Humanistic Nursing Theory

Humanism

tries to take a broader perspective of the individual’s potential and tries to understand each individual through their personal experiences.

Existentialism

a philosophical approach to understanding life, believing that thinking begins with the human, as well as their free-choice, self-determination, and self-responsibility

Humanistic Nursing Theory

References

Generality

Clinical Significance

Overview

• General theory- it can be applied to different scenarios giving rise to more specific theories.

Anonymous. The Theory. (2013, November 16). Retrieved October 9, 2014, from http://humanisticnursing.weebly.com/the-theory.html

Anonymous. Humanistic Nursing Theory. (2009, June, 03). Retrieved October 5, 2014, from https://www.scribd.com/doc/16070080/HUMANISTIC-NURSING-THEORY

Kleiman, S. (2010). Josephine paterson and loretta zderad’s humanistic nursing theory. In M. E. Parker & M.C. Smith (Eds.), Nursing theories and nursing practice (3rd ed.) (pp.337-350). Philadelphia, PA: F. A. Davis

Paterson, J., & Zderad (2008). Humanistic Nursing. Retrieved from http://www.gutenberg.org/files/25020/25020-8.txt

Value of the Theory

• Paterson and Zderad mentioned in their humanistic theory that, the concept of health is more than the narrow view of health as the absence of disease

• The theory views patient care from a holistic perspective. As nurses, we should not base our care solely on physical findings, but we should take into consideration other aspects that might affect patient functioning and well being

• As the patients are coping with their health challenges, genuine interactions with the nurse will lead to a more positive experience and outcome.

Relevance to Nursing Practice

• Involves the nurse and the patient existing and interacting as human beings

• Relates to the nursing process, but involves deeper exploration of both the client and the nurse’s lived experiences

• Allows the inner self of the nurse to be able to connect to the patient’s situation and empathize with the patient.

“Another core component of humanistic nursing theory holds that humans are unique beings who have an inherent capacity and freedom to choose how to respond to situations they encounter. That is, I am my choices, I mean I am what I am this here and now person. But I am also what I have not become.” (Wu & Volker, 2011).

• nursing is viewed as a lived experience that involves the coming together of the nurse and client

• both nurse and client have their own lived experience and participate in a transactional dialogue with each other- "call & response"

• grounded in the principles of existentialism and humanism

• "being" and "doing" with the patient in time and space

• Appreciated for it humanistic values in nursing practice.
• Although the theory is very abstract, it is very understandable and well practiced in nursing
• It involves the existence of human becoming. The humanistic aspect makes the theory unique by making the nurse and patient connect with their inner self.

“Truly humanistic means that the nurse is involved as an experiencing, valuing, reflecting, conceptualizing human person.” (Paterson & Zderad, 1976-2008).

• The nurse continuously assesses the patient throughout the delivery of care. The theory guides the nurse to reflect and evaluate care provided to the patient. These continuous reflections enable the nurse to improve her practice and therefore provide quality care.

• We appreciate the holistic aspects of care involved in this theory. The humanistic nursing theory also emphasizes the concept of community, where people work together towards a common goal. The nurse

collaborates with other health care professionals to work towards

improves the patient’s well being.

Humanistic Nursing

Summary

Application to Nursing Practice

Several core components in this theory:

1) Everyone is unique and exists in the present situation

• theory also stresses although we are all unique we all

have commonalities

• our uniqueness shapes our perspectives and that is how we respond to the given situation
• the meaning of this theory is founded on occurrence of nursing as it is experienced in the everyday world

• Paterson's & Zderad's Humanistic Nursing Theory

• call & response & the between (ie. nursing)

• involves lived experiences as part of our "gestalt"

• 5 phases of humanistic nursing inquiry

• involves reflection of the transactional experience between nurse & client

Simplicity

Applicability

• This theory applies the basic foundation of human relationships in nursing practice
• Paterson and Zdered define nursing as “a lived experience between human beings”
• “Reciprocal call and response” which is achieved through an awareness of the nurse’s own views, values, understanding, and responses to their clients’ responses and knowledge
• An aspect of the theory that we would or that we do adopt into our practice

