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Van Sell (2002) the author of Nursing: Receding and evolving paradigms describes the worldview of nursing. This worldview is one of the profession, not individual nurses; it is evolving as technology evolves, it changes as society changes. The nursing profession is described by Van Sell to involve "receding, shifting and evolving paradigms" (74). He describes the profession as undergoing "revolutionary change" which in nursing is "real, accelerating, driven by rapid technological innovation, the globilization of the health care industry" (74).
The way in which nursing questions practice through inquiry and searches for answers through research and theory is also the way this profession seeks knowledge, expertice, and credit for the care nursing provides for clients. The paradigms of nursing are to authenticate nursing as a profession through changing worldviews; as the world around this profession changes, the nursing paradigm also evolves.
Two paradigms present in health care right now include the scientific paradigm and the social paradigm (Van Sell, 2002). The scientific paradigm is described by Van Sell as "a constellation of achievements - concepts, values, techniques, etc. - shared by a scientific community and used by that community to define legitimate problems and solutions" (75). In other words the medical science side of health care. The social paradigm Van Sell describes as "a constellation of concepts, values, perceptions, and practices shared by a community, which forms a particular vision of reality that is the basis of the way the community organizes itself" (75). In other words the social aspects of health care, social workers for example. As nursing as a profession has evolved, nursing has tried to incorporate both scientific and social world views into nursing practice.
Paradigms in nursing as described by Van Sell (2002) have shifted from the mechanistic worldview to a holistic worldview and is now again evolving to an ecological worldview. The mechanistic worldview is based on a "reductionism" concept; this means that illness, all aspects of illness (social, physical, cultural, spiritual) can be explained by a biological problem (Van Sell).
The mechanistic paradigm in nursing is a view of the universe as a mechanical system composed of elementary building blocks (Van Sell). In this worldview the human body is a machine in a stuggle to exist in society; as well that one follows the "basic laws of nature" in such women are subservient to men (Van Sell). In the mechanistic worldviews "the body and the state of the body in the focus for medical treatments and cure, from the outside in, while nursing focused on functional tasks, skills and 'doing' the role of nursing (Van Sell, 76).
The holistic paradigm in nursing as Van Sell (2002) states is the view that "the world is an integrated whole rather than a dissociated collection of parts" (76). Health refers to the "unity and harmony within the mind, body and soul" and the "entire nature of the individual in his/her physical, social, aesthetic and moral realms" of self (Van Sell, 76). Nursing in holistic paridigms provide client centered care, and empower clients to reach harmony within thier realms of self as described above (Van Sell).
In the ecological worldview which is where nursing is slowly heading towards, nurses are beginning to inquire more deeply and question thier practice more acutely. This paradigm as described by Van Sell (2002) "recognize[s] the fundamental interdependence of all phenomena and the fact that as indviduals and societies everyone is embedded in the cyclical process of nature" (77). In this sense one action of an individual in society may impact another. Nurses in this paradigm integrate concepts of intuition, synthesis of information, holistic care, and nonlinear processes as the basis of practice (Van Sell). Collaborative care process with organizations, individuals and communities is also a basis of care in this worldview, this incorporates concepts of empowerment and phenomenology into care. Research in this paradigm is evolved into "scientists being responsible for thier research not only intellectually but also morally" (Van Sell, 77).
Van Sell, S. L. (2002). Nursing: Receding and evolving paradigms (editorial). ICUs and Nursing Web Journal (10), 73-79. Received from http:///www.nursing.gr/selleditorial.pdf