Nursing: Art, Science, and Caring Concepts

Nursing as an Art and Science

• Nursing is both an art and a science, with caring as its theoretical base.
• Nursing and caring involve a relational understanding and unity between nurse and patient.
• Nurses enhance their ability to feel, sense, know, and perceive care delivery, demonstrating mastery and promoting favorable health changes.

Concepts of Caring

• Caring with knowledge form the core of nursing.
• Nurses must preserve a patient-centered approach.
• Technological advances require compassionate care and must not replace the nurse's role in caring.
• Caring enables nurses to work respectfully and therapeutically with people.

Caring Practice Models

• Meyerhoff: Relating to someone in a way that involves development, mutual trust, qualitative changes in a relationship.
• Benner: Helping clients recover from illness, find meaning in their illness, and maintain or reestablish connections.
• Leininger:
• Caring is the central domain that distinguishes nursing from other health disciplines.
• Caring is an essential human need for health and survival.
• Understanding cultural caring behaviors is important because caring varies among cultures.
• Jean Watson's Human Caring Theory:
• Caring is central to nursing.
• Conscious intention to care promotes healing and wholeness.
• The theory integrates human caring processes with healing environments.
• Carative Factors: Nursing interventions related to human care, referred to by Watson as the "Core of Nursing."
• Forming a humanistic-altruistic value system.
• Instilling faith and hope.
• Cultivating sensitivity to oneself and others.
• Developing helping-trust relationships.
• Promoting expression of positive and negative feelings.
• Using the problem-solving method.
• Promoting interpersonal teaching-learning.
• Providing supportive, protective, or corrective environments.
• Assisting with gratification of human needs.
• Allowing for existential-phenomenological forces.

Kristen Swanson’s Theory of Caring (1991)

• Caring is defined as nurturing relationships with commitment and responsibility.
• Caring is a central aspect of nursing, but not exclusive to it.
• Five processes involved in caring:
• Knowing: Understanding the meaning of an event in the other's life, avoiding assumptions, centering on the one cared, assessing thoroughly, seeing cues, and engaging the self of both.
• Being With: Being emotionally present, conveying ability, sharing feelings, and not burdening.
• Doing For: Doing for others what they would do if possible, including comforting, anticipating, performing competently, protecting, and preserving dignity.
• Enabling: Facilitating passage through transitions and unfamiliar events by informing, supporting, focusing, generating alternatives, and validating.
• Maintaining Belief: Sustaining faith in the other's capacity by holding in esteem, maintaining hope, offering optimism, and "going the distance".

Simone Roach

• Caring is the center of nursing attributes.
• Nurses develop caring by being true to themselves.
• Seven C's of Caring:
• Compassion: Being with others in suffering, understanding their experience, and recognizing their true self.
• Competence: Using evidence-based knowledge and skills in nursing practice effectively, in the cognitive, affective, and psychomotor domains.
• Conscience: Directing moral, ethical, and legal decisions and adhering to professional standards.
• Confidence: Trusting one's ability to care, which helps create change.
• Commitment: Maintaining nursing standards and assuring excellent care.
• Comportment: Presenting oneself professionally through behavior, attitude, and appearance.
• Creativity: Envisioning better nursing care and creating healing environments.

Components of Caring in Nursing Practice

• Providing Presence establishes reassurance through eye contact, body language, voice tone, and positive attitude.
• Touch provides comfort through skillful and gentle nursing care.
• Listening involves paying attention to words and tone, entering the patient's frame of reference.
• Knowing the Client is the core of the process for clinical diagnoses.
• Spiritual Caring offers interconnectedness with oneself, others, and a higher power.
• Family Care requires knowing the family well.
• Suffering is relieved through comfort measures that provide dignity and peace.

