Wednesday, July 4, 2012

Strength and Limitations


by: JOEY MAGUNDAYAO AND BERNADETTE LEGASPI




    Anne Boykin’s Nursing as Caring Theory is a grand nursing theory that can be used a framework to guide nursing practice. It defines the standard role of a nurse. Nurses intentionally care for an individual which causes them to grow in caring. Nurses support, sustain, strengthen process of caring and growing in care. Nurse must be present, actively listening, sensitive to broad range of situations.

   The focus on caring abilities of a nurse is a primary strength which was given emphasis on the theory of Nursing as Caring. The assumptions presented by Boykin and Schoenhofer sounds analytical and acceptable. In addition, concepts and explanations are concise and easily understandable. Personality and character of the nurse affects the type and quality of care we are giving to our patients. Each nurse delivers his own care depending on the personhood, value and character. Boykin and Schoenhofer stated that personhood is enhanced through participating in nurturing relationships with caring others. Our continuous nurturing experiences and encounters with the patient will help develop and improve our caring abilities. The relationship that will be gained through nurse-client interaction using this theory will be extraordinary and unremarkable because we treat and give care to our patient as if they were our love ones. However, this may lead to development of emotional attachment to patients which may be a weakness of the theory. This theory can be used not only by nurses but by everyone who cares. Nursing education will take a little part in this theory since caring is a virtue and innate to humans as declared by Boykin and Schoenhofer.

     As a grand theory of Nursing as Caring, another major strength is it can be used with any other theory regardless of time and place. The nurse must know oneself regarding his own caring capabilities. The elements that make a holistic individual whole and complete were not enumerated. But viewing the person as a whole, it means we are respecting and keeping the dignity of the patient. In line with this, every patient has their own unique qualities and needs which means they need individualized care not depending on listed standards of health provided by other theorists. In this theory, the nurse is expected to initiate, offer and give care with or without a perceived deficit or need. In addition, because it is a helping model, it celebrates the fullness of life and human being.

    However, there are limited explanations regarding the concepts of a person, man, environment and nursing. The incompatibility of nursing process to this theory may be considered a limitation since all of us are using the nursing process in our profession. Nevertheless, theory is highly applicable, useful and much effective if used together with other theories. It will surely make a difference in the recovery of our patients and positive feedbacks will be received.

4 comments:

  1. I congratulate everyone in Group F(antastic) for your care-ful and serious examination of the theory of Nursing As Caring! Your studies have produced some insights that I hope will be valuable to the continuation of your study and of your practice of nursing.
    If I may, I would like to dialogue with you about a couple of ideas expressed here. One is the idea that the nurse/nursed relationship at times seems extraordinary…and at other times seems unremarkable. That is a mature insight and I think, a very accurate description of the “whole” of a nurse’s practice over time. Once in a while, the calls for caring we hear and the nursing responses of caring that we create do rise to the description of “extraordinary”…and most of the time the calls for caring we hear and the nurse responses of caring we create seem quite ordinary, quite unremarkable. One of the ideas that interests me is I think it is in these “unremarkable” moments of nursing that the power of nursing is most beautifully expressed. Many times I have heard a nurse say “Oh, I didn’t do much, just listened to the patient” or…”I just sat with her and held her hand while she cried”…or “I only did what anyone would have done”. When you think these kind of words about your own expressions of caring..or you hear nurses say similar words, I encourage you to stop and pay close attention, because usually the very essence of caring in nursing is alive in those “unremarkable” moments.
    Let me say a couple of words about “nursing process”. First of all, I am sure you were given a format to follow in evaluating all the theories that were studied in this class, and that you were expected to follow that format. But I would like to suggest to you that the particular format used is not necessarily the best one for ALL nursing theories…it’s sort of like evaluating all fruit on the same measures, even though there are groups of fruits that share unique similarities not shared by other groups of fruit. What I’m getting at is the idea of “nursing process”…and when most textbooks use this term, they are referring to the linear kind of thinking that arose early on in the development of nursing as a discipline (in the 1950’s and 1960’s). There ARE some nursing theories that were developed in that era that actually used the linear, sequential problem solving process that in nursing has been called “nursing process”. However, beginning with the late 1970’s and certainly strengthening in the 1980’s, nursing theories transcended the restrictions of previous theories. While nursing IS a process (we say in one of our writings that nursing is “processual”), we don’t accept the idea that there is one and only one “nursing process”. There are many processes of nursing! In fact, each nursing theory calls for its own process of nursing. I am sure you noticed in your class that theories like those of Rogers, Parse and Newman don’t conform to the mid-20th Century idea of nursing process…and neither does Nursing As Caring. In our view, the process of nursing is creative, not “fixed”, it is multidimensional, not linear or sequential…and in fact, to some extent it can be thought of as an “all-at-once” process.
    I encourage everyone to realize that the core of Nursing As Caring as a NURSING theory is the statement that “the focus of nursing is nurturing persons living caring and growing in caring”. So all that we do in nursing, all that we study about when studying nursing (at least from the perspective of Nursing As Caring) is about that core: nurturing persons living caring and growing in caring!
    Again, I congratulate you and thank you, Students of Group F(antastic) – I think you ARE fantastic!

    Dr. Savina O. Schoenhofer
    Savibus1@att.net

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  2. We are truly grateful that the Nursing Theorist herself made a comment on our blog. Your additional insights and inspiring messages contributed to our knowledge in Nursing as Caring theory since we have limited resources about your theory. I hope that more nurses will be motivated by your theory for the next coming years. Thank you very much! God bless you always!

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  3. Thank you, Bernadette. Maybe you can let your classmates know that we can dialogue on this blog (right?) about Nursing As Caring, for any of them who want to continue to explore this way of nursing. Although I am not familiar with Open University, is it okay to assume that you have internet resources, and even access to a good nursing journal data base like OVID, or at least PubMed, so that you can at least locate and study journal articles about Nursing As Caring? While the chapter by Julia George in her book was not written by us (the best nursing theory books have chapters actually written by the theorists themselves, rather than an interpretation of the theory by a secondary reference), we did review the chapter on Nursing As Caring before publication of the George chapter and it is accurate, as far as it goes...the only problem there is that George used a theory evalution approach that isn't completely relevant to Nursing As Caring, and at least George acknowledged this in her chapter.

    Dr. Schoenhofer

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