Martha Rogers: Science of Unitary Human Beings

Rogers' core claim is one you act on every shift without naming it: you cannot separate a patient from their environment when you treat them. The two are a single field. Her Science of Unitary Human Beings built nursing into a scientific discipline around that idea, and it pushed nurses to see the whole person instead of the parts.

Biography of Martha E. Rogers

Martha Elizabeth Rogers (May 12, 1914 – March 13, 1994) was an American nurse, researcher, theorist, and author known for the Science of Unitary Human Beings and her landmark book An Introduction to the Theoretical Basis of Nursing.

Early Life

Rogers was born on May 12, 1914, sharing a birthday with Florence Nightingale, the eldest of four children of Bruce Taylor Rogers and Lucy Mulholland Keener Rogers. She was a relentless reader from the start. Her father brought her to the public library at age three for storytime, and she was a regular there before she was six, before she could even read; by fourth grade she had read every book in her school library, and she was soon reading eight books at a time. She knew the Greek alphabet by age 10, and by sixth grade had finished all 20 volumes of The Child's Book of Knowledge and moved on to the Encyclopedia Britannica. She read across anthropology, archaeology, cosmology, ethnography, astronomy, ethics, psychology, eastern philosophy, and aesthetics. By her senior year she had finished every high school math course and took a college-level algebra class as the only female in the room.

Education

Rogers wanted work that served social welfare, like law or medicine, but studied medicine only briefly since women in medicine were unwelcome at the time. She and a friend entered a local hospital with a school of nursing; her parents were no happier about that than about medicine. She transferred to Knoxville General Hospital's nursing program, one of 25 students in her class, and called the training miserable at times, "Army, pre-Nightingale." She nearly quit after a week home but stayed once she found she enjoyed working with patients.

She earned her nursing diploma from Knoxville General Hospital School of Nursing in 1936 and her Public Health Nursing degree from George Peabody College in Tennessee in 1937, selling her car to pay tuition for full-time graduate study. Her Master of Arts came from Teachers College, Columbia University in 1945, and her Doctorate in Nursing from Johns Hopkins University in Baltimore in 1954. Her dissertation was titled "The association of maternal and fetal factors with the development of behavior problems among elementary school children."

Career and Appointments

After George Peabody in 1937, Rogers worked two years as a public health nurse for the Children's Fund of Michigan. In 1940 she joined the Visiting Nurse Association in Hartford, Connecticut, staying five years as Assistant Supervisor, then Assistant Education Director, then acting Director of Education, finishing her Teachers College coursework and her MA in 1945. She then became Executive Director at the Visiting Nurse Service in Phoenix, Arizona, where she believed she may have been the first nurse in Arizona with a master's degree, building up the service from 1945 to 1951. As a doctoral student she spent a year as a visiting lecturer at a Catholic university in Washington, DC.

Right after Hopkins, Rogers was appointed Professor and Head of the Division of Nursing at New York University, encouraged into the role by Ruth Freeman. Vera Fry had been the previous Division Head, and Joan Hoexter noted that all the nursing faculty left except her. Rogers was a Fellow of the American Academy of Nursing. She retired as Professor and Head in 1975 after 21 years, then kept teaching at NYU, presenting at scientific conferences worldwide, and refining her conceptual system. In 1979 she became Professor Emerita and stayed active in the Science of Unitary Human Beings.

Works

Rogers wrote Educational Revolution in Nursing (1961) and Reveille in Nursing (1964). Around 1963 she edited the journal Nursing Science while forming the ideas for her third book, An Introduction to the Theoretical Basis of Nursing (1970), which introduced the four Rogerian Principles of Homeodynamics. Her publications include Theoretical Basis of Nursing (1970), Nursing Science and Art: A Prospective (1988), Nursing: Science of Unitary, Irreducible, Human Beings Update (1990), and Vision of Space-Based Nursing (1990).

Awards and Death

Rogers received many awards for her contributions to nursing and science. In 1996 she was posthumously inducted into the American Nurses Association's Hall of Fame. She died on March 13, 1994, and was buried in Knoxville, Tennessee, with a memorial set on the sidewalk near her childhood home there.

The Science of Unitary Human Beings

Rogers defined nursing as "an art and science that is humanistic and humanitarian. It is directed toward the unitary human and is concerned with the nature and direction of human development. The goal of nurses is to participate in the process of change." The theory treats the human being as integral with the universe: the unitary human and the environment are one, and nursing focuses on what emerges from the mutual human-environmental field process.

It carries two dimensions: the science of nursing, the field-specific knowledge that comes from scientific research, and the art of nursing, using that science creatively to better the patient's life. The model makes the environment an integral part of the patient and asks nurses to blend the science and art to support recovery and the best possible health.

