FAR EASTERN UNIVERSITY

Institute of Nursing

NCM 1221 Decent Work Employment and Transcultural Nursing (DWE & TCN) SY 2020-2021

MODULE 5 : TRANSCULTURAL NURSING (ESSENCE OF NURSING)

INTRODUCTION:

At its essence, the profession of nursing combines the discipline of caring with the
practice of caring. In other words, the nursing profession comprises the practice of caring for
people who are in need or ill, along with the systematic study of caring in relation to disciplinary
knowledge of the body, mind, and spirit and the transcultural context. Philosophy and/or theory
often tie together the study of caring with the practice of caring.
Because caring is so universal and because it is so innate to nursing, it is incumbent upon
nurses to understand its many dimensions and perspectives before caring for human beings from
diverse cultures.

LEARNING OUTCOME:
At the end of this module, the student will be able to utilize the concepts of caring in
providing a safe, appropriate and holistic nursing care to a client with different practices, beliefs,
values and cultures.

TOPIC OUTLINES:
1. Dimension of the model: Essence of caring (love, empathy, authenticity, compassion, co-
presence, availability, attendance, and communication)

2. Ray’s Transcultural communicative spiritual-ethical caring tool for cultural competency

(compassion, advocacy, respect, interaction, negotiation, and guidance
LEARNING CONTENTS:

Dimension of the Model

Essence of Caring
(Love, Empathy, Authenticity,
Compassion, Co-Presence, Availability,
Attendance, Communication)
The action of compassion/love as the
mediating force to guide moral caring
behavior and facilitate right action
(justice or fairness) within
the dynamics of culture

History of Caring:
Nightingale’s Philosophy of Caring
- Caring in nursing began formally in the mid-1800s with the revolutionary work of
Florence Nightingale
- Nightingale did not confine herself to rational categories in creating her philosophy of
care in nursing. Rather, she also looked to the universe as a causal whole, the person
as a free agent, and the ideas of God and faith in her philosophy. Nightingale’s own
worldview underscored what we know today—that science is more than mechanism,
objectivity, and determinism.
- Nightingale as Transcultural and Transdisciplinary - Nightingale continues to
be a role model today for the evolution of transcultural nursing. As a frequent world
traveler, she came to appreciate culture, art, politics, and war.

Definitions and Meanings of Caring

Reviewing historical perceptions and development of the concept of caring is one way to
begin to grasp the essence of caring. Another component in the essence of caring is the word
itself and its many meanings, connotations, and interpretations.
• Care (noun): (1) worry, anxiety; (2) serious attention, heed, caution; (3) a protection,
charge.
• Care (verb): (1) feel concern for or about (nurture), (2) feel liking, affection for; (3)
provide for; (4) look after.
• Caring (adjective): (1) compassionate, especially professional care with sick or
elderly.
The Meaning of Caring: A disciplinary study

Caring has different meanings in different contexts. The following present perspectives of caring
from a variety of disciplines outside of nursing.

o Caring and Anthropology

o Caring and Theology and Spirituality
o Caring and Philosophy
o Caring and Ethics
o Caring and Science
o Caring and Education
o Caring and Political Science
o Caring and Art

Caring as the way of modern nursing:

➢ In the mid-1970s, Leininger asserted that caring is the essence of nursing. She said
that the “most unifying, dominant and central intellectual and practice focus of nursing is
caring” and that “there is no discipline that is so directly and intimately involved with
caring needs and behaviors than the discipline of nursing”
➢ Roach highlighted caring as a human mode of being and the most consistently
used concept to describe nursing since the evolution of the profession.
➢ Watson too revealed the critical role of caring in nursing science, education, and
practice. Watson professed that caring is the aspiration of nursing, a moral ideal fostering
protection and enhancement of human dignity and harmony of body, mind, and soul.
Eriksson, a nurse philosopher, remarked that caring is a way of living.
➢ According to Eriksson caring is caritas, a deep human and professional
communion, which requires being there in authentic presence, and reconciling suffering
for others. “To have the courage to see your neighbor’s suffering and to assume
responsibility to alleviate it without just walking by, are the responses in which all care
originates”. “Suffering and love are the deepest and innermost movements of the soul and
the spirit and, therefore, they are the most fundamental processes of life and health”.
 ➢ Boykin and Schoenhofer identified nursing as caring and suggest that the goal of
the nurse is to enhance life for self and others.
➢ Newman, Sime, and Corcoran-Perry concluded the following:
“...the domain of inquiry is caring in the human health experience...the task of nursing
inquiry will be to examine and explicate the meaning of caring in the human health
experience to ascertain the adequacy of this focus for the discipline, and to examine the
philosophic and scientific questions provoked by the focus statement.”
➢ Ray’s philosophy symbolizes caring as copresence and oblative love, giving, and
receiving in response to need. “Caring is authentic presence, availability, attendance and
communication which includes interest, acceptance, touch and empathy”. In the evolution
of her thought, Ray argued that dynamic transcultural caring is the dominant mode of
being for a transglobal world and nursing. Ray identified caring as an ontology (a way of
being), epistemology (a way of knowing), teleology (has a purpose), and praxis (is a
practice), and as complex caring dynamics, her ideas correlated with the new science of
complexity. This position defines caring by holistic and transcultural means and includes
the idea from complexity science that in complex caring dynamics there is recognition of
the notion of the “edge of chaos,” the point of creativity energy where disorder (disease,
pain, suffering) that drives change toward a new order, is a choice point for healing, well-
being, peaceful death—transformation or self-organization.

