1. THEORETICAL FOUNDATIONS IN
NURSING
“NEW NURSING
THEORIES”
Prepared By:
HANNAH MARIE M. BAGU, RN
1ST Year – MSN 2ND Semester

2. OBJECTIVES:
 After 30-45 minutes of discussion about
the New Nursing Theories, the
participants would be able to:
◦ Identify the 2 new nursing theories
discussed.
◦ State at least 3/4 major assumptions
underlying Rozzano Locsin’s theory.
◦ Utilize the Nursing as Caring Theory to the
Nursing practice, administration, education
& research.

3. ANNE BOYKIN &
SAVANA
SCHOENHOFER
Nursing as Caring

4. ANNE BOYKIN
 1944 - Kaukauna,
Wisconsin
 1966 – Nursing Career
◦ Alverno College in
Milwaukee, Wisconsin
 Master’s Degree
◦ Emory University Atlanta,
Georgia
 Doctorate
◦ Vanderbilt University in
Nashville, Tennessee

5.  1981 – South Florida
◦ Steve Staudenmeyer
 DEAN & PROFESSOR
◦ Christine E. Lynn College of Nursing,
Florida Atlantic University
 DIRECTOR
◦ Christine E. Lynn Center for Caring

6. Awards
 2009 - Visionary Caring Science Award by
the Watson Caring Science Institute
Book Publications
 Nursing as Caring: A Model for
Transforming Practice (1993, 2001a)
 Living a Caring-Based Program (1994b).
 Politics and Public Policy: A Matter of
Caring (1995)
 Caring as Healing: Renewal Through Hope

7. SAVANA SCHOENHOFER
 1940 – Kansas
 1960 – Volunteer
◦ Amazon, Brazil
 1983 – PhD
◦ Kansas State University

8.  PROFESSOR
◦ Cora S. Balmat School of Nursing, Alcorn
State University, Natchez, Mississippi
 1990 - Co-FOUNDER
◦ Nursing Aesthetics Publication,
Nightingale Songs
Book Publications
 Nursing as Caring: A Model for
Transforming Practice (1993, 2001a)

9. ASSUMPTIONS OF CARING AS
NURSING :
 Persons are caring by virtue of their
humanness.
 Persons are whole and complete in the
moment.
 Persons live caring from moment to
moment.
 Personhood is a way of living grounded in
caring.
 Personhood is enhanced through
participation in nurturing relationships with
caring others.

10. CARING
 Altruistic, active expression of love
 Intentional and embodied recognition of
value and connectedness
 Nursing uniquely focuses on caring as
its central value
 Illuminated in the experience of caring
and in reflection on that experience

11. FOCUS & INTENTION OF NURSING
 Focus of Nursing
◦ Persons living in caring and growing
in caring
 Intention of Nursing
◦ Nurturing persons living and growing
in caring

12. NURSING SITUATION
 A shared lived experience in which caring
between the nurse and nursed enhances
personhood
◦ Involves values, intentions and actions of
two or more persons choosing to live a
nursing relationship
 Nursing is created in the “caring between”
 All knowledge of nursing is understood within
the nursing situation

13. PERSONHOOD
 Personhood is living grounded in
caring.
 Personhood is the universal human
call.
 Understanding communicates the
paradox of person-as-person and
person-in-communion all at once.

14. CALL FOR NURSING
 Call for acknowledgement and
affirmation of the person living and
caring in specific ways in the immediate
situation
(Boykin & Schoenhofer, 1993, 2009)
 Calls for nurturance through personal
expressions of caring
 Originates within persons
 Intentionality and authentic presence
open the nurse to hear calls for nursing

15. CALL FOR NURSING (continued)
 There are relevant ways of saying
“know me as a caring person in the
moment and be with me as I try to live
fully who I truly am.”
 Calls are unique and cannot be
predicted as in a diagnosis.
 Nurses develop sensitivity and
expertise in hearing calls through
intention, experience, study, and
reflection.

16. NURSING RESPONSE
 Specific expression of caring
nurturance to sustain and enhance the
“other” as he or she lives caring and
grows in caring in the situation of
concern
 Uniquely created for the moment
 Cannot be predicted or applied as
preplanned protocols

17. THE CARING BETWEEN
 Source and ground of nursing
 Loving relation into which the nurse
and nursed enter and co-create by
living intention to care.
 Personhood is enhanced in the context
of the caring between
 Without the caring between,
unidirectional activity or reciprocal
exchange can occur but nursing in the
fullest sense does not

18. LIVED MEANING OF CARING AS
NURSING
 Meaning of nursing is best understood
by the study of a nursing situation.
 Nurse and nursed live caring uniquely.
 Courage is required to enter into the
unknown of a nursing situation.

