 Nursing as an Art  The purpose of the discipline and profession

of nursing is to know persons and nurture

Caring them as persons living and caring and
growing in caring.
> people, relationship and things matter
 Respect for persons as caring
Caring Practice
individuals and respect for what
> Involves connection, mutual recognition and matters to them
involvement
 Caring is a lifetime process, lived
 Nursing Theories on Caring moment to moment by the nurse
and constantly unfolding
 Culture Care Diversity and Universality
(Leininger)  Theory of Human Care (Watson)

 Caring as a nurturing behavior has been  Caring as the essence and moral ideal of
present throughout history and is one of the nursing
most critical factors in helping people
 Theory of Caring (Swanson)
maintain or regain health.
 Caring as nurturing way of relating to a
 Caring is the essence of nursing
valued other, toward whom one feels a
and the distinct, dominant and
personal sense of commitment and
unifying focus of nursing
responsibility.
 Nurses must understand different
 The Primacy of caring (Benner and Wrubel)
cultures in order to function
effectively  Caring is the essence of excellence in
nursing.
 Theory of Bureucratic Caring (Ray)
 Caring practice requires attending
 Caring in organizations as cultures. Caring
to the particular client over time,
in nursing is contextual and is influenced by
determining what matter to the
the organizational structure.
person and using this knowledge in
 Caring, the Human Mode of Being clinical judgement.
(Roach)
 THE 6 C’s of CARING
 Caring as a philosophical concept and
1. Compassion – awareness of one’s
proposes that caring is the human mode of
relationship to others, sharing their joys,
being, of the “most common, authentic
sorrows, pain and accomplishments.
criterion of humanness.”
Participation in the experience of another.
 All persons are caring, and develop
2. Competence – having the knowledge,
their caring abilities by being true
judgment, skills, energy, experience and
to self, being real and being who
motivation to respond adequately to others
they truly are.
within the demands of professional
 Nursing as Caring ( Boykin and responsibilities.
Schoenhofer)
3. Confidence – the quality that fosters
trusting relationships. Comfort with self,
client and family.
4. Conscience – morals, ethics, and an informed  Storytelling
sense of right and wrong. Awareness of personal
responsibility.  Music Therapy

5. Commitment – convergence between one’s  Yoga

desires and obligations and the deliberate choice to
 Communication
act in accordance with them.
 Any means of exchanging information or
6. Comportment – appropriate bearing, demeanor,
feelings between two or more people.
dress and language, that are in harmony with a caring
presence. Presenting oneself as someone who It is a basic component of human relationships,
respects others and demands respect. including nursing.
 Caring for Self and Others  Two purposes:
 Caring for Self – helping oneself grow and  To influence others
actualize one’s possibilities.
 To obtain information
 Self Care – responding to one’s own needs
to grow, is the opposite of self-complacency  Sender – a person or group who wishes to
that often accompanies egocentricity. convey a message to another

Self Care Activities  source-encoder

1. A balanced diet  Encoding

2. Regular exercise  Message – what is actually said or

written, the body language that
3. Adequate rest and sleep accompanies the words and how the
message is transmitted.
4. Recreational activities
 Channel
5. Meditation and prayer
 Receiver – the listener who must listen
 A Healthy Lifestyle
observe and attend
 Nutrition
 Decode
 Activity and Exercise
 Response – message that the receiver
 Recreation returns to the sender

 Avoiding unhealthy patterns – negative  Modes of Communication

thinking, destructive lifestyle choices like
 Verbal Communication – uses the spoken or
smoking, abuse of alcohol or drugs and
written word
misusing medications.
 Nonverbal communication – uses other
 Mind-Body Therapy
forms, such as gestures or facial expressions
 Guided imagery and touch

