REFERENCES

BOOKS:

George, J.B., et al. (1996). Nursing Theories: The base of professional nursing practice. 3rd edition.            
         Norwalk, Connecticut: Appleton and Lange.


ONLINE:

http://www.nursingascaring.com/
www.scribd.com/doc/63196184/Nursing-Theories-Nursing-Practice

KEY CONCEPTS

BY:  Leona Paula Macalintal  and Venice Joy T. Malonzo

            Anne Boykin and Savina Shoenhofer’s theory on caring as the major focus of nursing further conceptualizes other key concepts related to their theory and that is on the concept of PERSONHOOD. According to their theory,
            Persons are caring by virtue of their humanness. It reiterates that our caring values are inborn to us, humans.

Personhood is living life grounded in caring. We uphold the values on caring which we have experienced from the beginning and these in turn, mold us to practice that same experience towards the ones we care for. We believe that since we were cared for, we need to let others also experience the feeling of being cared and nurtured.

Personhood is enhanced through participating in nurturing relationships with caring others. Our personhood is further developed when we are given opportunities to nurture that relationship and value of caring by serving others and caring for them like a family member. Nursing, for instance, is one of the profession in which we can truly exemplify that value.

            Persons living their caring moment to moment. It means that our caring character is a GIFT that will carry until death. People might forget the names, faces but the way how they were taken care, how they were treated during state of hopelessness, how their lives were touch will always be cherished.
            Persons are whole or complete in the moment. It means that physical, spiritual and emotional aspects will join together as one and the level of holistic as well
            Nursing is both discipline and a profession. It focuses on nurturing. Living in caring and growing in caring in the nursing situation.
It means the way of acquiring knowledge and putting it into practice.

The basic premise of this theory is that all humans are caring persons, that to be human is to be called to live one’s innate caring nature.

Caring is the intentional and authentic presence of the nurse with another who is recognized as a person living, caring and growing in caring.

The idea of caring is an essential feature and expression of being human and is central in this theory.

The nurse endeavors to come to know the other as a caring person and seeks to understand how that person might be sustained, supported, and strengthened in their unique process of living caring and growing caring

NURSING SITUATION

Nursing takes place in the nursing situation. The idea of the nursing situation is conceptualized as the shared, lived experience in which caring between the nurse and the nursed enhances personhood and is the locus of all that is known and done in nursing.

Nursing situation is a construct in the mind of the nurse and is present whenever the intent of the nurse is to nurse. The practice of nursing, and thus the practical knowledge of nursing, is situated in the relational locus of person-with-person caring in the nursing situation. The nursing situation involves the expression of values, intentions, and actions of two or more persons choosing to live a nursing relationship

PERSONHOOD

Personhood is understood to mean living grounded in caring

Is the universal human call.

This implies that the fullness of being human is expressed in living caring uniquely day to day and enhanced through participation in caring relationship.

Is a process of living caring and growing in caring and implies being authentic, demonstrating congruence between beliefs and behaviours, and living out the meaning of one’s life.

NURSING RESPONSE

Is a specific expression of caring nurturance in order to sustain and enhance the person himself. The nurse responds through a caring attitude and the person being cared for recognizes that caring attitude and appreciates and acknowledges it.---

MAJOR CONCEPTS

By: Sally Lleva,Katherine Mallon,Hareen Lumabas

PERSON: All persons are caring, has as its focus a general call to nurture persons as they live caring uniquely and grow as caring persons even when not all chosen actions of the person live up to the ideal to which we are called to the virtue of our humanness. The theory of nursing as caring asserts that it is only through recognizing and responding to the other as a caring person that nursing is created and personhood enhanced. The idea that persons are whole and complete.  It is  illuminated as living grounded in caring

The importance of person as person, of person as caring, and of person as a whole.

Person as person – Acknowledges the uniquenesses and special gifts of each individual. Means we are committed to knowing and responding to that which truly matters. There is a commitment to listening and reflecting on our knowing. 

Person as Caring - The assumption that all people are caring implies that caring is a way of living our humanness. Caring is an innate human quality which is at various points of development in each individual. It is a process, and people throughout life grow in their ability to express caring. Caring can be express in different ways like knowing, courage, hope, patience, trust, humility and honesty.

Person as a whole – Is a view that simply recognizes that at all times that people are whole-never parts. This perspective is very important to nursing practice because it precludes any attempt to nurse simply a diagnosis or afflicted part. The whole is in the part. Therefore, to nurse is to nurse the wholeness of a person. This assumption values and respects each person’s beauty, worth and uniqueness “as one seeks to understand fully the meaning of values, choices, priority systems through which values are expressed”.

HEALTH: a well-being state of a person. In this theory, health did not fully describe but we can attain overall health thru proper caring in all aspects of life.

