CARING THEORIES By: Locsin, Boykin & Shonhoefer


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    It is only through recognizing and responding to the other as a caring person that nursing is created and personhood enhanced in a nursing situation.
    - Nursing as caring has the power to transform practice in a way that reflects unity without conformity and uniqueness with oneness.

    Technological Competency as Caring in Nursing
    Acknowledges the increasing demand for nursing actions that require technological proficiency
    Provides motivation, stimulation, and autonomy to judge nursing actions based on an appreciation of persons as whole in the moment rather than as object
    - Allows caring and technology to coexist in mechanistic health-care settings
  • CARING THEORIES By: Locsin, Boykin & Shonhoefer

    2. 2. OBJECTIVES:  After 30-45 minutes of discussion about the New Nursing Theories, the participants would be able to: ◦ Identify the 2 new nursing theories discussed. ◦ State at least 3/4 major assumptions underlying Rozzano Locsin’s theory. ◦ Utilize the Nursing as Caring Theory to the Nursing practice, administration, education & research.
    3. 3. ANNE BOYKIN & SAVANA SCHOENHOFER Nursing as Caring
    4. 4. ANNE BOYKIN  1944 - Kaukauna, Wisconsin  1966 – Nursing Career ◦ Alverno College in Milwaukee, Wisconsin  Master’s Degree ◦ Emory University Atlanta, Georgia  Doctorate ◦ Vanderbilt University in Nashville, Tennessee
    5. 5.  1981 – South Florida ◦ Steve Staudenmeyer  DEAN & PROFESSOR ◦ Christine E. Lynn College of Nursing, Florida Atlantic University  DIRECTOR ◦ Christine E. Lynn Center for Caring
    6. 6. Awards  2009 - Visionary Caring Science Award by the Watson Caring Science Institute Book Publications  Nursing as Caring: A Model for Transforming Practice (1993, 2001a)  Living a Caring-Based Program (1994b).  Politics and Public Policy: A Matter of Caring (1995)  Caring as Healing: Renewal Through Hope
    7. 7. SAVANA SCHOENHOFER  1940 – Kansas  1960 – Volunteer ◦ Amazon, Brazil  1983 – PhD ◦ Kansas State University
    8. 8.  PROFESSOR ◦ Cora S. Balmat School of Nursing, Alcorn State University, Natchez, Mississippi  1990 - Co-FOUNDER ◦ Nursing Aesthetics Publication, Nightingale Songs Book Publications  Nursing as Caring: A Model for Transforming Practice (1993, 2001a)
    9. 9. ASSUMPTIONS OF CARING AS NURSING :  Persons are caring by virtue of their humanness.  Persons are whole and complete in the moment.  Persons live caring from moment to moment.  Personhood is a way of living grounded in caring.  Personhood is enhanced through participation in nurturing relationships with caring others.
    10. 10. CARING  Altruistic, active expression of love  Intentional and embodied recognition of value and connectedness  Nursing uniquely focuses on caring as its central value  Illuminated in the experience of caring and in reflection on that experience
    11. 11. FOCUS & INTENTION OF NURSING  Focus of Nursing ◦ Persons living in caring and growing in caring  Intention of Nursing ◦ Nurturing persons living and growing in caring
    12. 12. NURSING SITUATION  A shared lived experience in which caring between the nurse and nursed enhances personhood ◦ Involves values, intentions and actions of two or more persons choosing to live a nursing relationship  Nursing is created in the “caring between”  All knowledge of nursing is understood within the nursing situation
    13. 13. PERSONHOOD  Personhood is living grounded in caring.  Personhood is the universal human call.  Understanding communicates the paradox of person-as-person and person-in-communion all at once.
    14. 14. CALL FOR NURSING  Call for acknowledgement and affirmation of the person living and caring in specific ways in the immediate situation (Boykin & Schoenhofer, 1993, 2009)  Calls for nurturance through personal expressions of caring  Originates within persons  Intentionality and authentic presence open the nurse to hear calls for nursing
    15. 15. CALL FOR NURSING (continued)  There are relevant ways of saying “know me as a caring person in the moment and be with me as I try to live fully who I truly am.”  Calls are unique and cannot be predicted as in a diagnosis.  Nurses develop sensitivity and expertise in hearing calls through intention, experience, study, and reflection.
    16. 16. NURSING RESPONSE  Specific expression of caring nurturance to sustain and enhance the “other” as he or she lives caring and grows in caring in the situation of concern  Uniquely created for the moment  Cannot be predicted or applied as preplanned protocols
    17. 17. THE CARING BETWEEN  Source and ground of nursing  Loving relation into which the nurse and nursed enter and co-create by living intention to care.  Personhood is enhanced in the context of the caring between  Without the caring between, unidirectional activity or reciprocal exchange can occur but nursing in the fullest sense does not
    18. 18. LIVED MEANING OF CARING AS NURSING  Meaning of nursing is best understood by the study of a nursing situation.  Nurse and nursed live caring uniquely.  Courage is required to enter into the unknown of a nursing situation.
