MYRA ESTRIN LEVINE

“CONSERVATION MODEL”
MYRA ESTRIN LEVINE
 BACKGROUND

•Diploma in nursing:-Cook County SON, Chicago, 1944

•BSN:-University of Chicago,1949
•MSN:-Wayne State University, Detroit, 1962
•Publication:- An Introduction to Clinical Nursing, 1969,
1973 & 1989
•Received honorary doctorate from Loyola University in
1992
•Clinical experience in OT technique and oncology nursing
 BACKGROUND

▪Civilian Nurse at the Gardiner General Hospital

▪Director of Nursing at Drexel Home in Chicago
▪Clinical Instructor at Bryan Memorial Hospital in Lincoln,
Nebraska
▪Administrative supervisor at University of Chicago
▪Chairperson of clinical nursing at Cook Country SON
▪Visiting professor at Tel Aviv University in Israel
▪Died in 1996
 MAJOR CONCEPTS OF
CONSERVATIONAL MODEL
➢Goal of the model is to promote adaptation and
maintain wholeness using the principles of conservation
➢Model guides the nurse to focus on the influences and
responses at the organismic level
➢Nurse accomplishes the goal of model through the
conservation of energy, structure and personal and social
integrity
ADAPTATION
❖Every individual has a unique range of adaptive responses
❖The responses will vary by heredity, age, gender or
challenges of illness experiences
❖While the responses are same, the timing and manifestation
of organismic responses will be unique for each individual
pulse rate.
❖An ongoing process of change in which patient maintains his
integrity within the realities of environment
❖Achieved through the "frugal, economic, contained and
controlled use of environmental resources by individual in his or
her best interest"
 WHOLENESS
•Exist when the interaction
or constant adaptations to
the environment permits
the assurance of integrity
•Promoted by use of
conservation principle
 CONSERVATION
❑The product of adaptation
❑"Keeping together "of the life systems or the wholeness
of the individual
❑Achieving a balance of energy supply and demand that
is with in the unique biological realities of the individual
NURSING’S PARADIGM
PERSON
A holistic being who constantly
strives to preserve wholeness
and integrity
A unique individual in unity and
integrity, feeling, believing,
thinking and whole system of
system
ENVIRONMENT
Competes the wholeness of person
Internal
 Homeostasis
 Homeorrhesis

External
 Preconceptual
 Operational
 Conceptual
INTERNAL ENVIRONMENT
Homeostasis
 A state of energy sparing that also provide the necessary
baselines for a multitude of synchronized physiological and
psychological factors
 A state of conservation
Homeorrhesis
 A stabilized flow rather than a static state
 Emphasis the fluidity of change within a space-time continuum
 Describe the pattern of adaptation, which permit the individual’s
body to sustain its well being with the vast changes which encroach
upon it from the environment
EXTERNAL ENVIRONMENT
Preconceptual
 Aspect of the world that individual are able to intercept
Operational
 Elements that may physically affects individuals but not
perceived by hem: radiation, micro-organism and
pollution
Conceptual
 Part of person's environment including cultural patterns
characterized by spiritual existence, ideas, values,
beliefs and tradition
PERSON AND ENVIRONMENT

Adaptation
Organismic response
Conservation
ADAPTATION
Characteristics
Historicity: Adaptations are grounded in history and
await the challenges to which they respond

Specificity: Individual responses and their adaptive

pattern varies on the base of specific genetic structure

Redundancy: Safe and fail options available to the

individual to ensure continued adaptation
ORGANISMIC RESPONSE

A change in behavior of an individual during an

attempt to adapt to the environment
Help individual to protect and maintain their
integrity
They co-exist
THEY ARE FOUR TYPES:
1. Flight or fight: An instantaneous response to real or
imagined threat, most primitive response

