Attending Caring Nurse Model Part II: Caring Praxis
from Caring For Our Future, Fall 2004
By Terri Woodward, MS, RN, CNS
“Holy Spirit, thank thee for the night. And for the pleasant morning light. For rest and food and loving care, and all that makes the world so fair. Help us to do the things we should. To be to others kind and good, in all we do and all we say, to grow more loving every day.”
– A Child’s Prayer, Author Unknown
Simplicity often expresses the profound. This child’s prayer captures the essence of Watson’s Transpersonal Caring Science, loving care as an expanding field of relational unity in the universe. Transpersonal Caring Science is a humanistic science concerned with human experiences of continuity and meaning.
“It is when we include caring and love in our science, we discover our caring-healing professions and disciplines are much more than a detached scientific endeavor, but a life-giving and life-receiving endeavor for humanity.” (Watson, 2005, p. 3).
Inspired and challenged by Watson’s Transpersonal Caring Science theory, the Third Floor Program’s (3 North) Attending Caring Team (ACT) has been called to translate theory into praxis. Wheeler and Chinn (1991, p.2) define praxis as “values made visible through deliberate action” bridging the theory-practice gap. Guided by Watson’s Caritas Processes (an evolution of the original Carative Factors), and the theory’s foundational principles of transpersonal relationships, consciousness, intentionality and authentic presence, ACT members are inspired to provide the space for healing through caring.
As caring cannot be expressed through algorithms or prescribed formats, the ACT mission is to honor the person of the caregiver and the person(s) of the patient/family, not as a thing or object, but as an embodied spirit. We established touchstones, daily practices and visible manifestations that remind, support and ground us in our caring intentions. Although the following presentation may appear to be a linear cause-and-effect progression, translating Watson’s theory into practice has been and continues to be a circular, holistic process.
In 2002, ACT’s birth (see article in Caring for Our Future, Summer 2004), coincided with a hospital-wide initiative to implement the FISH® philosophy (Lundin, 2000). FISH Philosophy, a marketing initiative tried at the Pikes Fish Market in Seattle, offers four basic principles to motivate and inspire employees resulting in improved customer satisfaction and enhanced profits. The four principles are:
- Play - have appropriate fun at work
- Make their day - engage others, inviting them to participate in the fun
- Presence - attend to and take care of the person(s) in front of you this moment
- Choose your attitude - consciously select your attitude just as you choose your outfit
These four principles provided the context of an interactive 3 North staff retreat, grounding the abstract in concrete interpretations such as the 3 North parade, story time, staff potlucks (where the off-going shift surprises the oncoming shift with a celebratory meal before commencing work) and colorful stickers that acknowledge others’ caring endeavors when “caught in the ACT” of caring, playing, being present, “making their day” and choosing one’s attitude.
Making our caring intentions visible provides opportunities throughout each day to commit to our caring core and to co-create authentic caring expressions and actions. Banners, signs and posters are conspicuously located throughout the unit to announce and describe ACT’s mission. Caring-Healing Touchstones are provided for contemplation. Signs posted by the stones invite interaction, stating: “Every human being has the ability to share their incredible gift of loving-healing. These stones serve as a reminder of our capacity to love and heal. Pick up a stone, feel its smooth cool surface, let its weight remind you of your own gifts of love and healing. Share in the love and healing of all who have touched this stone before you and pass on your love and healing to all who will hold this stone after you.”
Blessing baskets are located at each nursing station for families, visitors and staff to submit names for daily blessings, held in the Caring-Healing room. The 3 North team uses this room, decorated by artist Cynthia Telsey, the mother of a former Children’s Hospital patient, extensively. Quiet Time is a half-hour time slot each day when we enter patient rooms only at the family’s request. Lights are dimmed, voices are lowered and relaxing background music is played to provide time for reflection, a moment of silence or perhaps even a nap.
Most important, caring is a co-creation of equal partnership between health-care providers and the family. The family’s unique beliefs, values and life experiences are honored, as are their unique skills, talents and gifts. Health-care plans are created with the family and focus on building family strengths. Attending caring guidelines are written in the “order” section of charts to provide clear communication and to assist in continuity of care. Care conferences have become more frequent to assist both in transitioning children and families to 3 North when they have been on other inpatient units for prolonged periods, and to provide opportunities for all team members to collaborate, plan and promote teamwork.
Transpersonal caring science “can be read, taught, learned, studied, researched and even practiced; however, to truly “get it,” one has to personally experience it – interact and grow within the philosophy and intention of the model.” (Watson, 1996, p 160). Working with Watson’s Transpersonal Caring Science has returned caring as the core value for 3 North and ACT. Through our intention and deliberate actions, we are striving to make manifest as our praxis. Caring is not a state to be achieved, but an ever-evolving consciousness.
References
Lundin , S.C. (2000). FISH: A remarkable way to boost morale and improve results. New York: Hyperion.
Watson, J. (1996). Watson’s theory of transpersonal caring. In P.H. Walker & B. Newman (Eds.) Blueprint for use of nursing models: Education, research, practice and administration. New York: National League of Nursing Press.
Watson, J. (2004). Caring science as sacred science. Philadelphia: F.A. Davis Company.
Wheeler, C.E., and P.L. Chinn. (1991). Peace and power: A handbook of feminist process. New York: National League for Nursing Press.
Internet Resources
The Columbia Granger’s® World of Poetry, (2002), http://www.columbiagrangers.org.
