Introducing the Theorists
Dr. Josephine Paterson is originally from the East
Coast where she attended a diploma school of
nursing in New York City. She subsequently earned
her bachelor’s degree in nursing education from St.
John’s University. In her graduate work at Johns
Hopkins University, she focused on public health
nursing and then earned her doctor of nursing sci-
ence degree from Boston University. Her doctoral
dissertation was on comfort.
Dr. Loretta Zderad is from the Midwest where
she attended a diploma school of nursing. She later
earned her bachelor’s degree in nursing education
from Loyola University of Chicago. In her graduate
work she majored in psychiatric nursing at the
Catholic University of America. She subsequently
earned her doctor of philosophy from Georgetown
University. Her dissertation was on empathy.
Josephine Paterson and Loretta Zderad met in
the mid-1950s while working at Catholic University.
Their joint project was to create a new program
that would encompass the community health com-
ponent and the psychiatric component of the
graduate program. This started a collaboration, di-
alogue, and friendship that has lasted for over 45
years. They shared and developed their concepts,
approaches, and experiences of “existential phe-
nomenology,” which evolved into the formal Theory
of Humanistic Nursing. They incorporated these
concepts into their work as educators and shared
them across the country in seminars and work-
shops on Humanistic Nursing Theory.
In 1971, after their work in academia, Dr.
Paterson and Dr. Zderad went to the Veterans
Administration (VA) hospital in Northport, MA.
They were hired as “nursologists” by a forward-
thinking administrator who recognized the need
for staff support during a period of change in the
VA system. The position of nursologist involved a
three-pronged approach to the improvement of pa-
tient care through clinical practice, education, and
research. These functions were integrated within
the framework of Humanistic Nursing Theory.
They worked with the nurses at Northport from
1971 until 1978 on this project, running workshops
that incorporated their theory. In 1978 there was a
change in hospital administration that entailed a
reorganization of services. Dr. Paterson was as-
signed to the Mental Hygiene Clinic to work as a
psychotherapist while Dr. Zderad became the asso-
ciate chief of Nursing Service for Education. These
were the positions they held when I met them as a
graduate student in psychiatric mental health nurs-
ing. Dr. Paterson agreed to work with me as my
clinical supervisor.
The following two years brought me a world of
enrichment. For Dr. Paterson and Dr. Zderad, those
years culminated in their retirement and relocation
to the South. I, on the other hand, continue the
work that they started—as a fellow theorist and as
a friend and colleague in nursing. They have in-
spired me to carry on their work, using it in my
nursing situations, whether in clinical, administra-
tive, or most recently, with nursing students, and to
share what I have come to know.
The Humanistic Nursing Theory was originally
formulated as a way for nurses to define nursing.
That is, a way to illuminate the values and mean-
ings central to nursing experiences. Paterson and
Zderad were nursing visionaries who emphasized
synthesis and wholeness rather than reduction and
logical/mathematical analysis. They challenged the
notion that the reductionistic approach is the
touchstone of explanatory power, and they postu-
lated an “all-at-once” character of existence in
nurses’ experiences of being in the world. They led
the way to many of the contemporary nursing the-
ories that emphasize the caring aspects of nursing
(Benner, 1984; Parse, 1981; Watson, 1988).Introducing the Theory
Humanistic Nursing Theory is multidimensional.
It speaks to the essences of nursing and embraces
the dynamics of being, becoming, and change. It is
an interactive nursing theory that provides a
methodology for reflection and articulation of
nursing essences. It is also a theory that provides a
methodological bridge between theory and practice
by providing a broad guide for nursing “dialogue”
in a myriad of settings.
Nursing, as seen through Humanistic Nursing
Theory, is the ability to struggle with another
through “peak experiences related to health and suf-
fering in which the participants are and become in
accordance with their human potential” (Paterson
& Zderad, 1976, p. 7). The struggle evolves within
a dialogue between the participants, illuminating126 SECTION II Evolution of Nursing Theory: Essential Influences