By: Harris Lidasan,Liliana Marie Mabaet
· According
to Wilkinson (1996), nursing process is recognized as the foundation for
professional nursing practice, and provides the professional nurse with a
framework for decision making and problem solving in everyday practice and
situations. In the Theory of Nursing as Caring by Boykin and Schoenhofer, as a problem-solving approach or
mechanism, the nursing process is incompatible. Why? Because Boykin and
Schoenhofer believes that the focus of problem solving is to find something to
correct and this focus would distract the nurses from their primary mission of
caring. As a result there would be a loss in the context of nursing. In Nursing
as Caring, to know the other as caring person and to nurture that person in
ways that are specific to the situation as that challenge rather than to
discover what is missing or needed. Nursing is described as processual rather
than a process.
· The
practice of nursing requires changing in the conceptualization of nursing and
nursing situations. For instance, the problem solving introduced by Orlando
(1961), known as the nursing process. The focus of nursing process is on
correction and cure rather that to serve their primary mission of caring. Most
of the practice results in objectification, labeling, ritualism and non
involvement. Caring is an essential value in a nurse-patient relationship.
Nursing as Caring: A Model for Transforming Practice is a personal, not
abstract. It is a unique way of living caring in the world and not toward in
end product such as health or wellness. This theory provides the view that can
be lived in all nursing situations. The poem “Healing-HIV+” is an example of a
nursing situation that exemplifies the reconceptualization in nursing practice.
The nurse carried out a medically prescribed treatment, not a form of medicine
but a form of nursing.
Healing-HIV+
Your wound weeped
Purulent with the discharge of our
Pain and fear.
They tried to hide, only to reappear.
The treatment gentle, slow
A warm, loving balm to your soul.
Your stomach was led the comfort
Food of your youth
And your lips drank in deeply all
You knew and understood.
The memories sweetened each moment
You stood, face to face with terror of
What might be mistook.
All inside shifted asslowly it came,
A gradual awakening; embracing the pain
As you conquered your demons
A lightness appeared
To stay forever and
Abolish all fears (Wheeler, 1990)
Another application on Nursing as Caring
theory is to a patient who had been diagnosed as having a skin cancer. Mr. P’s experienced
a small mole on his back which was eventually diagnosed as a skin cancer. He
needed to know the truth about his condition and the “future”. His doctor told
him, he had cancer and that it was
“very serious” and had a chemotherapy plan
for him. Upon his admission in ward for his first chemotherapy session,
a caring attitude is nurse starts. Mr. P
experiences of “being cared for” in hospital is more important rather than to
prevent infection. A nurse needs to treat
Mr. P as individual and had time for the “person al touch”. The nurse will
focus on the feelings of Mr. P. The side effects of chemotherapy that can
decrease his immune system are secondary one.
Just a comment...nursing action to prevent infection IS an expression of caring in nursing - a way of caring for the person (as long as the focus is on person and not restricted to infection), although for any given patient at a point in time, other personal or social aspects of his/her experience may be more important than medical aspects at that point in time. The nurse mindfully taking action to protect the person from infection makes possible the patient experiencing being cared for. In working with Nursing As Caring as your nursing framework, it's best to avoid getting into the "either/or" trap, and instead, think: in what ways is this nursing action an expression of my caring for the person? OR how can I modify what I am doing so that it IS an expression of my caring for this person? It's important to form the intention of expressing caring for the person in all that you do as nursing...and then to check your actions against your intentions.
ReplyDeleteDr. Schoenhofer