untitled

designed and is the primary means of ongoing
assessment and evaluation (Parker, Barry, & King,
2000; Ryan, Hawkins, Parker, & Hawkins, 2004).

NURSING

The unique focus of nursing is nurturing the
wholeness of persons and environments through

The focus of nursing is nurturing whole-

ness of persons and environment through

caring.

caring (FAU, 1994/2003). Nursing practice, educa-
tion, and scholarship require creative integration
of multiple ways of knowing and understanding
through knowledge synthesis within a context of
value and meaning. Nursing knowledge is em-
bedded in the nursing situation, the lived experi-
ence of caring between the nurse and the one
receiving care. The nurse is authentically present
for the other, to hear calls for caring and to create
dynamic nursing responses. The school-based
community wellness centers and satellite sites in
the community become places for persons and
families to access nursing and social services where
they are: in homes, work camps, schools, or under
trees in a community gathering spot. Nursing is dy-
namic and portable; there is no predetermined
nursing and often no predetermined access place
(Parker, 1997; Parker & Barry, 1999).
Nursing practice is further described within the
context of transitional care and enhancing care.
Transitional care is that in which clients and fami-
lies are provided essential health care while being
enrolled in a local insurance plan that will partially
support that care. Over several weeks, clients are as-
sisted to enroll in long-term forms of health-care
insurance and related benefits and are referred to a
more permanent source of health care in the com-
munity. Transitional care, an ideal for nursing and
social work practice, is sometimes not possible due
to immigration status, a complex and confounding
application process, or other issues of the family.

Enhancing care describes nursing and social

work that is intended to assist the client

and family who need care in addition to

that provided by a local health-care

provider.

Enhancing care describes nursing and social work

that is intended to assist the client and family who

need care in addition to that provided by a local

health-care provider.

PERSON

Respect for person is present in all aspects of nurs-

ing, with clients, community members, and col-

leagues. Respect includes a stance of humility that

the nurse does not know all that can be known

about a person and a situation, acknowledging that

the person is the expert in his/her own care and

knowing his/her experience. Respect carries with it

an openness to learn and grow. Values and beliefs of

various cultures are reflected in expressions of re-

spect and caring. The person as whole and con-

nected with others, not the disease or problem, is

the focus of nursing.

Persons are empowered by understanding

choices, how to choose, and how to live daily with

choices made. The person defines what is necessary

to well-being and what priorities exist in daily life

of the family. Nursing and social work practice

based on practical, sound, culturally acceptable,

and cost-effective methods are necessary for well-

being and wholeness of persons, families, and com-

munities.

Early on, Swadener & Lubeck’s (1995) work on

deconstructing the discourse of risk was a major in-

fluence on practice. “At risk” connotes a deficiency

that needs fixing; a doing to rather than collaborat-

ing with. Thinking about children and families “at

promise” instead of “at risk” inspires an approach

to knowing the other as whole and filled with

potential.

Respect and caring in nursing require full

participation of persons, families, and

communities in assessment, design, and

evaluation of services.

Respect and caring in nursing require full par-

ticipation of persons, families, and communities in

assessment, design, and evaluation of services.

Based on this concept, an inquiry group method is

used for ongoing appraisal of services. This method

is defined as a “route of knowing” and “a route to

other questions.” Each person is a coparticipant, an

expert knower in their experience; the facilitator is

392 SECTION IV Nursing Theory: Illustrating Processes of Development