Elsevier

Nursing Outlook

Volume 51, Issue 3, May–June 2003, Pages 130-137
Nursing Outlook

Integral nursing: an emerging framework for engaging the evolution of the profession

https://doi.org/10.1016/S0029-6554(03)00080-0Get rights and content

Abstract

These are turbulent times for health care as well as nursing. Nursing needs to consciously evolve to survive and thrive in the 21st century. The authors suggest that nursing has many of the theoretical and conceptual models needed to facilitate this evolution. However, the profession would benefit from the addition of a comprehensive framework that can integrate various aspects of nursing and serve as a device to effectively interface nursing with the rest of the health care system. We believe that the Integral Nursing approach described here is such a framework. In this article, we describe the model and explore benefits of its application for nursing within health care.

Section snippets

Wilber’s All-Quadrant/All-Level model

The All-Quadrant/All-Level model, proposed by Wilber,4, 7 is a complex framework that functions exceptionally well as a heuristic device from which to organize all dimensions of human experience. The framework is derived from Wilber’s extensive efforts to synthesize and integrate knowledge and research from philosophy, psychology, sociology, anthropology, spirituality from the East and West, and ancient and modern points of view.4, 7, 9, 10 Wilber’s perspective is now being explored, developed,

Spiral dynamics

Spiral Dynamics is an emergent, systemic, biopsychosocial model of human development that is described by Beck and Cowan.8 The model is based on original work of the late Clare Graves, with whom Beck and Cowan studied. Gravesian theory,15, 16 derived from years of research, indicates that development progresses as newer, more complex biopsychosocial systems subordinate older, less complex systems when the conditions of existence change.

Beck and Cowan8 expanded the Spiral Dynamics model by

Integral nursing: tier two thinking

An Integral Nursing approach facilitates acknowledgment of the contributions of purple, red, blue, orange, and green perspectives in nursing and opens the profession to a leadership role in the evolution to yellow within the health care system. Wilber4 and Beck (personal communication, 2001), both suggest using the Integral model to facilitate movement upward. Wilber suggests that most adults in the developed world have the ability to understand this model, at least intellectually (personal

Conclusion

Health care today is dominated by the medical model, which is based in an orange worldview, is overly focused on Wilber’s Upper Right Quadrant, and uses Lower Right systems. The medical model has brought us great advances in medical science, from sulfa drugs to transplantation. The orange perspective has a great deal more to offer health care but is not sufficient to comprehensively explain and explore circumstances that affect health care practitioners, institutions, or the people they serve.

Acknowledgements

The authors hereby thank Dr Don Beck and Ken Wilbur for their review and approval of the manuscript.

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