Revisiting the Nursing Metaparadigm: Acknowledging Technology as Foundational to Progressing Nursing Knowledge

Technology has permeated every facet of both nursing knowledge and practice, from implantable patient devices such as pacemakers to the use of machine learning and artificial intelligence in our record systems and patient monitoring. Technology has become our “wise third eye,” overseeing critical components of patient care. Dualism of human and machine as a cyborg ontology was originally described by Haraway in the mid-1980s. Her work has been revisited by nursing theorists who acknowledge the radical and progressive path in nursing science whereby technology is part of humanness as evidenced by use of life-supporting machines that suspend human nature in favor of biotechnologically centered care (Teixeira de Almeida Vieira Montiero, 2015; Lapum et al., 2012). Both philosophically and in practice, technology, and human can no longer be separated. Using medical device spending as a marker, the United States spends upwards of 173 billion dollars per year on healthcare machines. This measure has noted an increase of 6% each year, further emphasizing that our reliance on machines and thus its presence in nursing practice is here to stay.

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and environment. Each of these constructs are used to support theory development by giving direction as to our focus as a scientific body. Nursing scientists have influenced informatics in the forms of biotechnological applications, mobile health, and more granularly with human-technology interface. Despite this advancement of informatics as a nursing science and obvious teathering of technology and humanness, technology has yet to appear within the nursing metaparadigm. Here we propose that to remain consistent with patient-centered care in the age where machine is enmeshed in daily human life, technology must be a component of the metaparadigm. This is both philosophically sound, logical, and necessary to continue advancing nursing science and knowledge. Through technology’s incorporation within the metapharadigm, we challenge nurses to consider approaches within their research and practice as to how technology will not only impact patient care but their personal development within the profession. Incorporation of technology within the metaparadigm signals to other bodies of science our willingness and ability to run at-pace with the novel, exciting new discoveries while adding the nursing perspective. Nurses become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation.

Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.