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Caring is a hot topic in nursing literature these days.There
are stories and affirmations of caring, tales and accusations
of lack of caring, theories of caring, research studies, two
journals and an International Association of Human Caring.
Caring seems to be taking center stage. Nursing has always
been defined by four overarching concepts (i.e., our metaparadigm):
nursing is what we do; person is the focus of
what we do (i.e., who we do it to); health is the goal
of nursing; and environment is the context in which
we nurse.The core of all nursing theories is examining and
elucidating these four concepts to explain and guide nursing.
But nursing is now also being defined as caring. Caring
has become the fifth metaparadigm concept.
Why point this out? For starters, this is a good thing. Nurses
have long known our “provision of a caring relationship
that facilitates health and healing” is an essential
feature of nursing.¹ Identifying, delineating and understanding
caring explains what we do, what is unique about nursing,
and guides us as we seek to care.
But an interesting problem has arisen. While every nurse
knows what caring is, it seems when you start looking at “it,”
caring is an elusive concept to nail down. Take a look at
nursing literature, and you’ll find different interpretations
of caring. Some of this comes from pulling the concept apart
to understand it. Analyzing any concept is like the story
of the five blind men describing an elephant. Each one was
feeling the same elephant but experienced it quite differently.
Like most everything else in life, worldview plays a huge
part in determining what you think “caring” is.
What I believe about “reality,” right and wrong,
our origins, what happens when we die, or what “truth”
is, greatly impacts what I understand caring to be. If I believe
all there is to life is the physical world, what we experience
through the five senses, then my idea of caring may tend to
be more hands-on, focusing on the here-and-now. This doesn’t
mean I’m not a caring nurse, but how I put caring into
practice is going to come from what I think is important.
If I believe a universal life force sustains and somehow connects
all things, my ideas of caring will probably incorporate aspects
of “life force” and take how I connect to others
into consideration.
Despite the impact our worldview has on how we think, authors
rarely state their underlying worldview in discussions of
caring (at least in those I’ve read). Assumptions, tenets
and principles are offered, but views of reality, truth and
the nature of the universe are typically not discussed—at
least not in a way that says “This is what I believe.”
It seems we assume ideas about caring are either worldview
neutral (i.e., have no impact on what we think), or because
worldviews are all equally valid and correct, worldview doesn’t
matter. If asked, all of us would exclaim,“Of course
everything comes from a worldview. Nothing is worldview
neutral!” But worldview typically isn’t openly acknowledged,
at least not in writing.
Not acknowledging worldview in our discussions of caring
is problematic. Why? Stating one’s worldview gives a
broader understanding of information. Say an author wrote:
“My theory of caring stems from my belief that the universe
evolved through natural, evolutionary, scientific, processes.
There is no ‘intelligent design’ or ‘designer’;
the world consists only of what we experience.” How would
you evaluate what you read? Say that you read, “My theory
of caring is derived from my belief in a Higher Power
(i.e. not the God of the Bible), which underlies all of life
and is in all things. This Power unites us so that everything
we do impacts all other living things.” What would your
interpretation be of that author’s ideas?
The worldview of Christian nurses originates and centers
on God. We seek to discern worldviews and compare them to
biblical truth. Colossians 2:8 explains why: “See to
it that no one takes you captive through philosophy and empty
deceit, according to human tradition, according to the elemental
spirits of the universe, and not according to Christ.”
Ultimately, caring is modeled in the life of Jesus, and our
understanding of caring is found in vigilant study of the
Bible.—KSS
¹American Nurses Association, Nursing’s Social Policy
Statement, 2nd ed. (Washington, DC:ANA, 2003): 5. Caring is
an elusive concept to nail down.
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