1. Technological Competency as Caring in Nursing by Rozzano C. Locsin
Ferris State University
Nursing 501
Reviewed by Jennifer Scott, Constance Vanderboon,
Sandra Hannon
This is a group review of Rozanno Locsin’s Theory of Technological Competency as Caring in Nursing.
By Jennifer Scott, Constance Vanderboon and Sandra Hannon
Master Copy

2. OBJECTIVES The student will be able to: Define Locsin’s theory
Identify nursing metaparadgim concepts
Identify the criteria for evaluating Locsin’s Theory
Describe the purpose of research article
The student will be able to:
Define Locsin’s theory of Technological Competency as Caring in Nursing
Identify nursing metaparadgim concepts within that theory
Identify the criteria for evaluating Locsin’s Theory
Describe the purpose of research article, Valuing Caring Behaviors Within Simulated Emergent Nursing Situations

3. Objectives continued
Identify how Locsin’s Theory was reflected in the research article
Identify how in the research article would have been different without the framework
Describe how the theory could be applied in practice
Identify the tie between theory and practice
Identify the importance to differentiating nursing knowledge from other disciplines
Identify how Locsin’s Theory was reflected in the research article Valuing Caring Behaviors Within Simulated Emergent Nursing Situations
Identify how the research article would have been different without the framework
Describe how the theory could be applied in practice
Identify the tie between theory and practice
Identify the importance to differentiating nursing knowledge from other disciplines

4. Overview of Theory
“Technological competency as caring is the skilled demonstration of intentional, deliberate, and authentic activities by experienced nurses who practice in environments requiring technological expertise.”
Knowing
Designing
Implementing & Evaluating
Verifying Knowledge
Locsin & Waraporn, 2011, p. 30
Locsin and Waraporn state that Technological competency as caring is a nursing phenomenon, the skilled demonstration of intentional, purposeful, and authentic activities of nurses in patient care environments requiring technological expertise. What this statement means is nursing needs to balance patient care and the technology used in that care without the nurse loosing their focus of the patient rendering them invisible.
Razzano Locsin introduced the theory Technological competency as caring in nursing in 2004.
Technological competency as caring in nursing is a four-phased nursing process:
The phases listed illustrate how practicing nurses are guided from a theory-based perspective in their practice -
Knowing the person involves understanding the patients as participants rather than objects of their care and the patient will let the nurse know only what they want them to know. Technology is used to gain further knowledge and essentially becomes a representation of the real person but only in that moment of time.
In designing both the nurse and the patient mutually plan care activities in response to the patient's desires.
Implementing & Evaluating is a stage of the process that alternates implementation and evaluation of care activities that reflect the process of knowing the patient either through the patient themselves or through the use of technology.
In verifying knowledge, the ways of knowing persons is made known through the use of technologies and nursing the nurse gains an appreciation of expertise and autonomy, and the knowledge of persons in the moment.

5. Paradigm Concepts Health Nursing Environment Person
Locsin’s Theoretical Framework
Locsin, 2006, p. 381
Masters, 2012, p. 48
Future, 2011
There are 4 metaparadigm concepts. Health, Nursing, Environment and Person
In relations to Locin’s theory within the health paradigm
The concept of Health is having the Patient participate in their own health. And in using technologies to better understand the hemodynamics of the patient to provide the best care and meet their individual needs
Nursing is described As a discipline and a specialized practice that uses technologies to individualize care to meet the unique needs of the person
Environment is in the surroundings that use technology. such as a critical care unit to understand the persons as a complete moment by moment. Increased technological monitoring allows for greater insight of whole state of health. Nurses must be efficient and proficient with technologies without losing focus on the person as a whole.
The last concept is Person. The person who is also the recipient of nursing care has desires, dreams, and ambitions are to live life completely as caring persons. They also want to feel acknowledged as a unique person with hopes and dreams and not as an object

6. Evaluation
Accuracy
Technology continues to evolve and encompasses the majority of functional activities that nurses are expected to perform, especially in a clinical setting.
Simplicity
The relationships noted in Locsin’s theory include three main components of “caring in nursing, human beings as persons, and technological competence”
Dudley-Brown, 1997, p. 80
Locsin, 2006, p. 382
Dudley Brown’s criteria was used In evaluating Locin’s theory of technological competency as caring
Based on his criteria, Locins theory is accurate because of the use and application of the theory and is current with today’s nursing practices. 
Technologies continue to evolve and encompasses the majority of functional activities the nurse is expected to perform in a clinical setting. Locisn’s theory provides an understanding of how technologies can assist the nurse in understanding the patient as whole and unique and to use the data to focus care on the individual and not on tasks.
SIMPLICITY – Locisn’s theory is simple in that is focuses on the relationships of a few concepts. 
The relationships in the theory are: caring in nursing, human beings as persons and technological competency.
These concept relationships demonstrate the need to be knowledgeable with technologies, and use the data to provide individualized nursing care to facilitate the best outcomes for the patients.

