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Junilyn Comunale

on 30 September 2014

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Coffman, S. (2014). Ray's Theory of Bureaucratic Caring.
Nursing theorists and their work.
(8th ed.). St. Louis, Missouri: Elsevier\Mosby
Critique of the applicability of Ray's work
Marilyn Ann Ray
Theory of Bureaucratic Caring
Marilyn A. Ray is a renowned researcher of caring in complex healthcare systems. She is an advanced transcultural nurse.
In 1938 she was born in Hamilton, Ontario, Canada
She was raised in a large family with 6 children
When she was 15 her father became ill.
His life was saved by a nurse
This lead her to pursue a nursing degree.
In 1958, she received her diploma from
St. Joseph's Hospital's School of Nursing in Hamilton, Ontario.
BSN and MSN from the University of Colorado
MA Anthropology from McMaster's University
Flight Nurse from the School of Aerospace Medicine, Brooks Air Force Base, Texas
PhD from the University of Utah/Transcultural Nursing
Bio Ethics from Georgetown University
Space Education Program from Marshall Space Flight Center in Huntsville Alabama
University of Los Angeles: OB-GYN, Emergency Department and Cardiac Critical Care
University of Colorado: Pediatric and Adult Critical Care, Renal Dialysis
Gates Company: Family Centered Occupational Health
McMaster's University Health Sciences Center: Educational Coordinator, FNP Program, and Clinical Nurse NICU
US Air Force Reserve Nurse Corps: Flight Nurse, Nursing Educator, Administrator, Researcher, Consultant
In addition, her background includes:
First nurse to go to Russia when it opened its space program to the Aerospace Medical Association & US space engineers and physicians
Marilyn Ray's Teaching Background includes:
University of California at San Francisco & University of San Francisco: Undergraduate Education
McMaster's University, Canada: Assisted in developing & taught in the Family Nurse Practitioner Program
University of Colorado: Graduate Education. Philosophy of Nursing, Caring Science, Qualitative Research
Florida Atlantic University, Christine E. Lynn Eminent Scholar: Professor
Virginia Commonwealth University: Yingling Visiting Scholar
Visiting Professor: Universities in Australia and New Zealand
Certified Transcultural Nurse
Founding Member of the International Association for Human Caring
Lectured on Transcultural Caring & Ethics in China, Sweden, Saudi Arabia, Canada, Australia, Philippines, Vietnam, & Japan
Nursing Theorist
Accomplished Writer and Author
The ethics of care and the ethics of cure: Synthesis in chronicity, 1998
Transcultural caring dynamics in nursing & health care, 2010
Nursing, caring, and complexity science: For human-environment well-being, 2011
A study of caring within an institutional culture: The discovery of the Theory of Bureaucratic Caring, 2010
Marilyn Ray's Research
Complex Caring Dynamics: A Unifying Model for Nursing Inquiry, 1994,2010,2011
The Ethical Theory of Existential Authenticity: The Lived Experience of the Art of Caring in Nursing Administration, 1997
Transcultural caring dynamics Model, 2010
TCC Assessment of Older Adults, 2000
Phenomenological Research Method, 1983-2013
Caring Inquiry, 1991,2013
where she practiced in a variety of settings
Including the following:
The Theory of Bureaucratic Caring
The theory suggests that there is a argued correlation (thesis, antithesis, synthesis) between the human (person & nurse) dimension of spiritual-ethical caring and the structural (nursing, environment) dimensions of the bureaucracy or organizational culture (technological, economic, political, legal and social).
The holographic model used everything in parts and all parts are fused to be part of the whole.
Major Concepts of this nursing theory
Spiritual-Ethical Caring
Major Concept: Caring
A complex, transcultural, relational process which is grounded in an ethical, spiritual context
It is the relationship between charity and right action, between love as compassion in response to human suffering and need, and fairness or justice in terms of what ought to be done.
Caring occurs within a culture or society, including personal culture, hospital organizational culture, or society and global culture.
Major Concept: Spiritual-Ethical Caring
Spirituality includes creativity and choice revealed in attachment, faith, hope, love, and community.
spiritual-ethical caring for nursing focuses on how the use of choices for the good of others can or should be accomplished.
Major Concept: Educational
Formal and informal educational programs, use of audiovisual media to convey information, and other forms of teaching and sharing information are examples of the educational factors related to the meaning of caring.
Major Concept: Social-Cultural
Social-Cultural factors are ethnicity and family structures; intimacy with friends and family; communication; social interaction and support; understanding interrelationships, involvement, and intimacy; and structures of cultural groups, community and society.
Major Concept: Legal
Legal factors relating to the meaning of caring include
responsibility and accountability
rules and principles to guide behaviors,such as policies and procedures
informed consents
right to privacy
malpractice and liability issues
client, family, and professional rights
the practice of defensive medicine and nursing
Major Concept: Technological
Technological factors include:
nonhuman resources - machinery to maintain the physiological well-being of the patient
diagnostic tests
pharmaceutical agents
knowledge and skill needed to use these resources
computer assisted practice
electronic documentation
social media
Major Concept: Economic factors relating to the meaning of caring include:
insurance systems
limitations and guidelines imposed by managed care organizations
allocation of scarce resources
which include maintaining the economic viability of the organization.
