Margaret A.
Newman (1933 - present) Person
MAJOR CONCEPTS
Health is the “pattern of the whole” of a
person and includes disease as a
manifestation of the pattern of the whole,
based on the premise that life is an ongoing
process of expanding consciousness.
Consciousness is both the informational
capacity of the system and the ability of the
system to interact with its environment.
Pattern is information that depicts the whole
and understanding of the meaning of all the
relationships at once.
Movement-space-time together as
dimensions of emerging patterns of
consciousness rather than as separate
concept of the theory.
Nursing
 Primacy of relationships as a focus
of nursing; both nurse-client
relationships and relationships within
clients' lives.
 “The emphasis of this process is on
knowing/caring through pattern
recognition”
 Nurse-client relationship is
characterized by “a rhythmic coming
together and moving apart as clients
encounter disruption of their
organized, predictable state.”
 Forming relationship with clients at
critical points in their lives and
connecting with them in authentic
ways.
 Nurses are partners in the process
of expanding consciousness and are
also transformed and have their lives
enhanced in the dialogical process.
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 Client, patient, person, individual,
and human being are used
interchangeably.
 Persons as individuals are identified
by their individual patterns of
consciousness and defined as
“centers of consciousness within an
overall pattern of expanding
consciousness”
 Clients are viewed as participants in
the transformative process.
 includes family and community.
Environment
 Being the larger whole, which
contains the consciousness of the
individual.
 Client and Environment are viewed
as a unitary evolving pattern.
 Interaction between person and
environment as a key process that
creates unique configurations for
each individual.
 Patterns of person-environment
evolve to higher levels of
consciousness
Health
 Major concept of Newman's theory
of health as expanding
consciousness.
 “health is the pattern of the whole,
and wholeness is.”
 A fusion of disease and non-disease
creates synthesis regarded as
health.
 Health and evolving pattern of
consciousness are the same;
specifically, health is viewed as a
“transformative process to more
inclusive consciousness.”
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 Hildegard E. Peplau
Theory of Interpersonal Relations
Background of the theorist
Movement of the personality and other
ongoing human processes that directs the
person towards creative, constructive,
productive, and community living

Reading, Pennsylvania-Place of Birth Environment

September 1, 1909-Date of Birth Forces outside the organism and in the

context of the socially-approved way of
March 7, 1999-Date of Death living, from which vital human social
◉ Graduated from Pottstown, processes are derived such as norms,
Pennsylvania Hospital School of customs, and beliefs.
Nursing in 1931. Nursing
◉ First worked as an operating room A significant, therapeutic interpersonal
supervisor in 1943 process. It functions cooperatively with
◉ Involved in saving the American human processes that present health as a
Nurses Association from possible goal for individuals.
experiencing bankruptcy
◉ “Mother of Psychiatric Nursing” Major Concepts
◉ Psychiatric Nursing Expert, author,
nursing leader, and theorist
◉ Member of Army Nurse Corps and
experienced working in a
neuropsychiatric hospital
◉ Regarded as “one of the renowned
nursing leaders of her time”
◉ First book is entitled as
“Interpersonal Relations in Nursing”
◉ Gave great importance to
nurse-patient relationship
◉ Deems such relationship as a
“significant therapeutic
interpersonal process”
Phases of Nurse-Patient Relationship

Metaparadigm in nursing ORIENTATION

Person ◉ Initial interaction between the two

parties.
A man who is an organism that lives in an
unstable balance of a given system ◉ Patient demonstrates his/her need
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for professional assistance from the

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Health nurse.

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IDENTIFICATION occurs when the nurse enables the patient
in becoming autonomous.
◉ A feeling of relatedness develops as
the nurse begins to discover the SURROGATE
experience and the needs of his/her
Nurse acts as a temporary caregiver who is
patient.
able to create similar feelings that were
EXPLOITATION previously felt.
◉ Patient moves from being dependent COUNSELOR
to being independent
Occurs when the nurse becomes “a
◉ New goals to be achieved are set, listening friend, an understanding family
but the power to accomplish them member, and someone who gives sound
leans more towards the patient. and empathetic advises”.
RESOLUTION
◉ Setting of new goals
◉ Patient finally “earns independency
over his care”
Four Psychobiological Responses

