THEORETICAL FOUNDATION OF NURSING

Florence Nightingale
ENVIRONMENTAL THEORY
“Nursing is the art of utilizing the patient’s environment for his or her recovery:

Background:
• Florence Nightingale (1820-1910) is known as the "Mother of Modern Nursing."
• Lady With The Lamp
• During the Crimean War, Florence Nightingale took 38 nurses to Turkey, finding hospitals in poor conditions
with filthy, overcrowded spaces, lacking basic supplies. Diseases like typhus and cholera caused high death
rates. Nightingale identified overcrowding, filth, and poor ventilation as key contributors to the soldiers' illnesses
• Nightingale returned to England as a national heroine in 1856
• She published two books: Notes on Hospital (1859) and Notes on Nursing (1859)
• She raised enough funds and used this to establish the Nightingale School and Home for Nurses at St. Thomas Hospital.
• Nightingale’s work greatly influenced John Stuart Mill’s book on women’s rights
.
Environmental Theory: Nightingale's nursing theory emphasizes manipulating the environment to support patient recovery. Key
components include:
1. Ventilation: Ensuring clean air to prevent disease.
2. Light: Direct sunlight for its health benefits.
3. Cleanliness: Daily hygiene for both patients and nurses.
4. Warmth: Maintaining optimal body temperature and room temperature.
5. Quiet: Minimizing noise to aid recovery.
6. Diet: Monitoring and assessing patient nutrition.
7. Management: Nurses control the environment to ensure patient safety and healing.

Nightingale's View of Nursing, Person, Health, and Environment:

• Nursing: A vocation requiring formal education, scientific principles, and skill in patient assessment and care.
• Person: The patient is the recipient of care, requiring assistance for health and environment management.
• Health: Health is seen as wellness and fulfilling one’s potential; illness is a reparative process for neglecting health.
• Environment: Everything external to the patient, including their physical, social, and emotional surroundings, impacts health and
healing.

Applications to Nursing:
• Practice: Principles like cleanliness, proper ventilation, nutrition, and comfort remain central to nursing care.
• Education: Nightingale established formal nursing education, emphasizing scientific training and separation of training from hospitals.
• Research: She pioneered the use of statistics in nursing research, advocating for data-driven care improvements. Her work continues
to influence modern nursing theory and practice.
 THEORETICAL FOUNDATION OF NURSING

THEORY OF TRANSPERSONAL CARING

JEAN WATSON
“Nursing is the human science of persons and human health–illness experiences that are mediated professional, personal, scientific,
aesthetic, and
ethical human care transactions.”
Overview:
• Jean Watson, a nurse theorist from West Virginia, developed her Theory of Transpersonal Caring while serving as the
assistant dean at the University of Colorado.
• Watson's theory emphasizes the importance of human connections in nursing and the holistic care of patients, integrating
the mind, body, and spirit.
• She introduced the 10 carative factors (later evolved into the clinical caritas processes) that guide the nursing care
experience, focusing on the spiritual and emotional dimensions of care.

Key Concepts:
1. Transpersonal Caring Relationship: Central to Watson's theory, it involves a deep, authentic connection between the nurse and the patient
that transcends the physical and reaches into the spiritual realm, promoting healing and well-being.
o Caritas (meaning "to cherish" in Greek) refers to compassionate, loving care, which is the essence of Watson's philosophy.

2. 10 Carative Factors / Clinical Caritas Processes:

o Humanistic-Altruistic System of Value involves practicing kindness, self-control, and compassion, while maintaining a caring
consciousness in all interactions.
o Faith-Hope focuses on being authentically present with the patient, supporting their belief system, and honoring their unique life
perspective.
o Sensitivity to Self and Others encourages the cultivation of spiritual practices, fostering compassion, and transcending the ego to
connect deeply with others.
o Helping-Trusting, Human Care Relationship centers on developing and nurturing an authentic, trusting, and caring relationship with the
patient.
o Expressing Positive and Negative Feelings supports the expression of both positive and negative emotions, allowing the nurse to
deepen the connection with the patient.
o Creative Problem-Solving Caring Process involves using creativity, intuition, and diverse forms of knowledge to enhance the healing
process.
o Transpersonal Teaching-Learning emphasizes engaging in meaningful, reciprocal teaching and learning experiences, respecting the
patient’s perspective and honoring their unity of being.
o Supportive, Protective, and/or Corrective Environment focuses on creating a healing environment that nurtures the patient's physical,
mental, and spiritual well-being.
o Human Needs Assistance addresses the patient’s basic human needs, aligning the mind, body, and spirit through intentional caring.
o Existential-Phenomenological-Spiritual Forces involves attending to the spiritual and existential dimensions of life, death, and soul
care, for both the nurse and the patient.