There are eight concepts in the theory: energy field, openness, pattern, pan-dimensionality, homeodynamic principles, resonance, helicy, and integrality. When first introduced the framework was called profound and too ambitious; it is now seen as ahead of its time and an influential alternative to traditional nursing approaches.

Assumptions

Five of them: (1) Man is a unified whole with his own integrity, manifesting characteristics that are more than and different from the sum of his parts. (2) Man and the environment continuously exchange matter and energy. (3) The life process evolves irreversibly and unidirectionally along the space-time continuum. (4) Pattern and organization identify the man and reflect his innovative wholeness. (5) Man is characterized by the capacity for abstraction and imagery, language and thought, sensation, and emotion.

Major Concepts

Human / unitary human being. An indivisible, pan-dimensional energy field identified by pattern and manifesting whole-specific characteristics that cannot be predicted from knowledge of the parts.

Health. An expression of the life process, the characteristics and behavior emerging from the mutual, simultaneous interaction of human and environmental fields. Health and illness sit on the same continuum, with the life process showing how a person reaches their maximum health potential.

Nursing. The study of unitary, irreducible, indivisible human and environmental fields: people and their world. Nursing exists to serve people, and safe practice depends on the scientific nursing knowledge the nurse brings to it.

Scope of nursing. To help people achieve maximum health potential, covering maintenance and promotion of health, disease prevention, nursing diagnosis, intervention, and rehabilitation. It reaches all people, well and sick, young and old, everywhere there are people: home, school, work, play, hospital, nursing home, clinic, on this planet and now into outer space.

Environmental field. "An irreducible, indivisible, pan-dimensional energy field identified by pattern and integral with the human field."

Energy field. The fundamental unit of both the living and the non-living, a way to view people and environment as irreducible wholes; the fields vary continuously in intensity, density, and extent.

Subconcepts

Openness. No boundaries stop energy flow between the human and environmental fields. Human beings and their environment are open systems.

Pan-dimensional. A "non-linear domain without spatial or temporal attributes." Parameters for describing events are arbitrary, the present is relative, and there is no temporal ordering of lives. Synergy, the unique behavior of whole systems unpredicted by their separate component functions, is the model for human behavior, which is synergistic.

Pattern. The distinguishing characteristic of an energy field, seen as a single wave; an abstraction that gives the field its identity.

Principles of homeodynamics. Homeodynamics is a dynamic version of homeostasis (a relatively steady state of internal operation in a living system). The three principles of homeodynamics are resonance, helicy, and integrality.

• Reciprocity postulates the inseparability of man and environment and predicts that sequential changes in the life process are continuous, probabilistic revisions arising from their interaction.
• Synchrony predicts that change in human behavior is determined by the simultaneous interaction of the actual states of the human and environmental fields at any point in space-time.
• Integrality (synchrony + reciprocity): because human and environment are inseparable, sequential life-process changes are continuous revisions from their interaction, with constant mutual change and simultaneous molding.
• Resonancy speaks to the nature of the change between the fields: the life process is a symphony of rhythmical vibrations, identifying the fields by wave patterns moving from longer, lower-frequency waves to shorter, higher-frequency ones.
• Helicy. The human-environment field is a dynamic, open system in continuous, innovative change; because of constant interchange, an open system is never the same at any two moments.

Nursing Process

Rogers' nursing process has three steps: assessment, voluntary mutual patterning, and evaluation. Assessment covers the total pattern of events at a given point in space-time, the simultaneous states of patient and environment, the rhythms of the life process, supplementary data, categorical disease entities, subsystem pathology, and pattern appraisal, and it should be comprehensive across both fields.

Mutual patterning of the human and environmental fields includes sharing knowledge, offering choices, empowering the patient, fostering patterning, evaluation, repeat pattern appraisal (nutrition, work/leisure activities, wake/sleep cycles, relationships, pain, and fears/hopes), identifying dissonance and harmony, validating the appraisal with the patient, and patient self-reflection.

Strengths and Weaknesses

The concepts give nurses a worldview from which to derive theories, hypotheses, and situation-specific relationships. The theory is not directly testable for lack of concrete hypotheses, but it is testable in principle.

The weaknesses follow from the abstraction. The model defines no specific hypotheses or theories, the concepts are not directly measurable so their validity is hard to test, and the framework was called too ambitious because the concepts are extremely abstract. Rogers said nursing exists to serve people but did not clearly define the nurse's role, and though the purpose is to promote health and well-being everywhere, the model offers no concrete definition of a health state.

Bottom Line

The Science of Unitary Human Beings is highly generalizable because its concepts are not tied to one nursing approach. Rogers' weight falls on how a nurse should see the patient: as a whole, integral with their environment, never separable from it when addressing health and treatment. The framework reshaped nursing by offering an alternative to traditional approaches.