19. I CARE FOR HIM
 My hands are
moist,
 My heart is quick,
 My nerves are taut,
 He’s in the next
room,
 I care for him.
 The room is tense,
 It’s anger-filled,
 The air seems
thick,
 I’m with him now,
 I care for him.

20.  Time goes slowly
by,
 As our fears
subside,
 I can sense his
calm,
 He softens now,
 I care for him.
 His eyes meet
mine,
 Unable to speak,
 I care for him.
 It’s time to leave.
 Our bond is made,
 Unspoken
thoughts,
 But understood,
 I care for him!
— J. M. Collins
(1993)

21. NURSING PRACTICE
 The nurse practicing nursing as caring
comes to know the other as a caring
person in the moment. The challenge is
not to discover what is missing,
weakened, or needed but to come to
know the other and to nurture that
person in situation-specific, creative
ways and to acknowledge, support, and
celebrate the caring that is.

22. NURSING ADMINISTRATION
 The practice of nursing administration
is grounded in a concern for creating,
maintaining, and supporting an
environment in which calls for nursing
are heard and nurturing responses are
created. Nursing administrators inspire
a culture that evolves from the values
of nursing as caring.

23. NURSING EDUCATION
 The curriculum asserts the focus and
domain of nursing as nurturing persons
living caring and growing in caring.
Faculty assist and mentor students as
co-learners; create caring learning
environments, that inspire the
appreciation and celebration both self
and other as caring persons.

24. NURSING RESEARCH &
DEVELOPMENT
 Research and development efforts are
focused on expanding the language of
caring; re-conceptualizing nursing
outcomes as “value experienced in
nursing situations”; and evaluating this
theory based model of caring in acute
and long-term health-care agencies.

25. FREQUENTLY ASKED
QUESTIONS:
 How does the nurse come to know
self?
 Must I like my patients to nurse them?
 What about nursing a person for whom
it is difficult to care?
 Is it possible to nurse someone who is
in an unconscious or altered state of

26. How does the nurse
come to know self?

27. How does the nurse come to know
self?
 Trust in self
 Learning to let go, to transcend
 Being open and humble
 Continuously calling into consciousness
that each person is living caring in the
moment
 Taking time to experience humanness
fully

28. Must I like my
patients to nurse
them?

29. Must I like my patients to nurse
them?
 To nurture persons as living and
growing in caring, it is necessary to
know the other as caring person living
his/her own caring in the moment.

30. What about nursing a
person for whom it is
difficult to care?

31. What about nursing a person for whom
it is difficult to care?
 All persons are caring.
 Nursing ethic to care supersedes all
other values.

32. Is it possible to nurse
someone who is in an
unconscious or altered state
of awareness?

33. Is it possible to nurse someone who is in
an unconscious or altered state of
awareness?
 Nurse makes self as caring person
available
 Nurse recognizes the vulnerability of
other.
 Other living caring in humility, hope,
and trust.

34. How Does this Theory Differ From Nursing
Process?
 Nursing is viewed as an ongoing
process that is guided by intentionality.
 Value of nursing is that which is
perceived as valuable to the other.
 There is no predictable outcome.

35. USEFULNESS OF IN NURSING IN
PRACTICE
 Nursing practice intentionally focused on
coming to know a person as caring and
nurturing and supporting those nursed as
they live caring leads to:
◦ Increased patient and nurse satisfaction
◦ Increased retention of nurses
◦ Environment of care becoming grounded in values
of and respect for person

36. ROZZANO LOCSIN
Technological Competency as
Caring and the Practice of
Knowing Persons in Nursing

37. “The practice of knowing
persons as whole, frequently
with the use of varying
technologies”
(Locsin, 2001) .

38. ROZZANO LOCSIN
 1976 – BSN &1978 - MAN
◦ Silliman University of the
Philippines
 1988 - PhD
◦ University of the Philippines
 1991 - PROFESSOR
◦ Christine E. Lynn College of
Nursing, Florida Atlantic
University
 Program of Research: “Life
transitions n the health-
illness experience”

39. Awards
 2000 - Fullbright Scholar to Uganda
 2004–2006 - Fullbright Alumni Initiative
Award to Uganda
 Fullbright Senior Specialist in Global and
Public Health and International
Development
 Edith Moore Copeland Excellence in
Creativity Award: Sigma Theta International
 Lifetime Achievement Awards from Schools
of Nursing in the Philippines

40. Book Publications
 Advancing Technology, Caring and Nursing
(2001)
 Technological Caring in Nursing: A Model
for Practice (2005)
 A Contemporary Process of Knowing: The
(Unbearable) Weight of Knowing in Nursing
(2009)

41.  ROZZANO LOCSIN’S ASSUMPTIONS:
◦ Persons are whole or complete in the
moment (Boykin and Schoenhofer, 2001)
◦ Knowing persons is a process of nursing
that allows for continuous appreciation of
persons moment to moment (Locsin, 2005).
◦ Nursing is a discipline and a professional
practice (Boykin and Schoenhofer, 2001)
◦ Technology is used to know persons as
whole moment to moment (Locsin, 2004).