Six Nursing Roles

STRANGER
Upon initial contact, the two parties are
considered as strangers to one another.
RESOURCE PERSON
The nurse acts as someone who is able to
give answers to the queries of the patient.
TEACHER
The information regarding therapeutic plan
is discussed by the nurse in order for the
patient to understand the subject.
LEADER
This role is accomplished with the help of
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cooperation and active participation and

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 Joyce Travelbee (1926-1973)
Human-to-Human Relationship Model
★ 1956: Bachelor of Science in
Nursing (Louisiana State University)
★ 1959: Master of Science in Nursing
(Yale University)
★ Psychiatric nursing and education
★ Psychiatric nurse, educator, author
Famous Works:
★ Travelbee's Intervention to
Psychiatric Nursing: A One-to-One
Relationship
★ Interpersonal Aspects of Nursing
★ Intervention in Psychiatric Nursing:
Process in the One-to-One
Relationship
Human-to-Human Relationship Model of
Nursing
★ "Human-to-human relationship is the
means through which the purpose of
nursing is fulfilled."
★ Therapeutic human relationship
★ Extension of Orlando’s and Peplau’s
interpersonal theory
★ Emphasis on caring stressed
empathy, sympathy, rapport, and
emotional aspects
★ Connecting and understanding the
patient in an intimate level
★ Compassion is central to holistic
Nursing care (Rich,2003)
★ Spiritual values and philosophical
beliefs
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Seven Basic Concepts
 Suffering
 Meaning
 Nursing
 Hope
 Communication
 Self-therapy
 Targeted intellectual approach
Accomplished through human-to-human
interaction
1. Original encounter
2. Emerging identities
3. Developing feelings of empathy
4. Developing feelings of sympathy
5. Attained rapport
4 METAPARADIGMS
Nursing
“An interpersonal process whereby the
professional nurse assists an individual to
prevent or cope with illness and suffering
and find meaning in these experiences.”
(Travelbee, 1966)
Person
“... a unique irreplaceable individual- a one
time being in the world- like yet unlike
person who has ever lived or ever will live.”
(Travelbee,1966)
Health
Subjective: “... an individually defined state
of well-being in accord with self-appraisal of
physical-emotional-spiritual status.”
(Travelbee, 1971)
Objective: “absence of discernible disease,
disability of defect as measured by physical
examination, laboratory tests and
assessment by spiritual director or
psychological counselor. “
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 IDA JEAN ORLANDO Four Paradigms
BACKGROUND

 diploma – New York Medical College

 BS in Public Nursing – St. John’s
University, New York
 MA in Mental Health Nursing –
Columbia University, New York
 Associate Professor at Yale
University School of Nursing and
Director of the Graduate Program in
Mental Health Psychiatric Nursing
Nursing Process Theory
OVERVIEW
Patients have their own meaning and
interpretations of situations
Nurses must validate their inferences and
analyses with patients before drawing
conclusions
DYNAMIC NURSE-PATIENT
RELATIONSHIP
Reciprocal relationship between the nurse
and the patient
Focuses on how to improve the patient’s
behavior.
APPLICATION
Concepts
It is applicable and effective practice theory
that is especially helpful to new nurses. FUNCTION OF PROFESSIONAL
NURSING
It is focused on the process of care in an
immediate experience, and is concerned
with providing direct assistance to a patient
in whatever setting they are found in for the
purpose of avoiding, relieving, diminishing,
or curing the sense of helplessness in the
patient.
PRESENTING BEHAVIOR
Regardless of how the presenting behavior
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appears, it may represent a cry for help

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from the patient. The presenting behavior of

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the patient, which is considered the
stimulus, causes an automatic internal
response in the nurse, which in turn causes
a response in the patient.
IMMEDIATE REACTION
The immediate reaction is the internal
response. The patient perceives objects
with his or her five senses. These
perceptions stimulate automatic thought,
and each thought stimulates an automatic
feeling, causing the patient to act.
NURSING PROCESS DISCIPLINE
The nursing process discipline is the
investigation into the patient’s needs. Any
observation shared and explored with the
patient is immediately useful in ascertaining
and meeting his or her need, or finding out
he or she has no needs at that time.
IMPROVEMENT
Improvement is the resolution to the
patient’s situation. In the resolution, the
nurse’s actions are not evaluated. Instead,
the result of his or her actions are evaluated
to determine whether his or her act.

