Transcultural Nursing

• The blending of nursing and

anthropology into an area of
specialization within the discipline
of nursing

• Conceptualized by Dr. Leininger

• A formal area of study that uses

the concepts of culture and caring
Transcultural Nursing (cont.)
• Transcultural nursing (TCN) is a nursing specialty
focused on the comparative study and analysis of
cultures and subcultures.
• It examines these groups with respect to their:
• Caring behavior
• Nursing care
• Health–illness values and beliefs
• Patterns of behavior
Transcultural
Nursing (cont.)
• Transcultural nursing’s goal is to:
• Develop a scientific and humanistic body of
knowledge in order to provide nursing care
that is both
• Culture specific
• Culture universal
Transcultural Nursing
(cont.)
• Culture-specific refers to:
• Particular values, beliefs, and patterns of behavior
that tend to be special or unique to a group and do
not tend to be shared with members of other
cultures
• Culture-universal refers to:
• The commonly shared values, norms of behavior, and
life patterns that are similarly held among cultures
about human behavior and lifestyles
Question
• Is the following statement true or false?

• Methods, rules, guidelines, and patterns of

behavior about food practices can be described as
culture-specific.
Answer
• True
• Rationale: The need for food is a culture-universal.
• Culture-specific determines methods, rules, guidelines,
and patterns of behavior. For example, items that are
considered to be edible; acceptable methods used to
prepare and eat meals; rules concerning who eats with
whom, the frequency of meals, etc.
Transcultural Nursing (cont.)
Anthropology:
• The study of humans including their:
• Origins
• Behavior
• Social relationships
• Physical and mental characteristics
• Customs
• Development through time and in all places in
the world
Transcultural Nursing (cont.)
Culture (as defined by Leininger) the “learned, shared, and
transmitted values, beliefs, norms, and lifeways of a
particular group of people that guide thinking, decisions,
and actions in a patterned way…

Culture is the blueprint that provides the broadest and

most comprehensive means to know, explain, and predict
peopleʼs lifeways over time and in different geographic
locations.”
Transcultural Nursing (cont.)
Influences a person’s definition of health and illness

Oftentimes connotes a person’s racial or ethnic

background. Culture also encompasses:
• Socioeconomic status
• Ability or disability
• Sexual orientation
• Age
• Occupation or profession
Transcultural Nursing (cont.)
• Ethnicity
• The perception of oneself and a sense of
belonging to a particular ethnic group or
groups. It can also mean feeling that one does
not belong to any group because of
multiethnicity.
• Currently five classifications; however, some people
may identify with more than one ethnicity/race.
Transcultural Nursing (cont.)
• Race
• Refers to a group of people who share such genetically
transmitted traits as skin color, hair texture, and eye
shape or color.
• Races are arbitrary classifications that lack definitional clarity;
all cultures have their own ways of categorizing or classifying
their members.
Historical and Theoretical
Foundations of Transcultural
Nursing
• Transcultural nursing:
• Dr. Madeleine M. Leininger, nurse anthropologist

• Initial conception in the 1950s

• Formal creation as a specialty and new discipline within

the profession in the 1960s−1970s

• Nurse scholars have generated a substantial and

important body of theoretical, research, and evidence-
based knowledge in TCN, which is ongoing.
Question
• Is the following statement true or false?

• Transcultural nursing has been formally considered

a nursing specialty since 2000.
Answer
• False

• Rationale: Transcultural nursing was formally

considered as a specialty and new discipline within
the profession in the 1960s and 1970s.
Leininger’s Contribution to
Transcultural Nursing
Theory of Culture Care Diversity and
Universality
• Focuses on describing, explaining, and predicting nursing
similarities and differences focused primarily on human
care and caring in human cultures

Sunrise Enabler

• Visual representation of the concepts of her theory. Based

on the concept of cultural care that guides nursing
judgments and activities to provide culturally congruent
care
Leininger’s Sunrise Enabler
Leininger’s Contribution to
Transcultural Nursing (cont.)
• Established the Transcultural Nursing Society (TCNS)
• TCNS Newsletter
• Created the Journal of Transcultural Nursing (JTN)
and served as founding editor
• Established the first master’s and doctoral programs
in nursing with a theoretical and research focus in
TCN
• Created a new qualitative research method called
enthnonursing research to investigate phenomena of
interest in TCN
Question
• Is the following statement true or false?

