CHAPTER 21 Anne Boykin and Savina O. Schoenhofer’s Nursing as Caring Theory 345The Lived Experience of Nursing as Caring
By Danielle Linden
The application of nursing as caring in my practice has been fulfilling both professionally and personally. I have
been invited to share this experience.
Nursing as caring requires the nurse to use many different ways of knowing to come to know “other” in
the fullness of one’s existence. Each domain contains a vast amount of knowledge. The nurse must be knowl-
edgeable of each and artfully apply this knowledge in an effort to transcend the physical boundaries of the human
body to come to know other’s complex existence. Personally, this effort is rewarded by enhancing who I am as
a person.
Current Practice as an Advanced Practice Nurse
As an advanced registered nurse practitioner (ARNP) in family practice, I see patients in a primary care setting.
Grounded in nursing as caring, I borrow knowledge from other disciplines, such as pathophysiology, microbiol-
ogy, pharmacology, and philosophy and use this knowledge to come to know other in each moment of our visit.
Some patients have immediate acute needs. Others have chronic problems that require maintenance therapy. All
of them need to be recognized as holistic and complex human beings with a unique existence in this world, liv-
ing in caring and growing in caring. I am a facilitator of this process and risk entering into another’s world with
the intent of living caring in that nursing situation.
In practice, I emphasize wellness and prevention. Nursing as caring guides the nursing situation, serving as a
framework in my patient encounters. I walk in the room with the intent of coming to know other as a holistic
being with a body, mind, and spirit. The call for nursing then begins to unfold and reveals itself to me. My pres-
ence with other is authentic, and there exists a genuine responsiveness to come to know other. Authentic pres-
ence allows one to know that which is not spoken. A person can speak one’s mind. A physical assessment can
reveal an ailment. The spirit, however, must be attended to as well. Everything is revealed in one’s spirit. When
you are in authentic presence with other, the call for nursing unfolds before you. These are the profound en-
counters that never leave you.
Then there are the more frequent encounters where reflection becomes a useful tool to uncover the deeper
meaning behind these chance nursing situations. Sometimes the patients’ call for nursing is physical. I recognize
it and treat accordingly. Reflection allows me to answer these questions:Was I nursing? What did I do differently
from another health-care provider? My answer is the perspective from which I practice. I walked into the room
with the willingness to come to know other, whatever may have been revealed in that moment. It was the way I
touched the patient, my tone of voice, my unhurried pace, and my smile—all the tools I use to convey to other
that I am there and that I care.The goal is to enhance other as he or she lives and grows in caring.
I take time regularly to reflect upon the profound and not-so-profound nursing situations in my life.
Reflection uncovers those hidden meanings that are not readily apparent in the moment. It is also a time for self-
growth and validation—a process of coming to know self and others as caring persons.
Sharing with Others
Another form of reflection is the sharing of nursing situations with others. There are many different ways one
can present a nursing situation, such as case presentations, poems, projects, and various other art forms. When
one shares a nursing situation with others, new possibilities for knowing other unfold exponentially. Each practi-
tioner brings the wealth of his or her education and experiences. New revelations come to life.
I share with you here a nursing situation I encountered. First, I will present it in the traditional medical model,
and then I will present the same story in a nursing perspective grounded in the nursing as caring theory.Through
comparison, the lived experience of both of these models will make clearer the difference between practice per-
spectives.
Medical Model Case Presentation
E. S. was a 76-year-old white female patient who came to the office with the complaint of a lump in her abdomen.
She remarked that she did not like going to the doctor and had neglected to have any checkups in quite a few years. A