Caring

Definition

• Central to all helping professions, and enables persons to create meaning in their lives.
• Means that people, relationships, and things matter

Nursing Theories of Caring

Culture Care Diversity and Universality Theory (Leininger)

• Based on transcultural nursing model
• Transcultural nursing: a learned branch of nursing that focuses on the comparative study & analysis of cultures as they apply to nursing and health-illness practices, beliefs, and values
• Goal of Transcultural Nursing: to provide care that is congruent with cultural values, beliefs, and practices
• Cultures exhibit both diversity and universality
• Diversity – perceiving, knowing, and practicing care in different ways
• Universality – commonalities of care
• Fundamental Theory Aspects – culture, care, cultural care, world view, folk health or well-being systems

Theory of Bureaucratic Caring (Ray)

• Ray’s theory focuses on caring in organizations (e.g. hospital) as cultures. The theory suggests that caring in nursing is contextual and is influenced by the organizational structure.
• Example: ICU had a dominant value of technological caring (i.e., monitors, ventilators, treatments), Oncology unit had a value of a more intimate, spiritual caring (i.e., family focused, comforting, compassionate). Furthermore, the meaning of caring was further influenced by the role and position a person held. Staff nurses valued caring in terms of its relatedness to client, while administrator valued caring as system related.
• Spiritual –ethical caring influences each of the aspects of the bureaucratic system (political, legal, economic,, educational, physiologic, social-cultural, and technological)

Caring, the Human Mode of Being (Roach)

• Caring is the human mode of being, proposes that all persons are caring, and develop their caring abilities by being true to self.
• Develop the Six C’s of Caring in Nursing:

Six C’s of Caring in Nursing
Compassion

• Awareness of one’s relationship to others, sharing their joys, sorrows, pain, and accomplishments. Participation in the experience of another

Competence

• Having the knowledge, judgment, skills, energy, experience, and motivation to respond adequately to others within the demands of professional responsibilities.

Confidence

• The quality that fosters trusting relationships. Comfort with self, client, and family.

Conscience

• Morals, ethics, and an informed sense of right and wrong. Awareness of personal responsibility.

Commitment

• Convergence between one’s desires and obligations and the deliberate choice to act in accordance with them.

Comportment

• Appropriate bearing, demeanor, dress, and language, that is in harmony with a caring presence. Presenting oneself as someone who respects others and demands respect.

Nursing as Caring (Boykin and Schoenhofer)

• Suggests that the purpose of the discipline and profession of nursing is to know persons and nurture them as persons living in caring and growing in caring.
• Similar to Roach idea that all persons are caring.
• Caring in nursing is “an altruistic, active expression of love, and is the intentional and embodied recognition of value and connectedness”.

Theory of Human Care (Watson)

• Human caring in nursing is not just an emotion, concern, attitude, or benevolent desire. Caring is a moral ideal of nursing whereby the end is protection, enhancement, and preservation of human dignity.

Theory of Caring (Swanson)

• Caring involves 5 processes:

Process	Definition	Sub dimensions
Knowing	Striving to understand an event as it has meaning in life of the other	Avoiding assumptions Centering on the one cared Assessing thoroughly Seeing cues Engaging the self of both
Being With	Being emotionally present to other	Being there Conveying ability Sharing feelings Not burdening
Doing For	Doing for the other as he/she would do for the self if it were at all possible	Comforting Anticipating Performing Competently/skillful Protecting Preserving dignity
Enabling	Facilitating the other’s passage through life transitions and unfamiliar events	Informing/explaining Supporting/allowing Focusing Generating Alternative/thinking it through Validating/giving feedback
Maintaining belief	Sustaining faith in the other’s capacity to get through an event or transition and face a future meaning	Believing in/ holding in esteem Maintaining a hope-filled attitude Offering realistic optimism “Going the distance”

The Primacy of Caring (Benner and Wrubel)

• Caring is central to the essence of nursing. Caring creates the possibilities for coping and creates possibilities for connecting with and concern for others.

Caring for Self

Caring for self means taking the time to nurture oneself. This involves initiating and maintaining behaviors that promote healthy living and well-being.

• A balanced diet
• Regular exercise
• Adequate rest and sleep
• Recreational Activities
• Meditation and prayer

Posted in: Fundamental of Nursing