• Dr. Madeleine M. Leininger authored both

conceptual frameworks, the Theory of Culture Care
Diversity and Universality and the Sunrise Model.
Answer
• True

• Rationale: Dr. Madeleine M. Leininger is credited

with authoring both of these conceptual
frameworks related to transcultural nursing.
Advancements in
Transcultural Nursing
• Expanded models by nursing scholars:
• Giger and Davidhizar Transcultural Assessment
Model
• Purnell Model for Cultural Competence
• Campinha-Bacote Model of Cultural Competence in
the Delivery of Healthcare Services
Advancements in
Transcultural Nursing (cont.)
• The Core Curriculum has been established to support
TCN practice with a core base of knowledge.

• Used in a variety of practice settings.

• Two certifications offered in TCN, basic and advanced.

 A new model, uses the scientific process for
delivering culturally congruent, quality care to
Andrews/Boyle people from diverse backgrounds across the life span
Transcultural
Facilitates the delivery of nursing and health care
Interprofessional consistent with cultural beliefs and practices of
Practice (TIP) clients from diverse backgrounds
Model Provides a conceptual framework to guide nurses in
the delivery of culturally congruent care that is
theoretically sound
TIP Model (cont.)
• Components of the model; the context from which
people's health-related values, attitudes, beliefs, and
practices emerge:
• Interprofessional Health Care Team
• Communication
• Problem Solving
TIP Model (cont.)

● Interprofessional Health Care Team

- Client at its core
- May also include Family and support
persons, other healthcare personnel,
traditional, folk and religious healers
- All providers working together to
deliver the highest quality of care
- A partnership among client and
providers that establishes trust,
collaboration, cooperation, and
communication
TIP Model (cont.)

• Communication
• Verbal—spoken word,
language (over 6,000
worldwide), tone of voice,
abbreviations, idioms
• Nonverbal—how people
convey meaning without
words. Facial expressions,
gestures, posture, physical
distance, silence, eye contact
• Mixed—modesty, technology
assisted
 • Problem solving
• Guides health care teams in determining
what the client needs to obtain optimal
TIP Model (cont.) well-being and health.
• Comprehensive assessment skills
• Mutual goal setting
• Planning care
• Implementing care
• Evaluation of care to achieve the goals
of:
• Culturally congruent, competent,
quality care based on evidence
and best practice
TIP Model (cont.)
TIP Model (cont.)

• Proficiency in using the problem-solving

process requires time and repeated
simulated and/or clinical experiences.

• Developing competence is uneven and

nonlinear, as is the process of developing
cultural competence.
Question

• Which of the following is an example of

verbal communication?
A. Avoiding eye contact
B. Nodding to convey understanding
C. Speaking another language
D. Arms folded and legs crossed
Answer

• C. Speaking another language

• Rationale: Speaking another language is

a verbal communication method. This is
an example of the spoken word versus
nonverbal communication, which is
conveying meaning without words.
HUMAN BECOMING
THEORY

Rosemarie Rizzo Parse

 INTRODUCTION
• The Parse theory of human becoming guides nurses In
their practice to focus on quality of life as it is described
and lived (Karen & Melnechenko, 1995).
• The human becoming theory of nursing presents an
alternative to both the conventional bio-medical
approach and the bio-psycho-social-spiritual (but still
normative) approach of most other theories of
nursing.(ICPS)
• The human becoming theory posits quality of life from
each person's own perspective as the goal of nursing
practice.(ICPS)
• Rosemarie Rizzo Parse first published the theory in 1981
as the "Man-living-health" theory (ICPS)
• The name was officially changed to "the human
becoming theory" in 1992 to remove the term "man,"
after the change in the dictionary definition of the word
from its former meaning of "humankind."
ABOUT THE THEORIST

• Educated at Duquesne University, Pittsburgh

• MSN and Ph.D. from University of Pittsburgh
• Published her theory of nursing, Man-Living-Health in 1981
• Name changed to Theory of Human Becoming in 1992
• Editor and Founder, Nursing Science Quarterly
• Has published eight books and hundreds of articles about
Human Becoming Theory
• Professor and Niehoff Chair at Loyola University, Chicago
THEORY DEVELOPMENT