    19. 19. I CARE FOR HIM  My hands are moist,  My heart is quick,  My nerves are taut,  He’s in the next room,  I care for him.  The room is tense,  It’s anger-filled,  The air seems thick,  I’m with him now,  I care for him.
    20. 20.  Time goes slowly by,  As our fears subside,  I can sense his calm,  He softens now,  I care for him.  His eyes meet mine,  Unable to speak,  I care for him.  It’s time to leave.  Our bond is made,  Unspoken thoughts,  But understood,  I care for him! — J. M. Collins (1993)
    21. 21. NURSING PRACTICE  The nurse practicing nursing as caring comes to know the other as a caring person in the moment. The challenge is not to discover what is missing, weakened, or needed but to come to know the other and to nurture that person in situation-specific, creative ways and to acknowledge, support, and celebrate the caring that is.
    22. 22. NURSING ADMINISTRATION  The practice of nursing administration is grounded in a concern for creating, maintaining, and supporting an environment in which calls for nursing are heard and nurturing responses are created. Nursing administrators inspire a culture that evolves from the values of nursing as caring.
    23. 23. NURSING EDUCATION  The curriculum asserts the focus and domain of nursing as nurturing persons living caring and growing in caring. Faculty assist and mentor students as co-learners; create caring learning environments, that inspire the appreciation and celebration both self and other as caring persons.
    24. 24. NURSING RESEARCH & DEVELOPMENT  Research and development efforts are focused on expanding the language of caring; re-conceptualizing nursing outcomes as “value experienced in nursing situations”; and evaluating this theory based model of caring in acute and long-term health-care agencies.
    25. 25. FREQUENTLY ASKED QUESTIONS:  How does the nurse come to know self?  Must I like my patients to nurse them?  What about nursing a person for whom it is difficult to care?  Is it possible to nurse someone who is in an unconscious or altered state of
    26. 26. How does the nurse come to know self?
    27. 27. How does the nurse come to know self?  Trust in self  Learning to let go, to transcend  Being open and humble  Continuously calling into consciousness that each person is living caring in the moment  Taking time to experience humanness fully
    28. 28. Must I like my patients to nurse them?
    29. 29. Must I like my patients to nurse them?  To nurture persons as living and growing in caring, it is necessary to know the other as caring person living his/her own caring in the moment.
    30. 30. What about nursing a person for whom it is difficult to care?
    31. 31. What about nursing a person for whom it is difficult to care?  All persons are caring.  Nursing ethic to care supersedes all other values.
    32. 32. Is it possible to nurse someone who is in an unconscious or altered state of awareness?
    33. 33. Is it possible to nurse someone who is in an unconscious or altered state of awareness?  Nurse makes self as caring person available  Nurse recognizes the vulnerability of other.  Other living caring in humility, hope, and trust.
    34. 34. How Does this Theory Differ From Nursing Process?  Nursing is viewed as an ongoing process that is guided by intentionality.  Value of nursing is that which is perceived as valuable to the other.  There is no predictable outcome.
    35. 35. USEFULNESS OF IN NURSING IN PRACTICE  Nursing practice intentionally focused on coming to know a person as caring and nurturing and supporting those nursed as they live caring leads to: ◦ Increased patient and nurse satisfaction ◦ Increased retention of nurses ◦ Environment of care becoming grounded in values of and respect for person
    36. 36. ROZZANO LOCSIN Technological Competency as Caring and the Practice of Knowing Persons in Nursing
    37. 37. “The practice of knowing persons as whole, frequently with the use of varying technologies” (Locsin, 2001) .
    38. 38. ROZZANO LOCSIN  1976 – BSN &1978 - MAN ◦ Silliman University of the Philippines  1988 - PhD ◦ University of the Philippines  1991 - PROFESSOR ◦ Christine E. Lynn College of Nursing, Florida Atlantic University  Program of Research: “Life transitions n the health- illness experience”
    39. 39. Awards  2000 - Fullbright Scholar to Uganda  2004–2006 - Fullbright Alumni Initiative Award to Uganda  Fullbright Senior Specialist in Global and Public Health and International Development  Edith Moore Copeland Excellence in Creativity Award: Sigma Theta International  Lifetime Achievement Awards from Schools of Nursing in the Philippines
    40. 40. Book Publications  Advancing Technology, Caring and Nursing (2001)  Technological Caring in Nursing: A Model for Practice (2005)  A Contemporary Process of Knowing: The (Unbearable) Weight of Knowing in Nursing (2009)
    41. 41.  ROZZANO LOCSIN’S ASSUMPTIONS: ◦ Persons are whole or complete in the moment (Boykin and Schoenhofer, 2001) ◦ Knowing persons is a process of nursing that allows for continuous appreciation of persons moment to moment (Locsin, 2005). ◦ Nursing is a discipline and a professional practice (Boykin and Schoenhofer, 2001) ◦ Technology is used to know persons as whole moment to moment (Locsin, 2004).