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 Kristen M. Swanson
Nursing as informed caring for the well-
being of others
Background of the Theory
• Nurses are best known for being
natural caregivers and Swanson’s
Theory of Caring focuses on
teaching and healing during
pregnancy. Her theory gives insight
on how families and healthcare
providers deal with miscarriages and
the healing process that is
necessary to provide closure
• Nursing is informed caring for the
well-being of others. As Carper
(1978) has noted, nurse caring is
informed by empirical knowledge
from nursing and the related
sciences, as well as ethical,
personal and aesthetic knowledge
derived from the humanities, clinical
experience and personal and
societal values and expectations.
4 Metaparadigms
PERSON / CLIENTS
 Persons are “unique beings who are
in the midst of becoming and whose
wholeness is made manifest in
thoughts, feelings and behaviors.”
The experienced life of each person
is influenced by a genetic heritage,
spiritual endowment and the
capacity to exercise free will.
 Persons both mold and are molded
by the environment in which they
exist. The genetic heritage serves as
a blueprint for each person's unique
human characteristics. The spiritual
endowment connects each being to
an eternal and universal source of
goodness, mystery, life, creativity
and serenity.
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ENVIRONMENT
Environment is defined situationally. For
nursing, it is any context that influences or is
influenced by the designated client. Realms
of influence are multiple, including the
cultural, political, economic, social,
biophysical, psychological and spiritual
realms.
For heuristic purposes the lens on
environmental designated client may
actually be further specified to the intra-
individual level, wherein the "client" may be
at the cellular level and the environment
may be the organs, tissues or body of which
the cell is a component.
HEALTH
Well-being is a complex process of curing
and healing that includes “releasing inner
pain, establishing new meaning, restoring
integration and emerging new meanings,
restoring integration and emerging into a
sense of renewed wholeness.”
NURSING
Informed caring for the well-being of others.
Nursing is informed by empirical knowledge
from nursing and related disciplines, as well
as ‘ethical, personal and aesthetic
knowledge derived from the humanities,
clinical experience and personal and
societal values and expectations.
Major Concepts
• CARING- Is a nurturing way of
relating to a valued toward whom
one feels a personal sense of
commitment and responsibility
• KNOWING- is striving to
understand the meaning of an event
in the life of the other including
assumptions, focusing on the
person, cared for, seeking cues,
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assessing meticulously, and
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engaging both the one caring and
 the one being cared for in the The Structure of Nursing
process of knowing.
• BEING WITH- means being
emotionally present to the other. It
incldes being there in person,
conveying availability and sharing
feelings without burdening the one
cared for.
• DOING FOR- means to do for others
what would one would do for self if
at all possible, including anticipating
needs, comforting performing
skillfully and competently, and
protecting the one cared for while
preserving his or her dignity.
• ENABLING- is facilitating the other’s
passage through life transitions and
unfamiliar events by focusing on the
event, informing, explaining,
suppoting, validating feelings
generating alternatives, thinking
things through, and giving feedback.
• MAINTAINING BELIEF- is
sustaining faith in the other’s
capacity to get through an event or
transition and face a future with
meaning.

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 Ramona T. Mercer
“Maternal Role Attainment-Becoming a
Mother”
Santillan, Jaira Marie F. | N1A | Group 4
 1950
 St. Margaret’s School of
Nursing in Montgomery,
Alabama
 L.L. Hill Award for Highest
Scholastic Standing
 1962
 University of New Mexico,
Albuquerque
 Bachelor’s degree graduated
with distinction
 1964
 Emory University
 Master’s degree in Maternal-
child nursing
 1973
 University of Pittsburgh
 Doctorate in Maternity
nursing
 1983 to Present-
 University of California in San
Francisco
 Professor
 Mercer received multiple numbers of
awards and scholarships due to her
excellence and contribution to the
nursing world
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Maternal Role Attainment-Becoming a
Mother: Major Assumptions
Major Assumptions
• 1. The Stable Core self will define
how mothers respond to real life
situation in correlation to the infant
• 2. Her/his developmental level and
personality will affect her/his
response and behavior to situations
as a mother/father
• 3. Partner in a mother’s role is the
infant (will reflect the role of the
mother through the growth and
development of a child)
• 4. The mother’s intimate partner has
a role in the development of the
mother/father and the infant and
cannot be duplicated by any other
else.
• 5. Maternal identity develops with
maternal attachment
4 Metaparadigms
Major Assumptions: Nursing
 Health professionals having the
most sustained and intense
interaction with women in the
maternity cycle
 With her theory, the kind of help and
care that a woman experiences
during her pregnancy and her first
year after giving birth that can have
a long-term effect on both the
mother and infant
 3 Foci of Nursing
 - Health promotion and
prevention of illness
 - Provider of care for those
that needs assistance
 - Researcher to enhance the
knowledge base for providing
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excellent nursing care
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Major Assumptions: Person Maternal Role Attainment-Becoming a
Mother:
 Self-core self Original Model and Theory
 Is different from the different roles a
person has or are played
 Separate role as a mother, as an
intimate partner, a friend, etc.
Major Assumptions: Health
 Health status as a perception and
the over-all well-being and illness of
the mother, father and infant
Major Assumptions: Environment
 Mutual accommodation with Person
and Environment
 PersEn
 Settings affects the development of
a person Maternal Role Attainment-Becoming a
Mother:
 Stresses and social support within Original Model and Theory
the environment influence both
maternal and paternal role  Focused on the transition of a
entertainment and developing of a woman in becoming the mother
child
 Motherhood involves an extensive
Maternal Role Attainment-Becoming a change in a woman’s life that is
Mother continuous and unending
 Placed within Bronfenbrenner’s
nested circles of micro, meso, and
macro system

