In the Totality Paradigm, the person, who is a combination of biological, psychological, social, and spiritual features, is in constant interaction

with the environment to accomplish goals and maintain balance. The goals of nursing in the totality paradigm focus on health promotion, care and cure of the sick, and prevention of illness. Those receiving nursing care are persons designated as ill by societal norms. Identification with the Totality Paradigm is understandable because it has been and is the prevailing paradigm in nursing. Many of the nursing theories developed to date have a view of the discipline of nursing that fits the Totality Paradigm. In the competing paradigm, the Simultaneity Paradigm, the personenvironment interaction is viewed very differently. In the Simultaneity Paradigm, the person is seen as more than and different from the sum of the parts, changing mutually and simultaneously with the environment . . . as a freely choosing being cocreating health through mutual interchange with the environment. The goals of nursing in the simultaneity paradigm focus on the quality of life from the persons perspective. Designation of illness by societal norms is not a significant factor. The authority and prime decision maker in regard to nursing is the person not the nurse (Parse, 1987). Clearly, these two paradigms represent very different

Nursing Paradigm Human beings are defined as individuals who are capable of conscious and organized thought who have inherent physiological and psychosocial needs. These individuals are not predefined but get defined in the course of living a life, where the mind, body, and spirit are integrated as one. Environment is believed to be the context in which human relationships occur. Environment is viewed throughout the curriculum to include personal, social, national, and global dimensions, physical, psychosocial, cultural diversity, historical development, economic and political aspects are considered in each dimension. The concept of holism and human development are integrated across the curriculum. Holism includes the biological, psychosocial, social, cultural, spiritual, and intellectual aspects of human beings. Health, a dynamic process, is the synthesis of wellness and illness and is defined by the perception of the client. It is defined as the experience of wellness and the experience of illness or loss/dysfunction that can be mediated by caring relationships. Stress can create a disruption in wellness and coping can restore the balance based on the individual experiences. Nursing practice is the development and progression of the student nurse through study and clinical practice. The learner role include student, scholar (expert learner), and beginning researcher. The clinical role of caregiver includes critical thinker, teacher, collaborator, and patient advocate which allows the student nurse to progress from

novice to expert clinician. The nursing role also involves moral/ethical and professional dimensions.