CRITIQUE AND

APPLICATION OF
NURSING THEORIES
MARK A. MACASADDU
JISELMARI ALTHERYN D. BULAN
JENIFER DELOS SANTOS
JOVAN CARL BALISI
 Nursing as Caring Theory by Anne Boykin and Sarvina Schoenhofer

s a process. Each person, throughout his or her life, grows in the capacity to
caring. Said another way, each person grows in his or her competency to express
caring person. The theory's assumption that all persons are caring does not
hat every act of a person necessarily be caring. There are many experiences of life
ch us that not every act of a person is caring. These acts are obviously not
ons of self as caring person and may well be labeled noncaring. Developing the
otential for expressing caring is an ideal. The theory of Nursing as Caring, then, is
n an understanding that the focus of nursing, both as a discipline and as a
on, involves the nurturing of persons living caring and growing in caring.
 Nursing as Caring Theory:
METAPARADIGM
PERSON
Anne Boykin and Sarvina Schoenhofers Theory of Caring as
Nursing gives emphasis in the fundamental idea that all persons
are caring; that to be a human means to be caring; and that being
a person is living in caring. Caring is innate to an individual and
that a person lives their lives growing the capacity of caring.
 Nursing as Caring Theory:
METAPARADIGM
HEALTH
Boykin and Schoenhofers theory did not fully describe health
but then it is believed that overall health is achieved with the
application of caring in all matters that deals with the patient. Since
this Theory of Caring is a grand theory, it can be used in collaboration
with other theories that further help a patient to improve the quality of
nursing care given to them so that they can achieve overall health.
 Nursing as Caring Theory:
METAPARADIGM
ENVIRONMENT
The Theory of Caring as Nursing suggest that a
person should have an environment that radiates a sense
of nurturing atmosphere which helps an individual to
grow in caring while revealing the richness of nursing.
 Nursing as Caring Theory:
METAPARADIGM
NURSING
Nursing, based on the Theory of Caring as Nursing, is said to be a
discipline and a profession. It focuses on the idea of nursing as
being grounded by caring and that nursing revolves around
caring people not just physically but in all aspects as well. The
theory also shows that the essence of caring is most essential
in the process of providing a holistic care needed by the patient
 NURSING AS CARING THEORY:
Application to Nursing Practice
By applying this theory in our nursing practice, we nurses are
encouraged to expand our understanding of caring, and to be
constantly looking for new ways to improve how we care for various
patients. When our work originates from a mindset of caring, the result
is greater compassion. Since evidence supports associations between
professional nursing and quality of health care outcomes, We can apply
the theory by delivering a quality nursing care to patients. For example,
being authentically present to the person we are caring for.
 NURSING AS CARING THEORY:
Application to Nursing Education
This theory can be applied in education by developing, organizing, and
communicating nursing knowledge. As such, nurse educators will be focusing on
humanizing care in the community through the integration of teaching grounded in
caring. They can also develop strategies to demonstrate to the students the value of
a model for healthcare delivery in an acute care setting that is intentionally
grounded in Nursing as Caring
Nursing as Caring in the context of nurse education, nursing school program
administrators can use the theory as baseline in designing and developing a
nursing curriculum.
It ties other nursing theory such as Capers Pattern of Knowing.
 NURSING AS CARING THEORY:
Application to Nursing Research
The theory can be applicable in research by being a framework for
future researches related to the theory. With the help of the theory,
researchers will be able to determine and evaluate nursing practice in
the clinical setting and maybe even explore the extent to which the
theory can be applied to various settings, scenarios and clinical
situations. Below are the examples of researches:
1. Dyes, S., Boykin, A., Bulfin, M., Hearing the Voice of Nurses in Caring-Theory based Practice.,
Nursing Science Quarterly. 4/2013. Vol. 26, Issue 2.
2. Bulfin, S. (2005). Nursing as caring theory: living caring in practice. Nursing Science Quarterly, 18(4),
313-319.
