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Theory-guided Practice Exemplar: United States Air Force Professional Caring Practice Using Ray’s Theory of Bureaucratic Caring

The first exemplar of theory-guided practice posted on Nursology.net was the United States Air Force Professional Caring Practice Using Ray’s Theory of Bureaucratic Caring.  In the process of preparing the information for posting, Dr. Marilyn “Dee” Ray shared how this came to be!  Here is her story:

It was a great honor to have the USAF, Nurse Corps accept my theory as their framework for

Photo credit: Lifetouch Church Directories – directories@lifetouch .com.

the new Interprofessional Person Centered Caring Model. The actual development came after Colonel Marcia Potter chose the Bureaucratic Caring Theory (BCT) for her doctoral (DNP) research on nurse and staff efficacy and economic outcomes regarding patients with diabetes. She completed her DNP in 2015. Her work improved USAF clinical practice and economic outcomes to the sum of over 2 million dollars.

At the same time, Lt General Dorothy Hogg, Surgeon General and Chief of the Air Force Nurse Corps wanted to develop a theory-guided person centered caring model for implementation in the Nurse Corps. She was the Deputy Surgeon General then but is now the first nurse and woman chosen to the rank of Lieutenant General (3 star) and Surgeon General of the US Air Force . She was recognized for her creativity, intellect, caring nature, and ability to motivate professionals toward health care collaboration and dynamic policy change. Colonel Potter recommended my theory to be the one that the executive should review to see if it would be the best to choose for development in the whole Nurse Corps for theory-guided practice because she had positive clinical and economic outcomes from her research in primary care. Colonel Potter called me on the phone after she found my information in the Society of Retired USAF nurses. So that call began our relationship and my reconnection to the executive of the USAF.

We had many discussions and a number of iterations of the model until the one posted on Nursology.net was selected. Colonel Potter has implemented Bureaucratic Caring Theory-Guided practice and research in all those areas you see on the website. It astounds me in terms of all she accomplishes.  All this has taken place since 2015.

There is now a new initiative that facilitates the development of person-centered caring in the USAF, NC called the C21 or Centers for Clinical Inquiry under the leadership of Brigadier General Robert Marks and Colonel Deedra Zabokrtsky. This initiative is planned in key locations around the Air Force where there are nurse researchers and librarians to support inquiries from the field looking for the best, most relevant research in the literature as it relates to nursing practice (evidence-based/informed practice), as well as engaging nurse researchers in different USAF sites directly in response to queries about improving nursing practice.

At the installation to Surgeon General and Lt. General in Washington, DC last June, Dorothy Hogg gave me this amazing recognition highlighting my theory as the theory that was selected to respond to the new health care initiative to focus on person centered and improve care in the USAF. As you can imagine, I was so deeply humbled and honored. I served in the USAF Nurse Corps for 32 years and served our country in many roles as flight nurse, clinician, educator, administrator, command nurse, consultant, and researcher in aerospace and organizational nursing and health care, veteran, and Colonel Retired, and now in this new role as a nursing theorist. What can I say, but a sincere thank you to so many people, including colleagues like [the Nursology.Net developers] who are role models and have encouraged and guided me throughout the years.

Kindest regards and caring thoughts,
Dee

Follow-up note –
I forgot to mention that I was invited to present the BCT guided interprofessional Person-Centered Caring Model and work in the USAF to the European Society for Person Centered Healthcare in London in September, 2016 where I was awarded an Honorary Distinguished Fellowship of the ESPCH. That is another great honor.

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