• The human becoming theory was developed as a human science

nursing theory in the tradition of Dilthey, Heidegger, Sartre, Merleau-
Ponty, and Gadamer and Science of Unitary Human Beings by Martha
Rogers .
• The assumptions underpinning the theory were synthesized from
works by the European philosophers, Heidegger, Sartre, and Merleau-
Ponty, along with works by the pioneer American nurse theorist,
Martha Rogers.
• The theory is structured around three abiding themes: meaning,
rhythmicity, and transcendence.
ASSUMPTIONS

• ABOUT MAN
• The human is coexisting while co-constituting rhythmical
patterns with the universe.
• The human is open, freely choosing meaning in situation,
bearing responsibility for decisions.
• The human is unitary, continuously co-constituting patterns
of relating.
• The human is transcending multidimensionally with the
possibles
ASSUMPTIONS
• ABOUT BECOMING
• Becoming is unitary human-living-health.
• Becoming is a rhythmically co-constituting human-universe process.
• Becoming is the human’s patterns of relating value priorities.
• Becoming is an intersubjective process of transcending with the
possibles.
• Becoming is unitary human’s emerging
THREE MAJOR ASSUMPTIONS OF HUMAN
BECOMING
• MEANING
• Human Becoming is freely choosing personal meaning in situations in the
intersubjective process of living value priorities.
• Man’s reality is given meaning through lived experiences
• Man and environment cocreate
• RHYTHMICITY
• Human Becoming is cocreating rhythmical patterns of relating in mutual process with
the universe.
• Man and environment cocreate ( imaging, valuing, languaging) in rhythmical patterns
• TRANSCENDENCE
• Human Becoming is cotranscending multidimensionally with emerging possibles.
• Refers to reaching out and beyond the limits that a person sets
• One constantly transforms
SUMMARY OF THE THEORY

Human Becoming Theory includes Totality Paradigm

• Man is a combination of biological, psychological, sociological
and spiritual factors
Simultaneity Paradigm
• Man is a unitary being in continuous, mutual interaction with
environment
Originally Man-Living-Health Theory
NURSING PARADIGMS AND PARSE'S THEORY

PERSON ENVIRONMENT HEALTH NURSING

• Open being • Everything in • Open process • A human

who is more the person and of being and science and art
than and his experiences becoming. that uses an
different from • Inseparable, Involves abstract body
the sum of the complimentary synthesis of of knowledge
parts to and evolving values to serve people
with
 SYMBOL OF HUMAN BECOMING THEORY
• Black and white = opposite paradox significant to ontology of human becoming and
green is hope
• Center joined =co created mutual human universe process at the ontological level &
nurse-person process
• Green and black swirls intertwining = human-universe co creation as an ongoing
process of becoming
APPLICATION OF THE THEORY
• NURSING PRACTICE
• A transformative approach to all levels of nursing
• Differs from the traditional nursing process, particularly in that it
does not seek to “fix” problems
• Ability to see patients' perspective allows nurse to “be with”
patient and guide them toward desired health outcomes
• Nurse-person relationship cocreates changing health patterns
APPLICATION OF THE THEORY
• RESEARCH
• Enhances understanding of human lived experience, health,
quality of life and quality of nursing practice
• Expands the theory of human becoming
• Builds new nursing knowledge about universal lived experiences
which may ultimately contribute to health and quality of life
Life Perspective
Rhythm Model
Joyce j. fitzpatrick
 • Born in 1944
• BSN - Georgetown University
• MS in psychiatric-mental health nursing
- Ohio State University
• PhD in nursing - New York University

About the theorist

and an MBA from Case Western Reserve
University.
• Fellow in the American Academy of
Nursing - 1981
• Presently, Elizabeth Brooks Ford
Professor of Nursing, Frances Payne
Bolton School of Nursing, Case Western
Reserve University, Cleveland, OH.
Major assumptions
• “The process of human development is characterized by
rhythms that occur within the context of continuous
person-environment interaction."
• Nursing activity focuses on enhancing the developmental
process toward health.
• A central concern of nursing science and the nursing
profession is the meaning attributed to life as the basic
understanding of human existence.
• The identification and labeling of concepts allows for
recognition and communication with others, and the rules
for combining those concepts permits thoughts to be
shared through language.
Core concepts
Person

• Person includes both self and others.

