ADR - Nursing As An Art LECTURE PART 2a CARING

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NURSING AS AN

ART
LECTURE PART 2-a: THE ART OF CARING
September 30, 2021
LEARNING OBJECTIVES
At the end of the session, the students shall be able to:

compare
discuss the and contrast apply the
essence of caring 6C’s of caring
caring in practice in caring for
models one’s self and
nursing
others
“Caring is the essence of NURSING.”

“There is no cure when there isno


CARE.”
Nursing is the pivotal health
profession highly valued for its CARING and
specialized knowlege skill, and knowledge are the core
CARING in improving the health
of nursing... with
CARING being a key
status of the individual, family component of what a
and community. nurse brings to a
-Nursing Agenda for the Future
patient experience.
(ANA, 2002) - American Organization of Nurse
Executives
(AONE, 2015)
MODELS of NURSING
PRACTICE
BENNER BOYKIN &
WATSON SCHOENHOFER
LEININGER SWANSON LOCSIN
BENNER’s MODEL
(include work with Wrubel 1989 and others in 2010)

➢ CARING - is primary because it determines what matters to


people CARING
➢ it involves a lot of interactions
➢ it determines what is stressful to people and how to IS
cope PRIMARY
➢ CARING creates a lot of POSSIBILITIES (Benner and Wrubel, 1989)
➢ connecting with people
➢ concern for others
➢ allows giving and receiving health
BENNER’s MODEL
(include work with Wrubel 1989 and others in 2010)
➢ NURSING – is a process of helping people cope with the
stress of illness
➢ not blindly following sets of prescribed rules CARING
➢ each patient is unique IS
PRIMARY
o ILLNESS – is not reducible to disease (cellular pathology)
o Caring depends on discerning problems, solutions and
helping patients implement, and live, a solution.
o Nursing is a moral act that goes beyond mere application
of scientific knowledge.
LEININGER’s MODEL
CARE – is the essence, central unifying and dominant
domain that distinuguishes nursing from all other
health disciplines
➢ is an essential HUMAN NEED (necessary for health and TRANS-
survival) CULTURAL
➢ CARE versus CURE CARING
ACTS of CARING – refer to those “nurturing” and skillful
activities
➢ empathetic
➢ compassionate
➢ supportive
LEININGER’s MODEL
CARING – is very personal (although universal)
➢ differ in expression, processes and patterns
➢ “culturally” based and rooted
TRANS-
NURSES – must understand “cultural caring” behaviors CULTURAL
➢ need to get to know the context of the person/s CARING
cared for
WATSON’S MODEL
CARING – is the “central” focus of nursing
➢ integral to maintain the ethical and philosophical
roots of the profession (2008)
TRANS-
➢ demands “high quality interaction” from nurses
PERSONAL
➢ HOLISTIC approach – a conscious intention to care CARING
promotes healing and wellness (2008; 2010)
➢ rejects the disease orientation to health care

➢ CARE before cure


WATSON’S MODEL
CARING – becomes almost spiritual (raises questions on
what it means to be human and humane)
- it involves the use of
TRANS-
o 10 carative factors
o Caritas processes PERSONAL
CARING
❖ The model is TRANSFORMATIVE – it influences both
the patient and the nurse (better or worse)

❖ Caring consciousness (on the part of the nurse)