2. Inflammatory: response intended to provide for

structural integrity and the promotion of healing

3. Stress: Response developed over time and influenced

by each stressful experience encountered by person

4. Perceptual: Involves gathering information from the

environment and converting it in to a meaning experience
 NINE MODELS OF GUIDED
ASSESSMENT
➢Vital’s signs
➢Body movement and positioning
➢Ministration of personal hygiene needs
➢Pressure gradient system in nursing interventions
➢Nursing determination in provision of nutritional needs
➢Pressure gradient system in nursing
➢Local application of heat and cold
➢Administration of medicine
➢Establishing an aseptic environment
ASSUMPTION
❑The nurse creates an environment in which healing could occur
❑A human being is more than the sum of the part
❑Human being respond in a predictable way
❑Human being are unique in their responses
❑Human being know and appraise objects ,condition and situation
❑Human being sense, reflects, reason and understand
❑human being action are self determined even when emotional
❑Human being are capable of prolonging reflection through such
strategists raising questions
CHARACTERISTICS OF THEORY
•The concept of illness adaptation, using interventions, and the
evaluation of nursing interventions are interrelated.
•Concepts are sequential and logical and can be used to explain the
consequences of nursing action.
•Levine’s theory is easy to use and elements are easily
comprehensible.
•Levine’s idea can be tested and hypothesis can be derived from
them.
•The principle of conservation are specific enough to be testable
•Levine’s idea have not yet been widely researched.
•Levine's theory has been applied in surgical settings.
•Levine’s ideas are consistent with other theories, laws and principles
particularly those from the humanities and sciences
CONSERVATIONAL PRINCIPLE

❑Conservation of energy
❑Conservation of structural integrity
❑Conservation of personal integrity
❑Conservation of social integrity
1. CONSERVATION OF ENERGY

Refers to balancing energy input and output to avoid

excessive fatigue
includes adequate rest, nutrition and exercise
Example:
Availability of adequate rest
Maintenance of adequate nutrition
 2. CONSERVATION OF STRUCTURAL
INTEGRITY

Refers to maintaining or restoring the structure of body

preventing physical breakdown And promoting healing
Example:
Assist patient in ROM exercise

Maintenance of patient’s personal hygiene

 3. CONSERVATION OF PERSONAL
INTEGRITY

•Recognizes the individual as one who strives for

recognition, respect, self awareness, selfhood and self
determination
•Example:
•Recognize and protect patient’s space needs
 4. CONSERVATION OF SOCIAL
INTEGRITY
An individual is recognized as some one who resides with in a
family, a community ,a religious group, an ethnic group, a
political system and a nation
Example:
Position patient in bed to foster social interaction with other
patients
Avoid sensory deprivation
Promote patient’s use of news paper, magazines, radio. TV
Provide support and assistance to family
METAPARADIGMS
 HEALTH
Health is a wholeness and successful adaptation
It is not merely healing of an afflicted part ,it is return to
daily activities, selfhood and the ability of the individual
to pursue once more his or her own interest without
constraints
Disease: It is unregulated and undisciplined change and
must be stopped or death will ensue
NURSING
"Nursing is a profession as well as an academic discipline,
always practiced and studied in concert with all of the
disciplines that together from the health sciences"
The human interaction relying on communication ,rooted in
the organic dependency of the individual human being in
his relationships with other human beings
Nursing involves engaging in "human interactions"
GOAL OF NURSING
To promote wholeness, realizing that every individual
requires a unique and separate cluster of activities
The individual integrity is his abiding concern and it is the
nurse’s responsibility to assist him to defend and to seek its
realization
 NURSING PROCESS ACCORDING TO
LEVINE
•Assessment
•Trophicognosis
•Hypothesis
•Interventions
•Evaluation
CONSERVATIONAL MODELS

Conservational model provides the basis

for development of two theories
 Theory of redundancy
 Theory of therapeutic intention
THEORY OF REDUNDANCY

Untested, speculative theory that redefined aging

and everything else that has to do with human life
Aging is diminished availability of redundant
system necessary for effective maintenance of
physical and social well being
THEORY OF THERAPEUTIC INTENTION
Goal: To seek a way of organizing nursing interventions
out of the biological realities which the nurse has to
confront
Therapeutic regimens should support the following goals:
Facilitate healing through natural response to disease
Provide support for a failing auto regulatory portion of
the integrated system
Restore individual integrity and well being
LIMITATION
Nurse has the responsibility for determining the patient
ability to participate in the care, and if the perception of
nurse and patient about the patient ability to participate
in care don’t match, this mismatch will be an area of
conflict.
The major limitation is the focus on individual in an illness
state and on the dependency of patient.
RESEARCH HIGHLIGHTS

