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630 UNIT V Middle Range Nursing Theories

p. 16). A defining characteristic of the Tidal Model resources. The theory integrates the need for nursing
is emphasis on story in the person’s own voice. studies, collaboration, empowerment, interpersonal re-
The empirically derived empowering interactions lationships, story, strengths-base, and solution-seeking
framework suggests that improvement in the person’s approaches, and is systemic. In the holistic assessment,
situation and lifestyle is possible, building on strengths nurses explore the person’s present ‘problems’ or ‘needs’,
is better than focusing on problems, collaboration is the scale of these problems/needs, what is currently
key, participation is the way, and self-determination is in a person’s life that might help to resolve problems
the ultimate goal (Barker & Buchanan-Barker, 2004a; or meet needs, and what needs to happen to bring
Barker, Stevenson & Leamy, 2000). Eight respectful, about change (Barker, 2000e; Barker & Buchanan-
empowering interactions bring generally invisible nurs- Barker, 2007a). Nurses help identify and mobilize per-
ing interactions into the practice arena (Michael, 1994). sons’ strengths and resources, and the person’s goals
De Shazer’s (1994) influence is evident as he asserts that direct the work of the health care team (Barker, 2000e;
change and intervention “boils down to stories about Stevenson, Jackson, & Barker, 2003). The Ten Tidal
the telling of stories, the shaping and reshaping of sto- Commitments support this perspective and direction
ries so that troubled people change their story” (p. xvii). (Box 32–1).
The strength base of the Tidal Model emphasizes This is a significant reframing of the view of the
searching for and revealing solutions, and identifying person-in-care and the proper focus of nursing.

BOX 32-1 The Ten Tidal Commitments: Essential Values of the Tidal Model
The Tidal Model draws on our values about relating voice of the person—rather than reinforce the
to people. These frame our efforts to help others in voice of authority.
their moment of distress. Traditionally, the person’s story is “translated”
The values of the Tidal Model reflect a philoso- into a third-person professional account by differ-
phy of how we would hope to be treated should we ent health care or social care practitioners. This
experience distress or difficulty in our lives. becomes not so much the person’s story (my
As more people around the world have become story) but the professional team’s view of the story
involved in exploring the Tidal Model for their (history).The Tidal Model seeks to help people
work in different settings, the need to reaffirm develop their own unique narrative accounts into
the core values of the Tidal Model has become a formalized version of “my story” by ensuring
more apparent. We have come to appreciate how that all assessments and records of care are writ-
both the “helper” (whether professional, friend, or ten in the person’s own “voice.” If the person is
fellow traveler) and the person need to make a unable or unwilling to write in his or her own
commitment to change. This commitment binds hand, then the nurse acts as secretary, recording
them together. what has been agreed conjointly is important—
The Ten Tidal Commitments distil the essence of writing this in the “voice” of the person.
the value base of the Tidal Model. These commit- 2. Respect the language: People develop unique
ments need to be firmly in place for any team or ways of expressing their life stories, representing
individual practitioner who wishes to develop the to others that which the person alone can know.
practice of the Tidal Model. The language of the story—complete with its
1. Value the voice: The person’s story is the be- unusual grammar and personal metaphors—is
ginning and end point of the whole helping the ideal medium for illuminating the way to
encounter, embracing not only the account of recovery. We encourage people to speak their
the person’s distress, but also the hope for its own words in their distinctive voice.
resolution. The story is spoken by the voice Stories written about patients by professionals
of experience. We seek to encourage the true are traditionally framed by arcane technical