3. Caring Occasion: The moment when the nurse and patient come together in a way that creates an opportunity for healing through mutual care
and connection.

Theory Assertions:
• The mind-body-spirit unity is central to Watson's view of health. Illness is seen not just as disease but as an internal imbalance within the
person’s mind, body, and spirit.
• The spirit is seen as the essence of a person, allowing them to transcend time and space and to experience the past, present, and future
simultaneously.

Major Assumptions:
• Nurses' ability to connect with patients at a transpersonal, spirit-to-spirit level is crucial for healing.
• Caring-healing practices help restore harmony, wholeness, and unity, with the nurse's personal and professional growth playing an essential
role in effective care.

Metaparadigms:
• Nursing: Nursing is defined as the human science of persons and their health-illness experiences, which are shaped by human care
interactions.
• Person: A person is a unified being of mind, body, spirit, and nature. Nursing cannot separate a person from their inner self, other people, or the
larger universe.
• Health: Health is seen as subjective, relating to harmony or disharmony within the mind, body, and spirit, rather than just the absence of
disease.
• Environment: Society’s values shape how people care for others. Caring is a cultural practice that has existed in all societies and is transmitted
through professional values.

Application to Nursing:
• Practice: Nurses should provide care that integrates both technical skills and compassionate, human-centered care, even in high-tech or high-
acuity settings.
• Education: Watson's theory is used in nursing curricula, focusing on ethical, philosophical, and ontological foundations, as well as research on
caring.
• Research: Watson’s theory has guided research on reducing patient distress, particularly in challenging settings like infertility treatments.

Implications of the Theory:

• Watson's theory underscores the humanity of nursing, reminding nurses to care for the whole person and to recognize the spiritual and
emotional dimensions of patient care.
• It calls for a more personalized approach to nursing, ensuring that patients are seen not just as cases, but as whole beings deserving of
compassionate, holistic care.
 THEORETICAL FOUNDATION OF NURSING

STAGES OF NURSING EXPERTISE

PATRICIA BENNER

"Nursing is a caring practice that focuses on the lived experiences of patients with health, illness, and disease, and their
interrelationships."

"The Nurse-Patient Relationship is a dynamic blend of intimacy and distance, unfolding in both profound and everyday
moments of life."

Biography and Background

• Born in Hampton, Virginia.
• Earned a bachelor's degree from Pasadena College in 1964 and a Master’s in Nursing from the University of California,
San Francisco.
• Extensive clinical experience in areas like medical-surgical, critical care, and home health nursing.
Core Ideas
1. Nursing as a Caring Practice: Nursing is framed as a caring relationship focused on the lived experiences of patients regarding health, illness,
and disease. It's not just about technical tasks but understanding and responding to the human experience.
2. The Dreyfus Model, proposed by Benner, describes the progression from novice to expert and the evolving use of clinical judgment and
intuition over time. The model consists of five stages of nursing skill development:
o Novice (0–1 year):
• Characteristics: Lacks experience and relies on rules and guidelines to navigate clinical situations. They are unable to
distinguish relevant from irrelevant aspects of care. Nursing students or nurses new to a practice area are in this stage.
• Differentiation: Focus on learning rules and basic tasks. Limited clinical decision-making based on theoretical knowledge rather
than hands-on experience.
o Advanced Beginner (1–2 years):
• Characteristics: Gaining some experience, the nurse can identify aspects of the situation but still requires guidance. The focus
is on completing tasks and following structured protocols.
• Differentiation: Transition from theory to practice. They start seeing the context of clinical situations, but still need help from
more experienced nurses. There is a shift from rules-based thinking to recognition of patterns in patient care.
o Competent (2–3 years):
• Characteristics: Demonstrates deliberate planning, an understanding of expected outcomes, and a sense of mastery. The
nurse can organize and manage more complex cases, but still relies on conscious reasoning.
• Differentiation: Able to handle increasing complexity and predictability in care. The nurse begins to focus on time management,
efficiency, and consistency. They are able to prioritize patient needs and manage multiple tasks more effectively.
o Proficient (3–5 years):
• Characteristics: Sees holistic views of patient care, and can recognize and respond to changing clinical situations intuitively.
They have a deeper understanding of the whole situation rather than focusing on individual tasks.
• Differentiation: Shift from rule-based practice to intuitive decision-making based on experience. Proficient nurses can
anticipate problems and adapt quickly to changes in the care environment, reflecting a more complex understanding of patients'
needs.
o Expert (>5 years):
• Characteristics: Demonstrates clinical grasp, profound intuition, and embodied know-how. The expert nurse no longer relies
on rules, guidelines, or maxims; they act based on deep, intuitive understanding developed from extensive experience.
• Differentiation: Expert nurses see the big picture and recognize subtle cues that others may miss. They make decisions based
on a deep understanding of the situation, not requiring much conscious deliberation. Their responses are fluid, resource-based,
and adaptable, reflecting their rich clinical experience
3. Competency and Experience:
o Competency refers to skill and performance, defined by its function and meaning.
o Experience is the active learning process where nurses refine theories and ideas based on real-world situations.
4. Hermeneutics and Phenomenology: Benner advocates for understanding nursing through interpretive methods, focusing on real human
experiences without making assumptions, and using narratives to bridge theory and practice.
5. Maxim – a mysterious description of skilled performance.
o ✔ It requires a certain level of experience to recognize the implications of the instructions.
o ✔ Paradigm case is a clinical experience that stands out.
o ✔ It alters the way the nurse will perceive and understand and open new clinical viewpoints and alternatives.
Theory in View of Metaparadigms
1. Person:
o Benner views the person as a self-interpreting being, shaped by their lived experiences. The person is not predefined but continuously
evolving through their interactions with their environment and healthcare providers.
o The embodied self plays a central role: The body reacts meaningfully to situations, whether through habitual actions, predefined
responses, or more complex, reflective thinking.
2. Health:
o Health is defined not just as the absence of disease but as well-being—a person’s lived experience of function and integration within
their environment.
o Benner distinguishes between illness (the subjective experience of dysfunction or loss of function) and disease (a measurable physical
state). Health, then, is seen as a state of wholeness, even if disease is present.
3. Environment:
o In Benner’s model, environment is not just a physical space but a situation in which people find themselves. These situations are
socially and contextually defined and carry personal meaning for the individual.
o The present situation is shaped by the person’s past experiences, future expectations, and personal interpretations, and these factors
influence how care is provided.
4. Nursing:
o Nursing is seen as a caring relationship that evolves from novice to expert. The nurse’s role is to engage with the patient in an
authentic, meaningful way, integrating clinical knowledge and intuitive understanding gained from experience.

Application of the Theory:

o Benner’s model has influenced nursing education by promoting experiential learning, recognizing different levels of skill, and providing
structures for career development (e.g., clinical ladders, new graduate programs).
o It emphasizes that learning through experience is crucial for both new nurses and experienced professionals to gain mastery.
 THEORETICAL FOUNDATION OF NURSING

BUREAUCRATIC NURSING
MARILYN ANN RAY

Her research interests continue to focus on nurses, nurse administrators and patients in critical care and intermediate care,
and in nursing administration in complex hospital organizational cultures.

Biography
• Early Career: Ray worked in various clinical settings, including OB-Gyn, ER, and CCU. She became a flight nurse in
the U.S. Air Force and was the first nurse to visit the Soviet Union as part of the Aerospace Medical Association.
• Academic Background: Ray earned a BSN and MSN in Medical-Surgical Nursing from the University of Colorado,
influenced by Dr. Madeleine Leininger's work on transcultural nursing.
• Professional Roles: Over her career, Ray served as an educator, researcher, and Eminent Scholar at Florida Atlantic
University, focusing on critical care, nursing administration, and organizational cultures in healthcare.