7. Evaluation Continued Scope
The scope of Locsin’s theory is narrow using technology, caring, and knowing persons
Acceptance
The broad concepts of caring and technology have been applied to nursing and critical care practice by a number of authors, including Locsin. These authors have taken the use of caring and technology in the direction of an optimistic, holistic view.
Price, 2013, p. 280
Dudley-Brown, 1997, p. 80
SCOPE- described what is being observed in the theory 
In continuing to evaluate Locin’s theory the next is scope.
The scope in Locisn’s midrange theory is narrow because its focus is using technological caring and knowing persons.
ACCEPTANCE questions if the theory used or referenced by other nurses in literature. 
Broad concepts of caring and technologies have been applied to nursing in the Critical care setting by a number of authors. Price uses Locisn’s theory within her article “Caring and Technology in the Intensive Care Unit” and how the nurse must be focused and present when caring for the patient. Locsin and these Authors have taken the concepts of caring and technology in the direction of optimistic and holistic view.

8. Evaluation Continued Socio-cultural Utility
Nursing occurs in critical care settings when technologies are used competently with the genuine purpose to know patients wholly, who are in the course of living and growing in caring.
Locsin, 1998, p. 55
Dudley-Brown, 1997, p. 80
In the last piece of evaluating Locin’s theory we look at socio-cultural utility or is the theory significant to society and does it make a difference in peoples lives?
Nursing occurs in the Critical care setting when technologies are used competently with the genuine purpose of knowing patients wholly, who are in the course of living and growing.

9. Valuing Caring Behaviors Within Simulated Emergent Nursing Situations'
Terry Eggenberger, RN, PhD(c), Kathryn Keller, RN, PhD, & Rozzano C. Locsin, RN, PhD, FAAN.
The article we reveiwed is:Valuing Caring Behaviors Within Simulated Emergent Nursing Situations'
Written by Terry Eggenberger, RN, PhD(c), Kathryn Keller, RN, PhD, & Rozzano C. Locsin, RN, PhD, FAAN.

10. Overview THEORY REFLECTED
Students demonstrate caring behaviors with patients in emergent situations using a simulation lab
THEORY REFLECTED
Locsin presented a foundational viewpoint of technological competency as caring in nursing in which technological knowing demonstrates the focused attention that the nurse makes toward persons as contributors in their care rather than objects of their care.
Overview:
This research study was done to explore how students demonstrate caring behaviors with patients and families in emergent situations using a high-fidelity human simulator. The students were introduced to the simulation lab in attempt to mimic a real world situation of a patient experiencing chest pain who deteriorated rapidly. The students interacted with participants that portrayed a nurse, doctor, patient’s wife and the simulator “Mr. Silver”.
THEORY was REFLECTED in the research paper by how Locsin’s theory was presented a foundational viewpoint of technological competency as caring in nursing in which technological knowing demonstrates the focused attention that the nurse makes toward persons as contributors in their care rather than objects of their care.

11. Questions
“How can a student be taught caring using simulation technology?
“Can caring nursing be taught using simulation technology?”
METHODS
Qualitative focus group research
method
Semi structured group sessions
Integrating, n.d.
Questions: 2 questions formulated in this research study
“How can a student be taught caring using simulation technology?
“Can caring nursing be taught using simulation technology?”
In analyzing the data, the researches looked for words and statements that described how the students came to know the person being nursed as caring within the simulated situation.
METHODS
The study utilized a qualitative focus group research method. The technique uses a semi structured group session, moderated by a group leader, with the purpose of obtaining opinions, beliefs, and attitudes about a designated topic.”

12. How the study would have been different
Find another study that would have addressed caring and technology
Getting to know the patient
No framework to balance nursing care and technology
Eggenberger, T., Keller, K., & Locsin, R. (2010).
The study would have been different if Locsin’s theory was not utilized as the basis of this research. First of all he authors would have had to find another theory that would have addressed caring and technology and the research would not have helped the nursed understand that in the high tech healthcare world that requires much of the nurses attention and expertise that it is still important to remember that there is still a patient to care for. And the practice of balancing both.

13. Theory in practice
Using technologies in nursing practice is only one way to know persons as whole
Understand data is only current in the moment
Invasive lines
Focus on person in the moment to individualize care
Vital signs
Using technologies in practice is one way to know persons as whole
Understanding the data obtained is only current in the moment and will change because persons are continually changing.
Invasive lines help monitor small changes that could become detrimental to persons health, shows improvement to persons health, and helps in providing appropriate therapy.
Using the data to focus on the person in the moment to provide appropriate, individualized care
B/P’s and oxometers help determine persons baselines, the opportunity to educate what may be causing these findings and ways to improve or maintain results. Responses to treatment – is the blood pressure medication working to help prevent stroke. Is the pain medication working for someone unable to verbalize.

