Martha Rogers

Martha Roger's:

A Brief Introduction to Science of Unitary Human Beings

The concept of Unitary Health Care emerged from the revolutionary work of the nursing academic Professor Martha E. Rogers during the 1950s in New York. She created the conceptual health care system that became known throughout the world as the Science of Unitary Human Beings, drawing knowledge from a variety of disciplines in the sciences, arts and humanities. This holistic view focused on treating the whole patient, and not just the illness. The Science of Unitary Human Beings provides an alternate approach to evaluating patients beyond the traditional scope of nursing care. It provides a framework for nursing practice, education and research. The basis for the concept of Unitary Health Care rests in the four postulates consisting of energy fields, open systems, pattern, and pandimensionality. From these postulates, Dr. Martha Roger's as well derived three hemodynamic principles those being resonancy, helicy, and integrality as a basis for structure of her theory. In the following script, I will focus on the postulate of Energy Fields, which describes human and environmental fields as one entity in constant interaction not as two separate wholes (Thomas, 2000).

A Brief History on M. D.

M. D. is a 93 year-old female admitted to Lawrence General on 3/14/2006 with chief complaint of chest pain/ CHF. The patient has a history of cardiovascular disease with risk factors significant for hypertension, family history of CAD, AF, recurrent pneumonia, and COPD. Patient had a permanent pacemaker inserted on 3/01/2004 for sick sinus syndrome with a cardiac echo revealing LVEF of 55% with aortic sclerosis. The patient has undergone numerous procedures including a cholecystectomy, umbilical hernia repair, exploratory laparotomy, and appendectomy. At 0600 3/28/2006, the patient coded and was placed on a ventilator but has since been unresponsive. Labs at 0800 revealed a Troponin I level of 0.49, a marked confirmation of unstable angina. The patient's condition continued to deteriorate with labs at 1608 revealing an elevation in the Troponin I level of 0.74. Throughout my care, M. D. remained in a semi-comatose state without use of any medical sedation, pupils were sluggish, and extremities remained flaccid with periods of rigidity. M. D.'s labs revealed an improvement in ABG values so weaning from CMV to CPAP was initiated and being adequately tolerated. Unexpectedly, the patient became a full DNR/DNI per family wishes post consult with the physician. In view of that, I found that the patient in all probability would not survive being extubated from the ventilator.

The Energy Fields

Energy is irreducible, indivisible and has a recognizable pattern. It's a continouse fusion between a person and the environment. Each individual has their own level of uniqueness and intensity of interaction with the environment. The main focus rests in the theory that combined energy between individual and environment is inseparable and integrated completely (Thomas, 2000). In the case of M.D. despite the fact of being in a semi-comatose state, energy was undoubtedly being disrupted and bound into many factors including but not limited to the crisis of the situation, anxiety (of patient, family, and staff), and the environmental stressors and condition. The family was noticeably present, extremely anxious and overly vigilant with the care family member had been receiving. Many issues arose given all the dominant personalities within the family attempting to take control of the situation. There was questionable action as to whether the patient was physically harmed by a family member during a visit and questioning as to why the family became increasingly unhappy with the physicians care and consequently wanting to file a formal complaint. Tensions between family members and staff were at an incredible high all throughout the patient's stay. Family was present from morning to night questioning and prodding all staff that came into contact with the patient. Of course, it is only normal to show concern for a family member but the continuous and repetitive barrage of questions made properly caring for the patient difficult so for that reason care had to be established around family visits and it became unfeasible to establish a nurse to patient relationship in such a stressful situation. Considering energy as a continuous and integrated dynamic, fields were continuously and considerably disrupted daily. The patient's field was being inundated not only by the daily on-going and restless environment of a CCU setting but by chaos and struggle between family and staff. A tense and volatile air lingered in the patient's room until her passing only to be replaced and consumed with grief.

Restructuring Energy Fields

With the belief of the interconnectedness of everything, the nurse should think of herself as part of the patient's environment. By doing so, the nurse can focus her role as a nurse to be a bright, energized field, connected with the patient's environment. In understanding this theory, the nurse can then aid in the restructuring of the human energy field. An initial approach would be in assuming a non-judgmental mind-set towards the patient and the family, especially if thoughts of a negative attitude toward the family members and patient as nuisances have developed into a state of consensus amongst the staff, as with M.D. Going into a situation with a clear mind, setting aside earlier experiences and expecting the best soothes not only the