Theoretical Influences
Ray’s work draws from several theoretical sources:
• Dr. Madeleine Leininger's transcultural nursing and ethnographic research methods.
• Hegel's philosophy, particularly the dialectical process of thesis, antithesis, and synthesis.
• Chaos Theory, which describes the coexistence of order and disorder in complex systems, helping nurses view organizational changes as
creative processes.

Major Concepts
Ray’s theory revolves around several interconnected concepts that describe the nature of caring and its application in nursing practice:
• Holography: The idea that everything is a whole within a context but also a part of something larger. Every individual or event is both
independent and interconnected.
• Caring: Described as a complex, transcultural, relational process that is grounded in ethical and spiritual contexts. Caring involves
compassion, justice, and love in response to human suffering and need.
• Spirituality: Refers to the creative and ethical choices made through attachment, love, and community. Spiritual-ethical caring is about
facilitating choices that promote the well-being of others.
• Caring Contexts: Ray identifies several dimensions that shape the meaning of caring:
o Educational: Formal and informal programs, including audiovisual methods.
o Physical: Biological and mental states.
o Social-Cultural: Social interactions, ethnicity, family structures.
o Legal: Rules, accountability, informed consent, privacy.
o Technological: Use of machinery and resources to maintain patient well-being.
o Economic: Financial considerations, budgets, insurance systems.
o Political: Power structures, decision-making, and competition in healthcare organizations.
o
Major Assumptions
Ray’s theory operates on the following assumptions:
• The meaning of caring is differential and context-dependent, shaped by social, cultural, legal, technological, and other structures.
• Caring is both a bureaucratic (organizational) and spiritual/ethical construct, meaning it is shaped by both the formal systems in which
nurses work and their ethical and relational engagement with patients.
• Caring is the primordial construct of nursing, the central essence that shapes all aspects of the profession.

Theory in View of Metaparadigms

Ray’s theory integrates the nursing metaparadigms (person, health, environment, and nursing) in a holistic, relational, and ethical framework:

• Person: Seen as a spiritual and cultural being, co-creating meaning and value in relationship with others.
• Health: A pattern of meaning influenced by beliefs and cultural practices regarding health and illness.
• Environment: A complex, spiritual, ethical, ecological, and cultural phenomenon. It includes the historical transmission of patterns of
meaning and values.
• Nursing: Focuses on holistic, relational, spiritual, and ethical caring that seeks the well-being of both self and others in complex
environments.

Application to Nursing
• Nursing Practice: The theory emphasizes the integration of knowledge, skills, and caring in nursing practice. It advocates for a relational
approach where nurses, patients, and administrators collaborate, fostering ethical choices, respect, and trust.
• Nursing Education: The theory is valuable for nursing education by promoting a broad, interconnected view of nursing and healthcare
systems, emphasizing the importance of caring in practice.
• Nursing Research: Ray encourages the use of phenomenological-hermeneutics, which aligns with humanistic and caring philosophies, to
study nursing experiences and practices.

Implications of the Theory

Ray’s theory offers several key benefits:
• Clarity: Major structures are clearly defined and resonate with the realities of nursing practice.
• Simplicity: It helps simplify the dynamics of complex bureaucratic healthcare organizations.
• Generality: It provides broad philosophical guidance on the nature of caring in nursing.
• Accessibility: The theory is continuously updated and grounded in observable, empirical reality.
• Relevance: It addresses critical issues in nursing today, including the challenges posed by economic constraints and managed care
environments
 THEORETICAL FOUNDATION OF NURSING

PHILOSOPHY OF CARING
KARI MARTINSEN
“Nursing is founded on caring for life, on neighborly love, … At the same time, it is necessary that the nurse is professionally
educated…”

Credentials and Background

• Academic Background: Martinsen studied at the University of Bergen, attending the Department of Philosophy from
1972 to 1974. She earned a Magister Artium degree (graduate degree in philosophy), where she examined the
intersection of philosophy and nursing.
• Dissertation: Her graduate dissertation, "Philosophy and Nursing: A Marxist and Phenomenological Contribution", sparked
debate and discussion in nursing and philosophical circles.
• Career Milestones: From 1976 to 1986, Martinsen published several historical articles and critically analyzed the state of
nursing. She also wrote the provocative book "Caring Without Care?", questioning whether modern nursing, with its
increasing emphasis on technical care and administration, was losing sight of the essential act of caring. She earned her
Doctor of Philosophy (Ph.D.) degree from the University of Bergen in 1984.