• Person is seen as an open system , a
unified whole characterized by a basic
human rhythm.
• The model recognizes individuals as
having unique biological, psychological,
emotional, social, cultural, and spiritual
attitudes.
Health

• Health is a dynamic state of being that

results from the interaction of person
and the environment.
• 'a human dimension under continuous
development, a heightened awareness
of the meaningfulness of life.
• Optimum health is the actualization of
both innate and obtained human
potential gathered from rewarding
relationships with others, goal directed
behavior, and expert personal care.
 Wellness- Illness
Professional nursing is rooted in the promotion of wellness practices.
Nursing
• "A developing discipline whose central concern is the meaning
attached to life (health)
• Primary purpose of nursing is the promotion and maintenance of an
optimal level of wellness.
Nursing as
caring

Anne Boykin and Savina Schoenhofer

About the theorists
Anne Boykin Savina Schoenhofer
Boykin’s life and career
• Grew up in Kaukauna, Wisconsin.
• Eldest of 6 children.
• Began her career in nursing in 1966.
• Graduated from Alverno College in Milwaukee,
Wisconsin.
• She received her Master's Degree from Emory
University in Atlanta, Georgia, and her Doctorate
from Vanderbilt University in Nashville, Tennessee.
• Anne Boykin is Dean and Professor of the Christine E.
Lynn College of nursing at Florida Atlantic University.
Schoenhofer’s life and
career

• Undergraduate and graduate in nursing,

psychology and counseling from Wichita State
University. PhD in education foundations and
administration from Kansas State University.
• Professor of Graduate Nursing at Cora S.
Balmat School of Nursing State University in
Natchez, Mississippi, and Professor at
University of Mississippi’s School of Nursing in
Jackson, Mississippi.
• Also manages website and forum on the
theory of nursing as caring.
Major
assumptions
1. Persons Are Caring by Virtue of
Their Humanness
2. Persons Are Whole and Complete
in the Moment
3. Persons Live Caring, Moment to
Moment
4. Personhood Is Living Life
Grounded in Caring
5. Personhood Is Enhanced Through
Participating in Nurturing
Relationships With Caring Others
6. Nursing Is Both a Discipline and a
Profession
 Nurturing Persons Living Caring
THE UNIQUE
FOCUS OF
NURSING
Nursing is… and Growing in Caring
CARING IN
NURSING…

THE INTENTIONAL AND

AUTHENTIC PRESENCE OF

THE NURSE WITH ANOTHER

WHO IS RECOGNIZED AS

PERSON LIVING CARING AND

GROWING IN CARING
NURSING SITUATION…
A SHARED LIVED EXPERIENCE
IN WHICH THE CARING BETWEEN
NURSE AND NURSED
ENHANCES PERSONHOOD
NURSING SITUATION – PART 1
EXAMPLE
• Mr. James is a 69-year-old farmer who lives alone since a divorce. He has one daughter who is
away in college. He was admitted to the community hospital with a diagnosis of an acute
exacerbation of chronic obstructive pulmonary disease (COPD). His monitor showed a rapid heart
rate with some arrhythmia. When I met him, he was sitting straight up in bed and struggling to
breathe, and he seemed scared. With the heart monitor beeping quietly in the background, he looked
at me with wide opened eyes. As a newly graduated nurse, I quietly introduced myself, and checked
his vital signs, then listened to his lungs. “I can see you are having difficulty breathing. Please help
me understand about your not wanting to do the breathing treatments prescribed for you.” With some
difficulty, he said, “I can’t take them, my doctor told me that was causing my heart to beat too fast.”
• As I learned in my nursing education program based in the Nursing As Caring theory, I asked
“what matters most to you right now? And he said, “I don’t want to die, I have a daughter to raise
and a farm to run.” I said, how can I help you? He told me he needs help to breathe right so he could
get out of the hospital quickly, going on to share that he has no health insurance and no one back
home caring for the farm. (to be continued)
What Do
Nurses Do?