 NURSING AS CARING THEORY:
CRITIQUE
The assumptions presented by Boykin and Schoenhofer sounds
analytical and acceptable and the concepts and explanations are concise
and easily understandable.. Boykin and Schoenhofer stated that
personhood is enhanced through participating in nurturing
relationships with caring others. Our continuous nurturing experiences
and encounters with the patient will help develop and improve our
caring abilities. The relationship that will be gained through nurse-
client interaction using this theory will be extraordinary and
unremarkable because we treat and give care to our patient as if they
were our love ones. However, this may lead to development of emotional
attachment to patients which may be a weakness of the theory.
 NURSING AS CARING THEORY:
CRITIQUE
Exceptional nursing care can be accomplished when the Nursing as Caring theory is put
into practice. A nurse must embrace the theory and focus on using it in everyday life,
since evidence shows that great appreciation is felt from the patient when a nurse
demonstrates that level of attention. Unfortunately, it may become difficult to exhibit
that level of meticulousness when working under stressful conditions. Today, especially
in our country, with the inadequate nurse-to-patient ratio, it becomes difficult to offer
consistently outstanding quality of care, as required by nursing as caring theory, to every
patient. Although caring should come naturally, reality is: there are external stressors
that may easily alter our attitude and dedication to caring as nursing. We nurses, can
only strive to consistently be an example of the Nursing as Caring Theory.
One of the major strength of This theory is that it can be used not only by nurses but by
everyone who cares. Nursing education will take a little part in this theory since caring
is a virtue and innate to humans as declared by Boykin and Schoenhofer, but nursing
education can be a big help in reinforcing and helping nurses to grow in their caring for
others.
 NURSING AS CARING THEORY:
CRITIQUE
However, there are limited explanations regarding the concepts of a
person, man, environment and nursing; and further analysis of the Nursing
as Caring theory is limited and most published analysis is theoretical in its
discussion. The implications of the theory in practice have been largely
untested and hence, should be recommended.Furthermore, the lack of
association of the nursing process to this theory may be considered a
limitation since all of us are using the nursing process in our profession.
Nevertheless, this theory is highly applicable, useful and much effective if
used together with other theories. It will surely make a difference in the
recovery of our patients and positive feedbacks will be received.
 Theory of Human Caring by Jean
Watson
Nursing is categorized as a humanitarian science and characterized as a profession
that performs personal, scientific, ethical, and aesthetical practice. Watsons theory of
Human Caring aims to ensure a balance and harmony between health and illness
experiences of a person. Watson states that in a holistic approach to caring for a
human, there are mind-body-spirit sub-dimensions, all of which reflect the whole as
the whole is different from her/his sub-dimensions (Jesse, 2006; Fawcett, 2005; Cara,
2003).
 Theory of Human Caring:
METAPARADIGM
PERSON
A person of value to be cared for, understood, nurtured
and respected.
a fully functional integrated self and he is viewed as
greater than and different from, the sum of his or her
parts
 Theory of Human Caring:
METAPARADIGM
THE ENVIRONMENT
Is crucial to the holistic healing (mental, physical,
social, emotional, spiritual, developmental, protective,
supportive environments), which is conducive to a
patients health and wellbeing.
 Theory of Human Caring:
METAPARADIGM
HEALTH
Is viewed holistically, as the unity between the physical, social, mental
and spiritual self, with all parts working together in harmony and
functioning to their full capacity
The absence of illness (or the presence of efforts that leads its
absence)
 Theory of Human Caring:
METAPARADIGM
NURSING
Is providing caring, professional and thoughtful
interactions to restore and promote holistic health
and to prevent illness.
 THEORY OF HUMAN CARING:
Application to Nursing Practice
When applying Jean Watson's nursing theory, nurses must be conscious of the
patient as a whole and complete individual, regardless of disease or illness, to create
a caring experience, according to the Watson Caring Science Institute and
International Caritas Consortium. In addition, patients need caring occasions where
the nurse and patient share common experiences to enhance the healing process.
The goal of us nurses, according to Watson's theory, is to provide assistance with the
gratification of the patient's needs and protect the physical, mental, spiritual and
socio-cultural well-being of the patients. Applying the theory goes well beyond
administering medicine and performing procedures. Watson's theory in application
involves a caring approach with all nursing responsibilities.
 THEORY OF HUMAN CARING:
Application to Nursing Practice
As nurses, we can integrate the Carative factors of the theory in caring for our patients
in the hospital, e.g. by providing an installation of faith and hope within patients
through kind words, nurturing and caring gestures and non-verbal messages of
support.