Nurse Self-Care

• Intentional, proactive actions maintain physical, mental, emotional, and professional well-being.
• Self-care prevents burnout, reduces stress, and promotes overall health.
• Self-care includes rest, nutrition, support, work-life balance, and professional growth; it enhances resilience and job satisfaction.
• Importance:
• Prevents burnout and compassion fatigue.
• Maintains physical well-being.
• Increases mental and emotional resilience.
• Balances work and life.
• Enhances patient care.
• Strategies:
• Physical: Sleep, hydration, exercise.
• Emotional: Talking, journaling, meditation.
• Professional: Training, mentorship, positive environment.
• Social: Connecting with family and friends.
• Psychological: Setting boundaries and seeking help.

Teaching in Nursing

• Teaching is an art that requires creativity, empathy, adaptability, and communication.
• Combination of scientific knowledge and human connection.
• Teaching imparts knowledge, skills, and attitudes to facilitate learning and behavior change.
• Learning involves acquiring and applying new knowledge, skills, and attitudes.

Theories of Learning in Nursing

• Behaviorism (Skinner, Pavlov, Watson): Learning is a result of stimulus-response associations.
• Reinforcement strengthens behavior.
• Nursing application: Use rewards to encourage compliance.
• Cognitivism (Piaget, Bruner, Vygotsky): An active mental process that emphasizes understanding concepts.
• Nursing application: Encouraging critical thinking.
• Constructivism (Dewey, Vygotsky): Learners construct knowledge based on experiences.
• Active learning strategies enhance understanding.
• Nursing application: Problem-based learning and case discussions.
• Humanism (Rogers, Maslow): Learning is self-directed and emphasizes personal growth.
• Nursing application: Encouraging patient involvement.
• Experiential Learning (Kolb): Learning from experience and reflection.
• Nursing application: Rotations, training, role-playing.

Principles of Teaching and Learning in Nursing

• Learning is an active process.
• Learners must engage with the content.
• Example: Hands on experience teaching self-injection method.
• Learning occurs best when relevant.
• Information should be meaningful and applicable.
• Example: Diabetic patients better understand when monitoring blood sugar using their own glucometer.
• Readiness to learn is critical.
• Learners must be physically, emotionally, and mentally ready.
• Example: Patients in pain may not be ready to learn.
• Repetition reinforces learning.
• Reviewing enhances retention.
• Example: Repeating medication instructions.
• Positive learning environment encourages retention.
• A supportive setting enhances learning.
• Example: Creating a welcoming space.
• Feedback is essential for improvement.
• Example: Providing guidance during wound dressing.
• Individual differences affect learning.
• Adjusting teaching strategies based on learning style.

Teaching Strategies in Nursing

• Lecture and Discussion:Provides knowledge for large groups and clarification.
• Demonstration and Return Demonstration: Effective for psychomotor skills.
• Role-Playing and Simulation: Helps experience real-life scenarios.
• Case Studies and Problem-Based Learning: Encourages critical thinking and decision-making.
• One-on-One Teaching: Provides individualized education.
• Technology and Multimedia: Enhances understanding.
• Group Discussions and Peer Teaching: Encourages sharing and collaboration.

Factors Affecting Teaching and Learning in Nursing

• Learner Factors:
• Motivation and interest, health condition, and cultural beliefs.
• Teacher Factors:
• Communication skills, knowledge, and expertise.
• Environmental Factors:
• Distractions, noise, and access to resources.

Role of Nurses as Educators

• Patient Education: Educating about disease management and self-care.
• Family and Caregiver Education: Equipping with skills for patient recovery.
• Nursing Students and New Nurses: Mentoring in clinical settings.
• Community Health Education: Promoting wellness through programs.

Teaching Methods Based on Patient's Development Capacity:

• Infant: Provide consistent routines,ensure safety, give sense of trust, and use textures.
• Toddler: Use picture books, play, and simple words.
• Preschooler: Use play and demonstrations.
• School-Aged Child: Teach maintenance of health skills and allows for discussion.
• Adolescent: Explore self-expression, use collaborative teaching, allow decisions, and use problem-solving.
• Young or Middle Adult: Encourage participation.
• Older Adult: Teach in relaxed environment and keep teachings short.