Boykin and Schoenhofer on the Theory of Nursing As Caring
Summary
TLDRThis video discusses the 'Nursing as Caring' theory, developed by Dr. Ann Boykin and Dr. Savina Schoenhofer. The theory emphasizes a holistic, person-centered approach to nursing, focusing on understanding patients as caring individuals by virtue of their humanity. It moves away from a traditional systems-based model, promoting a more personal, empathetic form of care where nurses respond to the unique needs and desires of each patient. The theory highlights the importance of nurturing relationships and the concept of nursing situations, where meaningful, shared experiences enhance the practice of nursing.
Takeaways
- 🌱 The nursing profession is evolving from a systems approach to a more holistic, caring-focused methodology.
- 💡 The Nursing as Caring theory, developed by Dr. Ann Boykin and Dr. Savina Shoenhofer, emphasizes the importance of caring as the central focus of nursing practice.
- 🩺 Traditional nursing education often focused heavily on medical science, with limited emphasis on the person-centered aspect of nursing care.
- 💖 The theory asserts that all individuals are inherently caring by virtue of their humanness, and this forms the basis for nursing relationships.
- 🤝 Nursing situations are seen as shared lived experiences where caring between nurse and patient enhances personhood.
- 🧠 Persons live caring moment to moment, and nurses must recognize and respond to these expressions of caring in unique and individualized ways.
- ✨ The assumption that persons are whole and complete in the moment challenges traditional views of nursing as ‘fixing’ or addressing deficits.
- 🌟 Nurses are called to know the person as a caring individual and respond to their specific needs in a way that supports their growth in caring.
- 🎭 The 'Dance of Caring Persons' concept emphasizes that everyone involved in healthcare contributes to the caring environment, from nurses to support staff.
- 📖 Aesthetic knowing, such as storytelling and sharing experiences, plays a critical role in understanding and practicing the Nursing as Caring theory.
Q & A
What is the primary shift in nursing education discussed in the transcript?
-The primary shift discussed is from a traditional systems approach to nursing education to more holistic approaches, such as the nursing as caring theory, which focuses on the person as a whole rather than just medical procedures.
Who are the founders of the Nursing as Caring theory, as mentioned in the transcript?
-The founders of the Nursing as Caring theory are Dr. Ann Boykin and Dr. Savina Shoenhofer.
What personal experience led Dr. Ann Boykin to rethink the traditional systems approach to nursing?
-Dr. Ann Boykin, after years of teaching nursing from a systems perspective, felt something was missing—she believed that nursing wasn’t fully focused on the person but more on medical science. This realization, coupled with her exposure to a conference on caring, led her to rethink nursing education.
What is the significance of the 'nursing situation' in the Nursing as Caring theory?
-In the Nursing as Caring theory, the 'nursing situation' is a shared, lived experience between the nurse and the nursed. It is in this interaction that nursing is created, known, and practiced. It allows nurses to understand and respond to what matters to the person being cared for.
What does the Nursing as Caring theory assume about people?
-The theory assumes that people are caring by virtue of their humanness. This inherent capacity for caring is present in every person, and it is the nurse’s role to nurture and support that caring nature.
How does the Nursing as Caring theory suggest nurses should approach situations where they struggle to see a patient as a 'caring person'?
-If a nurse struggles to see a patient as a 'caring person' due to their actions (e.g., a rapist), the nurse must acknowledge that they may not be able to provide true nursing care in that moment. The nurse can perform tasks, but without seeing the person as a whole, they cannot fully engage in nursing.
How does the Nursing as Caring theory define personhood?
-Personhood is defined as a way of living grounded in caring. It is enhanced through participation in nurturing relationships with caring others, such as in the relationship between the nurse and the patient.
What role does 'aesthetic knowing' play in the theory of Nursing as Caring?
-Aesthetic knowing is particularly relevant in the Nursing as Caring theory. It involves understanding nursing situations through artistic or creative expression, helping nurses to deeply understand and reflect on their lived experiences in nursing.
What are 'calls for nursing' according to the Nursing as Caring theory?
-Calls for nursing are ways in which patients express their needs for care. These calls help nurses understand what matters most to the patient at that moment and inform the nurse’s nurturing response.
What is the 'dance of caring persons' concept in the Nursing as Caring theory?
-The 'dance of caring persons' refers to the collaborative environment where all participants (nurses, patients, doctors, and others) contribute their unique caring to enhance the well-being and personhood of everyone involved.