Caring as an interpersonal resource (love, communication, professional knowledge)should be considered, as well as goods, money and services.
Major Concept: Political
Political factors and the power structure in healthcare administration influence how nursing is viewed in healthcare and include communication patterns and decisions in the organization;
role and gender stratification among nurses, physicians, and administrators,
union activities, including negotiation and confrontation; government and insurance company influences; uses of power, prestige, and privilege; and in general, competition for limited human and material resources.
Major Assumptions
: is holistic transcultual & relational, spiritual, ethical caring that looks for the good in self and others in a complex community, organizational, and bureaucratic cultures
: a spiritual and cultural being who is created by God, the Mystery of Being, a higher power, and engages co-creativity in human organizational and transcultural relationships to find meaning and value
: a meaning pattern for individuals, families and communities. Beliefs and caring practices about health & illness are the main features of culture. The social organization of health and illness determines how persons are recognized as sick or well, how health or illness is exhibited to health care professonals and the method where health is interpreted by the individual.
: complex spiritual, ethical, ecological and cultural phenomenon. This concept symbolizes knowledge & conscience about the beauty of life forms & symbolic systems or patterns of meaning. Nursing practice in environments embodies the elements of the social structure and spiritual and ethical caring patterns of meaning.
Application to Nursing Practice:
This theory demonstrates that nurses, patients, and administrators value caring science, & the intent of caring that is also created in the nurse-patient or administrator relationship.
With the creation of caring, spiritual-ethical relationships, nurses, & administrators can transform the workplace into moral communities within a culture of humanistic, social , economic, political and legal values.
Her education did not stop there...
She also received the following degrees:
Her Nursing Journey took her to many cities
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Research in complex health care systems, public/military hospitals, private hospitals, different units in hospitals; diverse cultures; study of technological & economics of caring
Marilyn Ray is well known for her nursing theory called:
This theory was generated from qualitative research involving patients and health professionals in the hospital settings
The ethical obligations of caring that join with the spiritual & relate to our moral obligation to others.
Major Assumptions
Highly applicable to modern day nursing
Focuses on the importance of care
Can be focused on socialized medicine as well as the private sector.
Non-profit facilities benefit by reducing patient risks
Private sectors have more potential of receiving returning patients when exceptional nursing care is delivered
Critique of Ray's Theory
The major weakness is utilizing the application of this theory to nursing outside of the hospital
Community nursing, such as clinics, health promotion do not benefit from applying the Bureaucratic Theory
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Nurses Rule
All levels of the bureaucratic caring will incorporate spiritual/ethical care in the physical, educational, political, economic, technological, legal, and sociocultural aspect of the system.
Ray, M. & Turkel, M. (2010). Marilyn Ann Ray's Theory of Bureacratic Caring.
Nursing theories & nursing practice.
Philadelphia: F. A. Davis Company.
Constantino, E. (2013). Marilyn Ann Ray's Theory of Bureaucratic Caring. Retrieved from: http://groupcee.blogspot.ca
Turkel, M. (2007). Dr. Marilyn ray's Theory of Bureaucratic Caring.
International Journal for Bureaucratic Caring. 11
(4), 57.
Pictures retrieved from Google images
Carthy, A. (2008). Kalimba [Recorded by Mr. Scruff]. On Ninja Tuna (CD) United Kingdom
Prem, (2013). Weightlifting Animation_2D Adobe Flash Bone Tool [Youtube Video]. Retrieved from http://www.youtube.com/ watch?v=Hf2vXUzXeKk
Ogul, A. (2013). 3D Animation - Weightlifting Fail (3ds Max) [Youtube video] . Retrieved from http://www.youtube.com/ watch?v=WzvhhvXXwrs
Junilyn V. Comunale
Jacksonville University
September 30, 2014
Theoretical Assertions
Caring is love; is highly differential depending on its context structures as demonstrated in complex organizations
Caring is observed as love and bureaucratic, depending on the extent to which its meaning can be comprehended in relation to science & the complex structure of the organization.
Caring is essential in the construct and consciousness of nursing
Theoretical Assertions
Application to Nursing Research:
Marilyn Ray has developed a caring inquiry that not only guides her research; but, guides other investigators by using a humanistic, caring approach when studying human health experiences and situations
The Theory of Bureaucratic Caring is useful in Nursing Education, Practice, and Research
In Education:
This theory is useful because of its broad focus on caring & complexity in nursing. In the health care system it can be used as an organizing framework for teaching.
Universities and Medical Centers have incorporated this theory in the framework for baccalaureate nursing programs, and clinical areas as a guideline for nursing evolution, practice, research, and administration.
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