system in such a way that the system itself grows to
support nursing.
NURSING AS CARING IN
NURSING ADMINISTRATION
From the viewpoint of nursing as caring, the nurse
administrator makes decisions through a lens in
which the focus of nursing is on nurturing persons
as they live caring and grow in caring. All activities
in the practice of nursing administration are
grounded in a concern for creating, maintaining,
and supporting an environment in which calls for
nursing are heard and nurturing responses are given
(Boykin & Schoenhofer, 2001). From this point of
view, the expectation arises that nursing adminis-
trators participate in shaping a culture that evolves
from the values articulated within nursing as caring.
Although often perceived to be “removed” from
the direct care of the nursed, the nursing adminis-
trator is intimately involved in multiple nursing sit-
uations simultaneously, hearing calls for nursing
and participating in responses to these calls. As calls
for nursing are known, one of the unique responses
of the nursing administrator is to enter the world of
the nursed either directly or indirectly, to under-
stand special calls when they occur, and to assist in
securing the resources needed by each nurse to nur-
ture persons as they live and grow in caring (Boykin
& Schoenhofer, 1993). All administrative activities
should be approached with this goal in mind. Here,
the nurse administrator reflects on the obligations
inherent in the role in relation to the nursed. The
presiding moral basis for determining right action
is the belief that all persons are caring. Frequently,
the nurse administrator may enter the world of the
nursed through the stories of colleagues who are
assuming another role, such as that of nurse man-
ager. The nursing administrator assists others
within the organization to understand the focus of
nursing and to secure the resources necessary to
achieve the goals of nursing.
The nurse administrator is subject to challenges
similar to those of the practitioner and often walks
a very precarious tightrope between direct care-
givers and corporate executives. The nurse adminis-
trator, whether at the executive or managerial level
of the organizational chart, is held accountable for
“customer satisfaction” as well as for “the bottom
line.” Nurses who “move up the executive ladder”
340 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration
may, on the one hand, be suspected of disassociat-
ing from their nursing colleagues, and, on the other
hand, of not being sufficiently cognizant of the
harsh realities of fiscal constraint. Administrative
practice guided by the assumptions and themes of
nursing as caring can enhance eloquence in articu-
lating the connection between caregiver and insti-
tutional mission: the person seeking care. Nursing
practice leaders who recognize their care role,Nursing practice leaders who recognize
their care role, indirect as it may be, are
in an excellent position to act on their
committed intention to promote caring
environments.indirect as it may be, are in an excellent position to
act on their committed intention to promote caring
environments. Participating in rigorous negotia-
tions for fiscal, material, and human resources
and for improvements in nursing practice calls
for special skill on the part of the nurse adminis-
trator—skill in recognizing, acknowledging, and
celebrating the other (e.g., CEO, CFO, nurse man-
ager, or staff nurse) as a caring person. The nurse
administrator who understands the caring ingredi-
ents (Mayeroff, 1971) recognizes that caring is nei-
ther soft nor fixed in its expression. A developed
understanding of the caring ingredients helps the
nurse administrator mobilize the courage to be
honest with self and other, to trust patience, and to
value alternating rhythm with true humility while
living a hope-filled commitment to knowing self
and other as caring persons.NURSING AS CARING IN
NURSING EDUCATION
From the perspective of nursing as caring, all struc-
tures and activities should reflect the fundamental
assumption that persons are caring by virtue of
their humanness. Other assumptions and values re-
flected in the education program include: knowing
the person as whole and complete in the moment
and living caring uniquely; understanding that per-
sonhood is a way of living grounded in caring and
is enhanced through participation in nurturing re-
lationships with caring others; and affirming nurs-
ing as a discipline and profession.