Nursing Metaparadigm Through the Lens of the Film Wit
This paper examines the nursing metaparadigm—encompassing patient, environment, health, and nursing—as demonstrated by the character of Susie Monahan in the 2001 film Wit. Through close analysis of Susie's interactions with the terminally ill protagonist Vivian Bearing, the paper argues that Susie consistently prioritizes patient-centered care over institutional research interests, fosters patient autonomy through the DNR discussion, and embodies a holistic definition of health that goes beyond the absence of illness. Drawing on nursing theory, including Jean Watson's concept of the spiritual dimension of care, the paper presents Susie as a model of empathetic, technically skilled nursing practice.
- Introduction: Susie Monahan and the Nursing Metaparadigm: Introducing Susie and the four-part metaparadigm framework
- The Patient as the Center of Ethical Care: Susie prioritizes patient over research interests
- Environment and the Tension Between Research and Patient Advocacy: Hospital research culture versus individual patient advocacy
- Health, Wellness, and Patient Empowerment: Redefining health through autonomy and lived experience
- Nursing as Technical Knowledge and Human Concern: Nursing integrates technical skill with empathetic, spiritual care
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What makes this paper effective
- The paper systematically applies each element of the nursing metaparadigm (patient, environment, health, and nursing) to concrete scenes and character behaviors from the film, grounding abstract theory in specific narrative evidence.
- It integrates scholarly nursing literature alongside the film analysis, lending academic credibility to what could otherwise remain a purely descriptive reading.
- The reflective closing connects the analysis to the student's own professional aspirations, demonstrating personal engagement with the material and its practical implications.
Key academic technique demonstrated
The paper uses a theoretical framework (the nursing metaparadigm) as an organizational lens, evaluating a cultural text against each of its four components in sequence. This structure allows the writer to move from the specific to the general and back, showing how theory manifests in observable behavior—an approach transferable to clinical case analyses and other nursing reflection assignments.
Structure breakdown
The paper opens by introducing Susie Monahan and framing her role within the metaparadigm. It then addresses each metaparadigm concept in turn—patient centrality, environmental pressures, the definition of health, and the meaning of nursing—before closing with a brief personal reflection. Each body paragraph builds on the last, culminating in the argument that Susie represents an ideal of empathetic, patient-empowering nursing care.
Introduction: Susie Monahan and the Nursing Metaparadigm
One of the pivotal characters in the film Wit (2001) is Susie Monahan. Susie is a nurse who has little knowledge of the poetry of John Donne—so dear to the protagonist Vivian Bearing—yet she demonstrates expert mastery of the role of a healthcare provider in relation to her patients. Regarding the nursing metaparadigm of patient, environment, health, and nursing, Susie again and again demonstrates that she regards the patient as central to the ethical responsibilities of the nurse (Nikfarid et al., 2018). Other characters, particularly the physicians and researchers handling Vivian's case, place their own research needs above the needs of the patient. Vivian, although highly educated, admits she knows little of cancer research and does not fully understand that she is being used as a test subject for research from which she is unlikely to benefit. For Susie, the patient is always first and foremost the focus of nursing care. Because Vivian is critically ill and has no family members to act as her advocate, Susie takes on that role.
The Patient as the Center of Ethical Care
At the beginning of the story, Vivian is encouraged to take part in a grueling chemotherapy regimen that—as the audience comes to realize before Vivian herself does—is unlikely to help her but may be beneficial to science and to the reputations of those handling her case. Susie alone strives to act as an advocate for the patient rather than for the research interests of the study. She treats the individual patient's wellbeing as the primary concern, even within an institutional setting that consistently subordinates personal interests to scientific progress.
Environment and the Tension Between Research and Patient Advocacy
Susie also takes into careful consideration the patient's environment—a hospital extremely focused on advancing research—in which the individual patient's own interests may easily be forgotten. With this awareness, and using the resources of medical ethics and the legal system, Susie discusses the possibility of a do-not-resuscitate (DNR) order with Vivian. Susie empowers her patient with knowledge that Vivian can understand, despite Vivian's weakened state, and allows Vivian to recognize that even amid the external pressures of her environment, she still retains autonomy over her own care.
References
McCance, T. V., McKenna, H. P., & Boore, J. R. (1999). Caring: Theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30(6), 1388–1395.
Metaparadigm concepts. (2018). [University]. Retrieved from https://nursing.tcnj.edu/about/mission-and-philosophy__trashed/meta-concepts/
Nichols, M. (Director). (2001). Wit [Film]. Avenue Pictures.
Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: A comparative study. Journal of Medical Ethics and History of Medicine, 11(6). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150916/
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