• Enter into the world of the

one nursed
• Come to know
• Offer Direct Invitation
• Hear calls for nursing
• Respond with nursing
expressions of caring
DANCE OF
CARING PERSONS
• Source: Boykin, A., & Schoenhofer, S.
O. (2001). Nursing As Caring: A Model
for Transforming Practice, p. 37
DANCE OF
LIVING
CARING
DANCE OF LIVING
CARING
FOUNDATIONS AND
INFLUENCES

• Foundations
• Boykin & Schoenhofer’s
Theory of Nursing As
Caring
• Boykin & Schoenhofer’s
Dance of Caring Persons
NURSING
• I said the breathing treatment will help your breathing and will help you relax too as
you start taking deep slow breaths. I asked if it is ok with you, I am going to check on
your orders and I’ll be right back, and he said that would be ok. I left the room to
check his chart and to consult with the charge nurse. Having been introduced to
advancing AI and robotic technology in school, I wanted to bring Nicki, our new

SITUATION
healthcare robot, in to help with Mr. James’ care. Although my charge nurse was still
skeptical of the value of Nicki, our robot, she agreed to let me try.
• Nicki had been programmed to speak, to monitor and report vital signs, to SKYPE and
to show videos. We walked back to the room, and I introduced Nicki to Mr. James. I
explained that the breathing treatment that was ordered for him did not have any

– PART 2
medication that would speed up his heart. And I explained Nicki’s capabilities including
SKYPEing his daughter once his breathing was stabilized. Mr. James agreed to try the
new treatment and to allow Nicki to be with him during his treatment and then to call
his daughter. Before we activated Nicki, I told Mr. James that the healthcare robot
could show a calming video if he thought that might help. He said ok and told us he

with
relaxes by sitting on his back porch looking out over the fields and crops at sundown.
We turned Nicki on and programmed her for breathing assist, to monitor respiratory
rate and send results to the nurse, and to play a video of sunset on an open field. Nicki
blinked on and introduced herself in her soft, quiet, but steady voice. She said, “Mr.
James, I am going to help remind you to stay calm and to take deeper breaths. I am

Robotic
going to stay with you, and you will not be alone. So let us start.” Respiratory therapy
had been called and was ready to administer the breathing treatment again. As the
treatment was administered, Nicki quietly reminded him to take in a breath and to
slowly release. The video started and Nicki began to describe the beauty of the sunset,
the slow descent of the sun and the colors of various shades of red and yellow as the
sun slowly set, birds flew home to roost, and the cows walked slowly toward the barn.

Partner-in-
She continued on, with moments of quiet and then reminded Mr. James that he was
doing fine and to continue to take a breath in and let it slowly out. I stayed with Mr.
James, Nicki, and the respiratory therapist until Mr. James began to stabilize, breathe
more slowly and deeply, and his heart rate slowed down too. I left the room to the voice
of Mr. James talking to Nicki and the steady beat of the heart monitor. About 30 minutes

Caring
later Mr. James said he’d like to SKYPE his daughter and tell her about Nicki. Mr.
James took a “selfie” with Nicki and forwarded it to his daughter and set up a time to
SKYPE. Later that day, within 24 hours of admission, Mr. James was discharged home
with a prescription to obtain the new medication for his nebulizer and with further
instructions for fluids and rest as much as possible. I stood in the hallway with Nicki
and my charge nurse to say good-bye to Mr. James and wish him well. As he left, Mr.
James thanked us for being so helpful to him and stated that Nicki was very helpful too,
especially in calming him down. He said his daughter was very impressed that her Dad
had a personal healthcare robot and that he too was pleased.
 INTENTIONAL KNOWING OF
PERSON AS CARING

APPLICATION OF
DANCE OF
RESPECTING AND VALUING
LIVING CARING PERSONS AS CARING
TO NURSING
SITUATION
HEARING AND RESPONDING TO
CALLS FOR CARING
Margaret Newman’s
Theory of Health as
Expanding Consciousness
About the theorist
• Dr. Newman studied nursing at the University of
Tennessee, Memphis.
• She received her graduate degree at the University of
California in medical-surgical nursing and received her
master’s degree in 1964.
• She earned her PhD at New York University in 1972,
where she studied with Martha Rogers.
• She served as a director of nursing at a clinical
research center, and taught nursing at Penn State
University (1977-1984) and at University of Minnesota
(1984-1996).
• In 1978 Dr. Newman began to articulate her ideas on
the theory of health in nursing.
Health as expanding consciousness- inspiration