A theory of health promotion for preterm infants

based on conservational model of nursing.
Nursing science quarterly,2004 Jul,17 (3):The
article describes a new middle range theory of
health promotion for preterm infants based on
Levine’s conservational model that can be used to
guide neonatal nursing practice.
THE MODEL EXPLAINS THAT:
"Nursing is a profession as well as an academic
discipline, always practiced and studied in concert with all
of the disciplines that together form the health sciences."
Nursing involves human interactions, which rely on
communication, rooted in the organic dependency of the
individual human beings in relationships with other human
beings. The goal of nursing is to promote wholeness,
realizing that every individual patient requires a unique
and separate cluster of activities.
 MARTHA ROGERS
“SCIENCE OF UNITARY
HUMAN BEING”
 BACKGROUND
❑Born :May 12, 1914, Dallas, Texas, USA
❑Diploma : Knoxville General Hospital School of Nursing(1936)
❑Graduation in Public Health Nursing : George Peabody College, TN,
1937
❑MA :Teachers college, Columbia university, New York, 1945
❑MPH :Johns Hopkins University, Baltimore, MD, 1952
❑Doctorate in nursing :Johns Hopkins University, Baltimore, 1954
❑Fellowship: American academy of nursing
❑Position: Professor Emerita, Division of Nursing, New York University,
Consultant, Speaker
❑Died : March 13 , 1994
OVERVIEW OF ROGERIAN MODEL
❑Rogers conceptual system provides a body of knowledge in
nursing.
❑Rogers model provides the way of viewing the unitary human
being.
❑Humans are viewed as integral with the universe.
❑The unitary human being and the environment are one, not
dichotomous
❑Nursing focus on people and the manifestations that emerge
from the mutual human /environmental field process
OVERVIEW OF ROGERIAN MODEL
-Change of pattern and organization of the human field and
the environmental field is propagated by waves
-The manifestations of the field patterning that emerge are
observable events
-The identification of the pattern provide knowledge and
understanding of human experience
-Basic characteristics which describes the life process of
human: energy field, openness, pattern, and pan
dimensionality
-Basic concepts include unitary human being, environment, and
homeodynamic principles
ENERGY FIELD
❑The energy field is the fundamental unit of both
the living and nonliving
❑This energy field "provide a way to perceive
people and environment as irreducible wholes"
❑The energy fields continuously varies in intensity,
density, and extent.
OPENNESS

The human field and the environmental field are

constantly exchanging their energy
There are no boundaries or barrier that inhibit
energy flow between fields
PATTERN

Pattern is defined as the distinguishing

characteristic of an energy field perceived as a
single waves
"pattern is an abstraction and it gives identity to
the field"
PAN DIMENSIONALITY
Pan dimensionality is defined as "non linear
domain without spatial or temporal attributes"
The parameters that human use in language to
describe events are arbitrary.
The present is relative, there is no temporal
ordering of lives.
METAPARADIGMS
HOMEODYNAMIC PRINCIPLES
The principles of homeodynamic postulates the way of
perceiving unitary human beings
The fundamental unit of the living system is an energy
field
Three principle of homeodynamics
 Resonancy
 Helicy
 integrality
INTEGRALITY

The mutual, continuous relationship of the human energy

field and the environmental field .
Changes occur by the continuous repatterning of the
human and environmental fields by resonance waves
The fields are one and integrated but unique to each
other
RESONANCE

Resonance is an ordered arrangement of rhythm

characterizing both human field and
environmental field that undergoes continuous
dynamic metamorphosis in the human
environmental process
HELICY

Helicy describes the unpredictable, but continuous,

nonlinear evolution of energy fields as evidenced by non
repeating rhythmicties
The principle of Helicy postulates an ordering of the
humans evolutionary emergence
UNITARY HUMAN BEING (PERSON)

