CARING

Case 1  

nA nurse enters a client’s room, greets the client warmly while touching the client lightly on the shoulder, makes eye contact, sits down for a few minutes and asks about the client’s thoughts and concerns, listens to the client’s story, looks at the intravenous (IV) solution hanging in the room, briefly examines the client, and then checks the vital sign summary on the bedside computer screen before departing the room.

  Case 2

nA nurse enters the client’s room, looks at the IV solution hanging in the room, checks the vital sign summary sheet on the bedside computer screen, and acknowledges the client but never sits down or touches the client. Eye contact with the client is from the nurse’s lofty vertical position to the client’s vulnerable horizontal position. The nurse asks a few brief questions about the client’s symptoms and then departs. 

Theoretical views 

nCaring is at the heart of a nurse’s ability to work with people in a respectful and therapeutic way.

  Caring is primary(Benner)  

nThe essence of excellent nursing practice is caring

nCaring means that persons, events projects, and things matter to people (Benner & Wrubel, 1989)

nIt describes a wide range of involvements, from parental love to friendship, from caring for one’s work to caring for one’s pet, to caring for and about one’s client

  The essence of nursing and health
(Leininger)

nCare is the essence and central, unifying and dominant domain that distinguishes nursing from other health disciplines.

nCare is oriented to assisting an individual or group in improving a human condition

nActs of caring refer to the nurturant and skillful activities, processes, and decisions that assist people in ways that are empathetic, compassionate and supportive.

  

  Transpersonal caring
(Jean Watson)

nTheory of caring describes a consciousness that allows nurses to raise new questions about what it means to be a nurse, to be ill, and to be caring and healing.

nWatson rejects the disease orientation to health care and places care before cure.

nCaring becomes almost spiritual

nThe model is transformative, as both the nurse and the client are influenced by the relationship, for better or for worse.

nThe caring-healing consciousness can promote healing.

  Swanson’s Theory of caring

 

nCaring is a nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment and responsibility.

Caring is consisting of five categories or processes

5 processes of caring 

Caring process	Definitions	Sub dimensions
Knowing	Striving to understand an event as it has meaning in the life of the other	Avoiding assumptions Centering on the one cared for Assessing thoroughly Seeking cues Engaging the self or both

Caring Process	Definition	Sub dimension
Being with	Being emotionally present to the other	Being there Conveying ability Sharing feelings Not burdening

 

Caring process	Definition	Sub dimension
Doing for	Doing for the other as he or she would do for the self if it were at all possible	Comforting Anticipating Performing skillfully Protecting Preserving dignity

 

Caring process	Definition	Sub dimension
Enabling	Facilitating the other’s passage through life transitions (e.g., birth, death) and unfamiliar events	Informing/explaining Supporting/allowing Focusing Generating alternatives Validating/giving feedback

 

Maintaining belief	Sustaining faith in the other’s capacity to get through an event or transition and face a future with meaning	Believing in/holding in esteem Maintaining a hope-filled attitude Offering realistic optimism Going the distance

 
 Caring in nursing practice 

Nursing behaviors;

nProviding presence

 Being there and being with 

nTouch

Contact and non contact

Three categories of touch: task oriented touch, caring touch and protective touch. 

Listening    

Nurse caring behaviors as perceived by families  

1.Being honest

2.Giving clear explanations

3.Keeping family members informed

4.Trying to make the client comfortable

5.Showing interest in answering questions

 

Providing necessary emergency care

7. Assuring the client that nursing services will be available

8. Answering family members’ questions honestly, openly, and willingly

9. Allowing clients to do as much for themselves as possible

10. Teaching the family how to keep the relative physically comfortable 

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