• Margaret’s experience caring for her mother with amyotrophic lateral sclerosis.
• Martha Rogers- a teacher and colleague to Newman (Health as Expanding
Consciousness, 2014).
• Theorists: Bentov, Bohm, and Ferguson (Bateman & Merryfeather, 2014, p.58).
• Margaret’s mother lived with amyotrophic lateral sclerosis and eventually died
from the disease. This served as inspiration for Newman to become a nurse.
Health as Expanding consciousness
• The theory asserts that every person in every situation,
no matter how disordered and hopeless it may seem, is
part of the universal process of expanding
consciousness – a process of becoming more of
oneself, of finding greater meaning in life, and of
reaching new dimensions of connectedness with other
people and the world (Health as Expanding
Consciousness, 2014).
• The basic components of this theory are redefining
health, recognizing patterns, defining meaning in a
person, and creating a turning point to bring them to a
higher level of consciousness.
Health as expanding consciousness- components

Definition of Patterns: Definition of

Are any interaction an Consciousness:
individual has with
Medical definition of An interaction of the
any piece of the
health: The absence of whole environmental
environment. They are
disease or illness. system involving
significant or
meaningful moments space, time, and
in an individual’s life. movement.
 • Relationship between the nurse
and patient: the nurse facilitates
Health as the process of identifying patterns,
helps the patient move beyond
expanding limitations, and helps evaluate the
consciousness- process to expand consciousness.
summary
Theory Applied to Nursing
• Parts of a person’s underlying pattern, that emerge
“Our nursing from interaction:
responsibility is to • Physical signs and appearances
• Mental/cognitive insights
help patients let go of • Emotional expressions
the artificial • Spiritual insights
boundaries they have • Nurses must strive for pattern recognition and knowing
imposed on their lives the patient on a deep level
• Nurse –client relationship often begins in times of
and get in touch with disruption, uncertainty, and unpredictability
the whole” (Newman, • Newman recognizes that nurses are change by their
2003). interactions with patients, just as patients are changed
by their interactions with the nurses.
HUMANISTIC NURSING
THEORY
Drs Josephine Paterson and Loretta Zderad

74
 About the • Dr Zderad majored in psychiatric nursing,
completed at doctorate at Georgetown
University in philosophy with dissertation
theorists on empathy.
• Dr Paterson majored in public health,
completed doctor of nursing science
degree at Boston University – dissertation
in comfort.
• Met in the 1950’s whilst working at Catholic
University, where their task was to create a
new program that would include psychiatric
and community health components as part
of the graduate program à friendship that
has lasted over 35 years.
• Shared experiences, ideas and insight to
form a concept that evolved into the formal
Theory of Humanistic Nursing.

75
 “Humanistic nursing embraces more
than a benevolent technically
competent subject-object one-way

HUMANISTIC relationship guided by a nurse on

behalf of another. Rather it dictates

NURSING:
that nursing is a responsible
searching, transactional relationship
whose meaningfulness demands
ITS conceptualization founded on a
nurse's existential awareness of self
MEANING and of the other” (Paterson &
Zderad, 2008)

76
• “Humanistic nursing theory is
multidimensional (Kleiman, 2001)”.
• In humanistic nursing theory the
components identified as human are the
patient (can refer to the person, family,
community or humanity); and the nurse
• Patient sends call for help à person
receiving and recognising is the nurse

77
• Nurse has made a
decision and dedicated
themselves to helping
others with their health
care needs
• Humanistic nursing
term exists known as
“all-at-once” (Kleiman,
2001)
• Nurses and patients
have their own
‘gestalts’, or concept of
wholeness

78
Patient and Nurse gestalts (Kleiman, 2001)
79
• Nurse bring their whole self when helping in
patient treatment, i.e., experience, education
etc, to create a type of mosaic to use with
nursing interventions
• Humanistic nursing theory accepts the likeness in
our differences but attempts to identify the
sameness in each other or our unifying links that
make up the soul or essence of nursing.