• For example, cultural competency - an ability to interact and care for clients effectively who are of different cultures or socio-economic backgrounds
• In order to provide culturally competent care, we need to be aware of our own bias, and be able to listen to and respond to our clients’ needs
• Using the humanistic nursing approach would be the basis of providing culturally competent care

3 Concepts:

• Can be applied to individuals, families, communities, and societies, but since it is abstract is can be difficult to apply

• Past experiences shape how humans experience and respond to new ones the encounter

• Reflecting on one’s own past experiences can help a person grow in the present and future

• The purpose of the theory can be applied to anyone, not a specific group of individuals

• We can all try to apply aspects of this theory, however it is best used within nursing in general, because nurses use a holistic approach when caring for people.

Patient & Nurse Gestalts

Accessibility

Founders of the Theory

• Bracketing
• Angular view
• Noetic loci

Structural Clarity/Consistency

Dr. Josephine Paterson

• graduate work in public health nursing
• completed phD at Georgetown University in philosophy with dissertation on patient comfort

Dr. Loretta Zderad

Clarity

• graduate work in psychiatric nursing
• completed PhD at Georgetown University with dissertation on empathy

2) Humans are unique and have the capacity

to respond to a given situation how they would like

• humans use past experiences by reflecting on them and then learning and responding to new ones they encounter

Semantic Clarity:

• Like many theories, the concepts are abstract and multidimensional

• However, the main idea of this theory is concrete and clinically relevant

• An inductive approach to theory

building through exploration and

description

• The basis of the theory is used in

practice, as well as emphasized in

nursing education

• Concepts can be clinically relevant, depending on which situation they are used in
• For example, when used in palliative care, it may be beneficial, but when used on a surgical or medical floor it can be difficult, as clinical encounters are brief. Having the time to build a relationship that is caring and authentic can be hard in these situations.

3) Nursing is based on the foundation of call

and response where the nurse responds to the call by caring who has health related needs-- makes nursing goal directed because we are nurturing someones’

human potential

• Humanism

• met while working at a Catholic university in the 1950s developing a new graduate program

• integrating their lived nursing experience with their shared interest in phenomenological and existential philosophies, they developed the Humanistic Nursing Theory

Five Phases of the Nursing Process

• Existentialism

• published their book Humanistic Nursing in 1976

• Angular View

• Paterson and Zderad both retired in 1985 and have remained friends for 40 years

- the gestalt of the unique person

4) Concept of community is also emphasized

• theory describes it as two of more people struggling towards an identified goal
• nurse and patient, patient’s family, and other identified health professionals become a “we” as they work toward same goal
• each entity in the community i.e nurse, is a “microcosm”, and they are influenced by their own biases depending on their own personal experiences.
• In order to grow and see the other person’s experience, nurses must become open by reflecting on their own experiences

• Bracketing

Preparation of the nurse knower for coming to know (angular view, bracketing)

Nurse knowing the other intuitively

Nurse knowing the other scientifically

Nurse complementarily synthesizing known others (noetic locus)

- the temporary holding or pausing of our own

angular view so that we do not superimpose it

on others

• Noetic loci

Semantic Clarity

- a “knowing place” or ability to relate to

others which later becomes part of the

angular view

• Moreness
• Relating-all-at-once
• Call and response
• Holding in abeyance

Succession within the nurse from the many to the paradoxical one (expansion of angular view)

Importance

• Strongly emphasizes the nurse-client relationship

• Trust between the patient and nurse builds a strong basis for a positive nurse-client relationship

• A dual process of communication and

care between the patient and nurse

• Getting to know the client and listening to their personal experiences prevents judgments based on appearance

• The nurse and client work with one another to achieve a common goal of wellness. The team approaches the patient with holistic views, therefore focuses on patient care, rather than the medical model.

Evaluation

• finished work in a timely manner
• communicated well
• attended scheduled group meetings and arrived on time
• prepared quality work
• cooperated well and supported each others opinions

Discussion

1) Think of a scenario in your clinical practice experiences where you used the humanistic nursing theory and discuss how it went.

2) Has there ever been a time where your experience with clients and using the humanistic nursing approach was negative for you or your client?

3) Think of a time when your own bias affected the delivery of care for your client. How did you grow, or learn from this experience?

“Nursing is an experience lived between human beings”