promotes HEALING
SWANSON’s MODEL
CARING - is a nurturing way of relating to a valued
other towards whom one feels a personal sense of THEORY
commitment and responsibility
of
➢ it is growth and health-producing (nurturing) CARING &
➢ occurs in relationships (relating) to the one cared- HEALING
for (a valued other)
➢ individualized and intimate (personal), with a sense
of commitment (passion), accountability and duty
(responsibility)
SWANSON’s MODEL
NURTURING is a set of interrelated processes that evolve from
the nurse’s own convictions, knowledge, and interaction
with a patient THEORY
of
CARING &
HEALING
BOYKIN and SCHOENHOFER’s MODEL
CARING – an innate human characteristic
➢ all persons are caring by virtue of their humanness
➢ is an essential feature and expression of being
human NURSING
➢ being a person means “living” caring AS
o Caring is living in context of relational
CARING
responsibilities.
o Caring is responsibility to self and others.
o Caring shapes relationships.
BOYKIN and SCHOENHOFER’s MODEL
6 major assumptions:
o Persons are caring by virtue of their
humanness.
o Persons are caring moment to moment. NURSING
o Persons are whole or complete in the moment. AS
o Personhood is living grounded in caring. CARING
o Personhood is enhanced through
participating in nurturing relationships with
others.
o Nursing is both a discipline and a profession.
LOCSIN’s MODEL
Assumptions:
o Persons are whole or complete in the moment
(Boykin and Schoenhofer, 2001)
TECHNOLOGICAL
o Knowing persons is a process of nursing that
COMPETENCY as
allows for continuous appreciation of persons CARING
moment to moment (Locsin, 2005)
o Nursing is a discipline and a professional
practice (Boykin and Schoenhofer, 2001)
o Technology is used to know persons as whole
moment to moment (Locsin, 2004)
LOCSIN’s MODEL
CARING – is an expression of TECHNOLOGICAL
COMPETENCY
➢ co-existence of technology and caring provides TECHNOLOGICAL
a framework for practice COMPETENCY as
CARING
FOCUS of NURSING:
➢ to know human beings fully as a whole person
➢ affirm, appreciate, and celebrate personhood
through expert and competent use of nursing
technologies
COMMON THEMES ACROSS the CARING
MODELS
Human interaction or communication

Mutuality

Appreciating the uniqueness of individuals

Improving the welfare of individuals and families


The 6 C’s of CARING
The 6 C’s of CARING
How to practice: How to practice:
How to practice:
✓ Keep them safe ✓ Be with them in
times of loneliness ✓ Regular
✓ Prevent harm
✓ Maintain “human” observations
✓ Ensure high
contact ✓ Thorough
quality care
✓ Attitude (show the assessments
✓ Get to know
6 Cs) ✓ Prevent: risks
them
✓ Maintain and falls
✓ Make them feel
affirm dignity infections
valued

CARE COMPASSION COMPETENCE


The 6 C’s of CARING

How to practice: How to practice:


How to practice:
✓ Regular interaction ✓ Challenging “poor”
✓ Enhancing comfort practice ✓ Professionalism
✓ Decreasing anxiety ✓ Proper reporting or ✓ Patient at the
✓ Make them feel “whistle-blowing” center of care
valued ✓ Admission of one’s ✓ Perseverance
✓ Verbal and non- limitations; ✓ Active “presence”
verbal (gentle apology and listening
approach) ✓ Patient advocate

COMMUNICATION COURAGE COMMITMENT


MANIFESTATIONS of CARING in PRACTICE

Provide Use appropriate Active


PRESENCE TOUCH LISTENING

KNOWING SPIRITUAL RELIEVING FAMILY


the patient Care symptoms and care
suffering
TAKING CARE of SELF and OTHERS
References:

American Nurses Association [ANA]. (2002). Nursing’s agenda for the future: a call to the nation.
Retrieved from: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.195.649&rep=rep1&type=pdf Accessed on
August 30, 2020
American Organization of Nurse Executives [AONE]. (2015). Guiding principles for the role of the nurse in future healthcare delivery toolkit.
Retrieved from: https://www.aonl.org/resources/guiding-principles Accessed on August 30, 2020

Benner, P.& Wrubel J. (1989). The Primacy of caring, stress and coping in health and illness. Menlo Park, CA, Addison Wesley
Boykin, A. & Schoenhofer, S. (2013). Nursing as caring. [Ebook #42988]. Retreived from: www.gutenberg.org Accessed on August 29, 2020
Locsin, R. (2007). Technological competency as caring: a model for nursing. Retreived from www.https://nursing.fau.edu
Accessed on August 29, 2020
Potter, P.A., Perry, A. G., Hall, A., & Stockert, P.A. (2017). Fundamentals of nursing. Ninth edition. St. Louis, Mo.: Mosby Elsevier.
Watson J. (2010). Caring science and the next decade of holistic healing: transforming self and system from the inside out. American Holistic
Nurses Association 30(2): 14. Retrieved from: https://pubmed.ncbi.nlm.nih.gov Accessed on August 29, 2020
Watson, J. (2008). The hilosphy and science of caring. Boulder, University Press of Colorado

Websites (for theorists and their work):

http://pmhealthnp.com/kristen-swanson-theory-of-caring-and-%20%20healing/
https://nursology.net/nurse-theorists-and-their-work/the-primacy-of-caring/
T h a n k y ou !

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