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Theorists: Drs Josephine Paterson and Loretta

Definition of theory
 Derived from Greek ‘to look at’ (theorein).

 “An abstract statement formulated to predict,

explain or describe the relationships among
concepts, constructs or events. A theory is
developed and tested by observation and
research, using factual data” (Mosby, 2006)

Background of theorists
 Dr Zderad majored in psychiatric nursing,
completed at doctorate at Georgetown University
in philosophy with dissertation on empathy.
 Dr Paterson majored in public health, completed
doctor of nursing science degree at Boston
University – dissertation in comfort.
 Met in the 1950’s whilst working at Catholic
University, where their task was to create a new
program that would include psychiatric and
community health components as part of the
graduate program friendship that has lasted over 35
 Shared experiences, ideas and insight to form a concept
that evolved into the formal Theory of Humanistic Nursing.
“Humanistic nursing embraces more than a
benevolent technically competent subject-
object one-way relationship guided by a nurse
in behalf of another. Rather it dictates that
nursing is a responsible searching,
transactional relationship whose
meaningfulness demands conceptualization
founded on a nurse's existential awareness of
self and of the other” (Paterson & Zderad,

 “Humanistic nursing theory is
multidimensional (Kleiman, 2001)”.
 In humanistic nursing theory the components
identified as human are the patient (can refer
to the person, family, community or
humanity); and the nurse
 Patient sends call for help person receiving
and recognising is the nurse

 Nurse has made a decision and dedicated
themselves to helping others with their health
care needs
 Humanistic nursing term exists known as “all-
at-once” (Kleiman, 2001)
 Nurses and patients have their own ‘gestalts’,
or concept of wholeness

Patient and Nurse gestalts (Kleiman, 2001)
 Nurse bring their whole self when helping in
patient treatment, i.e. experience, education
etc, to create a type of mosaic to use with
nursing interventions
 Humanistic nursing theory accepts the
likeness in our differences, but attempts to
identify the sameness in each other or our
unifying links that make up the soul or
essence of nursing.

Paterson and Zderad describe five
phases in their study of nursing:

1. Preparation of the nurse knower for

coming to know
 Understanding own viewpoint/angle helps to make
sense and aid in acquiring meaning of experience
 By identifying own views they can be withheld, so that

they do not interfere with one’s attempts to describe the

experiences of another
 Being open to new and different ideas/understandings is

a necessary position in being able to get to know the

other intuitively

2. Nurse knowing the other intuitively

 Paterson and Zderad describe this as “moving back and

forth between the impressions the nurse becomes
aware of herself and the recollected real experience of
the other” (Paterson & Zderad, 1976)
 Dialogue back and forth between patient and nurse

allows for clearer understanding further generalisation

in developing process

Nurse knowing the other intuitively. Adapted by Kleiman from
illustration in Briggs, J., & Peat, D. (1989). Nurse knowing the other
intuitively. In Turbulent Times (p. 176). New York: Harper & Row.
3. Nurse knowing the other scientifically

 Implies need for objectivity in coming to know the other

 Reflective practice validates patterns and themes

 “This is the time when the nurse mulls over, analyses,

sorts out, compares, contrasts, relates, interprets, gives

names to and categorises (Paterson & Zderad, 1976)”

Nurse knowing the other scientifically. Adapted by Kleiman
from illustration in Briggs, J., & Peat, D. (1989). Nurse knowing the 13
other intuitively. In Turbulent Times (p. 176). New York: Harper &
4. Nurse complimentarily synthesising
known others
 The ability of the nurse to develop or see themselves as
a source of knowledge, to continually develop the
nursing community through education, and increased
understanding of their owned learned experiences

Nurse complementarily synthesising known others (Kleiman,
2001) 15
5. Succession with the nurse from the
many to the paradoxical one.
 “Nurse comes up with a conception or abstraction that is
inclusive of and beyond the multiplicities and
contradictions (Paterson & Zderad, 1976)”.
 Process that allows for reflection, correction and

expansion of own angular interpretation

 Implies universal understanding from the simplest to

most complex dialogue and interactions between the

nurse and assimilates patient experiences
 No member of this interaction or experience is the same

as before
 Coming together of patient and nurse

The Concept of Community

 Definition of community as presented by

Paterson and Zderad is “Two or more persons
struggling together toward a centre” (Paterson
& Zderad, 1976).
 Humanistic Nursing Theory suggests that
there is an obligation on the part of the nurse
to each other, along with other members of
the community openness, sharing and
caring leads to expansion of individual or
group angular views each becoming more
than before
Clinical Application of Humanistic
Nursing Theory

 Encourages reflection, reflection being a

learned process that can help enhance the
experience of the nurse and prepare them for
similar situations in the clinical environment.
 The ability to be with and travel with the
patient in the routine of living is often
overlooked, but is an essential part of the
professional life of a nurse.
 Understanding the professional differences
between other medical staff and allied health
professionals, respect the difference and
accept responsibility for challenges of nursing 18
 “Mandate of Humanistic Nursing Theory is to
share with, thereby allowing each to become
more” (Kleiman, 2001).
 The current nursing shortage is leading to a
requirement for nurses to be more proactive,
use critical thinking.
 Nurses have for some time had the challenge
of being asked to help analyse, suggest and
implement changes in the health care system.

 Stress environments in acute care situations
do not allow proper time for nurses to reflect,
relate and provide support to each other
talking and listening helps to evaluate and
clarify the current function and value of
 “Through openness and sharing we are able to
differentiate our strengths” (Kleiman, 2001).
 Theory is the prototype for more recent
experiential nursing theories created by
people such as Jean Watson.

 Briggs, J., & Peat, D. (1989). Nurse knowing the

other intuitively. In Turbulent Times (p. 176). New
York: Harper & Row.
 Kleiman, S. (2001). Humanistic Nursing Theory
with Clinical Applications. In M. Parker, Nursing
theories and nursing practice (pp. 152-168).
Philadelphia: F A Davis Company.
 Mosby. (2008). Mosby's Dictionary of Medicine,
Nursing and Health Professions (1st Australian and
New Zealand Edition ed.). (P. Harris, S. Nagy,
Vardaxis, & N, Eds.) China: Elsevier.
 Paterson, J. G., & Zderad, L. T. (1976). Humanistic
Nursing. New York: Wiley.
 Paterson, J., & Zderad, L. (2008). Humanistic
Nursing. Project Gutenberg eBook 21