Theoretical Influences
Martinsen’s work draws from three major philosophers:
• Karl Marx: Influenced her views on social structures and the relationship between healthcare, society, and labor.
• Edmund Husserl: The founder of phenomenology, which Martinsen used to examine lived experiences and the nature of consciousness.
• Maurice Merleau-Ponty: A phenomenologist of the body, whose ideas on embodiment influenced Martinsen’s understanding of the nurse-patient
relationship.

Major Concepts & Definitions

• Care:
o Central to Nursing: Care is foundational to both nursing and life itself. It represents the positive development of the person through the Good.
o Trinity of Care: Care is relational (requires at least two people), practical (requires action and skill), and moral (requires ethical reflection on the
situation of the other).
o Sentimentality vs. Professional Knowledge: Martinsen stresses that care is not about sentimental gestures but requires professional judgment
and knowledge. Concern for the patient must be backed by competence.
• Professional Judgment and Discernment:
o Nurses develop their clinical skills through observation and perception in practical situations. This requires more than just sensory awareness; it
involves recognizing the context and acting in a good way to help the patient.
• Moral Practice:
o Care involves empathy and reflection, and moral actions must be accounted for. It is about discovering the best way to help the other and making
ethical decisions grounded in sincerity and professional judgment.
• Person-Oriented Professionalism:
o Martinsen emphasizes professional knowledge that sees the patient as a suffering person and protects their integrity. It challenges the nurse to
be both competent and human, with an understanding of the patient's life context and needs.
• Sovereign Life Utterances:
o These are pre-cultural phenomena present in all societies, such as hope, trust, mercy, and love. They represent the foundational conditions for
care, and caring actions help bring these sovereign life utterances to life in concrete situations.
• The Untouchable Zone:
o This refers to boundaries that must be respected in relationships and caregiving. It protects the nurse’s professional distance and ensures
impartiality while still maintaining an open and empathetic stance toward the patient. It is the balancing act between openness and distance.
• Vocation:
o Nursing is not just a profession but a vocation, a demand of life to care for others. It requires personal refinement as well as professional
expertise. It is grounded in neighborly love and ethical responsibility.
• The Eye of the Heart vs. The Registering Eye:
o The Eye of the Heart refers to empathy and being moved by the suffering of others, much like the Good Samaritan in Christian philosophy.
o The Registering Eye represents a more scientific and objectifying perspective, focused on systematizing and classifying information. It is
associated with the modern scientific approach to medicine.

Theoretical Assertions
Martinsen makes several key assertions in her philosophy:
• Relational and Dependent Nature of Humans: People are fundamentally dependent on each other and the world around them. Our relationships with
others and the environment shape our identity and well-being.
• Sovereign Life Utterances: These pre-cultural, life-affirming qualities—mercy, hope, love, and trust—are essential for human existence and form the
foundation of care.
• Life’s Possibilities: Sovereign life utterances are potentials that need to be actualized in caring actions, and caring is the vehicle for unlocking these
potentials.
Theory in View of Metaparadigms
• Nursing:
o Care is the fundamental principle of nursing practice. It involves a trinity of relational, practical, and moral elements. Nursing is not just about
technical skill but about moral practice, where nurses engage with patients as whole persons.
• Person:
o The person is both a body and a soul. The body is not just a biological unit but the site where spirit and flesh meet. Nurses must see patients as
embodied persons who are dependent on relationships with others for their well-being.
• Health:
o Health is not simply the absence of disease; it is also a reflection of the person’s competence and context. Health must be seen holistically,
considering both the physical condition and the life situation of the person.
o Martinsen’s motto is: "Cure sometimes, help often, comfort always."
• Environment:
o A person always exists in a specific space and situation, which affects their experience of care. The nurse’s role is to respect the dignity of the
person in these contexts, creating an environment where care can thrive.
Application to Nursing
• Nursing Practice: Martinsen’s philosophy provides a holistic framework for understanding nursing practice. It promotes the idea that caring is both a
moral and practical activity that requires reflection on the patient’s situation, the nurse’s own role, and the societal context.
• Nursing Education: Martinsen’s texts are widely used in nursing curricula, particularly in programs that emphasize philosophical reflection and the
moral dimensions of care. Her work encourages students to critically engage with nursing beyond the technicalities, considering the ethical and relational
aspects of care.
• Nursing Research: Many studies and dissertations have used Martinsen’s philosophy to explore empirical experiences in nursing practice, highlighting
how moral practice and professional judgment shape the patient-nurse relationship.

