HUMANISTIC NURSING THEORY

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HUMANISTIC NURSING THEORYTheorists: Drs Josephine Paterson and Loretta Zderad

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DEFINITION OF THEORY

Derived from Greek ‘to look at’ (theorein).

“An abstract statement formulated to predict, explain or describe the relationships among concepts, constructs or events. A theory is developed and tested by observation and research, using factual data” (Mosby, 2006)

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BACKGROUND OF THEORISTS Dr Zderad majored in psychiatric nursing, completed

at doctorate at Georgetown University in philosophy with dissertation 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 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.

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HUMANISTIC NURSING: ITS MEANING

“Humanistic nursing embraces more than a benevolent technically competent subject-object one-way relationship guided by a nurse in behalf of another. Rather it dictates that nursing is a responsible searching, transactional relationship whose meaningfulness demands conceptualization founded on a nurse's existential awareness of self and of the other” (Paterson & Zderad, 2008)

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“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 person receiving and recognising is the nurse

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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

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Patient and Nurse gestalts (Kleiman, 2001)

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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.

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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 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

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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 further generalisation in developing process

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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.

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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)”

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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

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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

15Nurse complementarily synthesising known others (Kleiman, 2001)

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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

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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 openness, sharing and caring leads to expansion of individual or group angular views each becoming more than before

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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.

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SUMMARY

Stress environments in acute care situations do not allow proper time for nurses to reflect, relate and provide support to each other 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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REFERENCES

Briggs, J., & Peat, D. (1989). Nurse knowing the other intuitively. In Turbulent Times (p. 176). New York: Harper & Row.

Kleiman, S. (2001). Humanistic Nursing Theory with Clinical Applications. In M. Parker, Nursing theories and nursing practice (pp. 152-168). Philadelphia: F A Davis Company.

Mosby. (2008). Mosby's Dictionary of Medicine, Nursing and Health Professions (1st Australian and New Zealand Edition ed.). (P. Harris, S. Nagy, Vardaxis, & N, Eds.) China: Elsevier.

Paterson, J. G., & Zderad, L. T. (1976). Humanistic Nursing. New York: Wiley.

Paterson, J., & Zderad, L. (2008). Humanistic Nursing. Project Gutenberg eBook