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1. Microsystem
 - Most influential on maternal
role attainment
 - The immediate environment
in which the maternal role
attainment occurs.
 - The variables contained in
this system interacts with
each other that affects the
development of a woman as
a mother
 Examples: Family
functioning, Mother-Father
relationship, social support,
economic values, family
values, stressors
2. Mesosystem
 - influences and interacts with
persons in the microsystem
 - may influence what happens to the
developing maternal role and the
child
 Examples: Day care, school, work
setting, places of worship, and other
entities
3. Macrosystem
 - prototypes existing in a particular
culture or transmitted cultural
consistencies
 Examples: Social, political and
cultural influences on the 2 other
systems
Maternal Role Attainment-Becoming a
Mother:
Original Model and Theory
• Anticipatory
• Initial and social and
psychological logical
adjustments to pregnancy
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• Mother learns the
expectations of the role of a
mother
• Fantasizing the role
• Formal
• Birth of the infant
• Mother learns and takes the
role as a mother that is
expected by the society
• Informal
• Mother develops unique
ways of dealing with the role
not conveyed from the social
system
• Personal
• Role-identity
• Woman internalizes her role
• Mother experience a sense
of harmony, confidence and
competence in a way she
performs the role
Maternal Role Attainment-Becoming a
Mother:
Revised Model and Theory
 The concept of role attainment
suggests and end point rather than
an ongoing process and may not
address the continued expansion of
the self as a mother. Mercer (2004)
 There may be a need to retire the
term “maternal role attainment”
because, “it implies a static situation
rather than a fluctuating process.”
McBride and Shore (2001).
 The concept of role attainment
suggests and end point rather than
11
an ongoing process and may not
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address the continued expansion of
the self as a mother. Mercer (2004)
  There may be a need to retire the
term “maternal role attainment”
because, “it implies a static situation
rather than a fluctuating process.”
McBride and Shore (2001)

