the ethical knowing that it is right to offer care, cre-
ating the integrated understanding of aesthetic
knowing that enables him to act on his nursing in-
tention (Boykin, Parker, & Schoenhofer, 1994;
Carper, 1978). Mayeroff ’s (1971) caring ingredients
of courage, trust, and alternating rhythm are clearly
evident.
Clarity of the call for nursing emerges as the
nurse begins to understand that this particular man
in this particular moment is calling to be known as
a uniquely caring person, a person of value, worthy
of respect and regard. The nurse listens intently and
recognizes the unadorned honesty that sounds
angry and demanding but is a personal expression
of a heartfelt desire to be truly known and worthy
of care. The nurse responds with steadfast presence
and caring, communicated in his way of being and
of doing. The caring ingredient of hope is drawn
forth as the man softens and the nurse takes notice.
In the fourth stanza, the “caring between” devel-
ops, and personhood is enhanced as dreams and as-
pirations for growing in caring are realized: “His
eyes meet mine...I open my heart.” In the last
stanza, the nursing situation is completed in linear
time. But each one, nurse and nursed, goes forward,
newly affirmed and celebrated as caring person, and
the nursing situation continues to be a source of in-
spiration for living caring and growing in caring.
Assumptions in the Context
of the Nursing Situation
In Collins’s poem, the power of the basic assump-
tion that all persons are caring by virtue of their
humanness enabled the nurse to find the courage to
live his intentions. The idea that persons are whole
and complete in the moment permits the nurse to
accept conflicting feelings and to be open to the
nursed as a person, not merely as an entity with a
diagnosis and superficially or normatively under-
stood behavior. The nurse demonstrated an under-
standing of the assumption that persons live caring
from moment to moment, striving to know self and
other as caring in the moment with a growing
repertoire of ways of expressing caring. Person-
hood, a way of living grounded in caring that can
be enhanced in relationship with caring other,
comes through in that the nurse is successfully liv-
ing his commitment to caring in the face of diffi-
culty and in the mutuality and connectedness
that emerged in the situation. The assumption that
nursing is both a discipline and a profession is af-
firmed as the nurse draws on a set of values and a
developed knowledge of nursing as caring to ac-
tively offer his presence in service to the nursed.NURSING AS CARING: HISTORICAL
PERSPECTIVE AND CURRENT
DEVELOPMENT
The theory of nursing as caring developed as an
outgrowth of the curriculum development work in
the College of Nursing at Florida Atlantic
University, where both authors were among the fac-
ulty group revising the caring-based curriculum.
When the revised curriculum was in place, each of
us recognized the potential and even the necessity
of continuing to develop and structure ideas and
themes toward a comprehensive expression of the
meaning and purpose of nursing as a discipline and
a profession. The point of departure was the ac-
ceptance that caring is the end, rather than the
means, of nursing, and that caring is the intention
of nursing rather than merely its instrument. This
work led to the statement of focus of nursing as
“nurturing persons living caring and growing in
caring.” Further work to identify foundational as-
sumptions about nursing clarified the idea of the
nursing situation, a shared lived experience in
which the caring between enhances personhood,
with personhood understood as living grounded in
caring. The clarified focus and the idea of the nurs-
ing situation are the key themes that draw forth the
meaning of the assumptions underlying the theory
and permit the practical understanding of nursing
as both a discipline and a profession. As critique of
the theory and study of nursing situations pro-
gressed, the notion of nursing being primarily con-
cerned with health was seen as limiting, and we
now understand nursing to be concerned with
human living.
Three bodies of work significantly influenced
the initial development of nursing as caring.
Roach’s (1987/2002) basic thesis that caring is the
human mode of being was incorporated into the
most basic assumption of the theory. We view
Paterson and Zderad’s (1988) existential phenome-
nological theory of humanistic nursing as the his-
torical antecedent of nursing as caring. Seminal
ideas such as “the between,” “call for nursing,”
“nursing response,” and “personhood” served as338 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration