Nursing as Caring: A Model for Transforming Practice — Inside the Classic

An Opening Invitation to Story

The preface and early chapters do not begin with a thesis statement. Instead, the authors instruct the reader to “tell the story of your finest nursing moment—aloud to another nurse, or in writing.” This directive is a structural choice: it positions the reader as a participant in theory-building. The text then treats that shared story as a “powerful resource” where “the essence of nursing” resides. By foregrounding personal narrative, Boykin and Schoenhofer signal that their model will be grounded in lived experience rather than abstract principles. The excerpts show that this storytelling frame recurs: the later chapter on the nursing situation as the “locus of nursing” reinforces the idea that meaning emerges from specific encounters, not from generalized protocols.

Critique of the Nursing Process as Structural Counterpoint

A substantial portion of the excerpted text is devoted to a pointed critique of Orlando’s Nursing Process, which the authors argue is “incompatible” with the worldview undergirding nursing as caring. They trace the historical adoption of problem-solving language from medicine and document systems, claiming it leads to “objectification, labeling, ritualism, and non-involvement.” This critique serves as a structural counterpoint: by first dismantling an established framework, the authors clear space for their alternative. The language is specific—they cite Gadow’s phrase “touch is a gift from one who is whole to one who is not” to characterize the demeaning paradigm they reject. This section functions as a pivot, moving the reader from what nursing should not be toward what it could be.

The Nursing Situation as Central Scene

Chapter III, titled “Nursing Situation as the Locus of Nursing,” is where the model’s structure becomes explicit. The nursing situation is presented as the fundamental unit of analysis—a lived moment of caring between nurse and nursed. The excerpts do not provide a full definition, but the surrounding text indicates that this situation is where the theory is enacted and studied. The authors contrast this with the problem-oriented approach, which they claim “directs nurses to locate something … that is in need of correction.” Instead, the nursing situation is an unfolding, relational event. The story “Connectedness” illustrates this: a home-nursing visit where the nurse experiences “authentic presence” for the first time with a patient named J. The scene is described as an occasion for nursing, not for problem-solving.

Movement from Theory to Practice and Education

The table of contents reveals a deliberate progression: after establishing foundations and the nursing situation, the book moves to implications for practice, nursing service administration, education, and theory development. This structure suggests that the model is intended to be applied across multiple domains. The excerpts hint at this movement—the authors note that for many nurses, practicing nursing as caring “will require changes in the conceptualization of nursing and nursing practice structures.” The final chapters on education and research imply that the model is not only a clinical guide but also a framework for curriculum and inquiry. The epilogue and conclusion likely return to the opening invitation, completing a circular structure that begins and ends with the reader’s own experience.

Readers approaching this text will benefit from attending to its structural rhythm: the alternation between critique and story, the recurring image of the nursing situation as a narrative event, and the movement from personal invitation to institutional implication. The excerpts suggest that the book is best read not as a linear argument but as a series of invitations to reconsider what counts as nursing knowledge. Pay particular attention to the stories embedded in the chapters—they are not illustrations but the primary data of the theory.

Re-reading Nursing as Caring felt like sitting beside someone who insists on telling the same story slowly, each time adding a softer detail. That patience reminded me of an old volume where unrelated facts rest side by side, waiting for a quiet afternoon. I found myself thinking of The Ladies Book of Useful Information Compiled from many sources — Reading Companion, whose gentle, unhurried pages hold no argument, only companionship for the reader’s own reflections.