A unitary human being is an "irreducible, indivisible, pan

dimensional (four-dimensional) energy field identified by
pattern and manifesting characteristics that are specific to
the whole and which cannot be predicted from knowledge
of the parts" and "a unified whole having its own
distinctive characteristics which cannot be perceived by
looking at, describing, or summarizing the parts"
ENVIRONMENT

The environment is an "irreducible, pan dimensional

energy field identified by pattern and integral with the
human field"
The field coexist and are integral.
Manifestation emerge from this field and are perceived.
HEALTH
"an expression of the life process; they are the
"characteristics and behavior emerging out of the mutual,
simultaneous interaction of the human and environmental
fields"
Health and illness are the part of the sane continuum.
The multiple events taking place along life's axis denote
the extent to which man is achieving his maximum health
potential and very in their expressions from greatest
health to those conditions which are incompatible with the
maintaining life process
NURSING
Two dimensions Independent science of
nursing
 An organized body of knowledge which is specific to
nursing is arrived at by scientific research and logical
analysis
 Art of nursing practice:
 The creative use of science for the betterment of the human
 The creative use of its knowledge is the art of its practice
Nursing exists to serve people.
It is the direct and overriding responsibility to the
society
The safe practice of nursing depends on the
nature and amount of scientific nursing knowledge
the individual brings to practice…the imaginative,
intellectual judgment with which such knowledge is
made in service to the man kind.
 PUBLICATIONS OF MARTHA
ROGERS
Theoretical basis of nursing (Rogers 1970)

Nursing science and art :a prospective (Rogers 1988)

Nursing :science of unitary, irreducible, human beings update (Rogers

1990)

Vision of space based nursing (Rogers 1990)

❑ ROGERIAN THEORIES-GRAND
THEORIES
-The theory of paranormal phenomena
-The theory of rhythmicities
-The theory of accelerating evolution
THEORY OF PARANORMAL
PHENOMENA
This theory explains precognition, déjàvu, clairvoyance,
telepathy, and therapeutic touch
Clairvoyance is rational in a four dimensional human field
in continuous mutual, simultaneous interaction with a four
dimensional world; there is no linear time nor any
separation of human and the environmental fields
THE THEORY OF ACCELERATING
EVOLUTION
Theory postulates that evolutionary change is
speeding up and that the range of diversity of
life process is widening.
Higher wave frequencies are associated with
accelerating human development
THEORY OF RHYTHMICITY
Focus on the human field rhythms (these rhythms are
different from the biological, psychological rhythm)
Theory deals with the manifestations of the whole unitary
man as changes in human sleep wake patterns, indices of
human field motion, perception of time passing, and other
rhythmic development
THEORY OF UNITARY HUMAN BEINGS
Views nursing as both a science and an art. The uniqueness
of nursing, like any other science, is in the phenomenon
central to its focus.
The purpose of nurses is to promote health and well-being
for all persons wherever they are.
The development of Rogers' abstract system was strongly
influenced by an early grounding in arts, as well as a
background in science and interest in space.
The science of unitary human beings began as a synthesis
of ideas and facts.
THEORIES DERIVED FROM THE
SCIENCE OF UNITARY HUMAN BEINGS
The perspective rhythm model (Patrick 1983)
Theory of health as expanding consciousness (Neuman,
1986)
Theory of creativity, actualization and empathy (Alligood
1991)
Theory of self transcendence (Reed1997)
Power as knowing participation in change (Barrett 1998)
 JOYCE FITZPATRICK
“LIFE PERSPECTIVE RHYTHM
MODEL”
DR. JOYCE FITZPATRICK
INTRODUCTION

Life Perspective Rhythm Model is a nursing model

developedSeptember 18, 2013lized her model from Martha Rogers'
Theory of Unitary Human beings.
BACKGROUND

Born in 1944
BSN - Georgetown University
MS in psychiatric-mental health nursing - Ohio State University
PhD in nursing - New York University and an MBA from Case Western
Reserve University.
Fellow in the American Academy of Nursing - 1981
Presently, Elizabeth Brooks Ford Professor of Nursing, Frances Payne
Bolton School of Nursing, Case Western Reserve University, Cleveland,
OH.
MAJOR ASSUMPTIONS

"The process of human development is characterized by rhythms that

occur within the context of continuous person-environment interaction."
Nursing activity focuses on enhancing the developmental process
toward health.
A central concern of nursing science and the nursing profession is the
meaning attributed to life as the basic understanding of human
existence.
The identification and labeling of concepts allows for recognition and
communication with others, and the rules for combining those concepts
permits thoughts to be shared through language.
CORE CONCEPTS

Rhythm Model includes four content concepts and they are:

person
health
wellness-illness and
metaparadigm.
PERSON

Person includes both self and others.