42. FOCUS & INTENTION OF NURSING
 Focus of Nursing
◦ A human being whose hopes, dreams, and
aspirations are to live fully as a caring person
(Boykin & Schoenhofer, 2001)
 Intention of Nursing
◦ To know human beings fully as a whole person
 By affirming, appreciating, and celebrating
personhood
 Through expert and competent use of nursing
technologies

43. TECHNOLOGY OF
COMPETENCY
 Conceptualized as:
◦ An expression of Caring
 Co-existence of technology and caring in
nursing
◦ Providing a framework for practice

44. Purpose:
 Acknowledge wholeness of persons as
a focus of nursing
 Technological means are used to know
wholeness more fully
 Technology used to know “who is
person” rather than “what is person”

45. THE WHAT IS / WHO IS PERSON
 What is Person?
◦ Empirical facts about the compositions of
the person
◦ Persons as objects
 Who is Person?
◦ Understanding the unpredictable,
irreducible person who is more and
different than the sum of his or her
empirical self
◦ Persons as unique individual

46. PERSON ARE COMPLETE AND
WHOLE IN THE MOMENT
 Persons are complete, unique and
unpredictable
◦ Expressions of completeness vary from moment to
moment
 Nursing interventions are not focused on
“fixing” or making persons “whole again.”
 Nurses come to know persons as whole.
 Nursing responses are based on the
persons’ uniqueness.

47. FOCUSING ON RECEIVED
TECHNOLOGICAL DATA ALONE TO KNOW
PERSON
 Provides the nurse with an
understanding of persons as objects
who need to be fixed or made whole
again

48. PROCESS OF KNOWING PERSON AS A
WHOLE AND COMPLETE IN THE MOMENT
 Persons choose whether or not to allow
nurses to know them fully.
 In holding the idealization of persons as
“complete in the moment,” nurses must
◦ Choose to enter the world of the other
◦ Establish rapport, trust, confidence,
commitment, and compassion

49. WHOLENESS PARADOX
 Because persons are unique and
unpredictable
 Persons can only be fully known
◦ In the moment
◦ If the nurse chooses to enter the world
of the other
◦ If the person allows the nurse to know
him/her

50. FROM THIS PERSPECTIVE
 The condition in which the nurse and
other allow each other to come to know
one another is the nursing situation.

51. NURSING SITUATION
 Shared lived experience between the
nurse and nursed
 Condition in which the nurse and the
other allow each other to know one
another
 Nurse’s responsibility to know the
person’s hopes, dreams, and
aspirations

52. VULNERABILITY
 The nurse and nursed become
vulnerable as they enter each other’s
world and move toward continuous
knowing of one another

53. VULNERABILITY IN CARING
SITUATIONS
 Allows participation
 Embodiment of vulnerability enables
recognition of it in others
 Allows engagement of “power with”
rather than “power over”
 Nurses’ work is to ameliorate
vulnerability (Daniels, 1998)

54. PROCESS OF NURSING
 The process of nursing is a dynamic
unfolding of situations encompassing
knowledgeable practices (Locsin, 2005)
 Knowing and appreciating uniqueness of
persons
 Designing participation in caring
 Implementation and evaluation
 Verifying knowledge of person through
continuous knowing (Swanson, 1991)

55. KNOWING IS THE PRIMARY
PROCESS OF NURSING
 Knowing nursing
◦ “All at once” knowing of personal, ethical,
empirical, and aesthetic realms (Boykin &
Schoenhofer, 2001)
 Continuous knowing of person
◦ Occurs moment to moment
◦ Deters objectification
◦ Overpowers the motivation to prescribe
and direct the person’s life

56. THE ENTIRETY OF NURSING
 Is to direct, focus, sustain, and maintain
the person (Locsin, 2005)
 Through calls and responses for
nursing

57. CALLS FOR NURSING
 Calls
◦ Nurses rely on the person for calls
◦ Knowing persons allows the nurse to use
technologies in articulating calls
◦ Illustrations of the person’s unique hopes,
dreams, and aspirations
◦ Individual expressions
 Desire to go home
 Wishing to die peacefully

58. NURSING RESPONSES
 Nurses respond to calls from persons.
 Nurses respond with authentic
intentions to fully know persons
continually in the moment.

59. REFERENCES:

60. THANK YOU 