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 MERLE H. MISHEL
Uncertainty in Illness Theory
BACKGROUND
 Born in Boston, Massachusetts
 Graduate 1961 with a Bachelors of
Arts from Boston University
 Graduate 1966 with Master of
Science in Psychiatric nursing from
University of California
 Graduate 1976,1980 with Masters of
Arts, Doctorate in social psychology
from Claremont Graduate school,
Claremont California.
“There is an absence of systemic
investigation of uncertainty as a perceptual
variable influencing the appraisal of illness
related events.” (Mishel, 1981)
MAJOR CONCEPT-UNCERTAINTY IN
ILLNESS
The theory of uncertainty of illness is
composed of three major themes:
1. Antecedents of uncertainty- anything that
occurs prior to the illness experience that
affects the patient's thinking such as pain,
prior experiences, and perception.
2. Appraisal of uncertainty- the process of
placing a value on the uncertain situation.
3. Coping with uncertainty- activities that are
used in dealing with the uncertainty.
UNCERTAINTY IN ILLNESS
 Mishel began her work in 1981 when
she developed a 30-item scale to
measure uncertainty, a key concept
in her original 1988 theory. In
formulating the original theory,
Mishel recognized that a person’s
stimuli frame could reduce
uncertainty in illness. The stimuli
frame is composed of the symptom
pattern, event familiarity, and event
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congruence (or the consistency
between expected and experienced
events).
 In addition, she proposed that a
person’s stimuli frame could be
enhanced by his or her cognitive
capacities and structure providers.
Structure providers include credible
authorities like doctors and nurses,
and also social supports. These
concepts are grouped together as
the antecedents of uncertainty.
 Based on Mishel’s original theory,
people only view uncertainty as an
opportunity when the alternative is
facing the certainty of a poor
outcome. Using appropriate coping
strategies, individuals adapt to their
illness
 Uncertainty occurs when individuals
are unable to determine the meaning
of illness-related events. Individuals
appraise uncertainty as either a
danger or an opportunity using
inference and illusion. Inference is
the process of evaluating a situation
based on past experiences.
Whereas, illusion is the process of
constructing positive beliefs.
 Research completed after
publication of Mishel’s original theory
supported its application to acutely ill
patients, but did not support the
theory’s application to chronically ill
patients or those facing recurrence
of a disease in remission. These
patients initially viewed uncertainty
as dangerous, but over time came to
accept it as an opportunity.
 This conflicted with Mishel’s original
theory, which proposed that only
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individuals faced with the certainty of
poor outcomes would view
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uncertainty as an opportunity.
  Therefore, Mishel updated her work
in 1990 to accommodate the
response over time of chronically ill
patients and those facing disease
recurrence.
 Recognizing the cultural bias
inherent in her original work, she
abandoned the Western mechanistic
assumption that adaptation is the
single desired outcome and that
uncertainty in illness is a linear
trajectory.
 The new model proposed that under
conditions of chronic uncertainty,
people move away from evaluating
uncertainty as dangerous and adopt
a new world view that accepts
uncertainty as part of life. The re-
conceptualized model also
introduced the concept of
probabilistic thinking, or the ability to
consider multiple ways of
accomplishing goals. When people
with chronic illnesses or disease
remission accept uncertainty as part
of life, they perceive it as an
opportunity to grow and change.
UNCERTAINTY IN ILLNESS- What does it
do?
 The uncertainty in illness theory
helps measure the degree to which
an individual is experiencing
uncertainty during illness or an acute
injury.
 The illness causes uncertainty that
spreads into the individual’s life and
breaks down the individual’s point of
view and reality. Slowly a new point
of view is formed.
 Uncertainty is the driving force and
is accepted as reality. Now the
individual may see that many
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options are possible as opposed to
only a cause and effect paradigm.
FOUR METAPARADIGMS- PHEN
• A person gradually moves away from an
evaluation of uncertainty as aversive to
adopt a new view of life that accepts
uncertainty as a part of reality.
• Uncertainty in Illness has been researched
primarily in the hospital setting. Illness
effects many aspects of life and with
increased research it might show how
Uncertainty in Illness theory can be used to
help a variety of patients in different
environments.
• An open system that exchanges energy
and matter with the person
• Addressing these areas and assisting the
patient to build better coping mechanisms
will improve the patient’s health during times
of illness.
• to accept and promote probabilistic
thinking and to avoid focusing on
predictability and certainty
• promote consideration of alternatives that
allow their patients to adjust to the changing
nature of their illness and foster the notion
that there are many factors that influence a
patient’s response to illness.
SUMMARY
 The uncertainty in illness theory
provides a comprehensive
framework within which to view the
experience of acute and chronic
illness and to organize nursing
interventions to promote optimal
adjustment.
 The theory helps explain the
stresses associated with the
14
diagnosis and treatment of major
illnesses, the process by which
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individuals assess and respond to
 the uncertainty inherent in an illness
experience and the importance the
professional care givers in
supporting individuals in
understanding and managing
uncertainty.
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Dr. Katharine Kolcaba
THE COMFORT THEORY
BACKGROUND
• Born and educated in Cleveland,
Ohio
• 1965, she received a diploma in
nursing
• Practiced part time in medical-
surgical nursing, long term nursing,
and home care for many years
before returning to graduate school
• 1987, graduated in the first RN to
MSN class at Case Western
Reserve University (CWRU) Frances
Payne Bolton School of Nursing
specialized in Gerontology
• Joined the faculty at the University of
Akron College of Nursing
• Gained Americsn Nurses
Association (ANA) certification in
gerontology
MAJOR CONCEPTS AND DEFINITIONS
HEALTH CARE NEEDS
o Comfort needs arising from stressful
health care situations that cannot be
met by recipients’ traditional support
systems
o The needs may be physical,
psychospiritual, sociocultural, or
environmental
COMFORT INTERVENTIONS
are nursing actions and referrals designed
to address specific comfort needs of
recipients, including physiological, social,
cultural, financial, psychological, spiritual,
environmental, and physical needs
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COMFORT Recipients of care may be individuals,
families, institutions or communities in need
Immediate state experienced by recipients
of health care
of comfort interventions.
Environment
Three types of comfort:
Any aspect of patient, family, or institutional
o Relief
settings thath can be manipulated by the
o Ease
nurse, loved ones, or the institution to
o Transcendence
enhance comfort
Four Contexts: Health
o Physical
Optimal functioning of a patient, family,
o Psychospiritual
health care provider, or community as
o Sociocultural
defined by the patient or group
o Environmental
Health SEEKING BEHAVIOURS
Compose of broad category of purposes
related to the pursuit of health as defined by
the recipients in consultation with the nurse
Institutional Integrity
Corporations, communities, schools,
hospitals, regions, states, and countries
Best practices
Use of health care interventions-based om
evidence to produce the best possible
patient and family outcomes
Best policies
Institutional or regional policies ranging from
protocols for procedures and medical
conditions

