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Caring in Nursing Practice (NURS 308 Professionalism)

Caring in Nursing Practice

  • Core elements (from the Caring in Nursing Practice outline):
    • Caring
    • Sincerity
    • Presence
    • Availability
    • Engagement
    • Compassion
    • Relationship-centered
    • Patient-focus
  • Purpose of these qualities:
    • Underpin professional nursing practice
    • Support relationship-centered, patient-focused care
    • Help build trust, empathy, and effective patient interactions

Theoretical Views on Caring

  • Benner: Caring is primary, the essence of nursing practice
    • Aims: help patients recover, give meaning to illness, maintain/reestablish connection
  • Leininger: Transcultural caring
    • Caring is personal
    • Respond with culturally specific behaviors
  • Watson: Transpersonal caring
    • Central focus of nursing
    • Holistic approach to promote healing
    • Care precedes cure
  • Swanson: Nurturing
    • Key processes: knowing, being with, doing for, enabling, maintaining belief
  • Invisible relationship element
    • Demonstrates respect, concern, support, empathy, compassion
    • Roles: coach, partner, enable, understand

Patients’ Perception of Caring

  • Caring assessment tool (CAT) is used to gauge patient perceptions
  • Patients’ sense of caring includes nurses who are:
    • Sensitive
    • Sympathetic
    • Compassionate
    • Interested
  • Patient satisfaction with nursing care is essential for overall outcomes and quality of care

Ethic of Care

  • Core principles:
    • Mutual respect and trust
    • Collaboration
    • Encouragement, hope, support, compassion
  • Ethics definition:
    • The study of right and wrong behavior; ethics guide what is ethically appropriate
  • Ethic of care focus:
    • Relationship between patient and nurse
    • Nurse’s character and attitude as foundational to ethical practice

Caring in Nursing: Presence and Communication

  • Presence definition
    • Person-to-person, being with, giving of yourself
  • Key components:
    • Communication, understanding, sensitivity
  • Touch as a therapeutic modality
    • Skin-to-skin contact
    • Ask permission when you first meet your patient
  • Practical expressions of caring touch
    • Gentleness, holding a hand, repositioning, back rub
    • Offering comfort, speaking softly, reassurance, support
  • Protective touch
    • Used to prevent accidents or injuries
  • Listening and knowing the patient
    • Listening as an active, deliberate practice
    • Silence and patient-led conversations
  • Knowing what is important to the patient
    • Facilitates knowing and responding to patient needs
  • Continuous assessment
    • Time, continuity, teamwork, trust, and experience
    • More than merely gathering data; involves ongoing interpretation of patient needs

Spiritual Caring and Patient-Centered Care

  • Spiritual caring concepts
    • Balance with life values, goals, and beliefs
    • Interconnectedness with self, others, and a higher being
    • Spirituality promotes connection and meaning
    • Mobilize hope to cope with illness
    • Relieving symptoms and suffering through holistic care
  • Patient-centered care implications
    • Address physical, emotional, spiritual, and social dimensions
    • Involve medications, repositioning, wound care, and palliative care as appropriate
    • Maintain comfort, dignity, respect, and peace

Family Care

  • Family and caregivers play a central role
    • Nurses must strive to know the family’s needs and context
  • Communication and information sharing
    • Providing information
    • Listening
  • Care planning and decision-making support
    • Implementing orders, advance directives
    • Educating family members
    • Comforting, assuring, and supporting

Challenges of Caring

  • Time constraints
  • Technology
  • Cost-effective modalities
  • Standardized work processes
  • Task-oriented environments
  • Multiple stressors on healthcare professionals

Connections and Implications (Foundational Principles and Real-World Relevance)

  • Caring as the foundation of professional nursing aligns with patient-centered care models and quality of life outcomes.
  • Theoretical views (Benner, Leininger, Watson, Swanson) provide a framework for understanding how care is enacted across clinical practice and cultural contexts.
  • Patient perception (CAT) emphasizes that the patient experience of care is a critical metric for quality, not just clinical outcomes.
  • The Ethic of Care foregrounds relational ethics: the nurse-patient relationship, character, and attitudes as central to ethical practice.
  • Presence, communication, and touch are concrete skills that translate caring into tangible patient interactions.
  • Spiritual and family care expand the scope of care beyond the patient to include meaning, belief systems, and the social network surrounding the patient.
  • Real-world implications include balancing compassionate practice with time and resource constraints, designing workflows that preserve interpersonal connection, and ensuring ethical considerations guide daily care.