Florida Atlantic University Christine E. Lynn College of Nursing

Contributors: Peggy L. Chinn, Marian Turkel
September 9, 2018

Education/Theory Exemplar

Location – Christine E. Lynn College of Nursing,  Boca Raton, Florida

View the October 2018 “Transforming Care” magazine
Framework title – Caring

Guiding the philosophy and objectives of the Christine E. Lynn College of Nursing is one prevailing concept:  caring.  It is caring that informs how we study nursing, how we practice our profession and how we interact with others throughout our lives.

At the Christine E. Lynn College of Nursing, we study caring as lived in the ordinariness of life and as a central domain of our profession. We recognize each individual as caring and uniquely connected with others and the environment. We also believe that every interaction we have with others is an opportunity to demonstrate and live this caring philosophy.

Year Curriculum initiated – 1984
Key Faculty

Faculty authors of “Nursing as Caring”

Other faculty involved in curriculum development:

Download PDF of “Nursing as Caring” (shared by permission)

Description of theoretical framework

(from The Dance of Caring Persons )

The journey to change the curriculum was grounded in the questions what is the content of the discipline of nursing? and What changes do we need to make to our program of study to advance  disciplinary knowledge?  The theoretical framework was influenced by the work of two scholars, Sister Simone Roach and Milton Mayeroff.  Roach’s 6 Cs of caring in nursing include compassion, competence, conscience, confidence, commitment and comportment. Mayeroff’s caring ingredients include knowing, alternating rhythms, patience, honesty, trust, humility, hope and courage.  Nursing knowledge resides in the nursing situation and the nursing situation provides the context for knowing nursing.

“In Boykin and Schoenhofer’s theory of Nursing as Caring, the model for being in relationships resembles a dance of caring persons (Boykin & Schoenhofer, 1990).
The dance of caring persons is the image of dancers in a circle, moving freely as individuals while engaging in a rhythm that connects all. The nature of relating in a circle is grounded in respect for and valuing of person.

“Each person is encouraged and supported in a culture that values person-as-person, person as caring. All persons are committed to knowing self and others as living and growing in caring. Each person is in the circle because of their unique contribution to the person being cared for – Nurses, administrators, human resources, educators, etc. Their roles would not exist if it were not for the nursed. As each person authentically expresses their commitment is being there for and with the nursed caring relationships are lived.” (Boykin & Schoehhofer, 2001 , p 36).

Major assumptions underlying the Theory of Nursing as Caring:

  • Persons are caring by virtue of their humanness
  • Persons are caring moment to moment
  • Persons are whole or complete in the moment
  • Personhood is a process of living grounded in caring
  • Nursing is both a discipline and a profession
  • Personhood is enhanced through participating in nurturing relations with caring others

Sources:

Boykin, A., & Schoenhofer, S. (1990). Caring in nursing: analysis of extant theory. Nursing Science Quarterly, 3(4), 149–155.

Boykin, A., & Schoenhofer, S. (2002). Nursing as caring: A Model for transforming practice. Sudbury, MA: Harper Perenial.

Curriculum Model
Description of the curriculum

The College of Nursing Curriculum Model is visualized as a net composed of bands, strands and pearls. The circular bands of the net are the concepts identified in the College of Nursing philosophy and program outcomes. The concepts are seamlessly integrated. The net is open, without a boundary representing the openness and evolving knowledge that continues to in-form and re-form the curriculum. The strands of the net that emanate outward from the center cross the circular bands and represent the units of instruction within the curriculum. The pearls in the net are nursing situations, the vehicle through which nursing is studied and learned in our curriculum. The image of a net represents the interconnectedness of these concepts throughout the curriculum with the pearls as reflection of the interconnectedness in the concrete nursing situation.

The bands emanate from the center identified as Nursing as a discipline and profession grounded in caring. The threads emanating from the center are the levels of instruction: the four degree programs, courses, and units that include the content bands. The pearls in the net are the nursing situations, co-created lived experiences in which the caring between nurses and persons enhance well-being. Each nursing situation reflects the whole caring curriculum; the curricular concepts are revealed in each nursing situation as it is shared, discussed and experienced. Nursing is taught, studied and learned through nursing situations.

