal interaction as the main component and medical tasks are supportive. While most nurse authors believe interpersonal interaction as the center focus of nursing, there are some differences that remain. For example, the patient that comes in contact with the nurse is the main aspect of directing what plan of care will be taken and the goals that are achieved. For others, the nurse’s role in the relationship is predominantly the person leading the plan of care. Each patient and nurse relationship is unique and determined by many factors like time, culture, experience, psychological development, situation, age, goals, values, and many others. Although these relationships vary, the importance of their similarity is the human interaction for developing health as a whole. It is fundamental for nurses to incorporate these four metaparadigms into their nursing practices when caring for patients to address them as a whole. Personal thoughts and beliefsThe four concepts of the nursing metaparadigm play a major role in the nursing process and is imperative when caring for patients. William Osler was quoted in his belief that, “a good physician treats the disease; the great physician treats the patient who has the disease.” This quote illuminates my personal philosophy and the foundation of my future practice. Patients are not just a number or diagnoses; they are each individuals who require and deserve quality care. Quality care is compromised of a comprehensive assessment, which requiresevaluating the patient as a whole. It is important to not only focus on the physiological aspects but the psychological and spiritual as well.NursingI believe the metaparadigm nursing ties all of the concepts together. The nursing profession is more complex than most people understand. Nurses have the responsibility of someone’s life in their hands while balancing several tasks, passing medications, thinking critically about the next step, communicating with many people involved in each patient’s care, and remaining compassionate and empathetic. I strongly agree with the idea that every relationship between each patient and myself is different but the care given remains the same providing as much dedication and love as if they were my own family members. Some patients and parents are exceptionally involved in their plan of care, while others are just in the hospital to be treated and proceed home. The attitude of each individual strongly determines the plan of care for that particular patient, which leads into the metaparadigm person. PersonEach patient is cared for in the same manner by the healthcare team I work with daily and everyone is treated based on a holistic standard. I believe each individual should be assessed, diagnosed, and treated for after reviewing all aspects of a patient’s life. Many new parents come to the hospital terrified to ask questions about the actions they are taking at home, but this is the best time for nurses and medical professional to educate on the benefits and risks of all healthcare aspects. For example, I have cared for several infants that are diagnosed with failure to thrive. If I were to just simply come to work, treat the patient, give medications, and go home then not only would I despise my profession but also my patient would not benefit from anything I have provided. It is crucial for the healthcare team and myself to consider all factors related to this patient. My concerns and questions would vary from how long has he/she not been taking the bottle, what formula is being fed, how often and how much is in each bottle, has the formula ever been changed, was he/she full term or premature, is the baby well-groomed, are the parents involved in the infant’s care, etc. There are many factors that could be vital in treating this patient along with labs and procedures needing to be completed. In this situation a parent may ponder why the healthcare team is asking all of these questions but the resolution to this failure to thrive infant could be a simple change in formula with added calories per ounce or a formula without soy. These questions give the healthcare team a better outlook on the person, health, and environment. EnvironmentEnvironment is a vital aspect in the care of individuals. I have no doubt a person’s surroundings and care that is received can alter their healing process. For instance, consider how many people go in and out of a patient’s hospital room within a 24-hour period. If every person knocked loudly, flipped the blinding light on, were rude and inconsiderate of the sick patient, then left by shutting the door too hard, the patient would have no rest or calm environment for his or her body to heal, resulting in a longer visit and complications. This is an effortless yet imperative effort to provide optimal care for a patient. The environment should be a place where patient feels safe and the healthcare team should promote comfort, such as opening a window or using aromatherapy. Equally important, a person’s home environment could alter their overall health as well. People can perform everyday healthy lifestyle changes to better themselves and others around them. For example, taking their medications daily, drinking more water, going for a walk, keeping their house clean of dust, eating more fruits and vegetables, etc. These are all environmental factors that can drastically change a person’s health. HealthThe metaparadigm health in my opinion is focusing on preventing and maintaining excellent health in the hospital and at home. I believe care focused on preventing disease rather than treating illnesses, by working, as a team and taking necessary measures to promote healthy behaviors, would result in patients having better health outcomes. In addition, early detection is a dynamic aspect of health promotion that is vital to preventing the chronic disease burden. In the first example above, the education given to a parent about the change in formula or even a change in the bottle’s nipple could have prevented this infant with the diagnoses of failure to thrive and the later complications that could be associated. In my opinion, nurses need to focus on educating patients and family members more than simply administering a medication or performing a procedure. In the second example, education about basic everyday lifestyles could change someone’s health and prevent them from being hospitalized in the future. Even providing education about health to family members could go be beneficial and passed on to several people in the community. ?Nursing actions are based on the interrelationships between these four concepts. A person can refer to more than just the patient but also the support system and healthcare team involved in one’s care. An individual’s health will be influenced by his or her environment and everyday lifestyles. Nurses should consider a person’s culture, spirituality, beliefs, and wishes, as well as their home environment and overall health and possible lifestyle changes when providing nursing care. It does not go without difficulty to define one metaparadigm without correlating with another. In my practice, I believe each of these metapardigms isessential in caring for patients.