ENVIRONMENT: Nurturing persons living caring and growing in caring. Committed intention to promote a healthy and caring environment. Defines situational to any context that is influenced by the client

NURSING: Both a discipline and a profession is affirmed as nurse draws on a set of values and a developed knowledge of nursing as caring to actively offer his presence in service to the nursed. The point of departure was the acceptance that caring is the end, rather than the means, of nursing, and the intention of nursing rather than merely its instrument. This work lead to the focus of nursing as “nurturing persons living caring and growing in caring.

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The Theorist

BACKGROUND AND CREDENTIALS OF THE THEORIST:

By Jhoana Lurian and Lei Kristel Lontoc

ANNE BOYKIN

Anne Boykin grew up in Kaukauna, Wisconsin, the eldest of six children. She begun her career in nursing in 1966, graduating from Alverno College in Milwaukee, Wisconsin. She received her, master’s degree from Emory University Atlanta, Georgia, and her doctorate from Vanderbilt University in Nashville, Tennessee. South Florida became her home in 1981 and, today, continues to enchant and nourish her love for the natural life. Dr. Boykin is married to Steve Staudenmeyer, and they have four children.

         Anne Boykin is dean and professor of the Christine E. Lynn College of Nursing at Florida Atlantic University. She is the director of the Christine E. Lynn Center for Caring, which is housed in the College of Nursing. This center was created for the purpose of humanizing care through the integration of teaching, research, and service. Boykin has demonstrated a longstanding commitment to the advancement of knowledge in the discipline, especially regarding the phenomenon of caring.

        Positions she has held within the International Association for Human Caring include president elect (1990 - 1993 ), president ( 1993-1996 ) and member of the nominating committee (1997 - 1999 ). As immediate past president, she served as coeditor of the journal, International Association for Human Caring, from 1996 to 1999.

        Boykin's scholarly work is centered on caring as the grounding for nursing. This is evidenced in her book ( coauthored with Schoenhofer). Nursing as Caring: A Model for Transforming Practice (1993, 2001a), and the book, Living a Caring-Based Program (1994b). The latter book illustrates how caring grounds the development of a nursing program from creating the environment for study through evaluation. In addition to these books Dr. Boykin is editor of Power, Politics and Public Policy: A Matter of Caring (1995) and co-editor ( along with Gaut) of Caring as Healing: Renewal Through Hope (1994). She has also written numerous book chapters and articles and serves as a consultant locally, regionally, nationally, and internationally on the topic of caring.

   She was honored with the 2009 Visionary Caring Science Award by the Watson Caring Science Institute. The Watson Caring Science Institute is anon-profit foundation whose mission is to continue and expand the nature and depth of the work of Caring and healing in health care. Currently, she and Dr.Shoenhofer are engaged in a two-year funded demonstration project. The purpose of this project is to demonstrate the value of a model for health care delivery in an acute care setting that is intentionally grounded in Nursing as Caring.

Message from Ms. Anne Boykin

SAVINA O. SCHOENHOFER

Savina Schoenhofer was born the second child and eldest daughter in a family of nine children and spent her formative years on the family cattle ranch in Kansas. She is named for her maternal grandfather, who was a classical musician in Kansas City, Missouri. She has a daughter, Carrie and a grand-daughter Emma.

During the 1960s, Schoenhofer spent 3 years in the Amazon region of Brazil, working as a volunteer in a community development. Her initial nursing study was at Wichita University, where she earned undergraduate degrees in nursing, psychology and counselling. She completed a Ph.D. In educational foundations and administration at Kansas State University in 1983. In 1990, Schoenhofer co-founded Nightingale Songs, an early venue for communicating the beauty of nursing in poetry and prose.An early study made it apparent to Schoenhofer that caring was the service that patients overwhelmingly recognized. In addition to her work on caring, including coauthorship with Boykin of Nursing as Caring: A Model for Transforming Practice (1993, 2001a), Schoenhofer has written numerous articles on nursing values, primary care, nursing education, support, touch, personnel management in nursing homes and mentoring.

Her career in nursing has been influenced significantly by three colleagues: Lt. Col. Ann Ashjian (Ret.), whose community nursing practice in Brazil presented an inspiring model of nursing; Marilyn E. Parker, Ph.D., a faculty colleague who mentored her in the idea of nursing as a discipline, the academic role in higher education, and the world of nursing theories and theorists; and Anne Boykin, Ph.D., who introduced her to caring as a substantive field of nursing study. Schoenhofer created and manages the Web site and discussion forum on the theory of Nursing as Caring. She is currently a professor of graduate nursing at the Cora S. Balmat School of Nursing, Alcorn State University, Natchez, Mississippi, and lives her commitment and passion for illuminating the study of nursing as caring.

            Dr. Shoenhofer is a co-founder of the nursing aesthetics publication, Nightingale Songs.Her research and publication were in the areas of everyday caring, outcomes of caring in nursing, nursing values, nursing home management, and affectional touch.

