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364 UNIT IV Nursing Theories

is a way of knowing, being, valuing, and living in the
world, and is envisaged as a unity of knowledge within
a larger unity. The discipline of nursing attends to the
discovery, creation, development, and refinement of
knowledge needed for the practice of nursing. The pro-
fession of nursing attends to the application of that
knowledge in response to human needs.
Nursing as caring focuses on the knowledge
needed for plenary understanding of what it means to
be human and the distinctive methods needed to
verify this knowledge. As a human science, knowing
nursing means knowing in the realms of personal,
empirical, ethical, and aesthetic all at once (Carper,
1978; Phenix, 1964). These patterns of knowing pro-
vide an organizing framework for asking epistemo- FIGURE 19-1 The Dance of Caring Persons. (From Boykin,
logical questions of caring in nursing. A., & Schoenhofer, S. O. [2001a]. Nursing as caring: A model
for transforming practice [p. 37] [Re-release of original 1993
volume, with epilogue added]. Sudbury, (MA): Jones & Bartlett;
Theoretical Assertions
graphic created by Shawn Pennell, Florida Atlantic University,
The broad philosophical framework of the theory as- Boca Raton, FL.)
sures its congruence in a variety of nursing situations.
As a general theory, Nursing as Caring is appropriate
for various nursing roles, such as individual practice, integrated functioning (Boykin, Schoenhofer, Smith,
group or institutional practice, and a variety of practice et al., 2003). Dancers move freely; some dancers
venues such as acute care, long-term care, nursing touch, some dance alone, but all dance in relation
administration, and nursing education. to each other and to the circle. Each dancer brings
The fundamental assumptions of Nursing as Caring special gifts as the nursing situation evolves. Some
underpin the assertions and concepts of the theory. dancers may hear different notes and a different
They are as follows: (1) To be human is to be caring, rhythm, but all harmonize in the unity of the dance
and (2) the purpose of the discipline and profession is and the oneness of the circle. Personal knowing of self
to come to know persons and nurture them as persons and other is integral to the connectedness of persons
living caring and growing in caring. These assumptions in the dance, in which the nature of relating in the
give rise to the concept of respect for persons as caring circle is grounded in valuing and respecting person
individuals and respect for what matters to them. The (Boykin & Schoenhofer, 2001a). All in the nursing
notion of respect grounds and characterizes relation- situation, including the nurse and the nursed, sustain
ships and is the starting place for all nursing caring the dance, being energized and resonating with the
activities. music of caring.
Dance of Caring Persons Outcomes of Nursing Care
The Dance of Caring Persons is a visual representation Outcomes of nursing care are conceptualized from
of the theoretical assertion that lived caring between values experienced in the nursing relationship, and
the nurse and the nursed expresses underlying rela- in normative documentation, these outcomes are
tionships (Figure 19–1). The egalitarian spirit of car- unacknowledged. Boykin and Schoenhofer (1997)
ing respect characterizes each participant in the dance note that it is the responsibility of the courageous
of caring persons, where the contributions of each advanced practice nurse to “go beyond what is cur-
dancer, including the one nursed, are honored. rently accepted in delimiting and languaging the
Dancers enter the nursing situation, visualized as a value expressed by persons who participate in nursing
circle of caring that provides organizing purpose and situations” (p. 63).