untitled

students and guiding doctoral students’ research
that focuses on the administrative, ethical, and in-
formation technological practice of nursing and
transcultural nursing.

Introducing the Theory

This chapter will present a discussion of contempo-
rary nursing culture, share theoretical views related
to the author’s developmental theoretical vision of
nursing, and discuss the Theory of Bureaucratic
Caring as a grounded theory. After revisiting the
theory in the contemporary age, the author will
elucidate bureaucratic caring theory as a holo-
graphic theory to further the vision of nursing and
organizations as relational, integrated, and com-
plex. Theory is the intellectual life of nursing
(Levine, 1995). “Scientific theories in the discipline
of nursing have developed out of the choices and
assumptions a particular theorist believes about
nursing, what the basis of nursing’s knowledge is,
and what nurses do or how they practice in the real
world” (Ray, 1998, p. 91). Van Manen (1982) refers
to theory as “wakefulness of mind” or the pure
viewing of truth.Truthin the Greek sense is not the
property of consensus among theorists but the dis-
closure of the essential nature or the good of things.
In essence, truth refers to contemplating the good
(van Manen, 1982). Collectively, theories in nursing
have focused on the good of nursing—what nurs-
ing is and what it does or should do. Based on the
assumptions of nursing as serving the good, the
locus of the discipline centers on caring for others,
caring in the human health experience (Newman,
1992; Newman, Sime, & Corcoran-Perry, 1991). A
theory of nursing actually must direct or enlighten
the good. Theories such as the classical grand theo-
ries in nursing of Rogers, Leininger, Newman,
Watson, and Parse demonstrate a diversity of inte-
grated approaches to nursing based on the world-
view and education of an individual theorist.
Ongoing research through testing and evaluation
has supported the validity and reliability of the the-
ories. Grounded or middle-range theories, how-
ever, focus on particular aspects of nursing practice
and are commonly generated from nursing prac-
tice. As such, some intellectuals view middle-range
theories as more relevant and useful to nursing
than the application of grand theories (Cody,
1996). However, rather than show partiality for one

theory over another, the diversity of nursing

theories that emphasize holistic points of view ac-

tually support the new picture of reality in science.

Revolutionary approaches to scientific theory de-

velopment, such as the quantum theory, the science

of wholeness, holographic and chaos theories, and

fractals or the idea of self-similarity within the sci-

ences of complexity (Bassingthwaighte, Liebovitch,

& West, 1994; Battista, 1982; Briggs & Peat, 1984;

Davidson & Ray, 1991; Harmon, 1998; Peat, 2003;

Ray, 1998; Wheatley, 1999; Wilbur, 1982) illuminate

the nature and creativity of science itself. The con-

ception of the multiple interconnectedness and re-

lational reality of all things, the interdependence of

all human phenomena, and the discovery of order

in a chaotic world demonstrate the pioneering

story of twentieth-century science and how the in-

sightful idea of relationality (a powerful nursing

concept) is shaping the science of the twenty-first

century.

Given the nature of nursing as expanded con-

sciousness (Newman, in Parker, 2001) and the no-

tion of theory as wakefulness, this author holds the

position that nurses do need nursing theory to

stimulate thinking and critique as they function in

the complex world of nursing science, research, ed-

ucation, and practice. Theories, as the integration

of knowledge, research, and experience, highlight

the way in which scholars of nursing interpret their

world and the context where nursing is lived.

Theories in this sense are also philosophies or ide-

ologies that serve a practical purpose. The Theory

The Theory of Bureaucratic Caring illu-

minated in this chapter is a theory with

a practical purpose that emerged from

the worldviews of health professionals

and clients in practice.

of Bureaucratic Caring illuminated in this chapter

is a theory with a practical purpose that emerged

from the worldviews of health professionals and

clients in practice (Ray, 1981, 1989). By illustrating

the significance of spiritual and ethical caring in re-

lation to the structural dimensions of complex or-

ganizational cultures, such as political, economic,

technological, and legal, bureaucratic caring theory

invites us to view how a new model may facilitate

understanding of how nursing can be practiced in

modern health-care environments.

CHAPTER 23 Marilyn Anne Ray’s Theory of Bureaucratic Caring 361