Boykin and Schoenhofer's nursing theory framework

¶ … Boykin and Schoenhofer in their theory of Nursing as Care. I first attempt to define the concepts according to the way that they are interpreted in the secondary literature. I then go on to provide some insights pertaining to the relevancy that these concepts have in the context of performing nursing care upon patients.

Nursing as Care, according to Boykin and Schoenhofer, has several influences which shed light on the meaning of the particular concepts that are constructed in the course of the theory's development. Most significantly, the theory is influenced by Humanism and its emphasis upon the penchant possessed by humans for improvement. This underlying premise affects the construction of the concept of "person." The patient is interpreted as more than simply the recipient of medical interventions. Instead, he or she is perceived as a unique being with personalized needs.

Additionally, the theory adopts a phenomenological existentialist perspective when formulating its understanding of care. Accordingly, care is interpreted as a mode of being in which the nurse should attempt to exist "authentically " when in the presence of the patient. Existing authentically entails failing to simply assume the role that society or culture typically attributes to one who is attributable with a social identity in a social context. Accordingly, it means acting originally as opposed to acting in ways that merely reflect the typified expectations that society has of a nurse. In order to act authentically when caring for a patient, one must be properly attuned to the specific situation, so that he or she can recognize aspects of the person undergoing care that transcend the definition of patient (McCance, McKenna & Boore). Consequently, the nurse goes beyond only applying standard medical interventions. The nurse is properly involved in an interpersonal relationship in which he or she learns of the patient's unique personal qualities -- what make the patient an individual -- in order to attend to needs that differentiate that person from others who might fill the role of patient. [1: A Heideggerian term that is used to indicate a modality of being in which the person acts uniquely as opposed to a state of existence in which the person merely acts according to the expectations associated with his or her assumed or ascribed status in society.ReferencesBoykin, A., & Shoenhofer, S.O. (2000). Is There Really Time to Care? Nursing Forum, 35(4). Feele, T.W., Fly, H.S., Albright, H., Walter, R., & Burke, T.W. (2010). A Method for Defining Value in Healthcare Using Cancer Care as a Model. Journal of Healthcare Management, 55(6). Landreanau, C.J. (2003). Cast Issues Related to American Healthcare Policy. Nursing Forum, 38(1). McCance, T.V., McKenna, H.P., & Boore, J.R.P. (1999). Caring: theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30(6). Nixon, T.R., & Aruguete, M.S. (2010). Healthcare Attitudes, Knowledge, and Decision Making. North American Journal of Psychology, 12(2). Taylor, B. (2001). Nursing as Caring: A Transformative Model by A. Boykin and S.O.Schoenhofer. International Journal of Nursing Practice, 7, 359.]

Nursing as Care recognizes that all people are unique and they have different ways in which they express themselves. Nursing, in its best form, attempts to understand the person who is being treated as a whole person with unique qualities. Therefore, a nurse should not attempt to only treat only an aspect of the person, such as an illness. Rather, it is important to discover the person in his or her totality, so that the nurse can relate to the person and understand that person also as a being capable of care (Boykin and Shoenhofer, 2000). By discovering the patient as a person, the nurse uncovers aspects of the patient that might suggest unique ways for which the patient can be cared.

This process of appreciating the person as a unique individual involves learning how to see and to recognize aspects of one's working environment that might not be ordinarily perceived if the caregiver acts in-authentically. We, as nurses, might have a tendency to interpret the patient as only a medical diagnosis. By narrowing our understanding of the patient, we can miss aspects of the patient that make him or her unique. By delving beyond labels and by recognizing the object of our care as unique, we make ourselves aware of the particular traits belonging to the patient and the situation that he or she is in, allowing us to tailor our approach toward treatment so that it is responsive to the needs that are particular to that patient (Boykin and Shoenhofer, 2000).

The definition of person is related to the meaning that the concept, nursing, acquires in the context of the theory. Nursing is a mode of being in which caring takes on its significance. While it is important for the nurse to be knowledgeable about the state of the profession, it is also important for the nurse not to allow his or her identification as a nurse to result in inauthenticity. The failure to act authentically will preclude the practitioner from perceiving the patient as a whole person who can also exhibit care (although such care may be demonstrated differently depending upon the individual).

This way of perceiving the patient as an individual -- rather than only as the object of medical treatment -- is related to the meaning that the concept, health, acquires in the context of the theory. Health is more than simply a return to what medical science defines as normality. Health in this context refers to spiritual qualities that the person undergoing medical treatment possesses. Therefore, it is incumbent upon the nurse to address more than the physical symptoms associated with the diagnosis. The nurse should attempt to interact with the patient in a way that contributes to the person's overall development, including the patient's spiritual dimensions.