Classification System of Caring

Practical Interactive

Spiritual-
Ethical
Caring

Philosophical Psychological

Meaning of Spiritual-Ethical Caring

Compassion and Love

Co-Presence and Dialogue
Being, Knowing, Doing
Authentic
Presence
One with the Other
Justice: Taking Responsibility
One for the Other
Existential Advocacy
 Ray’s Transcultural Communicative
Spiritual-Ethical CARING Tool for Cultural
Competency
Transcultural communicative caring is a multidirectional way of caring in
professional life that encourages transcultural communication (symbolic
interaction, oral or linguistic interaction [or through an interpreter]) to
mutually understand the needs, suffering, problems, and questions of
people that arise in culturally dynamic situations.

C: Compassion
Respond lovingly in authentic presence in person or via
electronic communication by opening one’s mind and
heart to the other.
Act ethically by doing good, being fair, and facilitating choice.
A: Advocacy
Discern by discovering, ascertaining, distinguishing the
vision of reality (worldview) of the other, and the
contributions to the situation of the patient, family or
significant other to facilitate mutual understanding and
transformation.
R: Respect
Respect the culture (including the traditional or folk culture)
of the patient and family, and the dynamics of the
transcultural relationship of the patient, family, and
community.
I: Interaction
Act competently by interviewing, listening, and
manifesting transcultural knowledge and skill.
Ask questions to enhance the history and physical examination:
What do you think is causing your suffering/pain/problem?
How are you affected by the suffering/pain/problem?
What do you think may help or benefit you?
N: Negotiation
Mediate relationships and codevelop a plan of care by
transcultural caring: allowing, recognizing,
acknowledging, encouraging, affirming, confirming, and
transforming the transcultural encounter.
Cocreate transforming self/life patterns by understanding
the power within and the life-world patterns that promote
connection of one to the other in community.
Mutually shape and devise a plan of care from the
shared alliance (ethics of caring and responsibility
[agreement, compromise, and understanding]) in
choice-making with patients and family/significant
others.

Summary:

The following summarizes the essence of caring and transcultural caring in particular:
➢ Caring is the human mode of being.
➢ Caring is grounded in Roach’s (2002) 6 Cs of commitment, compassion, conscience,
confidence, competency, and comportment.
➢ Caring includes communication and context (the environment, organizations, and
the universe).
➢ Caring is a human trait, moral imperative, human action and interaction,
intervention, and transcultural phenomenon.
➢ Caring is the process that connects people, cultures, and societies and makes clear that
underneath the separation created by professional disciplines, there lies a common need for
belonging.
➢ Caring and love are the visible means that binds each of us together. “Love is the
ultimate and highest goal to which man can aspire”.
➢ Caring involves understanding of compassion as love and right action as justice in
culturally dynamic nursing situations.
➢ Caring is dynamic, complex, and emergent, thus is grounded in the new sciences of
complexity (belongingness and interconnectedness).
➢ Caring forms the foundation for an ethical commitment to uphold the good of the
other.
➢ Caring promotes a social and ethical obligation, responsibility, and accountability.
➢ Caring includes economical, technologic, legal, and political dimensions (the
cultural context of society and organizations).
➢ Caring promotes respect for persons, animals, and the environment.
➢ Caring fosters spiritual-ethical communication/interaction that illuminates
knowledge, skill, and transcultural and multicultural competency.
➢ Caring facilitates advocacy and mediation.
➢ Caring enhances choice making and relational self-organization.
➢ Caring guides others through counseling, codirection, and coeducation.

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