Page 165 - Nursing: The Philosophy and Science of Caring

F r o m ca ra t i v e F a c t o r 8 t o C a r i t a s P r o C e s s 8
dignity, and peace are potentiated. In this expanded process, environ-
ment takes on an entirely new meaning whereby the nurse is in the envi-
ronment, addressing all the above aspects of environment, but in the
Caritas Process the nurse becomes or is the environment (Quinn 1992).
Nightingale considered environment core to a nursing paradigm.
As part of an evolved approach to environment, the original goal for this
Carative Factor, consistent with Nightingale, was to strengthen com-
fort, privacy, safety, aesthetics, and so forth, resulting in supporting the
patient’s well-being through holistic attention to the physical, mental,
sociocultural, and spiritual aspects of the health-healing environment.
In the Caritas Nursing model, the concept and notion of environ-
ment undergo a reconceptualization, resulting in a transformation.
While still attending to conventional physical-environmental con-
cerns and issues, nonphysical concepts now come to our attention: for
example, concepts such as consciousness, intentionality, energy, and
awareness of the Nurse-self come into focus. New questions emerge as
to the nature of the subtle environment as well as the more obvious
physical environment. These expanded and transformative views of
environment represent my evolved thinking and are enhanced by the
framework proposed by Quinn (1992).

exPanDeD levels of environmental ConCePtualization
This expanded view of the Caritas environment moves
• From an exclusive, external physical-environmental focus
(whereby the nurse alters, controls, and influences the physical
surroundings in specific ways—consistent with original Carative
Factor)
• Toward considering notions such as “environmental field” and
“re-patterning-the-field” for patient healing (whereby the nurse
and patient are integral to the broader field—consistent with car-
ing modalities in Watson 1999) (Quinn 1992)
• To a consideration of the “Nurse-as-the Environment” (Quinn 1992).

Quinn’s (1992) work is helpful in seeking to clarify my evolution-
ary thinking and the transition from conventional views of environ-
ment toward a transformative Caritas view. For example, in her classic

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