(Adapted from detailed description of the curriculum model here )

Evaluation

Evaluation of student outcomes for the BSN, MSN, DNP and PhD programs is based on specific values related to the curriculum model. (See http://nursing.fau.edu/academics/curriculum-model.php for tables showing specific outcomes for each level)

VALUE: Prepare students to fulfill a productive destiny in the workplace and in society.

1. Nurture self, living and growing in caring.

VALUE: Provide a secure environment for the pursuit of learning.

2. Practice nursing reflectively guided by a caring philosophy and integrating a broad base of knowledge that includes theory and best evidence.

VALUE: Respect all persons and display civility in all interactions

3. Integrate multiple, complex patterns of knowing in coming to know persons and creatively responding to calls within nursing situations

VALUE: Promote honesty in all spheres, social and moral development and ethical standards in all areas of human activity.

4. Demonstrate accountability for ethical, safe nursing practice and inquiry.

VALUE: Respect all persons and display civility in all interactions; support all those who rely on the University, such as parents, employers of students and graduates, and community partners.

5. Approach nursing situations with cultural humility.

VALUE: Promote academic freedom and an atmosphere of free and open inquiry; value and disseminate scholarship, research, creative activity and use that scholarship to inform the academic discipline, teaching and community engagement

6. Engage in systematic inquiry as a foundation for nursing practice, healthcare delivery, and the evolution of nursing as a caring science.

VALUE: Ensure clear and open communication and sharing of information.

7. Use technology and information systems to promote well-being, facilitate decision-making and enhance collaboration.

VALUE: Support all those who rely on the University, such as parents, employers of students and graduates, and community partners.

8. Promote well-being for persons and populations across the lifespan.

VALUE: Provide equal access, equal rights and equal justice for all persons and encourage mutual regard for the rights and liberties of all persons; Foster community engagement, service and social responsibility.

9. Create caring environments that nurture wholeness.

VALUE: Account for the sound use and careful stewardship of its resources provided to the University; Provide equal access, equal rights and equal justice, and encourage mutual regard for the rights and liberties of all persons.

10. Honor human dignity and advocate for equity in healthcare outcomes, local and global health policy and healthcare delivery.

VALUE: Recognize and reward superior performance, creativity, innovation and entrepreneurship in all facets of University activity.

11. Transform complex healthcare systems through caring leadership that facilitates intra and interprofessional collaboration to achieve quality outcomes.

VALUE: Account for the sound use and careful stewardship of its resources provided to the University.

12. Engage in responsible stewardship to advance the discipline and profession, preserve resources and respect the environment.

Note: The FAU values are found at http://www.fau.edu/strategicplan/values.php .

Challenges

A major challenge was presenting the curriculum changes with courses grounded in caring to the Florida State Board of Nursing. Also faculty who were used to teaching pathophysiology, pharmacology, physical assessment were not comfortable with making a change from the empirical  to advancing nursing knowledge and using all ways of knowing. We lost some faculty as they choose to leave.  When accreditors came to accredit the graduate program they were not sure about a curriculum grounded in caring.   However when they met with the graduate students they changed their mind as students could articulate the meaning of caring, how it is lived in practice and outcomes they experienced after practicing and living caring.  An important dialogue was students sharing how caring was grounding their Master’s thesis research.

Rewards

From Dr. Anne Boykin, Dean at the time of the curriculum development: “I was able to hire faculty who were passionate about the advancement of nursing knowledge which led to excitement of discovery with students and colleagues. Through conference attendance, myself and faculty came to know nursing situations as the grounding for our curriculum. As a group we came to learn about aesthetic knowing and the beauty of nursing. Myself and other faculty  became very involved with the International Association for Human Caring and began to attend their annual conferences which led to scholarly discourse about the nature of caring.”