14. Theory in practice continued
Maintain current in technologies
Simulated learning
Medication scanners
Databases
No technology should be the focus of care. Technologies provide one component to knowing persons complete and in the moment.
Keep current on the technologies so they do not overwhelm and become the focus of care
Using simulators to learn how to perform life saving actions as ACLS or how to use new equipment in a lab or class provides a safe environment for nurses to learn and become more efficient with technologies so the technologies do not become the focus of care.
Medication scanners – prevent wrong medications from being given and preventing harm to persons
Creation and use of data bases help to provide nurses access to current information and help provide up to date evidence based information that is accessible any time any place.
No technology should be the focus of care. Technologies provide one component to knowing persons complete and in the moment.

15. Theory vs. practice Nursing Theory
Conclusions of real events and conditions
Nursing Practice
Actual work performed by nurses.
Relationship, (n.d.).
“Nursing theory consists of a collection of conclusions about real events and conditions that may be applied to real world nursing situations. Like other theories, it is often based on observations and written to be consistent and logical. Nursing practice, on the other hand, refers to the actual work that is performed by nurses.
The major reason for structuring and advancing nursing knowledge is for the sake of nursing practice. The primary purpose of nursing theories is to further the development and understanding of nursing practice. Theory-based research is needed in order to explain and predict nursing outcomes essential to the delivery of nursing care. Because nursing theory exists to improve practice, the test of nursing theory is a test of its usefulness in professional practice. Through use of theory, nurses find different ways of looking at and assessing phenomena, have rationale for their practice and criteria for evaluating outcomes.  Development of nursing knowledge is a result of theory-based nursing inquiry. Nursing theory must be seen as practical and useful to practice and the insights of practice must in turn continue to enrich nursing theory.

16. Importance of nursing knowledge
Nursing’s unique body of knowledge
Theories act as the foundation for nursing practice
Butts, Rich, & Fawcett, 2012
Carper, 1978
Knowledge, 2005, November 29
Mallik, Hall, & Howard, 2009, p. 1
Profession, n.d..
In conclusion, nurses are the backbone of the health care system. The knowledge that is required to care for patients and families goes beyond utilizing technical skills. Nurses need to have knowledge about the total person they are tending to. It is also essential to have a working knowledge about institutional policies, guidelines, and procedures. Also, nurses must have the ability to deliver evidence-based care to foster health in addition to the ability to care for those who are ill (Mallik, Hall, & Howard, 2009, p. 1).
In order to be recognized as a discipline, separate from medicine and other health sciences, nursing needs to have its own body of knowledge. Carper grouped nursing knowledge into four categories. Empirical or the science of nursing, esthetic is the art of nursing, personal is actualizing nursing, and ethics or moral right or wrong in nursing.
Theories act as the foundation for nursing practice and are used to develop nursing actions. Dr. Jacqueline Fawcett states that having nursing models and theories are crucial to providing a rational for what nurses do and why they do what they do. She continues to say that nursing knowledge guides practical nursing activities. This is because a discipline has by definition a distinct body of knowledge. Knowledge is basically what classifies us as a profession because having a ‘unique body of knowledge’ is one of the things that defines a profession in society ("Profession," n.d.).
We hope you have enjoyed our presentation of Razzano Locsin’s theory of Technology Competency in Caring and the research study that utilized this theory: Valuing Caring Behaviors Within Simulated Emergent Nursing Situations'
Thank you.

17. References
Butts, J. B., Rich, K. L., & Fawcett, J. (2012). The future of nursing: how important is discipline-specific knowledge? A conversation with Jacquelin Fawcett. Nursing Science Quarterly, 25(2), Retrieved from
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, Retrieved from /Fundamen tal_Patterns_of_Knowing_in_Nursing.4aspx.
Defining nursing knowledge. (2005, November 29). Nursing times. Retrieved from practice/clinical-zomes/educators/defining-nursing- knowledge/ article.

18. References Continued
Eggenberger, T., Keller, K., & Locsin, R. C. (2010). Valuing caring behaviors within simulated emergent nursing situaions. International Journal for Human Caring, 14(2),
Future of nursing [Drawing]. (2011). Retrieved from content/uploads/2011/07/p30_FutureofNursing.jpg.
Integrating technology into nursing [Photograph]. (n.d.). Retrieved fromhttp:// nursing.html.

19. References Continued
Locsin, R. C. (2006). Technological Competency as Caring and the Practice of Knowing Persons as Whole. Parker, M.E. (2nd ed.) In Nursing Theories & Nursing Practice. Philadelphia, PA: F. A. Davis Company.
Locsin, R. C., & Waraporn, K. (2011). The invisible person in a technological world of nursing practice. UPNAAI Nursing Journal, 7(1),
Locsin, R. (1998). Technologic competence as caring in critical care nursing. Holistic Nursing Practice, 12(4),
Masters, K. (2012). Nursing theories: a framework for professional practice. Retrieved from

20. References Continued
Price, A. M. (2013). Caring and technology in an intensive care unit: an ethnographic study. Nursing in Critical Care, 18: 278–288. doi:  /nicc
Profession. (n.d.). Retrieved March 22, 2014, from
What is the relationship between nursing theory and nursing practice. (n.d.). Retrieved from relationship-between-nursing-theory-and-nursing-practice.htm.