    42. 42. FOCUS & INTENTION OF NURSING  Focus of Nursing ◦ A human being whose hopes, dreams, and aspirations are to live fully as a caring person (Boykin & Schoenhofer, 2001)  Intention of Nursing ◦ To know human beings fully as a whole person  By affirming, appreciating, and celebrating personhood  Through expert and competent use of nursing technologies
    43. 43. TECHNOLOGY OF COMPETENCY  Conceptualized as: ◦ An expression of Caring  Co-existence of technology and caring in nursing ◦ Providing a framework for practice
    44. 44. Purpose:  Acknowledge wholeness of persons as a focus of nursing  Technological means are used to know wholeness more fully  Technology used to know “who is person” rather than “what is person”
    45. 45. THE WHAT IS / WHO IS PERSON  What is Person? ◦ Empirical facts about the compositions of the person ◦ Persons as objects  Who is Person? ◦ Understanding the unpredictable, irreducible person who is more and different than the sum of his or her empirical self ◦ Persons as unique individual
    46. 46. PERSON ARE COMPLETE AND WHOLE IN THE MOMENT  Persons are complete, unique and unpredictable ◦ Expressions of completeness vary from moment to moment  Nursing interventions are not focused on “fixing” or making persons “whole again.”  Nurses come to know persons as whole.  Nursing responses are based on the persons’ uniqueness.
    47. 47. FOCUSING ON RECEIVED TECHNOLOGICAL DATA ALONE TO KNOW PERSON  Provides the nurse with an understanding of persons as objects who need to be fixed or made whole again
    48. 48. PROCESS OF KNOWING PERSON AS A WHOLE AND COMPLETE IN THE MOMENT  Persons choose whether or not to allow nurses to know them fully.  In holding the idealization of persons as “complete in the moment,” nurses must ◦ Choose to enter the world of the other ◦ Establish rapport, trust, confidence, commitment, and compassion
    49. 49. WHOLENESS PARADOX  Because persons are unique and unpredictable  Persons can only be fully known ◦ In the moment ◦ If the nurse chooses to enter the world of the other ◦ If the person allows the nurse to know him/her
    50. 50. FROM THIS PERSPECTIVE  The condition in which the nurse and other allow each other to come to know one another is the nursing situation.
    51. 51. NURSING SITUATION  Shared lived experience between the nurse and nursed  Condition in which the nurse and the other allow each other to know one another  Nurse’s responsibility to know the person’s hopes, dreams, and aspirations
    52. 52. VULNERABILITY  The nurse and nursed become vulnerable as they enter each other’s world and move toward continuous knowing of one another
    53. 53. VULNERABILITY IN CARING SITUATIONS  Allows participation  Embodiment of vulnerability enables recognition of it in others  Allows engagement of “power with” rather than “power over”  Nurses’ work is to ameliorate vulnerability (Daniels, 1998)
    54. 54. PROCESS OF NURSING  The process of nursing is a dynamic unfolding of situations encompassing knowledgeable practices (Locsin, 2005)  Knowing and appreciating uniqueness of persons  Designing participation in caring  Implementation and evaluation  Verifying knowledge of person through continuous knowing (Swanson, 1991)
    55. 55. KNOWING IS THE PRIMARY PROCESS OF NURSING  Knowing nursing ◦ “All at once” knowing of personal, ethical, empirical, and aesthetic realms (Boykin & Schoenhofer, 2001)  Continuous knowing of person ◦ Occurs moment to moment ◦ Deters objectification ◦ Overpowers the motivation to prescribe and direct the person’s life
    56. 56. THE ENTIRETY OF NURSING  Is to direct, focus, sustain, and maintain the person (Locsin, 2005)  Through calls and responses for nursing
    57. 57. CALLS FOR NURSING  Calls ◦ Nurses rely on the person for calls ◦ Knowing persons allows the nurse to use technologies in articulating calls ◦ Illustrations of the person’s unique hopes, dreams, and aspirations ◦ Individual expressions  Desire to go home  Wishing to die peacefully
    58. 58. NURSING RESPONSES  Nurses respond to calls from persons.  Nurses respond with authentic intentions to fully know persons continually in the moment.
    59. 59. REFERENCES:
    60. 60. THANK YOU 