Contributor – Rudolf Cymorr Kirby Martinez
Author – Rudolf Cymorr Kirby Martinez, PhD, MA, RN, CGNC, CNE, WWCC, HWNC-BC, AHN-BC, SGAHN, FFNMRCSI
First published – 2024
Major Concepts
- The nursing situation is a deliberately dialogical, momentarily existential, and uniquely transcendental moment occurring within a sacred, transient, and transactional space of knowing-unknowing.
- Situations involving nurses and nursing are independent of and not automatically caring moments.
- Intentionally ensuring that all or a majority of the elements of caring moments are present and maintained allows a situation involving nurses to be appreciated as a nursing situation that is a caring moment.
Typology
For Filipinos: Grand Theory
For Global Nursing: Middle-Range Theory
Brief Description
NurCaM theory is grounded within the unitary-transformative and simultaneity paradigms, whose theoretical statement asserts that “Intentionally ensuring that nursing situations with our kapwa are consistently appreciated as caring moments fosters their deliberate self-empowerment by championing their kaginhawahan, to be fully lived.”
Central to this assertion is the intent of Filipino nursing to champion the kaginhawahan (symphony of health, wellness, and relational harmony; the telos of Filipino caring) of our kapwa (co-person whom we nursed; the axis of Filipino caring emphasizing the “self-in-the-other”) to be fully lived. Within this theory, the aim of nursing is to deliberately facilitate the self-empowerment of our kapwa, so they may have the freedom to choose and decide on their own, the path that they will take to live their life meaningfully as they see fit. This is realized by ensuring that nursing situations are consistently appreciated as caring moments, wherein all or the majority of the elements of caring moments are present and sustained throughout the nursing situation.
The holistic nursing practice (HolNurP) model is the default process of nursing within the NurCaM. This model is person-centered, caring-based, culturally congruent, evidence-informed, theory-driven, and holistic in nature. This model has two distinct interconnected processes: knowing persons and nursing therapeutics. These two processes and the systems within these processes are always cyclical, continuous, and ever-changing. Knowing persons involves understanding the person as kapwa, who is unitary, irreducible, unique, complex, sentient, autonomous, self-actualizing, complete within the moment yet unpredictable. The process of knowing persons necessitates the use of various patterns of knowing in nursing to have a clear unitary picture of the person’s condition, concern, and context. Nursing therapeutics involves the utilization of nursing knowledge through the use of various nursing technologies and aided by ancillary knowledge, to champion the kaginhawahan of our kapwa as an expression of caring in nursing. Nursing therapeutics includes all health-healing processes from conventional, mainstream, allopathic medicine and non-orthodox medical systems, traditional, indigenous, and folkloric practices, and other emerging and contemporary health-healing interventions that are either informed by various forms of evidence or longstanding, time-tested cultural heritage, and traditions, such as but not limited to oral mythologies and folklores. Also included in the nursing therapeutics are the health patterning modalities described by Barrett (2015). Both the process of knowing persons and nursing therapeutics call for the nurse to not only master scientific knowledge but also embrace other forms of knowledge, including the ability to tap into their indigenous mind and the collective mystical wisdom. HolNurP is a journey of continuous dialogue towards sense & meaning-making between the nurse and the person nursed.
Assumptions of the NurCaM
The following are the assumptions of NurCaM:
A. Persons as kapwa, are unitary, irreducible, unique, complex, sentient, autonomous, self-actualizing, complete within the moment yet unpredictable (Boykin & Schoenhofer, 2001; Rogers, 1994);
B. Kaginhawahan, as the symphony of health, wellness, and relational harmony, is fundamental in facilitating self-empowerment;
C. Caring in nursing, as the unity of human caring and professional caring, is expressed and appreciated as gestalt;
D. Nursing situations allow persons to be nursed and nurses to live nursing;
E. Nursing is a discipline and a profession (Boykin & Schoenhofer, 2001) whose sacred societal covenant is the advancement of society through the betterment of human lives (Rogers, 1994).
Propositions and Concepts
Below are the major propositions of NurCaM:
A. The nursing situation is a deliberately dialogical, momentarily existential, and uniquely transcendental moment occurring within a sacred, transient, and transactional space of knowing-unknowing.
B. Situations involving nurses and nursing are independent of and not automatically caring moments.
C. Intentionally ensuring that all or a majority of the elements of caring moments are present and maintained allows a situation involving nurses to be appreciated as a nursing situation that is a caring moment. These elements include:
(1) The nurse’s purposeful action as an expression of nursing knowledge is appreciated as caring,
(2) Rituals of caring are acknowledged, respected, and expressed,
(3) The nature of the relationship between the nurse and their kapwa is grounded in caring,
(4) Our kapwa, the co-person whom we nursed, is self-empowered and a willing co-creator of the moment,
(5) The presence of the nurse within the moment communicates intentional caring,
(6) The encounter between the nurse and their kapwa is appreciated as caring,
(7) The space where the encounter occurs is sacred, allowing for caring to be fully expressed.
D. The appreciation of the nursing situation as caring moment is UNITARY such that when one or more elements cannot be modified, other elements may compensate so the moment will be continually appreciated as caring.
E. The holistic nursing practice (HolNurP) model, framed within the unitary-transformative paradigm, is the default process of nursing within the NurCaM.