Outlines
🩺 Evolution of Nursing Education and the Birth of Nursing as Caring
This paragraph discusses the transition in nursing education from a systems approach to a more holistic view. Dr. Ann Boykin reflects on her dissatisfaction with the traditional method of teaching nursing, which focused more on medical science than on caring for individuals. Her experience at an international caring conference led her to explore nursing as caring, emphasizing the need to study the discipline of nursing itself. Boykin, along with other scholars, sought to redefine nursing education to focus on the person and caring, filling a gap in the traditional curriculum.
🌱 The Core Assumptions of Nursing as Caring Theory
This section introduces the foundational assumptions of the Nursing as Caring theory, notably the idea that all humans are inherently caring. The example of nursing a rapist is used to demonstrate that a nurse’s role is not to judge but to care for the individual as a human being. The theory emphasizes that nursing is about understanding the unique caring expression of individuals, and nurses must focus on the person rather than the actions or labels associated with them. If a nurse cannot emotionally connect with a person due to their actions, they may not truly be able to nurse them.
⏳ Living Caring Moment to Moment
This paragraph delves into the idea that caring is expressed moment to moment and that each moment presents a choice to live and express caring. The authors discuss the importance of being intentional in caring and how each interaction helps both the nurse and the person being cared for grow. Another significant idea presented is that persons are whole and complete in every moment, challenging the traditional medical model that sees individuals as broken and needing fixing. Instead, nursing involves affirming and supporting the person’s uniqueness and helping them grow in their own way.
🤝 Personhood and Nurturing Relationships in Nursing
Here, the concept of personhood as a way of living grounded in caring is explored. Personhood is enhanced through nurturing relationships, and the role of the nurse is to support and enhance this aspect in patients. The authors argue that nursing is both a discipline and a profession, requiring a deep understanding of caring as a domain of knowledge. The Nursing as Caring theory positions caring as the essence of nursing and emphasizes the need for nursing programs to study and incorporate caring into their curriculum.
👩⚕️ The Nursing Situation: A Shared, Lived Experience
This section highlights the central concept of a 'nursing situation,' described as a shared, lived experience where the interaction between nurse and patient enhances personhood. Through these situations, nursing becomes known and practiced. The authors introduce different types of knowledge used in nursing (personal, ethical, empirical, and aesthetic), stressing the importance of aesthetic knowing in understanding and expressing the lived experience of nursing. Through sharing stories of these experiences, nurses grow in their ability to care.
📞 The Call for Nursing and the Nurturing Response
The concept of a 'call for nursing' is introduced, where nurses enter the world of the patient to understand their unique caring needs and what matters most to them. The 'nurturing response' is the nurse's individual response to the call, shaped by the moment and the patient’s needs. The text emphasizes that no two calls or responses are alike, and both must be uniquely created for each situation. This dynamic interaction lies at the heart of the nurse-patient relationship, and understanding it helps nurses provide appropriate care.
🗣️ Direct Invitation and the Dance of Caring Persons
In this paragraph, the concept of 'direct invitation' is discussed, where nurses openly ask patients how they can care for them in ways that matter most. The 'dance of caring persons' describes a holistic environment where everyone involved in the care process, from nurses to support staff, contributes to the person’s well-being. Each person’s unique caring contributes to the overall care environment. This reinforces the importance of teamwork and the collective effort to enhance the personhood of the patient.
💬 Stories of Caring: Growing in Competency
This part presents a touching story of a nurse caring for a dying child, illustrating the uniqueness of how nurses express caring. Through stories like this, nurses share their experiences and grow in their ability to provide compassionate care. The story highlights how individual acts of caring, such as hugging a child and mother, shape the way nurses understand and perform their roles. Sharing these stories helps nurses learn from one another and expand their capacity to express caring in meaningful ways.
💖 Compassionate Nursing: Focusing on the Person
In this concluding paragraph, the importance of compassionate care is emphasized. The speaker reflects on how patients often remember the compassion and empathy shown by nurses more than the technical procedures. A specific example is provided of a woman who felt comforted and supported by a nurse after her husband was taken away for treatment. This scenario underscores the growing shift toward person-centered care, where the emotional and human needs of patients are given priority in nursing practice.
Mindmap
Keywords
💡Nursing as Caring
💡Personhood
💡Systems Approach
💡Empirical Knowledge
💡Caring Relationships
💡Nursing Situation
💡Call for Nursing
💡Nurturing Response
💡Aesthetic Knowing
💡Authentic Presence
Highlights
The shift from a systems-based approach to a more holistic, caring-based perspective in nursing education.