Person is seen as an open system , a unified whole characterized by a
basic human rhythm.
The model recognizes individuals as having unique biological,
psychological, emotional, social, cultural, and spiritual attitudes.
HEALTH

Health is a dynamic state of being that results from the interaction of

person and the environment.
'a human dimension under continuous development, a heightened
awareness of the meaningfullness of life.
Optimum health is the actualization of both innate and obtained
human potential gathered from rewarding relationships with others,
goal directed behavior, and expert personal care.
WELLNESS-LLNESS

Professional nursing is rooted in the promotion of wellness practices.

NURSING

"A developing discipline whose central concern is the meaning

attached to life (health)
Primary purpose of nursing is the promotion and maintenance of an
optimal level of wellness.
METAPARADIGM

It refers to the transitions through basic metaparadigm concepts of

person, environment, health and nursing.
CONCLUSION

Life Perspective Rhythm Model is a complex nursing model which

contribute to nursing knowledge by providing taxonomy for identifying
and labeling nursing concepts to allow for their universal recognition
and communication with others.
 RAY’S THEORY OF
BUREAUCRATIC CARING
MARILYN ANNE RAY
 RAY’S EDUCATIONAL BACKGROUND
▪Diploma: St Joseph’s Hospital School of Nursing,
Hamilton, Ontario, Canada
▪BSN and MSN, University of Colorado
▪MA Anthropology, McMaster University
▪Flight Nurse: School of Aerospace Medicine, Brooks
Air Force Base, Texas
▪PhD: University of Utah/Transcultural Nsg.
▪Bio Ethics, Georgetown University
▪Space Education Program: Marshall Space Flight
Center, Huntsville, Alabama
RAY’S PRACTICE BACKGROUND
▪University of California: OB-GYN, Emergency Dept and
Cardiac Critical Care
▪University of Colorado: Critical Care-- children & adults),
Renal Dialysis
▪Gates Company: Family Centered Occupational Health
▪McMaster 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
RAY’S PRACTICE BACKGROUND

▪Transcultural nursing and caring practice

▪First nurse to go to Russia when opened its space
program to Aerospace Medical Assoc. & US
space engineers and physicians
▪Research (quantitative and qualitative) in
complex health care systems, public/military
hospitals, private hospitals , different units in
hospitals; diverse cultures; study of technological
& economics of caring
THEORY OF BUREAUCRATIC CARING
❑The theory was generated from qualitative research
involving health professionals and patients in the hospital
setting,
❑The theory implies that there is a dialectical relationship
(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 Model is holographic, illuminating the holistic nature
of caring & synthesis of the humanistic systems and
technologic, economic, political, legal systems.
MAJOR CONCEPTS
▪Caring
▪Spiritual-Ethical Caring
▪Educational
▪Physical
▪Socio-cultural
▪Legal
▪Technological
▪Economic
▪Political
COMPLEX ORGANIZATIONAL CULTURES: RAY’S THEORY OF
BUREAUCRATIC CARING ( 1981, 1984, 1989, 2010, 2013 )

