Dunphy (1998) drew on aspects of the theory of Nursing as Caring,
particularly the idea of knowing the other as caring person, in the
development of a model for advanced practice nursing, "the circle of
caring." Dunphy was concerned with clarifying the disciplinary identify
of advanced practice nursing as nursing. In an effort to transcend
perspectives of advanced practice nursing based on the traditional
reductionist medical science and nursing process models, processes of
care are superimposed on a traditional medical model (Dunphy, 1998). The
circle of care "incorporates individual strengths of both nursing and
medicine but reformulates them in a new model of care... rooted in the
lived experience of the patient" (p. 11). Caring quality indicators
suffuse the entire model, and include courage, authentic presence,
advocacy, knowing, commitment and patience. Elements formerly termed
diagnosis and treatment are termed caring processes in the new model,
in an attempt to ground advanced practice in nursing values. The core
component of the model, caring processes, focuses on ways of knowing the
person as caring and of truly being with the person in advanced practice
nursing situations. It is this core that provides the crucial link of
caring as the central focus of both traditional nursing and advanced
practice nursing.
CRITICAL ANALYSIS OF THE THEORY OF NURSING AS CARING
There is evidence that the theory of Nursing as Caring has entered the
mainstream of nursing thought. Nursing as Caring is included in several
collected and/or edited works on nursing theories (George, 1995; Parker,
1993; Parker, 2000). In George's (1995) compendium of general nursing
theories, Nursing as Caring is described and the structures of nursing
process and the metaparadigm concepts of Fawcett are used as a
framework for analysis and evaluation. Parker's books, Patterns of
Nursing Theories in Practice (1993) and Nursing Theories and Nursing
Practice (2000) are collections of original chapters authored by the
various nurse theorists and by nurses using the particular theory in
practice.
Nursing as Caring is represented in both these books by original
chapters authored by the theory's originators (Schoenhofer & Boykin,
1993; Boykin & Schoenhofer, 2000) as well as by chapters written by
nurses describing their practice which is guided by the theory (Kearney
&Yeager, 1993; Linden, 2000).
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