80
Paterson and Zderad describe five
phases in their study of nursing:

1. Preparation of the nurse knower for coming to know

• Understanding own viewpoint/angle à helps to

make sense and aid in acquiring meaning of
experience
• By identifying own views, they can be withheld, so
that they do not interfere with one’s attempts to
describe the experiences of another
• Being open to new and different
ideas/understandings is a necessary position in
being able to get to know the other intuitively

81
2. Nurse knowing the other intuitively

• Paterson and Zderad describe this as

“moving back and forth between the
impressions the nurse becomes aware of
herself and the recollected real
experience of the other” (Paterson &
Zderad, 1976)
• Dialogue back and forth between patient
and nurse allows for clearer
understanding à further generalisation
in developing process

82
Nurse knowing the other intuitively. Adapted by Kleiman from illustration in Briggs,
J., & Peat, D. (1989). Nurse knowing the other intuitively. In Turbulent Times (p.
176). New York: Harper & Row.

83
3. Nurse knowing the other scientifically

• Implies need for objectivity in coming to know the

other scientifically
• Reflective practice validates patterns and themes
• “This is the time when the nurse mulls over,
analyses, sorts out, compares, contrasts, relates,
interprets, gives names to and categorises (Paterson
& Zderad, 1976)”

84
 Nurse knowing the other scientifically. Adapted by Kleiman from illustration in
Briggs, J., & Peat, D. (1989). Nurse knowing the other intuitively. In Turbulent Times
(p. 176). New York: Harper & Row
85
4. Nurse complimentarily synthesising known
others

• The ability of the nurse to develop or see

themselves as a source of knowledge, to
continually develop the nursing community
through education, and increased
understanding of their owned learned
experiences

86
Nurse complementarily synthesising known others (Kleiman, 2001)

87
5. Succession with the nurse from the many to
the paradoxical one.

• “Nurse comes up with a conception or abstraction

that is inclusive of and beyond the multiplicities and
contradictions (Paterson & Zderad, 1976)”.
• Process that allows for reflection, correction and
expansion of own angular interpretation
• Implies universal understanding from the simplest to
most complex dialogue and interactions between the
nurse and assimilates patient experiences
• No member of this interaction or experience is the
same as before
• Coming together of patient and nurse

88
The Concept of Community

• Definition of community as presented by Paterson

and Zderad is “Two or more persons struggling
together toward a centre” (Paterson & Zderad,
1976).
• Humanistic Nursing Theory suggests that there is
an obligation on the part of the nurse to each
other, along with other members of the community
à openness, sharing and caring leads to expansion
of individual or group angular views à each
becoming more than before

89
Clinical Application of Humanistic
Nursing Theory

• Encourages reflection, reflection being a

learned process that can help enhance the
experience of the nurse and prepare them for
similar situations in the clinical environment.
• The ability to be with and travel with the
patient in the routine of living is often
overlooked but is an essential part of the
professional life of a nurse.
• Understanding the professional differences
between other medical staff and allied health
professionals, respect the difference and
accept responsibility for challenges of nursing

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Summary
• “Mandate of Humanistic Nursing
Theory is to share with, thereby
allowing each to become more”
(Kleiman, 2001).
• The current nursing shortage is leading
to a requirement for nurses to be more
proactive, use critical thinking.
• Nurses have for some time had the
challenge of being asked to help
analyse, suggest and implement
changes in the health care system.

91
Summary
• Stress environments in acute care
situations do not allow proper time for
nurses to reflect, relate and provide
support to each other à talking and
listening helps to evaluate and clarify
the current function and value of
nurses.
• “Through openness and sharing we are
able to differentiate our strengths”
(Kleiman, 2001).
• Theory is the prototype for more recent
experiential nursing theories created by
people such as Jean Watson.

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Filipino Theorist
Sr. Letty G. Kuan,
• Retirement and Role Discontinuity Model
EdD, MAN, MSN

Sr. Carolina • CASAGRA Transformative Leadership

Model: Servant-Leader Formula and the
Agravante, SPC, RN, Nursing Faculty’s Transformative
PhD Leadership Behavior

Carmelita
• Advanced Nurse Practitioners’ Composure
Divinagracia, RN, Behavior and Patients’ Wellness Outcome
PhD

Cecile Marcaida • Theory of Nursing Practice and Career

Laurente, RN, PhD

Carmencita
• PREPARE ME Holistic Nursing Interventions
Abaquin, RN, PhD

Rozzano C. Locsin, • Technological Competency as Caring in

RN, PhD, FAAN Nursing
Assignment • Research the Filipino nursing
theories using the format below:
A. About the Theory (Briefly)