Health as Expanded Consciousness


Some stakeholders in nursing think of the discipline as particularistic and structured; however, Newman believed that the holistic approach would be more transformative. In order to understand this assertion, it is necessary to dissect her values and principles.

Short history of Margaret Newman’s life

Margaret Newman was a primary caregiver to her ailing mother who suffered from amyotrophic lateral sclerosis. It was this experience that catapulted her into the nursing profession (Newman, 2008). She appreciated and thrived in the challenging environment. Margaret did her baccalaureate degree in the University of Tennessee. She later joined the University of California where she completed her master’s degree. Margaret served as a nursing director and a junior professor in her first University. She later joined New York University for her doctoral studies and later became a professor in Pennsylvania State where she was in charge of nursing graduate studies. She also went to the University of Minnesota to work as a nurse theorist. Dr. Newman became an American Academy of Nursing fellow and later received several awards from outside and inside the medical fraternity.

Background to the theory in nursing

Newman (1997) explains that her theory was derived from a new paradigm in the field of nursing known as the Rogerian paradigm. Margaret believed that Roger’s thinking was not an amalgamation of previous theories, but was a reflection of a truly original school of thought. Roger held that human beings were holistic elements of their environment. Furthermore, the theorist believed that patterning could be a useful way of learning about life and illness. Newman felt that these teachings were in tandem with her own perspectives on health and well being.

Having experienced first hand what it meant to have time and space restrictions when taking care of her mother, Newman realized that consciousness could enter into nursing practice. She explains that Itzhak Bentov originally gave her these ideas; he looked at life as an expansion of consciousness. Bentov explained that one can never really master a situation without establishing a pattern. Even if one has infinite knowledge about the matter, one can do nothing with the information if it is all cluttered. Newman felt that Bentov’s expansion of consciousness and Roger’s theory would be the perfect fit for her own nursing practice.

The theory

In her theory, Newman assumes that diseases are part of one’s health, they are a manifestation of a patient’s pattern, and they come before the manifestation of functional or physical changes. She also assumes that “health is the expansion of consciousness” (Newman, 1997). In this theory, Newman argues that time, consciousness and movement were vital elements in the expansion of consciousness. However, these elements should be considered holistically; not in isolation. Newman (2008) recalls a moment in time when she first recognized the importance of expanded consciousness. She had plenty of information about a patient’s condition, but could not determine what to do with it. As such, she could not assist the patient. Her instructor immediately intervened and in a short amount of time was able to connect to the patient in a profound way. By using this example, Dr. Newman wanted to show that it was possible to have a lot of information about a patient, but have no way of applying it. This was because, as an undergraduate, she did not think holistically about the patient. Newman then understood that one must not rely solely on isolated pieces of information. Instead, one must strive to alter one’s state of consciousness by making a deep connection with the patient. Time and movement are vital parts of the theory because every single individual has their own perception of time. She gives the example of patients with spinal cord injuries, who have movement restrictions. A number of them feel like they have too much time on their hands. Conversely, a nurse who only has a few minutes to see a patient may have a totally different understanding of time. As caregivers, nurses need to synchronize their consciousness of time and space with that of their patients in order to create a feeling of oneness. The caregiver ought to adopt a rhythmic rather than a linear perception of health.

Margaret Newman also believes that pattern recognition is paramount to application of the theory in practice. In the argument, she claims that a nurse must look for meanings in the patient’s case. One’s ability to recognize patterns is influenced by the relationship that one has with one’s client. It is also affected by the nature of interactions that the person has with his environment (Newman, 1997). For instance, a patient with a heart attack may possess the following pattern: he experienced a life of alienation in his upbringing. Later on, the person tries to look for recognition through achievement and work. Eventually, the person is interrupted by a heart attack and must then look for meaning again. A person who is applying health-as-expanded-consciousness (HEC) needs to see how these experiences evolved into a disease, thus find meaning in them. Nurses ought to relate the stories that took place in patients’ lives with their relationship patterns and then mirror these patterns back to the client.

Newman also explains that her work involves being fully present when interacting with patients. The caregiver plays a crucial role in the clients’ understanding of his state of health as well as the actions that he or she should take in order to restore it. This is the reason why Newman felt that nursing shifts were counterproductive. By rotating staff on the basis of shifts, the hospital was assuming that nurses were interchangeable, yet each nurse had a unique relationship with each client.

Example in scholarly work

Jones (2006) explains that health as expanding consciousness has played a large part in knowledge development. These changes have occurred in clinical practice as well as in educational research. In clinical practice, nurses have been able to acquire crucial information about caring for a terminally ill patient. Alternatively, other nurses have provided great support to patients at the end of their illnesses. It has also facilitated understandings about lifestyle changes that formerly obese women can take after loosing weight.

HEC has also transformed a series of clinical areas of practice outside the clinical setting. For instance, this theory has guided practice for nurses working in patients’ homes. This has worked by enhancing patient comfort and enriching their immediate care needs. It has also altered the ability of nurses to deal with clinical patients. Plenty of insights have also been gained when dealing with preadmission testing as this is the area when nurses can perform patter appraisals and hence determine the course of the care process. HEC has also transformed research in nursing because now researchers can engage in meaningful dialogues about the challenges and the issues that the patient experienced.


Newman has played a vital role in nursing owing to her insights about the relationship between the nurse and patient. Her theory has also altered the manner n which nursing research and practice occurs because of the great state of awareness that the patient and nurse experience.


Jones, D. (2006). Newman’s Health as expanding consciousness. Nursing Quarterly, 19(4), 330-332

Newman, M. (1997). Evolution of the theory of health as expanding consciousness. Nursing Science Quarterly, 10(1), 22-26

Newman, M. (2008). It’s about time. Nursing Science Quarterly, 21(3). 225-227.

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