Nursing Theory Caring As an Integral Nursing Peer Reviewed Journal

Nursing Theory

Caring as an integral nursing concept can be viewed from diverse perspectives. It can be an attribute, a complex set of behaviors, or an attitude. This has made some people believe that it is impossible to improve and measure it although there is evidence that both improvement and measurement are possible. People recognize that caring models of professional practice affect the service users, health outcomes, healthcare staff, and ultimately health care costs. The ability of healthcare staff to deliver caring-based models is driven by characteristics of healthcare service users and organizational behaviors. While nursing has generated a lot of research about caring, this concept remains relevant to all healthcare professionals encountering users of health care services. The caring concept has many similarities with relationship-based care and person-centered care.

B. Literature review

Nurse at risk of threatened well-being

In many countries, an increasing tendency to abandon the nursing field has been observed. Studies indicate that care providers experience a feeling of incapacity when they are unable to offer the care that preserves the dignity of the patient. In addition, the situations that frustrate the good intentions of nurses generate a feeling of disempowerment leading to suffering and exhaustion. This jeopardizes the ability to maintain caring relationships with patients. Multidisciplinary studies indicate that emotional labor underlying caring if accompanied by emotional dissonance causes emotional strain, job related stress, burnout, feelings of estrangement and depersonalization of caregivers in diverse cultures. This suggests that avoiding connecting with patients and being inauthentic leads to feelings of apathy and powerlessness among nurses with low emotional awareness (Moyer & Whitman-Price, 2007).

Caring and human conscious

Conscious designates an individual's morality or ethic because it is expressed in the direct sense of the demands of their sensible nature. It encompasses a development process informed by an individual's understanding of others, experience, courage, humility, hope, honesty and trust in others.

The core of caring

In professional nursing, the ultimate goal of caring is to preserve the dignity and the absolute value of patients as human beings. The human aspect involves serving others and being there for them. Therefore, all human beings are of equal value and due to such caring work, the mental well-being of nurses and patients are improved. Nurses report higher job satisfaction and personal growth when they work in environments that allow them to provide high quality care. They are comfortable with the fundamental ethos and values of caring in nursing (Watson Caring Science Institute, 2009).

Caring acts

Caring has been described as a model of interpersonal process of becoming human. Caring profession has been attributed as burdensome in some organizational and personal contexts. The nursing profession maintains the need for critical reflection on caring and roots of caring when nurses are observed to abandon their profession (Moyer & Whitman-Price, 2007).

C. Determine defining criteria for the concept

Many of the criteria for defining the concept of caring is similar to the criteria proposed by Kuhn. The criteria that will be described in terms of their similarities include consistency, accuracy, complexity or simplicity, fruitfulness, acceptability, scope and socio-cultural utility.

Accuracy has been listed as an attribute of a good theory. It can be defined as a precision or without mistakes and errors. Related synonyms include just, perfect, truthful, correct and unerring (Dennis, 2007). In any nursing theory, accuracy is tied to describing nursing as it is currently and not nursing of the past or the future. When evaluating this theory, it is important to assess whether it contains a worldview of nursing consistent with the current reality in this field. In this case, current reality refers to the current culture or philosophy of nursing where it could be applied or used. Consistency will be frequently used to describe the theory. Consistency refers to the internal consistency. The caring theory does not necessarily need to be consistent with alternative acknowledged theories in nursing. In nursing, theorizing requires a change: the caring concept will not be developed based on a criterion of evaluating extant theories (Moyer & Whitman-Price, 2007).

However, other philosophers have described internal consistency as the existence of logical order, consistency in language and connectedness. Since all inconsistencies must be avoided whenever presented in the caring theory, it will not be practical or necessary to scrap the entire theory. As shown in various nursing philosophies, consistency is within the list of internal criteria for evaluating the caring theory. Inconsistencies exist in the method, use of terms, and principles (Watson, 2009). In most cases, it entails inconsistency in the definition of terms. For instance, the theory described nursing as care of groups or individuals but proceeds to describe nursing only as it applies to care of the individual.

Another criterion is fruitful, which is linked conceptually to other criteria. Fruitful is synonymous with fertility or productivity (Moyer & Whitman-Price, 2007). When describing this concept, theorists like Kuhn stated that the caring theory must expose new phenomenon, new feelings, and previously unknown relationships among already existing phenomenon. Here, fruitful refers to success in evaluating empirical work resulting from the caring theory and in explaining observable phenomenon. Fruitful has much similarity with the term fertility, which is described as the scope for further development. The caring theory must contain ideations to further research. Consistency is the criteria of generation of information; the caring theory must generate hypotheses. Studies indicate that this is the ultimate criteria for the definition of the caring theory (Watson Caring Science Institute, 2009). This is because if the theory generates many hypotheses, even some that are difficult to test and some without high probability, it will contribute to understanding.

However, some theorists espouse simplicity as a vital definition criterion. Others have recommended complexity. However, it depends on whether the theory in question has many relationships and phenomena or if concentrates on fewer relationships and fewer concepts. Essentially, it appears logical, because of the need for a balance of simple and complex theories for and of nursing. Nevertheless, this criterion requires it to be part of the definition of the caring theory. The importance of the theory is consistent with its recommended complexity and simplicity. Such a pragmatic approach to the complexity/simplicity debate is evident in the definition of simple, which has been described as bringing order to a phenomenon, which in its absence might be confused and isolated. Seemingly, this definition is a useful feature and a good concept in nursing. It is important in the definition of the caring theory (Moyer & Whitman-Price, 2007).

The criterion of scope has been widely dichotomized as either narrow or broad. The broader the scope in terms of the variety and number of related concepts and facts, the greater the significance of the theory. This approach tends to be confusing as it is argued that the scope must be judged in terms of the phenomena and generalizations pertinent to the individual human species. This means that the theory will be more useful if it is more general and covers as many issues as possible. However, limited scope sometimes focuses on the development of middle range philosophies of limited nursing aspects. With the changing focus of nursing triggered by the response to societal changes, the propositions, concepts, and the caring theory will have to change (Watson, 2009).

Another criterion is the circle of contagiousness, which describes the adoption or acceptance of the concept by another. The contagious circle increases when the caring theory starts to cover various concentric circles from its original jurisdiction. This infers that the theory is receiving more acceptability without the influence of the theorist. It is an indication that its development can go ahead whether others are buying into and accepting it. The issue of problem solving has attracted massive attention in nursing both within the across cultures. However, this theory is opposed to such a concept while scholarly dialogues regarding it are not common. Nursing must advance, just as any other professions where professionals in the discipline communicate about its adoption and multicultural acceptance by others (Watson Caring Science Institute, 2009).

D. Give real life examples or the concept in use.

The concept of nursing has been applied in the clinical practice discipline. Professional nurses seek control and autonomy of their practice. They desire to apply their nursing skills and knowledge without interference from physicians, nurse managers and other people involved in the discipline. The nurse manager must trust the professional nurse to apply skills and knowledge correctly in caring for patients. As a result, the clinical nurse will trust the manager to coordinate equipment, supplies, and support systems with staff in other departments. Clinical nurses trust human relations managers whereby they are involved rather than where they have rules and regulations imposed on them. The theory of nursing is used to meet the needs of the practice and determine how the profession should be practiced. By doing this, they conform to management policies despite issues such as quality improvement and documentation because they form part of the clinical nursing practice.

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