Social-
Physical
Cultural

Educational Spiritual-
Economic
Ethical
Caring
Political
Technological
Legal
MAJOR CONCEPT: CARING
▪Caring: a complex, transcultural, relational
process, grounded in an ethical, spiritual context.
▪ Caring is the relationship between charity and
right action, between love as compassion in
response to human suffering and need, and justice
or fairness 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 (Ray, 1989;
Ray in Coffman, 2006; 2010, 2013).
 MAJOR CONCEPT: SPIRITUAL-ETHICAL CARING
▪Spirituality involves creativity and choice revealed in
attachment, faith, hope, love, and community.
▪The ethical imperatives of caring that join with the
spiritual & relate to our moral obligation to others.
▪ Spiritual- ethical caring for nursing focuses on how the
facilitation of choices for the good of others (caring,
healing, well-being that should be accomplished or can be
 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
educational factors related to the meaning of caring.
MAJOR CONCEPT: PHYSICAL
▪Physical factors relate to the physical state of being
including biological and mental patterns.
▪Because the mind and body are interrelated, each
pattern influences the other.
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 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; and
the practice of defensive medicine and nursing.
MAJOR CONCEPT: TECHNOLOGICAL

Technological factors include nonhuman resources,

such as the use of machinery to maintain the
physiological well-being of the patient, diagnostic
tests, pharmaceutical agents, and the knowledge
and skill needed to utilize these resources. Also
included with technology are computer assisted
practice and electronic documentation and social
media.
MAJOR CONCEPT: ECONOMIC
▪Economic factors relating to the meaning of caring
include money, budget, insurance systems,
limitations and guidelines imposed by managed
care organizations and in general, allocation of
scare resources including to maintain 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 governance & power structure

within health care administration influence how nursing is
viewed in health care and include patterns of
communication 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 scarce human and material
resources.
MAJOR ASSUMPTIONS

▪Nursing/Caring
▪Person/Cultural Being
▪Health
▪Environment/Culture of Organization
NURSING
▪Nursing is holistic, transcultural & relational, spiritual, and
ethical caring that seeks the good of self and others in
complex community, organizational, and bureaucratic
cultures.
▪Dwelling with the nature of nursing reveals that the
foundation of spiritual caring is love. Love calls forth a
responsible ethical life that enables the expression of
concrete actions of caring in the lives of nurses and for
health & healing.
PERSON

❑A person is a spiritual and cultural being.

❑Persons are created by God, the Mystery of Being, a
higher power and engages co-creatively in human
organizational and transcultural relationships to find
meaning and value.
HEALTH

▪Health is a pattern of meaning for individuals, families

and communities.
▪Beliefs and caring practices about health & illness are
central features of culture.
▪The social organization of health and illness determines
how persons are recognized as sick or well, how health or
illness is presented to health care professionals and the
way health is interpreted by the individual.
ENVIRONMENT

▪Environment is a complex spiritual, ethical,

ecological and cultural phenomenon. This
conceptualization embodies 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.
THEORETICAL ASSERTIONS
▪Caring is the essential construct and consciousness
of nursing.
▪The meaning of caring is love and is highly
differential depending on its context--structures
(social-cultural, educational, political, economic.
physical, technological and legal) as expressed in
complex organizations.
▪Caring is viewed as love and bureaucratic, given
the extent to which its meaning can be understood
in relation to science & the complex organizational
structure.
 APPLICATION TO
PRACTICE/EDUCATION/RESEARCH
Practice:
Ray’s research has shown that nurses, patients and
administrators value caring science, & the caring
intentionality that is co-created in the nurse-patient or
administrator relationship.
By creating spiritual-ethical caring relationships, clinical
nurses & administrators can transform the workplace into
moral communities within the culture of humanistic, social,
economic, political and legal values.
APPLICATION TO
PRACTICE/EDUCATION/RESEARCH
Education:
The theory is useful to nursing education because of its
broad focus on caring & complexity science /s in nursing
and the conceptualization of the health care system—used
as an organizing framework for curricula.
Universities and hospitals have incorporated Ray’s Model
of Bureaucratic Caring in the framework for the
baccalaureate nursing programs, and clinical environments
to guide nursing evolution, practice, research, and
administration.
 APPLICATION TO
PRACTICE/EDUCATION/RESEARCH
Research:
Through Ray’s extensive experience with research, she has
developed a phenomenological-hermeneutical approach
(caring inquiry) that continues to guide her research and
has been adopted by many researchers for the humanistic
approach, using a lens of caring & caring science to study
the human experience in health situations.
Presenting Caring Inquiry Method August, 2013 at 32nd
International Human Science Research Conference,
Aalborg, Denmark
 KARL MARTISEN
PHILOSOPHY OF CARING
DR. KARL MARTINSEN
 NURSE – PHILOSOPHER WHO MAKES
CASE FOR COMPASSION, CARING AS A
PRIMARY VALUE
CARING IS CENTRAL TO NURSING

