Re-conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice.

Jacqueline Fawcett's nursing metaparadigm-the domains of person, health, environment, and nursing-remains popular in nursing curricula, despite having been repeatedly challenged as a logical philosophy of nursing. Fawcett appropriated the word "metaparadigm" (indirectly) from Margaret Masterman and Thomas Kuhn as a devise that allowed her to organize then-current areas of nursing interest into a philosophical "hierarchy of knowledge," and thereby claim nursing inquiry and practice as rigorously "scientific." Scholars have consistently rejected the logic of Fawcett's metaparadigm, but have not yet proposed a substantially agreed-upon alternative. Through an analysis of articles introducing and critiquing Fawcett's metaparadigm, I argue for a re-conceptualized metaparadigm that articulates nursing's ontology. What exists for the nursing discipline are not already-demarcated metaparadigm domains, but rather interdependent, dynamic relations that constitute people, including nurses, in their health/environment circumstance. The nursing discipline aims to skillfully access this dynamic relationality as the basis for action and reflection to produce both positive health trajectories and knowledge that facilitates future action and reflection. Further inquiry into the onto-epistemology of nursing will produce a more robust understanding of nursing practice, science, and philosophy, and clarify its unique contribution to health and healthcare.