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Newman, M.A. (2008). Transforming Presence: The Difference that Nursing Makes.

Newman, M.A. (2008).Transforming Presence: The Difference that Nursing Makes. Philadelphia: F.A. Davis Company.

Transforming Presence: The Difference That Nursing Makes, written by Dr. Margaret Newman, is a transformative contribution to the body of knowledge that constitutes the discipline of nursing. The text will soon be a classic piece of literature that is essential reading for nurses in practice and those studying and contributing to the development of nursing knowledge. In eight chapters, Newman parsimoniously presents complex theoretical ideas extending what is already known in nursing science and revealing the often-veiled transformative beauty associated with nursing.

In chapters 1 & 2, Newman provides a brilliant historical account that relays personal, professional, and scientific events that informed, influenced and pushed the boundaries of nursing science. Newman emphasizes that unification of the epistemology (knowing) and ontology (being) for nursing will be accelerated when the fundamental nature of the unitary transformative paradigm (Newman, Sime, & Corcoran, 1991) is accepted and guides all nursing practice, education and research.

In chapter 3, Newman offers a clear extension of nursing praxis, a concept originally articulated in the theory of Health as Expanding Consciousness (HEC) (Newman, 1986; 1990; 1994a; 1994b; 1997), as an appropriate method for revolutionizing the advancement of knowledge and practice development in nursing. Clear examples of nursing praxis are provided. These examples allow the reader to glimpse how a nurse embracing HEC approaches practice, research and theory development as a unity. HEC praxis fosters insight into patterning toward transformation. Three distinct phases for nursing praxis as process are identified related to individual and community practice; but, the phases are open and evolving continuously in accordance with the nurse, the person-environment interaction and their recognition of the whole.

The concepts of resonating with the whole and being fully present are each articulated by Newman who dedicates chapters 4 & 5 to these ideas. These two theoretical concepts may appear to be highly abstract in nature, but Newman is able to clearly describe and provide illuminating examples of each as she expands upon what is already known. The clarity given to each concept enables one to grasp the depth and breadth of knowing and practicing HEC.

Resonating with the whole "begins with whatever level presents itself"(p.38) and it is not focused on words or dissection of the whole into pieces; rather, it is a holistic appreciation of "all" that includes meaning, intuition, and relationships. Newman acknowledges that an analytical mind is challenged to grasp the concept of resonancy because words may not adequately communicate knowing the perception of the whole.

Being fully present mandates relationship with other. Newman directly highlights that contextual knowing and connecting fully to the whole of a nurse and person-environment interaction contributes to the expanding consciousness for all involved; it is within these processes that transforming presence occurs. Transforming presence, "becoming one with the client" (Newman, 2008, p.56), allows for the embodiment of the theoretical underpinnings described by Newman which are thought to enhance the interpenetration of those involved in the nursing and permit unique pattern identification, mutual transcendence and transformation.

Chapter 6 challenges the nurse practicing from HEC to fully explore understanding and focusing on the whole person to reveal patterning. This focus may separate the nurse from traditional empirical health options and research; but the focus will allow for co- participating in the health and consciousness that is evolving and being experienced simultaneously. Newman carefully portrays research within HEC to be relation-oriented, not result-oriented.

Educating our current and future nurses is the theme for chapter 7. Newman charges nurse educators to be vigilant in communicating the perspective of the discipline. Teaching HEC, like HEC nursing, requires a dedication and authentic intention to actualize the principles that support the theoretical framework. Examples of educators in action and guides for dialogue are offered. Many nurses, who have been students of HEC, report to Newman a sense of renewal in nursing as they become familiar with and begin to practice nursing through this lens. Our future nurses deserve this type of inspirational commitment to education and nursing. Our patients deserve this attention to relationship and health that can transform their lives.

The concluding thoughts in chapter 8 underscore the powerful role nurses share in determining the future of nursing and caring in health. A questions and answer section and appendices are included in the text and offer further clarification of HEC and guidance for application in practice. Newman inspires each one of us to contribute our part to the expanding consciousness of health and healing in the global environment. She also invites current and upcoming members of the nursing profession to courageously advance theoretical discourse and praxis into the 21st century.


Newman, M.A. (1986). Health as expanding consciousness. St. Louis, MO.: Mosby.

Newman, M. A. (1990). Newman's theory of health as praxis. Nursing Science Quarterly, 3, 37-41.

Newman, M.A. (1994a). Health as expanding consciousness (2nd Ed.). Boston: Jones and Bartlett.

Newman, M. A. (1994b). Theory for nursing practice. Nursing Science Quarterly, 7(4), 153-157.

Newman, M. A. (1997). Evolution of the theory of health as expanding consciousness. Nursing Science Quarterly, 10(1), 22-25.

Newman, M.A. (2008).Transforming Presence: The Difference that Nursing Makes. Philadelphia: F.A. Davis Company.

Newman, M. A., Sime, A. M., & Corcoran, S.A.(1991).The focus of the discipline of nursing. Advances in Nursing Science. 14(1), 1-6.

Susan Dyess RN, MS, PhD (c)

Teaching & Research Associate

Project Director, Novice Nurse Leadership Institute

Christine E. Lynn College of Nursing

Florida Atlantic University

Boca Raton, FL, 33431
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Title Annotation:Transforming Presence: The Difference That Nursing Makes
Author:Dyess, Susan
Publication:Visions: The Journal of Rogerian Nursing Science
Article Type:Book review
Geographic Code:1U5FL
Date:Jan 1, 2008
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