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First, we want to reassure you that being confused about nursing worldviews puts you in some good company. Many nurse practitioners find that the approach that place worldviews at the beginning of nursing inquiry may actually be hampering the development of nursing scholarship and keeping the profession from evolving as quickly and as efficiently as it should. In addition, the material can become very confusing because different authors use the words paradigm and worldview interchangeably, though they distinguish them from metaparadigms.
Broadly stated, an individual’s worldview consists of the beliefs and assumptions that the person uses to interpret and explain their experience. Worldview is often influenced by culture, but is not necessarily delineated by culture, which is why there are multiple worldviews that are used as the base for nursing practices. A person’s individual worldview plays a role in which of the nursing worldviews will likely apply to their practice. The importance of understanding a worldview is not because one worldview necessarily leads to better patient outcomes than other worldviews, but to give the nurse a better understanding of how they approach their profession. It can also help nurses understand employers, as they may have different worldviews that do not align with the nurse’s worldview.
The three worldviews generally discussed in nursing are the reciprocal worldview, the simultaneous worldview, and the reaction worldview. We will start with the reaction worldview, because it is the worldview that is most in-line with modern medical practices. It is a disease-focused view of nursing. The nurse’s role is to help the patient overcome disease by emphasizing better health, which leads to an improvement in quality of life. In the reciprocal worldview, the nurse wants to make sure and be inclusive about the patient’s culture and personal experiences, but does not go through those experiences with them. In the simultaneous worldview, the nurse seeks to share the experience with the patient and is almost as focused on thoughts and feelings as they are on the promotion of health.
If you understand the paradigms, then it may be helpful to view the worldviews in terms of the paradigms that they encompass. The reaction worldview can be described as a combination of the particulate deterministic and totality paradigms. The reciprocal worldview can be described as a combination of the totality, interactive integrative, and simultaneity paradigms. The simultaneous worldview can be described as a combination of the simultaneity and unitary transformative paradigms.