▪It involves concern and love for one’s neighbor that is coupled
with concrete, professional and moral discernment.
▪Nurses care for people as people who are created dependent
▪and relational.
▪As created beings, humans are eternal and infinitely valuable.
▪That sets a high standard for nursing – or for any profession –
in several ways.
• A nursing theorist who proposed a philosophy of
caring in reaction to social and health care inequalities
and what she considered nursing's uncritical adoption
of science as the basis for nursing.
• It involves a collectivist vision of humanity in which the
individual is dependent upon the community and
creation, or nature, and caring rather than control
should be the guiding philosophy.
• As it relates to nursing, caring is simultaneously
relational, practical, and moral.
• Caring involves concrete action based on education
and training, without which concern for the patient is
mere sentimentality.
MARTINSEN…

❑Philosophically she sounds like an intelligent, caring,

realistic existentialist – a Christian existentialist. She’s
doing a different work, but reminds me Gabriel Marcel
(French, Catholic, dramatist, “Christian existentialist”).
❑Metaphysics is an interpretation of phenomena that all
humans recognize. These phenomena are precultural,
prescientific and foundational to existence.
❑Ah, “interpretation”! Ah, “all humans recognize.”
According to Martinsen, good human
interactions depend on:

❖openness,
❖mercy,
❖trust,
❖hope
❖love.

“Without these phenomena, life disintegrates and care for

one another is impossible.”
AWESOME QUOTES:
•Care “forms not only the value base of nursing, but
is a fundamental precondition for our lives. Care is
the positive development of the person through the
Good.”
•“Without professional knowledge, concern for the
patient becomes mere sentimentality.”
•“Moral practice is when empathy and reflection
work together such that caring can be expressed in
nursing.”
▪Sovereign life utterances are openness, mercy, trust, hope, and
love.

▪These are phenomena we receive in the same way we receive

time, space, air, water, and food. Unless we receive them, life
disintegrates.

▪Sovereign life utterances are preconditions for care … “

▪Vocation “is a demand life makes to me in a completely human
way to encounter and care for one’s fellow person. Vocation is
given as a law of life concerning neighborly love which is
foundationally human.”
KATIE ERIKSSON
“CARITATIVE CARING”
KATIE ERIKSSON
ACCORDING TO ERIKSSON…

“I have tried to speak of a suffering where hope and

despair meet, where light and darkness break like waves
against each other in the distant horizon, where the rays of
hope illuminate the way. It is a message about life and love
and about the human being s infinite potential and the all-
embracing communion of love that unites human beings
around the world..”
BIOGRAPHY AND CAREER OF KATIE ERIKSSON
•Katie Eriksson is a Finland-Swedish nurse.
•After taking nursing in 1965 to be able to practice
nursing, she became a nursing instructor at Helsinki
Swedish Medical Institute.
•She currently works as a professor of health sciences at
Abo Akademi University in Vaasa, where she built a
master's degree program in health sciences, and a four-
year postgraduate studies program leading to a doctoral
degree in health sciences.
•
ONE OF KATIE ERIKSSON'S WORKS IS:
“The Suffering Human Being”
It integrates her caring research findings with philosophy,
psychology and theology to present a broad perspective
of suffering related to illness, to care, and to life. For
Eriksson, the ultimate purpose of caring is to alleviate the
suffering of others through compassion, confirmation of
dignity, and a caring communion that is based on caritas,
or love.
THE THEORY OF CARITATIVE CARING
This model of nursing distinguishes between caring ethics,
the practical relationship between the patient and the
nurse, and nursing ethics.
Nursing ethics are the ethical principles that guide a
nurse's decision-making abilities.
Caritative caring consists of love and charity, which is also
known as caritas, and respect and reverence for human
holiness and dignity.
According to the theory, suffering that occurs as a result of
a lack of caritative care is a violation of human dignity.