Introduction

By: Mercy Joy Lubiano

       Caring and nursing most of the times are being thought in synonymous manner because caring in the nursing profession takes place in every nurse-patient interaction. Congruently in order to be a good nurse, we must have in-depth knowledge about caring and competent skills in putting it into practice. Caring is a vital part and one of the major focus in nursing, that's why there are many of nurse theorists/leaders who created nursing theories with caring as one of their key concepts like Jean Watson and Lydia Hall. There are many other nurse theorists/leaders who mentioned caring as part of their theories, but we'll focus mainly on the work of Anne Boykin and Savina Shoenhofer.

Together, Anne Boykin and Savina Shoenhofe created a grand nursing theory, which is the Theory of Nursing as Caring that states persons are caring by virtues of their humanness and live their caring moment to moment when they are whole and complete. For them, person-hood is living life grounded in caring and is being enhanced through caring for others. The basic premise of this theory is that all humans are caring person and nursing is both a discipline and a profession.

In this theory we'll learn to appreciate our innate ability to touch the lives of our needy patients through the care we are providing them. It also introduces the efficiency of using of our human potentials to help and give care naturally. Truly, there are a lot of ways on how we can show our patients that we care, like giving hope, implementing nursing interventions, keeping our patient's privacy, communicating therapeutically, promoting comfort, establishing a warm and peaceful environment, giving medicines correctly, providing health  teaching, listening attentively and even through simple ways like calling them by their own names.

To help us more in exploring the concept of caring we presented in this blog the details about Anne Boykin and Savina Shoenhofer's Theory of Nursing as Caring, its accomplishments, contributions, major concepts, key concepts, nursing process application including its strengths and weaknesses.

CONTRIBUTION OF THE THEORY IN HUMANITY

By : Marites Lingkob

Nursing as CARING

To Nursing Practice: The focus of nursing ... is person as living in caring and growing in care (Boykin & Schoenhofer,1993 pg.25). Nursing practice has been influenced by this idea. The challenge is not to discover what is missing ,weakened or disabled but to know that the other person is a caring individual and to nurture that person in situation- specific, creative and individualized caring ways. We will not consider nursing as a complicated process of acts that will result to a predictable end product but rather an inherent process of unfolding and guided intention.

To Nursing Administration: Nursing profession has subspecialties and administration is one of the area. All activities under nursing administration are concerned for creating, maintaining and supporting an environment which calls for nursing. Administration is directly and indirectly involved in multiple nursing situations, whether to nurse individual (as they uniquely responds to the calls) or to assist a nurse as they deliver care. Nurses in the administration formulate and implement policies within the organization to help them understand the goal/ focus of nursing and to make sure that the resources are available.

To Nursing Education: Understanding humanhood is a way of living grounded in caring and is enhanced by participating in nurturing relationships with caring others thus, affirming that nursing is both a discipline and profession. In teaching nursing, teachers guide students to know, appreciate and celebrate both self and others as caring persons. Students and teachers are in continual search to discover wider implication of caring as uniquely expressed in nursing. Examples are clearly stated on the book living as caring based Program by Boykin, 1994.

To Nursing Research & Development: The caring theory influenced nursing researcher and developer to explore and illuminate the patterns of caring personality. Dialogue, description and innovations in interpretation approach characterize research methods. Nursing science from a caring perspective is a human science that may require newer and different ways of defining nursing.

APPRECIATION OF THE THEORY:

By: Marites Macapagal

          The Theory of Nursing as Caring: A Model for Transforming Practice authored by Anne Boykin and Savina O. Schoenhofer tackle about the interaction of a nurse to the client as well as the relationship to the personhood. Their Theory has a big contribution to the nursing profession because the Theory stated about caring. We all know that a nurse itself will nourish to the client whether ill or well. The one will provide assistance and guidance until the client will fully recovered from illness. It is her/his duty and responsibility to ensure the good health and proper client's needs. The significance of Boykin and Schoenhofer's Theory to the other Theories is the closeness and it is related to our personal life. How we treat and give importance to a person showing our care to them especially if it is one of the member of the family. But the Theory tell us not only to our family we will show our care but to the personhood as well. Especially those who needs our service moment to moment in any status of life.
         Being a nurse is not an easy job. It takes time to understand the situation and how to facilitate the needs of the client. How to perform directly and surely to be able to make a right process in every task, especially when you are in the field of actual demostration that you have to decide independently. To act like a professional one. Giving your confidence can help to a nurse to succeed and show that you are competent like other in the same profession. It is not easy but the feeling that you've helped the client to recover from illness is the best achievement that you received, and even a simple word of "Thank You" that can make you smile and a feeling of enjoyment. That's how a nurse give a full interaction between the client and the each member of a client's family and also the member of health team.

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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.

Nursing Process

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.