Fundamentals of Nursing Chapter 7: Caring in Nursing Practice

Theoretical Views on Caring

• Caring is primary and has common themes among nursing theories
• Leininger's Transcultural Caring theory focuses on cultural aspects
• Watson's Transpersonal Caring theory emphasizes the connection between nurse and patient
• Swanson's Theory of Caring highlights the importance of knowing the patient's context

Patient's Perspective of Caring

• Patients value the affective dimension of nursing care
• The Caring Assessment Tool measures patients' perceptions of caring
• When patients feel sensitive, sympathetic, and compassionate care, they become active partners in the plan of care
• Assessing patient expectations and building a nurse-patient relationship are essential

Ethic of Care

• Caring is an interaction of mutual respect and trust
• The ethic of care is concerned with relationships between people and a nurse's character
• Caring is an important aspect of a nurse's behavior

Caring in Nursing Practice

• Caring is a skill that develops with practice and experience
• Caring is a human behavior that can be given and received
• Recognizing the importance of self-care and caring for colleagues is essential

Providing Presence

• Providing presence is a person-to-person encounter that conveys closeness and caring
• Presence involves "being there" and "being with" the patient
• Nursing presence is the connectedness between a nurse and a patient
• Establishing presence strengthens the ability to provide effective patient-centered care

Touch

• Touch provides comfort and creates a connection
• Types of touch include noncontact touch, contact touch, task-oriented touch, caring touch, protective touch, and therapeutic touch
• Touch conveys many messages, so it should be used with discretion

Listening

• Listening is necessary for meaningful interactions with patients
• True listening leads to knowing and responding to what really matters to a patient and family
• Effective listening requires silence and an open mind
• Active listening helps to truly know patients and what is important to them

Knowing the Patient

• Knowing the patient is the core of clinical decision making and patient-centered care
• Factors that facilitate knowing include time, continuity of care, teamwork, trust, and experience
• Clinical expertise is essential for knowing the patient

Spiritual Caring

• Spiritual health is achieved when a person finds balance between their life values, goals, and beliefs
• Spirituality offers a sense of intrapersonal, interpersonal, and transpersonal connectedness

Relieving Symptoms and Suffering

• Reducing symptoms and suffering requires caring nursing actions that provide comfort, dignity, respect, and peace
• A quiet, caring presence, touching, and listening can help assess and understand a patient's discomfort
• Providing comfort through a listening, nonjudgmental, caring presence is essential

Family Care

• Caring for an individual includes caring for their family
• Nurses should help family caregivers be active participants
• Understanding the stress a patient's illness places on family members is essential

The Challenge of Caring

• Challenges to caring include the task-oriented biomedical model, institutional demands, time constraints, and reliance on technology
• Health care must become more compassionate to make a positive difference