Through the application of the theory, we are prompted to create a non-threatening
environment that accepts expressions of negative and positive feelings and a
promotion of interpersonal lessons to help the patient make decision and thus we will
be able to build interdependent relationships with our patients
The theory can be used as a framework for the nursing process and guide us in our
decision regarding our patients care.
 THEORY OF HUMAN CARING;
Application to Nursing Practice
The application of theory helps to
understand how caring works in solving
individual case and even nursing
management problems.
 THEORY OF HUMAN CARING:
Application to Nursing Education
The incorporation of caring in nursing education will bring the importance and thoughtfulness
of caring to the forefront of nursing education. Caring must be defined, understood, and
practiced in everyday living and serving. Nursing faculty and nursing students must become
aware of caring behaviors. When caring is demonstrated through action and word it allows
intentional being with others, promotes respect, and encourages open, trusting
communication (Watson, 1988).
Several universities use nursing education models based on caring philosophies. This
theory thus emphasizes and enhances the phenomenon of clinical reasoning and critical
thinking which are exceptionally valuable aspects of experienced nurses. Teaching this
theory to student nurses may enhance their skills in these vital areas.
 THEORY OF HUMAN CARING:
Application to Nursing Education
Through Watsons theory, students are taught to care for patients
holistically.
Theory of human caring will enable faculty and students realize their
caring behaviors.
Nursing educators will be able to promote civility in nursing education
and practice by more intentionally incorporating caring in the nursing
curriculum and environment.
 THEORY OF HUMAN CARING:
Application to Nursing Research
It gives nurses the opportunity to organize principles that will
help evaluate patient care and improve the nursing
interventions based on the evaluation findings of researchers
Core Concepts of the theory serves as a basis in formulating
tools for researchers. One example is the Caring Behavior
Inventory used by most researchers.
The theory can be a great help in generating further
knowledge and indicate which direction nursing should
develop in the future.
 THEORY OF HUMAN CARING:
Application to Nursing Research
There are many research studies available that utilized Watsons Theory
of Caring. One research study applied this theory to a group of 52
patients with hypertension in four health care groups in Turkey(Erci et
al., 2003). Each nurse researcher was trained in the use of Watsons
Theory of Caring and the 10 carative factors(Erci et al., 2003). This
training served as the foundation of the caring process(Erci et al.,2003).
This studyestablisheda relationship between care given accordingto
Watsons Caring Model and quality of life forthese patients(Erci et al.,
2003). A relationship between the Caring Model and a decrease in the
patients blood pressurewas also recognized. This theory isproposedas
amodel forpatients with hypertension, as one means of decreasing blood
pressure andincreasingquality of life(Erci et al., 2003).
 THEORY OF HUMAN CARING:
CRITIQUE
Nursing is caring. Nurses must care for those who are unable to care
for themselves thus this theory is extremely appropriate. Caring is
the core of most of our practices and we want this theory to be reality
but it does not always reflect the real world.
This theory provides many useful concept for the practice of nursing,
however some concepts are a little complex and need to be read more
than once to understand the meaning. One must read through each
carative factor or clinical caritas multiple times to really grasp their
meaning. But then, she has increasingly used art, personal reflections
and poetry to make her concepts more easily understood. The
detailed descriptions of the carative factors can give guidance to
those who wish to employ them in practice or research.
 THEORY OF HUMAN CARING:
CRITIQUE
However, this theory does not specify precise guidelines on how to establish a caring-
healing relationship, which can be considered as its limitation. But even though the
theory is broad and complex it is extremely applicable and beneficial to nursing practice.
This theory is also practical for all ages and populations in the health care discipline. She
also ties together many theories commonly used in nursing education. Many educational
institutions and hospital systems are incorporating this theory in their philosophies .
Much research has utilized it and the research and results generated are significant and
has improved health outcomes and quality of life.

It is concluded therefore that, Jean Watsons Theory of Human Caring is important to the
future of nursing throughout humanity. Her initial wisdom to create meaning and focus
to nursing as an emerging discipline and a unique health profession is even more
applicable in todays raging health care environment. Nursing is quickly moving towards
the forefront of our health care system but it must not forget caring as its foundation.