Page 97 - Nursing: The Philosophy and Science of Caring

Fr om carative Fa c t o r 4 t o C ar it as ProC e s s 4
The Carative Factors/Caritas Processes discussed earlier, such as
mindfulness, loving-kindness, sensitivity, hope, and faith, all contribute
to the quality of an authentic caring relationship. Nevertheless, the rela-
tionship itself merits study and attention. Whether we see nursing as
the Philosophy and Science of Caring or caring as the Philosophy and
Science of Nursing, either way we are required to consider seriously the
empirical as well as the ethical, theoretical, and experiential evidence
related to development of an authentic caring-healing relationship.
Of the many problems that can arise in nursing, perhaps one of
the most common is the failure to establish rapport, being insensi-
tive, unable to connect or create an alliance with another. Put another
way, a major problem is the lack of a reflective, mindful awareness of
how one’s presence and consciousness toward self and other can and
do affect the nature and outcome of one’s relationship with another,
whether the other is a colleague, a patient, or a family member. It is
common knowledge, as well as empirical knowledge, that a patient
who feels the nurse truly, authentically cares about and for the patient
and sees who she or he is behind the patient status is more likely to
establish trust, faith, and hope and sustain a caring relationship with
the nurse. When one is able to engage in presence and truly listen to
and hear another person’s story, that may be the greatest healing gift
of all. It is then that the other is far more likely to talk about sensitive
matters—what is really bothering him or her behind the superficial
words or overt behavior.
As the discipline of nursing has evolved to honor and develop the
art and science of human caring, relationship itself has become core to
professional practices. Indeed, the philosophical, theoretical, and sci-
entific nursing literature now subsumes many constructs tied to heal-
ing: empathy, compassion, commitments, communication, humanistic-
altruistic values, instilling faith and hope, sensitivity to self and other,
respect, trust, love, patient- and person-centered relationships, and so
on (Quinn et al. 2003).
Some of the more formal research on caring and outcomes was
conducted by Swanson (1999), who described outcomes of caring and
noncaring relationships. The meta-analysis showed that for patients
who experienced caring, outcomes included:

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