4 Meta paradigms
Nursing
Intentional assessment of comfort needs,
the fesign of comfort interventions to
address those needs and assessment of
comfort levels after implementation
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compared with baseline

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Patient

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 Margaret Jean Harman Watson
PhD. RN, AHN-BC. FAAN
• Born and grew up in Welch West
Virginia
• Youngest of 8 children
• Married to Douglas Watson
• Moved to the state of Colorado
• Two daughters: Jennifer and Julie; 5
grandchildren
• Present: lives in Boulder, Colorado
Four Meta-Paradigms
Person:
• Terms: human being, person, life,
personhood and self
• “a unity of mind, body, spirit and
nature”
• “…often considered as dualistic…”
• Unitary Transformative Paradigm-
Holographic
Health:
• Originally derived from the World
Health Organization
• “unity and harmony within the mind,
body and soul” –Watson
• Self as perceived and self as
experienced
• Definition of illness and disease
Environment:
• Nurse’s role in the environment:
“attending to supportive, protective
and/or corrective mental, physical,
societal environments.”
• “The caring science is not only for
sustaining humanity, but also for
sustaining the planet…”
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• “Healing spaces can be used to help
others transcend illness, pain and
suffering.”
Nursing:
• Interested in understanding health,
illness and human experience,
promoting and restoring health, and
preventing illness.
• “Knowledge, thought, values,
philosophy, commitment and action,
with some degree of passion.”
Major Concepts:
Ten Caritas Processes: based her theory
on 10 Carative factors. Includes a decidedly
spiritual dimension and overt evocation of
love and caring.
1. Cultivating the practice of loving-
kindness and equanimity toward self
and other as foundational to Caritas
consciousness.
2. Being authentically present:
Enabling, sustaining, and honoring
the faith, hope. Deep belief system
and inner-subjective world of
self/other.
3. Cultivation of one’s own spiritual
practices and transpersonal self,
going beyond ego self.
4. Developing and sustaining a
helping-trust caring relationship
5. Being present to, and supportive of,
the expression of positive and
negative feelings.
6. Creative use of self and all ways of
knowing as a part of the caring
process; engage in the artistry of
caritas nursing.
7. Engage in genuine teaching-learning
experience that attends to unity of
being and subjective meaning –
attempting to stay within the others
17
frame of reference.
8. Creating a healing environment at all
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levels.
 9. Administering sacred nursing acts of
caring-healing by tending to basic
human needs.
10. Opening and attending to
spiritual/mysterious and existential
unknowns of life-death.

Theory of Transpersonal Caring:

• Moral commitment, intentionality and
caritas consciousness by the nurse
• The conscious will of the nurse
affirms the subjective and spiritual
significance of the patient
• Recognize, detect and connect with
the inner condition of the spirit

• Nurse’s ability to connect with

another at this transpersonal spirit-
to-spirit level
• Caring- healing modalities through
the context of transpersonal caring
• Ongoing personal and professional
development and spiritual growth
• Nurse’s own past experiences for
the opportunity for a focused study
• Other facilitators are personal
growth experiences
• Continuous growth for developing
and maturing within a transpersonal
caring model is ongoing.

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