The development of the Nursing as Caring theory by Dr. Ann Boykin and Dr. Savina Schoenhofer.
Dr. Boykin’s realization that nursing was not focusing enough on the person, but rather on medical science, prompting the shift to a caring-focused approach.
The key influence of attending the International Association for Human Caring conference on Dr. Boykin's perspective.
The idea that caring is fundamental to personhood and that all persons are caring by virtue of their humanness.
The importance of recognizing that nursing is about nurturing and supporting the person in what matters to them.
A nurse’s obligation to look past a patient’s actions, such as criminal acts, and focus on their humanity and capacity for caring.
The assumption that persons are living caring moment to moment and express their caring in unique ways.
Caring is a choice that can be expressed in every moment, and nurses have an obligation to be intentional about living caring.
The challenging assumption that persons are whole and complete in the moment, rejecting the fix-it approach common in medical practice.
Nursing situations are lived experiences that enhance personhood through the caring relationship between nurse and patient.
The use of the ‘call for nursing’ to understand what matters to the person and how to provide care based on those unique needs.
The concept of the ‘nurturing response,’ which is the nurse’s unique response to the patient’s call for nursing in the moment.
The ‘dance of caring persons’ emphasizes that everyone involved in the patient’s care contributes to the overall development of personhood.
The value of sharing nursing stories to enhance competency in expressing caring and to help nurses grow in their practice.
Transcripts
[Music]
nurses have traditionally been schooled
in a systems approach to nursing
but more holistic approaches are being
developed and these influence how
nursing is taught and practiced
the nursing as caring theory is one of
these approaches
in this program nursing as caring is
discussed by its founders dr ann boykin
and dr savina shonifers
well
how did i
come to
think about nursing as caring
um
you know i've been a nurse since the 60s
and have studied nursing
and regular ways studying it from a
systems perspective
teaching it from a systems perspective
just as i was taught and i think that's
very common with faculty that we teach
as we were taught
and all of the different places that i
had taught there was one thing that
always bothered me and that truly was
that i didn't think we were really
studying the discipline of nursing
i knew we were focusing on medical
science and bringing a little bit of
nursing
in at the end called nursing care
but somehow or other i just knew we
never focused on the person
but i really didn't know how to do that
either because i'd never witnessed it
i'd never been taught that so i didn't
know
and
in 1981 when i came to florida atlantic
university
the model for the study of nursing was
systems model pretty much like it was at
a lot of institutions at the time
and in the early 80s i had an
opportunity to attend an international
association for human caring conference
and that really
changed my life
because it was a very small group of
scholars devoted to the study of caring
you know gene watson dolores scott doris
riemann madeleine lininger kathleen
valentine just a small group
so over the years in the very beginning
piece of that what we did is we were
very small faculty
and we came together at a table
and
i said
let's bring our syllabus and let's look
at what are we studying
and we did including myself
and we sorted it all out into little
piles and we had pathophysiology and
pharmacology and
all of the
empirical knowledges
and so i said well where's the nursing
content
and there was a big hole
and how would we fill that hole and over
the course of many years
we
developed the study of caring we did a
little bit of caring we went to the
literature and we studied it a little
and we realized that there was a really
a formal way we could really study
caring and we began then to study mayor
often we can't begin to bring in works
that were really substantively grounded
in caring
and it was the nursing situation that
really filled that void
for the study of nursing
the importance of nursing as caring
is that it is a perspective that is
grounded in the humanness of personhood
that it is grounded in
the phenomena of nursing as person
and that is what it is all about it is
coming to no person
to respond to person to research from
that human perspective and to answer the
questions that matter to those being
nursed
in working with faculty
we recognized that there needed to be a
shared consensus
of an understanding of caring to
undergird the curriculum
however
ann and i wanted to go beyond
that curriculum work and actually
develop a full-fledged theoretical
systematic expression
of nursing as caring we asked ourselves
in our view what's the unique focus of
nursing
where does caring fit as a central part
of the unique focus of nursing
and what we came up with
was the understanding that stated in our
statement of focus
nursing is nurturing persons living
caring and growing and caring
the first and most fundamental
assumption underlying the theory of
nursing is caring
is that persons are caring by virtue of
their humanness
so there's no question
we don't have to evaluate whether a
person is caring or not we start with
that assumption
simone roach who talks about caring says
that although it's innate within us we
have to draw it forward
we have to give the person something to
respond to that matters to them to bring
forth that innate capability
so
from a nursing perspective if i'm in the
emergency department
and i have someone who walks into that
emergency department who's a rapist
