CARING IN

NURSING

What is Caring?
Central focus of nursing
More difficult in todays fast pace health
care
Legalities of any aspect of health care has
made the aspect of caring appear missing
to the client
Technology have made some things easier
but has increased time spent away from
the client
We see many clients who remember the
way it was 25-30 years ago
With these changes we must make sure
that we hold the caring and compassion
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along side the knowledge

Caring is Universal
Influences the way people think, feel
and act
Many nursing theorists have tired to
define caring Nightingale was
first
Caring is the heart of nursing

Caring is Relational
Patients value nurse Effectiveness
Ability to perform tasks

Also value nurse Affect

Attitude or demeanor while performing
the tasks

Patients are more willing to

participate if they sense that they
are cared about

Theoretical Views on Caring

A universal phenomenon that
influences the way we think, feel,
and behave
Studied from a variety of
philosophical and ethical
perspectives since the time of
Florence Nightingale
Patricia Benner
Benner and Wrubel

The Essence of
Nursing and Health
Madeleine Leininger (1978)
Caring is:
Essential for well-being, health, growth,
survival, and facing handicap or death
Trans cultural perspective
Caring is essential for health and survival
Caring is expressed in different ways in many
cultures

Transpersonal Caring
Jean Watsons theory of caring (1979,
1988a, 1988b, 1995, 1999, 2003)

Focuses on individuals and meaning for their

quality of life
Caring involves sensitivity, respect, and high
moral and ethical commitment
Places care before cure
Caring becomes the ethical standard by
which we measure nursing
Caring preserves human dignity
Caring is a choice
Emphasis on nurse-patient relationship
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Jean Watson
Watson defined nursing as a human
science of persons and human health
illness experiences that are
mediated by professional, personal,
scientific, esthetic, and ethical
human care transactions (Watson,
1988, p. 54)

Major Elements of the

Caring Theory
Carative factors, evolving into Caritas
factors
Transpersonal Caring Relationships
Caring occasion/Caring moment

Carative Factors
Guides the core of nursing
Carative factors attempt to honor
the human dimensions of nursings
work and the inner life world and
subjective experiences of the people
we serve (Watson, 1997, p. 50).
Contrasts the curative factors of
medicine (curative means to cure a
disease)
Carative factors evolve into Caritas

Caritas
Caritas has a greater spiritual
dimension
In Greek, caritas means to cherish
and to give special loving attention

The Carative Factors

Evolve into Caritas Factors
Carative
Faith and hope

Helping-trusting,
human care
relationship

Caritas
Being authentically
present and
enabling the beliefs
of the one being
cared for and the
one giving care
Developing and
maintaining a
trusting, authentic,
caring relationship
(Watson, 1999, p.62)

The Carative Factors Evolve

into Caritas Factors, cont.
Carative
Creative problem
solving caring process
Expressing positive
and negative feelings
Transpersonal
teaching- learning

Caritas
Creative use of self
Being present to and
supporting the
positive and negative
feelings with a
connection of a
deeper spirit
Engaging in genuine
teaching-learning
experience
(Watson, 1999, p.62)

Transpersonal Caring
Relationship
Transpersonal means to go beyond ones own
ego and reach a deeper spiritual connection
while comforting a patient.
The transpersonal relationship depends on:
A commitment from the nurse to enhance
and protect human dignity
An awareness from the nurse that they have
the ability to heal
The nurse must go beyond the objective role

The Goal of Transpersonal

Relationships
To preserve and protect a persons
humanity, and dignity
Preserve a patients spirit to ensure
the patient does not become an
object
This relationship allows the nurse
and the patient to to mutually seek
out meaning and in turn lead to a
transcendence of suffering (Watson,
2001).

Caring Occasion/Caring
Moment
Watson (1998, 1999) stated that when human
caring is created the nurse and patient come
together to create a moment, this is known as
the caring occasion/caring moment
Watson (1999) feels as though the nurse and
the patient must be aware of the caring
moment so as to make appropriate choices
and actions, thereby the nurse without
knowing becomes a part of the patients life
history

Swansons Theory of Caring

A composite of three studies
Defines caring as
A nurturing way of relating to a valued
other toward whom one feels a personal
sense of commitment and responsibility

A central nursing phenomenon

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Swansons Theory of
Caringcontd

Knowing
Being with
Doing for
Enabling
Maintaining belief

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Expressions of Care
Spiritual
Being aware of & honoring patients
beliefs

Presence
Being there
Physically present
Demonstrating understanding

Being with
Sharing oneself

 Touch
Skin-to-skin
Eye contact (nonverbal)
Protective to prevent injury

Listening
Taking in patient information
Interpreting what has been taken in

 Knowing
Understanding the client
Understanding the planned
interventions
Avoid making assumptions
Focuses on client

Can You Learn Caring Behaviors?

Some of you already do caring
behaviors
You may have learned as a part of
your values and experiences
As you continue as a student you
may learn new and different ways to
care for others
You will improve those behaviors as
you work toward being an expert
nurse
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Knowing the Patient

A central aspect of nursing practice
that develops in the everyday
practical work of patient care
The core of clinical decision making
More than just collecting clinical data

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Spiritual Caring
Spiritual health is achieved when a
person finds a balance between life
values, goals, and belief systems and
those of others.
Watson (1979) describes the caring
relationship in a spiritual sense
Spirituality offers a sense of
connectedness.
Intrapersonally, interpersonally, and
trans personally
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Family Care
Individuals experience life through
relationships with others.
Caring does not occur in isolation
from a patients family.
Family is an important resource.

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CHALLENGE OF CARING
You may have decided to go into
nursing because you care
You will have the responsibility to
maintain the caring nature of nursing
Begin here by developing that
relationship with other students
and the carry that over into your
career
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Ethic of Care
Protects human dignity
Often perceived as a moral
imperative
Requires awareness of potential
unequality in relationships
This due to either real or perceived
power that patient assigns to the
nurse
Knowledge is power

erences:
Christina Shoemaker & Holly Smith, Theory of Human Caring:
Jean Watson
Joyce Smith, Caring in Nursing Practice

THANK YOU