Defining the Concept of Personhood
In the traditional biomedical model, patients are often reduced to their diagnosis or list of symptoms. In stark contrast, the Nursing as Caring theory, developed by Anne Boykin and Savina Schoenhofer, asserts a transformative view of the patient. Personhood is not seen as a state that can be lost due to illness, disability, or cognitive decline. Instead, it is an inherent quality of being human, present in every individual regardless of their circumstances. This perspective is particularly profound in senior care and healthy aging, where physical and cognitive changes can sometimes threaten a person's sense of self and dignity.
The Core Assumptions of Nursing as Caring
To understand personhood within this framework, it is essential to explore the fundamental assumptions of the theory itself. These assumptions guide the nurse's approach and provide the philosophical basis for their actions.
- Persons are caring by virtue of their humanness: Every person, by their very nature, possesses the capacity to care. This means that caring is not merely a task or a feeling but an essential aspect of who a person is.
- Persons are whole and complete in the moment: The theory emphasizes that a person should be viewed as complete at any given moment, not as a broken or incomplete version of their former self. This shifts the nursing focus from fixing deficits to celebrating and nurturing the person's current wholeness.
- Persons live caring, moment to moment: Caring is an ongoing, lived process that unfolds through daily experiences. The nurse's role is to enter into this process with the patient, recognizing and valuing their unique way of living caring.
- Personhood is living life grounded in caring: This is the essence of the concept. It is through the act of living caring that personhood is expressed and realized. The nurse’s authentic presence helps to enhance this process.
- Personhood is enhanced through nurturing relationships: A crucial element is the idea that caring relationships are what bring personhood to its fullest expression. The connection between the nurse and the patient, known as the "caring between," is the context in which personhood is nurtured and sustained.
Personhood in the Nursing Situation
The "nursing situation" is the shared, lived experience where caring between the nurse and the nursed takes place. It is the core context for all nursing actions. Within this situation, the nurse's intention is to come to know the person as a caring individual and to respond to their unique calls for caring.
- Intentionality: The nurse's approach is deliberate and purposeful, centered on knowing the patient as a person. It is not a mechanical, task-driven interaction but an authentic, human connection.
- Authentic Presence: The nurse must be fully present with the patient, engaging with them in a way that is honest and genuine. This requires setting aside biases and assumptions to truly perceive and understand the patient's perspective.
- Knowing the Person: The goal is to move beyond a surface-level understanding of the patient's medical needs. By listening to their stories and observing their unique expressions of being, the nurse gains insight into what matters most to them.
- Hearing the Calls for Caring: In the nursing situation, patients express their needs, aspirations, and fears. These expressions, or "calls for caring," are often subtle and require deep attention and empathy to be heard and understood.
- Caring Response: The nurse's response is a co-creation with the patient, uniquely designed for the moment. It is a nurturing action that honors the patient's personhood and supports their growth in caring.
Comparing Approaches: Task-Oriented vs. Caring-Centered
In many senior care settings, a task-oriented model can inadvertently diminish a person's sense of self. The Nursing as Caring theory offers a powerful alternative that prioritizes the human relationship.
| Aspect | Task-Oriented Approach | Caring-Centered Approach |
|---|---|---|
| View of the Patient | Object to be managed, a list of tasks. | Unique, whole, and complete person. |
| Focus | Completing procedures and medical interventions efficiently. | Nurturing the person and their intrinsic capacity to care. |
| Nurse's Role | Provider of services, fulfilling a duty. | Authentic partner in a relational encounter. |
| Interaction Style | Detached, procedural, focused on physical needs. | Empathetic, engaging, attentive to emotional and spiritual needs. |
| Language Used | Clinical, directive, often speaking over the patient. | Respectful, collaborative, conversational, actively listening. |
| Measure of Success | Completion of tasks, stable vital signs. | Enhanced personhood, sense of dignity, patient empowerment. |
Implications for Senior Care and Healthy Aging
The Nursing as Caring theory has profound implications for the way we approach healthy aging and senior care. It reframes the experience of aging, shifting the focus from decline and loss to one of growth and unfolding possibilities.
- Empowerment: By recognizing and honoring a senior's personhood, nurses empower them to remain active participants in their own care. This promotes autonomy and self-determination, even in the face of significant health challenges.
- Dignity: The theory's emphasis on treating each person as whole and complete ensures that dignity is always upheld. This is vital in situations where individuals may feel vulnerable or diminished.
- Building Trust: The authentic, intentional relationships fostered by a caring approach are the foundation of trust between a nurse and a patient. For older adults, who may be navigating complex and frightening health situations, this trust is invaluable.
- Cultural Sensitivity: Honoring a person's unique way of being and valuing their lived experience requires a deep commitment to cultural sensitivity. Nurses are encouraged to understand the patient's cultural context to provide truly personalized and meaningful care.
Enhancing Personhood in Practice
For senior care providers, operationalizing the principles of the Nursing as Caring theory can lead to better patient outcomes and increased professional fulfillment. It is a matter of cultivating a mindset and a practice that prioritize human connection over mere task completion.
Here are some strategies for enhancing personhood in a clinical or care setting:
- Engage in Authentic Dialogue: Move beyond asking a person what their needs are. Instead, invite them to share what matters most to them. This opens the door to a deeper understanding and a more meaningful connection.
- Use Storytelling: Storytelling is a powerful way to understand a person's life and experiences. Encouraging patients to share their stories helps preserve their sense of identity and history.
- Create a Supportive Environment: Ensure the physical and social environment supports a person's dignity and sense of self. Simple gestures, like calling a person by their preferred name or providing a comfortable, personal space, can make a huge difference.
- Practice Reflective Care: Regularly reflect on your own practice and intentions. Ask yourself if your actions are affirming the patient's personhood or inadvertently diminishing it. This self-awareness is key to living out the theory's principles.
- Focus on Shared Decision-Making: Whenever possible, involve the patient in decisions about their care. This respects their autonomy and signals that their input is valued and essential.
Ultimately, the Nursing as Caring theory serves as a powerful reminder that nursing is not just a profession of tasks, but a way of being rooted in compassionate, relational connection. By prioritizing personhood, nurses can provide care that is not only clinically effective but also profoundly humane and dignified, enriching the lives of both those receiving care and those providing it. The theory is an invitation to engage in a deeper, more meaningful practice that honors the full humanity of every person. To learn more about this and other nursing theories, you can consult resources like Nursology.net.
Conclusion
The question of what is personhood in nursing as caring theory leads to a profound understanding of what it means to be human and to provide humanistic care. This theoretical framework, developed by Boykin and Schoenhofer, redefines the nurse-patient relationship, shifting the paradigm from a biomedical, task-oriented model to one centered on authentic presence, relational engagement, and the enhancement of inherent personhood. In the context of senior care, where maintaining a sense of dignity and self can be challenging, this theory offers a beacon of hope and a practical guide for nurses committed to delivering truly compassionate and holistic care. It affirms that every person, at every stage of life, is complete and worthy of respect, and that the act of caring is a mutual journey that enhances the personhood of both the caregiver and the one being cared for.
