Humanistic Nursing

A written Output / Requirement

Submitted to: Dr. Helen C. Estrella

In partial fulfillment
Of the requirement
Nursing 201-A

Submitted by: Jayson Y. Cataraja, R.N.

Date of Submission: August 16, 2014
 Graduate School

SUBJECT : NURSING 205 (Advanced Nursing Administration 1)

TOPIC : Humanistic Theory
GENERAL OBJECTIVES : After 1 hour of varied teaching-learning strategies, the MAN 1 students shall acquire advanced knowledge, skills, and positive attitude
on Management

SPECIFIC TIME
CONTENTS METHODOLOGY RESOURCES EVALUATION
OBJECTIVES ALLOTMENT

Specifically, the • Opening Prayer Audio Visual Material After 1 hour of

students will be Presentation Resources: varied
able to:  Projector teaching-
• Preconditioning Activity Group Activity  Laptop learning
 Pen & paper strategies, the
 Books and students will be
1. Definition Humanism attempts to take a broader perspective of the Lecture- Internet source able to
of terms individual's potential and tries to understand each individual from Discussion on participate in:
the context of their own personal experiences. management
 Group
Existentialism is a philosophical approach to understanding Discussion
life. It's the belief that thinking begins with the human - the feeling,  Question &
acting, living individual. Existentialism emphasizes the individual's Answer
free-choice, self-determination and self-responsibility.  Synthesis
Formation
Nursing Dialogue is when a nurse and patient come
together. The nurse presents themselves as a helper ready to on Health and
assist the patient. The nurse is open to understanding how the Economics.
patient feels with the intention of improvement. Openness is an
essential quality for humanistic nursing dialogue.
  A theory is a group of related concepts that propose action
2. Define that guide practice.
Humanistic  Theory refers to “a coherent group of general propositions
Theory
used as principles of explanation”
 A nursing theory is a set of concepts, definitions,
relationships, and assumptions or propositions derived from
nursing models or from other disciplines and project a
purposive, systematic view of phenomena by designing
specific inter-relationships among concepts for the
purposes of describing, explaining, predicting, and /or
prescribing.

 Concepts
o Concepts are basically vehicles of thought that
involve images.
o Concepts are words that describe objects ,
properties, or events and are basic components of
theory.
o Types of Concepts:
 Empirical concepts
 Inferential concepts
 Abstract concepts.

 Models
o Models are representations of the interaction among
and between the concepts showing patterns.
o Models allow the concepts in nursing theory to be
successfully applied to nursing practice.
o They provide an overview of the thinking behind the
 theory and may demonstrate how theory can be
introduced into practice, for example, through
specific methods of assessment.
 Propositions
o Prepositions are statements that explain the
relationship between the concepts.
 Process
o Processes are series of actions, changes or
functions intended to bring about a desired result .
o During a process one takes systemic and continuous
steps to meet a goal and uses both assessments
and feedback to direct actions to the goal.
o A particular theory or conceptual frame work directs
how these actions are carried out .
o The delivery of nursing care within the nursing
process is directed by the way specific conceptual
frameworks and theories define the person (patient),
the environment, health and nursing
 Josephine Paterson Loretta Zderad
 Josephine Paterson and Loretta Zderad are from the United
States. They both earned first diplomas in nursing, then
Bachelor's degrees in Nursing education before continuing
to graduate programs. Their career as nursing academics
got started in the 1950s, when they were both employed at
Catholic University where they met. They continued to work
together and remained friends for the next 40 years. They
later continued onto their doctorate degrees in the 1960s.
 Humanistic Nursing Theory. By 1971, they had begun to
define their theory and what it was that made it unique as
an approach to nursing. They then began to research other
nurse's experience, and used their theory as a perspective
and method for nurses to examine their experiences.
Through this, their goal was to develop it into theoretical
propositions, which could serve as guides for nursing
practitioners.
Humanistic nursing theories
 a foundation in the belief that patients can grow in a healthy
and creative way.
 believed that nursing education should be founded in
experience, and that a nurse's training should focus as
much on the nurse's ability to relate to and interact with
patients as a scientific and medical background.

Patient sends call for help person receiving and recognising is the nurse

Nurse bring their whole self when helping inpatient treatment,

i.e. experience, educationetc, to create a type of mosaic to use
withnursing interventions

Humanistic nursing theory accepts thelikeness in our differences, but

attempts toidentify the sameness in each other or ourunifying links that
make up the soul oressence of nursing.

