CARING IN NURSING By Purwaningsih

2 What is Caring? Central focus of nursing More difficult in today’s fast pace health care Legalities of any aspect of health care has made the aspect of caring appear missing to the client Technology have made some things easier but has increased time spent away from the client We see many clients who remember the way it was years ago With these changes we must make sure that we hold the caring and compassion along side the knowledge

Caring is Universal Influences the way people think, feel and act Many nursing theorists have tired to “define” caring – Nightingale was first Caring is the heart of nursing

Caring is Relational Patients value nurse Effectiveness – Ability to perform tasks Also value nurse Affect – Attitude or demeanor while performing the tasks Patients are more willing to participate if they sense that they are cared about

5 Theoretical Views on Caring A universal phenomenon that influences the way we think, feel, and behave Studied from a variety of philosophical and ethical perspectives since the time of Florence Nightingale – Patricia Benner – Benner and Wrubel

6 The Essence of Nursing and Health Madeleine Leininger (1978) Caring is: – Essential for well-being, health, growth, survival, and facing handicap or death Trans cultural perspective – Caring is essential for health and survival – Caring is expressed in different ways in many cultures

7 Transpersonal Caring Jean Watson’s theory of caring (1979, 1988a, 1988b, 1995, 1999, 2003) – Focuses on individuals and meaning for their quality of life – Caring involves sensitivity, respect, and high moral and ethical commitment – Places care before cure – Caring becomes the ethical standard by which we measure nursing – Caring preserves human dignity – Caring is a choice – Emphasis on nurse-patient relationship

Watson defined nursing “as a human science of persons and human health—illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human care transactions” (Watson, 1988, p. 54)

Carative factors, evolving into Caritas factors Transpersonal Caring Relationships Caring occasion/Caring moment

Guides the core of nursing Carative factors attempt to “honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve” (Watson, 1997, p. 50). Contrasts the curative factors of medicine (curative means to cure a disease) Carative factors evolve into Caritas factors

Caritas has a greater spiritual dimension In Greek, caritas means “to cherish and to give special loving attention”

Carative Faith and hope Helping-trusting, human care relationship Caritas Being authentically present and enabling the beliefs of the one being cared for and the one giving care Developing and maintaining a trusting, authentic, caring relationship (Watson, 1999, p.62)

Carative Creative problem solving caring process Expressing positive and negative feelings Transpersonal teaching- learning Caritas Creative use of self Being present to and supporting the positive and negative feelings with a connection of a deeper spirit Engaging in genuine teaching-learning experience (Watson, 1999, p.62)

Transpersonal means to go beyond one’s own ego and reach a deeper spiritual connection while comforting a patient. The transpersonal relationship depends on: A commitment from the nurse to enhance and protect human dignity An awareness from the nurse that they have the ability to heal The nurse must go beyond the objective role

To preserve and protect a person’s humanity, and dignity Preserve a patients spirit to ensure the patient does not become an object This relationship allows the nurse and the patient to to mutually seek out meaning and in turn lead to a transcendence of suffering (Watson, 2001).

Watson (1998, 1999) stated that when human caring is created the nurse and patient come together to create a moment, this is known as the caring occasion/caring moment Watson (1999) feels as though the nurse and the patient must be aware of the caring moment so as to make appropriate choices and actions, thereby the nurse without knowing becomes a part of the patients “life history”

17 Swanson’s Theory of Caring A composite of three studies Defines caring as – A nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility A central nursing phenomenon

18 Swanson’s Theory of Caring—cont’d Knowing Being with Doing for Enabling Maintaining belief

Expressions of Care Spiritual – Being aware of & honoring patient’s beliefs Presence – Being there Physically present Demonstrating understanding – Being with Sharing oneself

Touch – Skin-to-skin – Eye contact (nonverbal) – Protective – to prevent injury Listening – Taking in patient information – Interpreting what has been taken in

Knowing – Understanding the client – Understanding the planned interventions – Avoid making assumptions – Focuses on client

22 Can You Learn Caring Behaviors? Some of you already do caring behaviors You may have learned as a part of your values and experiences As you continue as a student you may learn new and different ways to care for others You will improve those behaviors as you work toward being an expert nurse

23 Knowing the Patient A central aspect of nursing practice that develops in the everyday practical work of patient care The core of clinical decision making More than just collecting clinical data

24 Spiritual Caring Spiritual health is achieved when a person finds a balance between life values, goals, and belief systems and those of others. Watson (1979) describes the caring relationship in a spiritual sense Spirituality offers a sense of connectedness. – Intrapersonally, interpersonally, and trans personally

25 Family Care Individuals experience life through relationships with others. Caring does not occur in isolation from a patient’s family. Family is an important resource.

26 CHALLENGE OF CARING You may have decided to go into nursing because you care You will have the responsibility to maintain the caring nature of nursing Begin here by developing that relationship with other students and the carry that over into your career

Ethic of Care Protects human dignity Often perceived as a moral imperative Requires awareness of potential unequality in relationships – This due to either real or perceived “power” that patient assigns to the nurse – Knowledge is power

THANK YOU