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CHAPTER 19 Anne Boykin and Savina O. Schoenhofer 369

between project personnel and all stakeholders. All technological competence, and the medium of techno-
persons on the unit participated in the process to cre- logically produced data. The theory is being tested
ate an innovative approach that blends with the exist- in critical care settings, with development and refine-
ing facility design. Major themes revolve around ment ongoing (Kongsuwan & Locsin, 2011; Parcells &
responding to that which matters, caring as a way of Locsin, 2011).
expressing spiritual commitment, devotion inspired Purnell (2006) created a Model for Nursing Educa-
by love for others, commitment to creating a home tion grounded in caring, with three major aspects
environment, and coming to know and respect per- characterizing the model: the Theory of Nursing as
son as person. Caring, the metaphor of the Dance of Caring Persons
In a study titled “The Value Experienced in (see Figure 19–1) as organizing construct, and inten-
Relationships Involving Nurse Practitioner-Nursed tionality in nursing with its transformative aspect of
Dyads,” Thomas, Finch, Green, and Schoenhofer aesthetic knowing. Caring intention that guides the
(2004) sought to describe the shared experience of creation of the course and environment is understood
caring between nurse practitioners and those they as a vital energy that flows through and critically inter-
nurse, and to uncover the caring experienced in the connects every aspect of the course. The model is
relationship. The approach used was praxis, in which intended for us in traditional and online environments
dialogue ensued among the nurse practitioner, the with caring intention flowing throughout. From this
nursed, and the nurse researcher resulted in a portrait perspective, caring nursing intention in all its dimen-
of caring relationships between the nurse practitioner sions is essential in the shaping of teaching and learn-
and the nursed. ing. Touhy and Boykin (2008) have proposed caring as
The major nursing models for acute care hospitals the central domain for nursing education.
and the long-term care facility each reflect themes
that are central to Nursing as Caring, but these Research
themes are drawn out in ways that are unique to the Research and development efforts are focused on ex-
setting and to the persons involved in each setting. panding the language of caring by uncovering personal
The differences and similarities demonstrate the ways of living caring in everyday life (Schoenhofer,
power of Nursing as Caring to transform practice in a Bingham, & Hutchins, 1998) and on reconceptualizing
way that reflects unity without conformity and nursing outcomes as “value experienced in nursing
uniqueness within oneness (Touhy, 2004; Touhy & situations” (Boykin & Schoenhofer, 1997; Schoenhofer
Boykin, 2008). & Boykin, 1998a, 1998b). In consultation with gradu-
ate students, nursing faculties and health care agencies
Further Development are using aspects of the theory to ground research,
teaching, and practice. Developmental efforts include
Theory the following areas: (1) clarification of the concept
As a general theory of nursing, Nursing as Caring serves of personhood, (2) expansion of the understanding
as a broad, conceptual framework underpinning of enhancing personhood as the general outcome of
middle-range theory development. Drawing on Nurs- nursing, (3) illuminating understanding of the concept
ing as Caring as the underlying theoretical framework, of direct invitation, (4) innovations in nursing
Locsin (1995) created a model of machine technologies research, (5) use of the theory in middle-range
and caring in nursing. Competence in machine tech- theory work, and (6) use of the theory in the critical
nology and caring was presented as nursing practice analysis of caring. Over the last 10 years, however,
when grounded in a caring perspective, without which in response to calls for transformation by health
nursing becomes the functional practice of machine care systems to a framework grounded in caring, par-
proficiency. Locsin (1998) developed this critical under- ticular attention has focused on development and
standing in the theory of Technologic Competence research of implementation and outcomes of caring.
as Caring in Critical Care Nursing. In this middle- In a development that signifies grass roots acceptance
range theory, the intention to care and to nurture the of the theory, Nursing as Caring has been translated
other as caring is actualized through direct knowing, into Japanese.