Paterson and Zderad developed the five phases of the nursing

process:

1) Preparation of the Nurse Knower For Coming to Know:

In this stage the nurse acts as investigator who willingly takes
risks and has an open-mind. The nurse must be a risk-taker and
be willing to experience anything. "Accepting the decision to
approach the unknown openly".

2) Nurse Knowing of the Other Intuitively:

In this stage the nurse tries to understand the other, as in the "I-
thou" relationship, where the nurse as the "I" does
notsuperimpose themselves on the "thou" of the patient.

3) Nurse Knowing the Other Scientifically:

The nurse as the observer must observe and analyze from the
outside. At this stage, the nurse goes from intuition to analysis.
Analysis is the sorting, comparing, contrasting, relating,
interpreting and categorizing.

4) Nurse Complementarily Synthesizing 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.

5) Succession Within the Nurse From the Many to the Paradoxical

One:
In this stage the nurse takes the information gleaned and applies it
in the practical clinical setting. Here the nurse takes brings the
dilemma towards resolution.
.

COMMON CONCEPTS IN NURSING THEORIES

 Four concepts common in nursing theory that influence and

determine nursing practice are
o The person( patient)
o The environment
o Health
o Nursing (goals, roles, functions)
 Each of these concepts is usually defined and described by
 a nursing theorist. Of the four concepts, the most important
is that of the person. The focus of nursing is the person.

Person
 are viewed as open energy fields with special life
experiences. As energy fields, they are greater than and
different from the sum of their parts and cannot be
predicted from knowledge of their parts. Human beings,
are viewed as being holistic in nature, are special, dynamic,
aware, and multidimensional, capable of abstract thought,
creativity, capable of taking responsibility. Language,
empathy, caring, and other abstract patterns of
communication are aspects of an individually high level of
complexity and diversity and enable one to increase
knowledge of self and environment. Persons are to be
valued, to be respected, nurtured and understood with the
right to make informed choices regarding their health, may
include families and communities.

Health
Health: Well-Being and More-Being

According to humanistic Nursing theory there is a call from a

person, a family, a community or from humanity for help with some
health related issue. The nursing act is always related to the
health-illness quality of the human condition, or fundamentally, to
a man's personal survival. This is not to say that all instances of
nursing are matters of life and death, but rather that every nursing
act has to do with the quality of a person's living and dying. That
nursing is related to health and illness is self-evident. How it is
related is not so apparent.

"Health" is valued as necessary for survival and is often proposed

as the goal of nursing. There are, in actuality, many instances of
nursing that could be described as "health restoring," "health
sustaining," or "health promoting." Nurses engage in "health
teaching" and "health supervision."

On the other hand, there are instances in which health, taken in its
narrowest meaning as freedom from disease, is not seen as an
attainable goal, as evidenced, for example, in labels given to
patients such as "terminal," "hopeless," and "chronic." Yet in
actual practice these humans' conditions call forth some of the
most complete, expert, total, beautiful nursing care. Nursing, then,
as a human response, implies the valuing of some human
potential beyond the narrow concept of health taken as absence of
disease. Nursing's concern is not merely with a person's well-
being but with his more-being, with helping him become more as
humanly possible in his particular life situation.
Environment
According to Patterson and Zderad, the environment represents
the place where the service is delivered, the community or the
world.

The environment can be understood as the time and space in

which the nursing experience takes place. From the existential
perspective, it is the time and space as lived by the nurse and/or
patient during the experience.

"For example, waiting, silence, chronicity, emergency, positioning

a patient in bed, moving through space in a wheelchair, crutch-
walking, pacing, could be considered from the standpoint of the
patient's experienced space and time, or from the nurse's, or as a
shared event. Explorations of this kind could provide valuable
insights into important nursing phenomena, such as, presence,
empathy, comfort, timing. "
To understand the nursing dialogue, one must put the experience
in the context of time: the time lived as the patient and the
nurse. The nurse and the patient may be interacting within the
same actual time span, but the time may feel very different to the
nurse and client. Their experiences of time are unique to their
understanding of the situation.

Space is the lived perception of the world around the nurse and
patient. Space could be the hospital room, the bed, the waiting
room, the visiting area or any other space in which the interaction
takes place. The physical environment can enhance or impede
the nursing dialogue based on how comfortable the participants
feel and how well the space encourages communication.

