Caring in Nursing Practice (NURS 308 Professionalism)

• Overview of caring in nursing practice and its central role in professionalism and patient care

Key Qualities and Focus Areas

• Caring
• Sincerity
• Presence
• Availability
• Engagement
• Compassion
• Relationship-centered
• Patient-focus

Theoretical Views on Caring

• Benner: caring is primary, the essence of nursing practice
  • Goals: help patients recover, give meaning to illness, maintain/reestablish connection
• Leininger: transcultural caring
  • Caring is personal and culturally specific; respond with culturally appropriate behaviors
• Watson: transpersonal caring
  • Central focus of nursing; holistic approach to promote healing; care precedes cure
• Swanson: nurturing care
  • Components: knowing, being with, doing for, enabling, maintaining belief
• Additional note: An invisible relationship that demonstrates respect, concern, support, empathy, compassion; nurse acts as coach, partner, enabler, and understands the patient

Patients’ Perception of Caring

• Caring assessment tool (CAT) is used to gauge patient perceptions
• Patients’ sense that the nurse is:
  • Sensitive
  • Sympathetic
  • Compassionate
  • Interested
• Patient satisfaction with nursing care is essential to quality care and outcomes

Ethic of Care

• Core elements:
  • Mutual respect and trust
  • Collaboration
  • Encouragement, hope, support, compassion
• Ethics concept:
  • Ethic relates to right and wrong behavior; ethically appropriate actions
• Focus: relationship between patient and nurse and the nurse’s character and attitude

Caring in Nursing: Presence

• Presence is a person-to-person, being-with the patient; giving of yourself
• Communication, understanding, sensitivity; touch
  • Therapeutic touch; skin-to-skin contact
• Practices and boundaries:
  • Ask permission when you first meet your patient
  • Gentle actions: hold a hand, reposition, back rub; offer comfort; speak softly; reassure, support
  • Protective touch: used to prevent accidents
• Listening and silence:
  • Planned, deliberate listening; silence yourself to hear the patient
• Facilitates knowing and responding to the patient
  • What is important to them?
• Knowing is complex but essential to patient satisfaction and outcomes
• Continuous assessment involves time, continuity, teamwork, trust, and experience
• Caring is more than merely gathering data; it integrates ongoing assessment with empathy and relation-building

Spiritual and Holistic Caring

• Spiritual caring involves balance with life values, goals, and beliefs
• Interconnectedness: spirituality promotes connection with oneself, others, and a higher being
• Mobilize hope to support healing and coping
• Relieving symptoms and suffering through holistic approaches
• Patient-centered care encompasses multiple modalities:
  • Medications, repositioning, wound care, palliative care
• Maintaining comfort, dignity, respect, and peace across physical, emotional, spiritual, and social dimensions
• Family care: includes family members and caregivers
  • Nurses must strive to know the family, provide information, listen, implement orders, advance directives, educate, and offer comfort, assurance, and ongoing support

Family Care and Involvement

• Family and caregivers are integral to patient care
• Provide information and education to family members
• Listen to family concerns and preferences
• Implement advance directives and orders in collaboration with the patient and family
• Supportive roles include comforting, assuring, and ongoing presence

Practical Dimensions of Caring in Nursing Practice

• Patient-centered care is central to nursing practice
• The care process includes
  • Medications administration and monitoring
  • Repositioning and wound care
  • Palliative care when appropriate
  • Maintaining patient comfort and dignity
• Caring integrates physical, emotional, spiritual, and social aspects of health
• The nurse’s attitude and character influence ethical practice and patient trust

Challenges of Caring in Modern Nursing

• Time constraints limit meaningful interaction
• Technology can create barriers or opportunities for connection
• Need for cost-effective modalities without sacrificing quality of care
• Standardized work processes may reduce individualized attention
• Task-oriented workflows can undermine relational care
• Multiple stressors (workload, interruptions, emotional strain) impact caring practices

Connections to Practice and Real-World Relevance

• Caring is foundational to patient satisfaction and health outcomes
• Theoretical frameworks (Benner, Leininger, Watson, Swanson) inform how nurses interpret and enact care
• Ethic of care emphasizes moral character and relational ethics in clinical decision-making
• Presence and therapeutic touch are practical skills with measurable impact on patient experience
• Spiritual and family-centered care recognize patients as whole persons within social systems
• Managing time, technology, and workflow is essential to sustaining caring in busy clinical settings

Summary of Key Takeaways

• Caring is the core of nursing, underpinning all actions from technical care to ethical behavior and relational practice
• Nurses should strive for presence, sincerity, and a patient-centered approach that respects cultural, spiritual, and family contexts
• Theoretical models provide guidance on how to enact care, while practical skills (communication, touch, listening) translate theory into bedside practice
• Ethical considerations and relationship quality are as important as clinical tasks in achieving holistic healing
• Real-world care requires balancing compassion with efficiency, navigating time constraints and systemic pressures while maintaining patient dignity and comfort