Other Concepts:
Kapwa – the ontological AXIS of Filipino caring. It is the self in the other, serving as the pivot and perspective through which caring is lived. Rooted in collective identity, kapwa emphasizes the oneness of self and other. In Filipino nursing, kapwa is the default perspective through which the person being nursed is appreciated, preventing the process of othering that is often the default in most healthcare situations. Kapwa makes the caring within the nursing situation professional, human, and mystical. Through it, the “patient” is not just a body that needs fixing but a human person representing those whom we cherish, making the nurse-nursed relationship warmer, more intimate, and personal. From the perspective of kapwa, to care for another person as one’s kapwa is to care for yourself and the rest of humankind through that single person. The shared humanity of the nurse and nursed is epitomized through the perspective of kapwa. Within this perspective, the value of malasakit, the animating essence of Filipino caring, emerges. Kapwa and malasakit ground and sustain each other.
Malasakit – the ANIMATING ESSENCE of Filipino caring. It represents the foundational moral–ethical force that moves the life-nurturer—the term used in FilCaPS to refer to the “carer”—to bear witness to another person’s suffering and compel them to act toward its alleviation. Through Malasakit, caring becomes intentional and serves as an expression of our sacred obligation to care for one’s kapwa— our fellow human person. Without malasakit, caring becomes soulless, burdensome, and merely performative.
Kalinga – emancipatory care, oriented toward self-empowerment and meaning-making. It encompasses elements of both alaga and aruga but gravitates toward advocacy, grounded in solidarity, collective justice, and communal stewardship. Championing a person’s rights and dignity exemplifies the expression of kalinga. The archetypal persona of kalinga is the elder, whose relational stance embodies allness—a sense of boundaryless inclusiveness that fully embraces the Filipino perspective of kapwa, the self-in-the-other. Ray, Boykin & Schoenhoffer’s theory resonates with this archetype.
Lambing – the AURA of Filipino caring, its felt quality, giving it nuance and depth. Lambing is manifested as nurturing another in ways that echo care once received, opening a sacred space for the other person to freely choose intentional dependence. As an affective expression of caring, lambing humanizes, softens & enriches care by making it warm, welcoming, and inviting. In essence, lambing is caring made present. A nurse who is technically proficient in procedures such as changing IV lines but performs them without lambing may be seen as NOT caring.
Kaginhawahan – the teleological ASPIRATION of Filipino caring. It reflects the collective fulfillment of caring, representing the optimal human condition and the full flourishing of one’s potential. Kaginhawahan comes from “ginhawa,” meaning breath; thus, etymologically, it means “breathing with ease,” free from the burdens of their context and/or being. In Filipino nursing, it is the symphony of health, wellness, and relational harmony, emphasizing the pluralistic and relational nature of the human condition as opposed to an individualistic perspective, which is often the default with the concept of health and wellness. All caring actions are geared towards the achievement of Kaginhawahan, both of the nurse and the person being nursed.
Pakikiramdam – the epistemological APERTURE of Filipino caring. It is the lens through which caring is recognized, known, and felt. Derived from the root “ramdam” (to sense or perceive through internal awareness) and the Proto-Philippine term “damdam” (inner perception, feeling), it emphasizes an embodied, inner, intuitive way of sensing things. It is an amalgamation of feeling and knowing through relational attunement. The virtues, which form the structure of Filipino caring are known through pakikiramdam. For Filipinos, the authenticity and genuineness of caring is first felt before it is articulated, with the way it is performed is as important as the act itself. A person who cannot tap into pakikiramdam cannot fully perceive the person being nursed as kapwa, and thus cannot wholly embody the appropriate structure of caring necessary within the moment.
Primary Source
Martinez, R. C. K. P. (2024). Nursing-situation-as-caring-moment (NurCaM): A Filipino value-grounded theory of nursing. Philippine Nurses Association, Inc.; San Beda University, College of Nursing. https://osf.io/download/7yjxn/
About Rudolf Cymorr Kirby Martinez
Rudolf Cymorr Kirby P. Martinez, PhD, MA, RN, LMT, CAA, CSTP, CGNC, CNE, WWCC, HWNC BC, AHN BC, SGAHN, FFNMRCSI, is a Filipino nursologist, caring science scholar, and Kabaybay (Filipino Nurse Coach). He is the author of The Nursing Situation as Caring Moment Theory: A Filipino Value Based Theory of Nursing and The Filipino Caring Philosophy and Structure: A Life Nurturing System.
He is a Full Professor at the San Beda University College of Nursing and also teaches part time in the graduate programs of Arellano University–Florentino Cayco Memorial School, Graduate School of Nursing, and Holy Angel University–School of Nursing and Allied Medical Sciences. He serves as the Chairperson of the Philippine Nurses Association Department of Nursing Education and is the PNA representative to the Commission on Higher Education–Technical Panel for Nursing (2025–2028). Prior to transitioning to academia, he worked as a pediatric nurse in various capacities, including school nurse, clinic nurse, and staff nurse at the largest pediatric hospital in the Philippines.
Dr. Martinez is a scholar of the Global Academy of Holistic Nursing, a Wisdom of the Whole Certified Coach, and a Health and Wellness Nurse Coach–Board Certified. He is also an Advanced Holistic Nurse–Board Certified, a Certified Nurse Educator, a Certified Global Nurse Consultant, a Distinguished Fellow of the Faculty of Nursing and Midwifery of the Royal College of Surgeons in Ireland, and a regular member of the Department of Science and Technology–National Research Council of the Philippines.
His current advocacy focuses on the decolonization of Philippine nursing education and practice through the integration of caring science and indigenous, traditional, and folkloric health healing practices, as well as Filipino values and virtues, into nursing curricula and clinical practice.