Page 55 - Nursing: The Philosophy and Science of Caring

c a ra tiv e F act or s/ C ar it as ProC e s se s
The CFs were identified as the essential core of professional nurs-
ing practice, in contrast to what I called the “trim,” that which is con-
stantly changing and cannot be the content or the criteria with which
to describe, identify, and sustain professional nursing and its timeless
disciplinary stance with respect to caring in society.
As indicated in the original (1979) work, “carative” was a word I
made up to serve as a counterpoint to the “curative” orientation of
medical science. I identified these ten factors as the core activities and
orientations a professional nurse uses in the delivery of care. They
are the common and necessary professional practices that sustain
and reveal nursing as a distinct (caring) profession, not as comprising
a group of technicians. Nurses apply the CFs constantly but are not
aware of them, nor have they necessarily named them. Thus, nurses
generally are not conscious of their own phenomena; they do not have
the language to identify, chart, and communicate systematically and
so on. This is a result of both a lack of awareness and terminology of
caring and of recognized knowledge of those everyday practices that
define their work. Without an awareness, additional education, and
advancement of professional caring in nursing, these factors are likely
to occur in an ad hoc, rather than a systematic, fashion.
Nurses will not be aware or realize the importance of using them/
Becoming them to guide their professional caring practices. Further,
without a context to hold these practices, nurses have often devalued
their caring work, taking it for granted, without a common language
to “see,” articulate, act on, reinforce, and advance that work.
If nurses are committed to a model of professional caring-healing,
going beyond conventional medicalized-clinical routines and indus-
trial product-line views of nursing (and humanity), yet do not have a
theoretical guide to honor, frame, discuss, develop, and advance their
profession, a demoralized experience and despair set in over time
(Swanson 1999). If this continues, there is little hope for the survival
of professional nursing and its caring-healing practices. Likewise,
without furthering this work, there is little to no hope for advance-
ment of Caring Science as the disciplinary foundation for nursing
(and other health sciences), little hope for a foundation that guides
and contains the values, ethics, moral foundation, and philosophical

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