CHAPTER 21 Anne Boykin and Savina O. Schoenhofer’s Nursing as Caring Theory 347relationships. As the patient demonstrated in the words of her song, she knew that her physical existence was
coming to an end and she was not afraid.There was a mutual knowingness that was unspoken, even without the
lab work or biopsies. Her lack of fear and her courage allowed her spirit to soar free in the open sky, giving me
a glimpse of the spiritual existence.
This is not to devalue the importance of empirical knowledge. It, too, is an important part of coming to know
other. Empirical knowledge is the information that is organized into laws and theories to describe, explain, or
predict phenomena. This knowledge is acquired through the senses. Based in the sciences, it is our understand-
ing of anatomy and physiology, diagnostic processes, and treatment regimens. For me, it is the concrete form of
the foundation upon which my practice is built.
Empirical knowledge is essential to be recognized as a profession. The sixth assumption of nursing as caring
is that nursing is both a discipline and a profession.The scientific evidence that lends theory-based knowledge to
our profession gives us the diagnostic reasoning we need to address the physical needs that people have. In this
particular situation, the laboratory findings confirmed that which we knew personally. Oftentimes the bereaved
loved ones need a diagnosis to help cope with the grief of losing a family member.
This brings us to ethical knowing—the patience and compassion to be with grieving family members when
they are not ready to let go of a loved one who is ready to die. Ethical knowing is also the recognition that these
family members are caring persons as well, coping in the only way they know how, through their experiences.
Humility has allowed me to come to know and respect the family’s perspective. Patience is needed to allow other
to come to know hope in the moment a loved one is diagnosed with a terminal illness. Hope for a spiritual ex-
istence beyond this world was revealed to me in this nursing situation.
Each of these patterns of knowing—aesthetic, personal, empirical, and ethical—is borrowed from Carper
(1978).They serve as conceptual tools to help us understand and implement the theory of nursing as caring.
Broad Application for Advanced Practice Nursing: Summary
Nursing as caring provides a theoretical perspective with an organizing framework that guides practice and al-
lows for the generation of new knowledge. In addition, it lends a methodological process to define, explain, and
verify this knowledge. This theory reaches beyond the received view of traditional science. Nursing as caring
guides the use of nursing knowledge and information from other disciplines in ways appropriate to nursing.
Through the application of this theory, I have come to know new possibilities for nursing practice.
I believe now more than ever that, with the advancing roles of nurses, we need to be clear on what it is that
we do that is different from other practitioners. As advanced practice nurses (APNs) and ARNPs assume more
responsibilities and perform tasks that were traditionally reserved for those of the medical profession, the over-
lapping further blurs the boundaries of our professions. We need to maintain our nursing perspective. As nurse
practitioners continue to be lumped into categories with other midlevel practitioners, we need to demonstrate
to our patients that our profession was born of a need from society, a need that only nurses can fill. If there is
no call to nursing, our profession will dissolve into the sea of midlevel practitioners.
Nursing theory sets apart what nurse practitioners do from any other profession. To ensure that our prac-
tice maintains its identity, the practice must be built upon research-based nursing theory. The theory of nursing
as caring is one such theory.References
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