how do i live out that assumption that
persons are caring by virtue of their
humanness this person is a caring person
now it's my responsibility as a nurse
to see past the act because i am not
there to judge that act there is a
system that we have to judge that
i am there as nurse to see the person as
caring person
and to nurture and support the person
in what matters to them
now if i'm not able to get past the act
which sometimes happen because we are
human
then i have to acknowledge that i cannot
nurse
that then i may be able to do things to
the patient
really putting that patient in an object
role you know i may be able to start the
iv i may be able to do the things i need
to do but i cannot truly nurse because
i'm not able to get
to know you as person and to come to
know what matters to you
the next assumption
that's uh really important to an
understanding of the practice of this
theory
is that persons are caring moment to
moment
persons live their caring from moment to
moment express their own caring ways
very uniquely
as living caring we do live at moment to
moment
how i live my caring right now
informs me changes me and helps me to
grow in how i live my caring in the next
moment
and each moment
is an opportunity for us to choose
to live caring or not
we always have the choice
to express our caring in the moment or
not
but the obligation
if we believe that caring is the human
mode of being that all persons are
caring by virtue of the humanness the
obligation is
to pay attention to be intentional in
the living of caring moment to moment
another important assumption underlying
this theory
is the idea that persons are whole and
complete in the moment
and this is probably
one of the most difficult or challenging
assumptions
to buy into
in nursing we are used to taking
a medical perspective approach
which appropriately is a fix-it approach
from our perspective of nursing and from
the perspective of this theory
there is nothing to be fixed
there is nothing that's broken
there are no deficits
the function of nursing in the world is
to recognize the person as caring as
living caring uniquely and then to
affirm support and celebrate that person
in their caring
and in that way participate with them
in living their hopes and dreams for
growing and caring
the assumption that persons are whole or
complete in the moment is a precious
assumption to me
i am always with you with the intention
of knowing you as person
you are never part you're never defined
by part you're never an arm you're never
a leg you're never a heart you are
always whole
and it's my responsibility
through authentic presence to be with
you to come to know that wholeness
the next fundamental assumption
underlying the theory of nursing is
caring
is that personhood is a way of living
grounded in caring
and that of course is one of the things
that we attempt to achieve in the caring
between
enhancing personhood
enhancing
our capacity to live
caring in the world moment to moment
living grounded in caring
and associated with that is the next
assumption that says personhood is
enhanced through participation in
nurturing relationships with caring
others and that's where nursing practice
comes in
and then the final assumption which
we believe is important
contextually at least
is the idea that nursing is both a
discipline and a profession
nursing is indeed a very privileged
discipline and profession
and as such
it is incumbent upon us to really be
able to articulate
the specialized unique knowledge of
nursing
and a professional practice so when we
say that a discipline has a domain of
knowledge for example
we have said for many many years that
caring is the essence of nursing
that's something that every nurse would
probably agree to yes caring is the
essence of nursing
so if that is true then i believe that
that caring becomes a domain of
knowledge which we are obligated to
study
that's why we we ought to be studying
caring in every nursing program whether
it is nursing is caring or just studying
caring because caring is a very special
domain of knowledge within our
discipline
so one of the most
important concepts
that we work with in the theory is the
idea of nursing situation
and we understand nursing situation
to be a shared
lived experience in which the caring
between nurse and nurse enhances
personhood
it is in the nursing situation that
nursing is created
it's in the nursing situation that
nursing is known
we believe from our work with practicing
nurses and from our study that all that
is important of nursing is known through
the nursing situation
we use the nursing situation as a medium
for study
nursing situations once they've been
lived
originally creatively
can then be used to study nursing
and as each student enters into that
situation the situation actually lives
and continues to evolve and grow we use
the
harper's patterns of knowing personal
knowing ethical knowing empirical
knowing and aesthetic knowing in working
with our theory but here in particular
in talking about nursing situation i
think it's useful to point out that
aesthetic knowing is particularly
relevant
and when we're working with practicing
nurses or
in our teaching
we like to invite people to render their
understanding
their lived experience of nursing render
it aesthetically
another important concept in the theory
of nursing is caring is the idea of the
call for nursing
what it is that nurses do
nurses enter into the world of another
in order to come to know that person as
caring person and to hear calls for
nursing
to come to understand
what is it that matters to you today
who are you as caring person
what are your hopes and dreams for
growing and caring
and how can i be with you today
in a way that matters it is an idea that
helps direct
our attention
and helps nurses create the kind of
nursing that's appropriate for the
situation
together with the call for nursing is
the nurturing response
the nurturing response is the uniquely
created response of the nurse
to that which matters
to the person
a call for nursing
is always a call that says in one way or
another
know me as caring person and respect me
as caring person
so that a nurturing response then is
always
a response to that general call
but the nursing response is created
specifically
toward that which matters to the person
in the moment
neither calls nor responses
can be canned can be pre-conceptualized
can be predicted ahead of time
because calls are unique in the moment
calls are uniquely heard
in the moment
and thus responses are uniquely created
for this situation
it's not to say that there aren't some
commonalities so that we can study about
calls and prepare ourselves to create
ranges
of appropriate responses but the call
and the response
is something that occurs in the caring
between the caring between nurse and
nurse
related to the idea of call and response
is the idea of direct invitation
indirect invitation we say to the
patient i am here to care with and for
you today
how can i care for you in ways that
matter
how can we together create an
environment of caring that will help you
get to where you want to be
and again this theory doesn't address
brokenness or
needs for fixes
or needs for
replenishing deficits and so
that question that direct invitation is
not about
necessarily how can i fix you today
but how is it that today
you are trying to live caring in this
situation
in ways that are true for you
and how can i help you with that
another concept that's important to the
theory of nursing as caring is the
concept the dance of caring person
each person has something to contribute
to the caring environment
in some
theories it would be said that the
patient was at the center
in the dance of caring persons the
patient is there the nurse is there the
physician may be there the physical
therapist may be there the person that
manages the financial office may be
there
definitely the person who cleans the
room and who brings the food they're all
in this dance of caring persons
they are all contributing their own
unique caring to the full development of
personhood for all who are involved
we have the privilege of being with
someone with the intention of nursing
them
from the nursing is caring perspective
this happens in a nursing situation
which is that lived experience between
nurse and nurse
in which the caring enhances personhood
through this being with the person in
the caring between the nurse and nursed
now when i am with you in your wholeness
and with the intention of hearing your
story with the intention of wanting to
know who you are as caring person
through that i will hear what
i would call calls for nursing
what matters most to you what are your
calls for nursing and it is that
that informs my response so it's that
that directs then my nurturing response
for what i will do with you and for you
because of what i hear
and the way that i do that is through
how i live my unique caring my unique
expressions of caring it's another story
i'll never forget
oh years ago i was at a conference
and we were talking about stories
and this nurse stood up and she told
this beautiful story of a young child
who was dying from leukemia
and
had this story within her for 15 years
and just then shared this story
and she told how
this mother lived many miles away and
she had other children and how she had
to call this mom to come because she had
the sense that this little girl was
going to die
and when the mom got to the hospital
the mother
and the nurse
laid in bed and hugged this child
now the unique expression of caring of
that nurse was to get in bed and hug the
mom and the child together
now i don't know that i would have done
that that that would have been my unique
expression of caring but by hearing that
story
i learned and i think i would be free
to climb in bed and hug a child or hug
someone who needed that hug so it's in
sharing these expressions of caring
through the story that again we grow in
our competency to express our caring
it's it's kind of freeing
[Music]
i find that the caring model works for
me because i think being compassionate
is at the core of this all you know all
of this
people don't
think of the shots that we give or the
ivs that we hang or the compressions on
their chest is what they really care
about what they care about is that
you're caring for them as a person that
you're not forgetting that they're a
person in that bed and who you know who
they are there are situations every day
that happen here that really um
emphasize the fact that we're becoming
more person centered instead of object
centered
this morning for instance i walked in to
the triage room and there was a woman
all by herself in there crying and i
didn't know if she was the patient or
the family member but i asked her
if she was in distress and i said it can
i get your vital sign she goes oh i'm
not the patient that was my husband i
was just having my moment here
so i started talking to her and as i did
the triage nurse came back in the triage
nurse had just wheeled her husband away
and
talked to her a little bit she was
really upset about her husband's
condition
and the triage nurse said to her well
you know life is what happens to us when
we're making other plans and then they
hugged
and you could just see the relief on the
woman's face that she did feel she'd
been heard she'd been supported
and it was a really
caring situation and
it really showed how the nurse and the
nurse are communicating caring
and it was very
very indicative of how some of the
transformation has taken place here
you
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