Place is another component of space, but it is more personalized;

it belongs to the patient or nurse and is highly subjective. It
relates to "where I feel I belong or am". A person may feel out of
place or may feel at home or welcomed in the place. The nurse
may feel comfortable in the place while the patient does not.

Space and time coincide within the nursing experience. For

example, after a longer stay in a hospital, for example, a patient
may begin to feel at home, when initially it was foreign. The
nursing dialogue is reinforced when the nurse understands how
the patient relates to their space.

Nursing
Paterson and Zderad define nursing as a "lived experience
between human beings". It is an evolving, affecting, and helping
relationship in which the patient and nurse engage in a dialogue.
They emphasize the importance of the nurse being aware of
herself and of the client as unique human beings, and of
understanding the individual perspective, identity, experiences,
condition, and needs of each patient. The nurse must therefore
modify her/his response in offering a genuine presence.

Paterson and Zderad refer to this as a "reciprocal call and

response" that is achieved through an awareness of the nurse's
own worldview, values, understanding, and responses, and
responding to the others' responses and knowledge. Through
understanding the self and the other, the nurse can engage in an
authentic, therapeutic exchange of experience, understanding,
and of being.

Nursing is unique from other shared, authentic exchanges in that

the nurse's role is to help another who needs help. Nursing
possesses a humaneness that is inseparable from the nursing
role. Nursing is a "human transaction", and thus involves all of the
human limitations, emotions, and potentials of each patient, as an
exchange that affects the nurse, who in turn responds through
her/his perspective and authentic being, which in turn affects the
patient. Thus, while each participant might experience a situation
uniquely, they will also have experience of the shared interaction,
the "between" and its message and meaning. For example, the
nurse might experience providing care, the patient of being cared
for. They will both, however, have an experience of care-giving
and care-receiving through their transaction with the other. As
well, everything the nurse does physically is shaped by her
"character of being in the situation". Thus, while a nurse might
believe she has provided an insulin injection to a patient, she has
done so through her own unique character and way of being in
that moment. In doing so, the nurse is hereby communicating
herself and responding to the client as a human being in much the
same way as she is providing insulin in response to the client's
blood sugar levels.
Nursing is an inter-human, transactional, interconnected dialogue
of helping in a way that recognizes and expresses ones own
genuine human-ness, and responds to the unique human-ness of
the patient.

Palliative Care to the Cancer Patient: Reflections According to

Paterson and Zderad's View

 In Paterson and Zderad, nursing care emphasizes the nurse as

giving care, and the nursing process as a shared and meaningful
transaction between nurse and patient. As clients in palliative care
are in such a vulnerable position, and in such a unique place,
respecting the patient as uniquely human, and being aware of what
emotions and senses are communicated is especially
important. This approach helps to provide meaning to the client and
ensure she/he is respected and responded to authentically on the
client's terms, as well as allows him/her to experience his/her own
death humanely and as envisioned by him/herself. Authentically and
genuinely being with with the client will enable the client to connect
with the nurse, express his/her perceptions and values, and to be
comforted and cared for by the nurse as a human being.

The spiritual aspects of dying at home. Holistic Nursing Practice

Spirituality, in its broadest sense, is a part of the ontologic foundation of

nursing; it is regarded as a basic characteristic of humanness important in
human health and well-being.

Paterson and Zderad's humanistic nursing theory can be used to meet the
spiritual needs of terminally ill persons in the home setting. The spiritual
needs, as identified by Highfield and Cason, are applied to the hospice
patient.

The comforts of the home environment and humanistic nursing practice are
integrated in the "meetings" between dying persons, their families, and
hospice nurses. These meetings contribute to fulfilling the spiritual needs of
terminally ill persons. Hospice nurses practicing holistic nursing and using
caring behaviors help dying persons develop a "more-being" in themselves
as the triad of person, family, and nurse share the lived experiences.
Hospice nurses use the caring behaviors, rather than the curing behaviors,
to minister to the dying family. The nurse, the patient, and the family share
the nursing situation in the framework of a "lived dialogue."' As Paterson
and Zderad describe humanistic nursing practice, "a special kind of meeting
of human persons”.

Patient participation in nursing care: an interpretation by Swedish

Registered Nurses

One of the main objectives of positive health care is patient

participation. Registered nurses should encourage the participation of their
patients by informing the patient and promoting patient choice and decision
making.