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CHAPTER 19 Anne Boykin and Savina O. Schoenhofer 371

as caring, and nurturing them as persons living and
growing in caring. the study of story in the nursing situation is the
Formed intention and authentic presence guide method for knowing nursing.
the nurse in selecting and organizing empirically Carper’s (1978) fundamental patterns of know-
based knowledge for practical use in each unique ing, personal, empirical, ethical,and aesthetic open
and unfolding nursing situation. Because caring is useful pathways for organizing and understanding
uniquely created in the moment in response to a the rich content of nursing situations. Personal
uniquely experienced call for nursing caring, there knowing centers on encountering, experiencing,
can be no prescribed outcome. The caring that is and knowing self and other. Empathy, the shared
experienced by the nursed and others in the nursing knowing of other, is an expression of aesthetic
situation can, however, be described and valued knowing. Empirical knowing is factual and
(Boykin & Schoenhofer, 1997; Schoenhofer & Boykin, addresses the empirical science of nursing. Ethical
1998a, 1998b), and in the theory of nursing as caring, knowing is concerned with moral obligations
becomes a substantive focus for study and research. inherent in nursing situations and what ought to
Caring in nursing is “an altruistic, active expres- be. Aesthetic knowing is the subjective apprecia-
sion of love, and is the intentional and embodied tion of phenomena as lived in the nursing situa-
recognition of value and connectedness” (Boykin & tion: Nursing stories, therefore, represent both the
Schoenhofer, 2006, p. 336). Although caring is not process of aesthetic knowing (creative apprecia-
unique to nursing, it is uniquely lived in nursing. The tion) and the product of aesthetic knowing (illu-
understanding of nursing as a discipline and as a pro- mination and integration) (Boykin & Schoenhofer,
fession uniquely focuses on caring as its central value, 1991). The outcomes of nursing are the values
its primary interest, and the direct intention of its experienced within the nursing situation. For this
practice. study of a nursing situation, read the following
Models for practice are being developed in several story slowly, allowing yourself to be one with the
institutional practice areas, and Nursing as Caring nurse and with the ones nursed sharing in the feel-
is being used as a conceptual basis for developing ings of each and dwelling in your reflections.
middle-range theories. As the Theory of Nursing as Jane was a young woman who suffered from
Caring becomes more widely known, consideration metastatic cancer. The very first time that I entered
and referential inclusion in disciplinary journals have her room I remember thinking of just how beauti-
steadily increased. The theory has been used as a ful she was. I could not understand why someone
theoretical basis for master’s and doctoral research so young and so needed in the world would have
(Herrington, 2002; Linden, 1996, 2000). to endure such a drastic circumstance. Immedi-
ately, my heart poured with compassion for her
and her family.
CASE STUDY Jane was a long-term admit, requiring numer-
ous interventions for her nausea, vomiting, and
A Study of the Nursing Situation pain. Her husband came every single day with the
From the perspective of Nursing as Caring, the children, and they would sit at her bedside as they
nursing situation is the unit of knowledge for completed their school assignments. The family
study for a focus on personhood as a process of had filled her room with pictures that lined the
living that is grounded in caring (Boykin & windowsill, personal blankets from home, and a
Schoenhofer, 1991; Touhy, 2004). The mutual rela- small bottle of perfume that Jane wore every day.
tionship shared by the nurse and the nursed is one The fragrance was amazing, and the environment
of reciprocity and subjectivity. Because nursing was saturated with love.
knowledge is found in the nursing situation, the As Jane’s condition worsened, the case manager
shared, lived experience in the caring between the pushed for a hospice consult. Jane’s husband ada-
nurse and the nursed enhances personhood. Thus mantly refused. He firmly expressed his desire to
Continued