Implications of the Theory

• Clarity: Martinsen’s theory clearly states that care is fundamental to both nursing and life. It emphasizes the relational and moral aspects of care, making
it a practice grounded in human dignity.
• Simplicity: Her philosophy uses a poetic and philosophical language, which may seem abstract but resonates with common human experiences and is
easily recognizable in both personal and professional life.
• Generality: Martinsen’s philosophy applies broadly to all patients, particularly those who need help and assistance due to illness, injury, or other life
circumstances. It addresses universal themes of human vulnerability and dependence.
• Accessibility: Her approach to nursing theory is flexible and open to various interpretations, depending on the context. It allows for situation-dependent,
morally grounded nursing care.
• Importance: Martinsen’s work calls for an active, radical commitment to care—nursing as a moral practice that requires continuous reflection on social
issues, equality, and community. Caring is not passive; it demands solidarity, responsibility, and active engagement with others.
 THEORETICAL FOUNDATION OF NURSING

CARITATIVE CARING THEORY

KATIE ERIKSSON
“Caritative caring means that we take “caritas” into use when caring for the human being in health and suffering…Caritative caring is a
manifestation of the love that ‘just exists';… Caring communion, true caring, occurs when the one caring in a spirit of caritas alleviates the
suffering of the patient.”

Background & Credentials:

• Born in Jakobstad, Finland, in 1943.
• Studied philosophy at the University of Bergen (1972-1974).
• Pioneer in caring science, focusing on its development as a humanistic and independent discipline.
Theoretical Sources
• Eriksson focused on advancing both the substance of caring and establishing caring science as an independent discipline.
• She drew inspiration from Plato, Socrates, and Aristotle to shape the foundation of caring science.
• Based on her view of caring science as a humanistic field, she developed a meta-theory called "the theory of science for caring science."

Major Concepts & Definitions:

• Caritas: Caritas means unconditional love and charity, combining eros and agapé. It is the core motive of caring science, driving all acts of care through faith,
hope, and love.
• Caring Communion: A deep, intimate connection that requires conscious presence. It involves warmth, respect, and honesty, and is the source of strength and
meaning in caring.
• The Act of Caring: The act of caring combines elements like faith, hope, love, and learning, drawing from infinity and eternity. It transforms the ordinary into
something extraordinary.
• Dignity: Human dignity is both absolute (inherent through creation) and relative (shaped by culture). It involves recognizing each person’s uniqueness and
confirming their worth.
• Invitation: The act of welcoming the patient into a caring communion, providing a space for rest, comfort, and genuine hospitality.
• Suffering: A struggle between good and evil in the human condition, leading to spiritual and bodily reconciliation. Suffering is a unique, total experience, distinct
from mere pain.
• Suffering Related to Illness, Care, and Life: Suffering can arise from illness, neglect, or mistreatment during care, violating the patient's dignity. It can extend to
life’s broader existential struggles.
• The Suffering Human Being: The patient, derived from the Latin word patiens, is a human who suffers and endures. The concept emphasizes the patient's
experience of suffering.
• Reconciliation: The process by which suffering transforms into wholeness, bringing meaning to pain and achieving peace through sacrifice and acceptance of
imperfection.
• Caring Culture: Refers to the environment shaped by values, traditions, and rituals. It prioritizes human dignity and holiness, aiming to create a community of
care.
• Use of Empirical Evidence: Eriksson integrates a hermeneutical approach to caring science, arguing that evidence in natural science is too limited to capture the
complexity of caring. Her evidence concept aligns with Gadamer's broader notion of truth, encompassing beauty, goodness, and the true.