 Meditation  Factors Influencing Communication

Process
 Development – knowledge of the client’s
developmental stage will allow the nurse
to modify the message accordingly
 Gender – females and males communicate
differently
 Values and Perceptions
 Values – standards that influence
behavior
 Perceptions – personal view of an
event
 Personal Space – the distance people
prefer in interactions with others
 Intimate – touching to 1 ½ feet
 Personal – 1 ½ ft to 4 feet
 Social – 4 to 12 feet
 Public – 12 to 15 feet
 Territoriality – concept of the space and
things that an individual considers as
belonging to the self
 Roles and relationships – between sender
and receiver affect the communication
process
 Environment – temperature extremes,
excessive noise and a poorly ventilated
environment can all interfere with
communication
 Congruence – the verbal and nonverbal
aspects of the communication matched. If
there is incongruence, the body language
or nonverbal communication is usually
the one with the true meaning
 Interpersonal attitudes – caring and
warmth convey a feeling of emotional
closeness
 Therapeutic Communication
Promotes understanding and can help establish a
constructive relationship between the nurse and
the client. It is client and goal directed.
 Components:
 Attentive Listening – listening actively,
using all the senses
 Physical Attending – the manner of being
present to another or being with another
 Therapeutic Communication Techniques
 Using silence – accepting pauses or silences
for several seconds or minutes without
interjecting any verbal response
 Providing general leads – using statements
or questions that encourage the client to
verbalize, choose a topic of conversation
and facilitate continued verbalization
 Being specific and tentative – asking broad
questions that lead or invite the client to
explore thoughts or feelings
 Using touch – appropriate forms of touch to
reinforce caring feelings
 Restating or rephrasing – repeating
thoughts or feelings
 Seeking clarification – making the client’s
broad over-all message more understandable
 Perception checking or seeking
consensual validation – verifies the
meaning of specific words
 Offering self – suggesting one’s presence,
interest or wish to understand the client
without making any demands
 Giving information – providing in a simple
and direct manner, specific factual
information the client may or may not
request
 Acknowledging – giving recognition, in a
nonjudgmental way, of a change in
 behavior, an effort the client has made or a
contribution to a communication
 Clarifying time or sequence – helping the
client clarify an event, situation or
happening in relationship to time
 Presenting reality – helping the client
differentiate the real from the unreal
 Focusing – helping the client expand on and
develop a topic of importance
 Reflecting – directing ideas, feelings,
questions or content back to client to enable
him/her explore their own ideas and feelings
about a situation
 Summarizing and planning – stating he
main points of a discussion to clarify
relevant points discussed. Useful at the end
of the interview.
 Communication and the Nursing process
 Communication is an integral part of the
nursing process
 Nurses use communication skills in each
phase of the nursing process
 Communication is also important when
caring for clients who have communication
problems
 Communication skills are even more
important when the client has sensory,
language or cognitive deficits.
 Teaching
 a system of activities intended to produce
learning. The teaching-learning process
involves dynamic interaction between
teacher and learner
 Areas for Client Education
 PROMOTION OF HEALTH
 PREVENTION OF ILLNESS/INJURY
 RESTORATION OF HEALTH
 PROMOTION OF HEALTH
 Increasing a person’s level of wellness
 Growth and development topics
 Fertility control
 Hygiene; Nutrition; Exercise
 Stress management
 Lifestyle modification
 Resources with the community
 PREVENTION OF ILLNESS/INJURY
 Health screening (e.g., blood glucose level,
blood pressure, blood cholesterol, Pap test,
mammogram, vision, hearing, routine
physical examinations)
 Reducing health risk factors (e.g., lowering
cholesterol level)
 PREVENTION OF ILLNESS/INJURY
 Specific protective health measures ( e.g.,
immunizations, use of condoms, use of
sunscreen, use of medication, umbilical cord
care)
 First aid
 Safety (e.g., using seat belts, helmets,
walkers)
 RESTORATION OF HEALTH
 Information about tests, diagnosis,
treatment, medications
 Self-care skills or skills needed to care for
family members
 Resources within health care setting and
community