Getting Back to the Core of Nursing: Caring
from Caring For Our Future, Spring 2005
By Bridget A. Theunissen, MAOM, RN, Clinical Director, Third Floor Program
Attending Caring Nurse Model Part III
We all come to a crossroads in our careers and need to evaluate what is positive, what is not so positive and what is in our power to change with the resources available.
I was at that crossroads, as was the staff I was responsible for leading and managing. I recognized a need in the nursing profession to bring the nurse (the caregiver) back to the core of nursing: caring. At the same time, Roxie Foster and Dr. Jean Watson (who established the original Center for Human Caring at the University of Colorado School of Nursing in 1986), recognized that nurses had become more focused on the foundation of the nursing profession as well: caring. Leaders across the continuum of nursing, middle management, research/education and theory recognized the same need: to bring “caring” back into our profession and truly be present as healthcare providers to every child, mother, father, brother, sister and every person who walks into The -Children’s Hospital or any other healthcare institution.
I had a vision as a leader to empower nurses to embrace what brought most of them into the nursing profession: the connection of human beings from a soul-to-soul perspective. I was fortunate to know Dr. Foster and be able to co-create our visions with Dr. Watson and her “Caring Theory” into a reality of the Attending Caring Nurse (ACN) research project.
The ACN has since evolved into the Attending Caring Team (ACT). The ACT is a multidisciplinary team that empowers all healthcare providers to bring caring back into their practices instead of being viewed solely as taskmasters.
The Third Floor Program (3N) already was incorporating a form of the caring theory by bringing the FISH® Philosophy (Lundin, 2000) to the entire staff. FISH Philosophy is a marketing initiative that began at the Pike Place Market in Seattle . It offers four basic principles to motivate and inspire employees with consequent results of improved customer satisfaction and improved financial performance. 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 or your meals for the day
Interpreted through the lens of caring science, ethics, aesthetics, ontology and epistemology, these four principles provided the context of an interactive 3NO staff retreat. These principles grounded the abstract in concrete interpretations such as the 3NO 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, play, presence, making their day and choosing one’s attitude (Woodward, 2004). The FISH Philosophy provided the staff with a more concrete version of Watson’s “Caring Theory.”
The leaders were responsible for making this vision a reality by giving permission to practice healthcare from the soul and shifting or balancing the paradigm between caring and tasks.
Somewhere along the line, we became overwhelmed with all the tasks and lost some sense of connection to the reason we became healthcare providers – because we care about humanity. Nursing leaders must provide the education and resources to staff to make the intended changes that feel right for them. Leaders should empower individuals to be creative in their practice and workplace environment. Nursing leaders can promote open, honest communication among individuals, with the patient and family at the forefront.
Additionally, leaders must create a culture of accountability that maintains high-quality and safe patient and family care. Accountability is one of the core aspects of the caring theory. When one does care, he or she will hold each person accountable for his or her behavior, words and actions.
References
Lundin, S. C. (2000). FISH!: A remarkable way to boost morale and improve results. New York : Hyperion.
Woodward, T. (2004). Caring Praxis.
Caring for Our Future , The Children’s -Hospital, Denver.