Major Assumptions: Eriksson distinguishes between two kinds of major assumptions

1. Axioms (Fundamental Truths about the World):
• Human Nature: Humans are a unity of body, soul, and spirit.
• Religious Nature: Humans are inherently religious beings.
• Holiness and Dignity: Humans are holy by nature, and dignity involves serving others with love.
• Communion: Humanity is fundamentally interrelated, and communion is central to human existence.
• Caring as a Human Instinct: Caring is an innate human trait, driven by love and service.
• Suffering and Health: Suffering is inseparable from life and health; each is a prerequisite for the other.
• Health: Health is more than the absence of illness; it is about wholeness and holiness.
• Existential Reality: Human existence is marked by mystery, infinity, and eternity.
2. Theses (Core Statements about Caring Science):
• Ethos: The ethos (value system) provides the ultimate meaning in the caring context.
• Motive: The foundational motive of caring is caritas (love and charity).
• Suffering: Suffering is the core concept of caring.
• Caring Communion: Caring derives meaning from communion, rooted in love, responsibility, and sacrifice (caritative ethics).
• Health as Movement: Health is a dynamic process of becoming, striving for wholeness, and integrating suffering.
• Caring and Suffering: Caring involves alleviating suffering through charity, love, faith, and hope, expressed in an asymmetrical, ongoing relationship.
→Both axioms and theses have been tested through research, forming the foundational ontology (nature of being) and epistemology (knowledge) of caring science.

Theory in View of Metaparadigms:

1. Nursing:
• Caritas as Core: Love and charity (caritas) drive the essence of caring. Caring is natural and rooted in helping those who suffer. Its origin lies in the concept of
natural caring, epitomized by motherly love and nurturing.
2. Person:
• Human Nature: Humans are a unity of body, soul, and spirit, and they are fundamentally holy. Human dignity involves serving others with love. Humans are in
constant change, striving for both uniqueness and connection with others. They are creative, imaginative, and capable of experiencing and desiring meaning.
3. Health:
• Health as Wholeness: Health means being whole in body, soul, and spirit—an integration of these aspects. Health is a dynamic process of becoming, moving
between potential and actual states, driven by vitality and the will to seek meaning, life, and love.
4. Environment:
• Ethos of Caring: The environment of care is defined by ethos—the values and beliefs that shape the caring culture. Ethos reflects the moral foundation for caring
and guides ethical actions within the environment. It symbolizes a place where individuals feel at home, grounded in service and connection.

Application to Nursing:
Nursing Practice:
• Eriksson’s model is applicable across diverse nursing contexts, from acute care to preventive care. It has influenced nursing leadership and administration and is
foundational in nursing organizations.
Nursing Education:
• Eriksson’s theory is embedded in nursing curricula at all levels. Her works contribute to the development of nursing education, with a focus on caring science as an
academic discipline, fostering interdisciplinary cooperation, especially between caring science and medicine.
Nursing Research:
• Numerous research projects have explored practical and theoretical aspects of her theory, linking empirical findings with her conceptual framework.

Implications of the Theory:

Clarity:
• Conceptual Clarity: Eriksson’s theory emphasizes clear, logically structured concepts. This clarity is achieved through concept analysis and semantic clarity,
ensuring the theory’s core ideas are well-defined.
Simplicity:
• Hermeneutic Approach: Eriksson’s theory is simple yet profound, demonstrating how ideals and realities interact. This simplicity stems from her hermeneutic
approach, which clarifies the substance of caring.
Generality:
• The theory provides a broad, ontological and ethical foundation for caring, offering insight into complex caring realities. It applies to a range of caring contexts,
from the abstract to the practical.
Accessibility:
• Eriksson’s work is accessible to a wide range of professionals across disciplines, bridging the gap between research and practice. Its empirical rigor and clarity
have made it impactful both in academia and clinical settings.
Importance:
• Eriksson’s caritative theory of care is foundational in the Nordic countries and has influenced clinical practice, nursing education, and research. It has helped
shape a unique caring science tradition that continues to guide advancements in the field.

Summary:
• Visionary Work: Eriksson has shaped the field of caring science through a blend of abstract theoretical development and practical clinical application.
• Ethics First: Central to her theory is the idea that ethics precedes ontology, meaning that human dignity and holiness are foundational in all knowledge creation
and practice.
• Caring Science Tradition: Her work has fostered a strong caring science discipline, with her caritative caring theory influencing research, education, and clinical
practice globally.