HUMANISTIC

NURSING
THEORY
Dr. Josephine
Paterson
Dr. Loretta Zderad

BIOGRAPHY

DR. JOSEPHINE PATERSON

BIOGRAPHY
Josephine

Paterson was born on

the 1st of September 1924 in
Freeport, New York.

She

had graduated in August

1945 with a diploma from Lenox
Hill School of Nursing

 Nine

years later (1954, August) she

received her masters degree from
John Hopkins School of Hygiene and
Public Health, Baltimore, Maryland

Her

Doctor for Nursing is from

Boston University School of Nursing,
Boston, Massachusetts, where she
specialized in psychiatric nursing

 Dr.

Paterson conceptualized and taught

humanistic nursing to graduate students,
faculty, and staff in a variety of settings

She

also served on the faculty of the State

University of New York at Stonybrook

She

retired in 1985 as a clinical nurse specialist

at Northport Veterans Administration Medical
Center at Northport, New York

DR. LORETTA ZDERAD

 Zderad

is a graduate of St. Bernards

Hospital School of Nursing and Loyola
University

She

received her Master of Science

degree from Catholic University,
Washington, DC, and a doctor of
Philosophy (1968) from Georgetown
University, Washington, DC

She

has taught in several universities

and has led groups on humanistic
nursing

 Dr.

Zderad also served on the

faculty of the State University of
New York at Stonybrook

She

retired in 1985 as the

Associate Chief for Nursing
Education at the Northport
Veterans Administration Medical
Center, Northport, New York

 Paterson

and Zderad met in the 1950s

while working at Catholic University,
where their task was to create a new
program that would include psychiatric
and community health.

Friendship

years.

that has lasted over 35

HUMANISTIC NURSING
Embraces

more than abenevolent

technically competent subject-objectoneway relationship guided by a nurse
inbehalfof another. Rather it dictates that
nursing is aresponsible searching,
transactional relationshipwhose
meaningfulness demands conceptualization
founded on a nurse's existential awareness
of self and of other (Paterson & Zderad)

highly abstract theory with a

major focus on the process of
interaction or dialogue between
the nurse and patient.

Paterson

and Zderad believed

that a simple, scientific approach
to nursing education would not
be sufficient to create truly
effective and content nurses.

IMPLICIT ASSUMPTIONS
Nursing

involves two human beings

who are willing to enter into an
existential relationship with each
other.

Nurses

and patients as human

beings are unique and total
biopsychosocial beings with the
potential for becoming through
choice and intersubjectivity.

 Every

encounter with another human

being is an open and profound one,
with a great deal of intimacy that
deeply and humanistically influences
members in the encounter.

Human

beings are free and are

expected to be involved in their own
care and in decisions involving them.

All

nursing acts influence the quality

of a persons living and dying.

 Nurses

and patients coexist; they are

independent and interdependent.

nurse has to accept and believe in

the chaos of existence as lived and
experienced by each man despite the
shadows he casts, interpreted as poise,
control, order, and joy (Paterson and
Zderad, 1988,p. 56).

Human

beings have an innate force

that moves them to know their angular
views and others angular views of the
world (Paterson and Zderad, 1976;
Zderad, 1969).

THEORETICAL
ASSERTIONS

Through

the Humanistic Theory, the

nurse is able to connect with the patient
and their struggle, enabling them to
gain a deeper understanding of their
situation and face the battle together.

Humanistic

nursing practice is
developed from the lived experiences of
the nurse and the person receiving care.

 The

practice of nursing is rooted

from EXISTENTIALISM. It is a
philosophical approach to
understanding life. Individuals are
faced with possibilities when
making choices. These choices
determine the direction and
meaning in ones life.

 The

purpose of the nurse-patient

relationship, or intersubjective
relating, is, nurturing the wellbeing and more-being of persons in
need. Humanistic nursing focuses
on the intersubjectivity experience,
the most important activity for the
nurse to engage in may be the use
of self, or presence with the patient.

3 CONCEPTS PROVIDING
THE BASIS OF NURSING

DIALOGUE

Nursing is a lived dialogue. It is a nursenursed relating creatively.

Meeting
Response

Presence
Relating

Meeting
is characterized by the expectation
that there will be a nurse and a nursed

 Relating
is a process of nurse-nursed doing
with each other
Subject Subject Relating
"I-Thou" is a coming to know the other and the
self in relation, intuitively.

Subject Object Relating

"I-It" is an authentic analyzing, synthesizing, and
interpreting of the "I-Thou" relation through
reflection.

 Presence
is the quality of being open,
receptive, ready, and available to
another person
Call and Response
nurses and clients call and
respond to each other both
verbally and nonverbally

Call and response relationship is where

the client call for assistance and the
nurses hear the call and respond with
their knowledge, life experience, and
skills to help the caller with the health
related need. What happens during
this dialogue, the and in the call and
response, the between, is nursing.

 COMMUNITY

Meaning comes from the

realization that it is through each
other that we more fully
participate in and expand our lives
Two or more persons struggling
together toward a center
(Paterson & Zderad, 1976)

Through openness, sharing, and caring,

we each will expand our angular views,
each becoming more than before.
Subsequently, we take back into our
nursing community these expanded
selves, which in turn will touch our
patients, other colleagues, and the
world of health care.

According to Humanistic Nursing

Theory, there is an inherent obligation
of nurses to one another and to the
community of nurses. That which
enhances one of us, enhances all of us.

So for a health-nursing community to

truly be actualized each nurse would
prepare to be all it was possible forher
to be as a nurse. Then, through
exploration there would be a recognition
of the reality of the existentcommunity.
Over time a merger of the values of the
nurse and of the existing community
would be reflectedas moreness in each.
The nurse would be more through her

relation with the community; the

communitywould be more through its
relation with the nurse. Each would
make an important difference in the
other. Themacrocosm, the community,
would reflect the nurse's quality of
presence. The microcosm, the nurse,
wouldreflect the presence of the
community with her. Each unique man
becomes in community
throughcommunication with other
uniquely different men.

 PHENOMENOLOGIC

NURSOLOGY

Methodology for understanding and

describing nursing situations
Assumes a perceived health need by the
individual who is involved in an interaction
with a health care provider
Concerned with the nature of the facts and
what they mean to individuals

5 PHASES OF HUMANISTIC
NURSING INQUIRY
Preparation

of the nurse knower

for coming to know
Preparing to get to know the patients
point-of-view. This means the nurse uses
her education and life experiences to
prepare to relate with patients. Your
experience communicating with different
types of people
with different personalities helps you
prepare to communicate with patients.

 Nurse

knowing the other intuitively

Moving the other back and forth between

the impressions the nurse becomes aware
of herself and recollected real experience of
the other (Paterson & Zderad, 1976)
It is conceptualized as dialectic between
the impression and the real. This shifting
back and forth allows for sudden insights
on the nurses part, a new overall grasp,
which manifests itself in a clearer, or
perhaps a new, understanding. These
understandings generate further
development of the process

 The nurse gains knowledge of the patient

through intuitive impressions and learning
about the patients experiences
At this time, the nurses general
impressions are in a dialogue with her
unbracketed view

Nurse knowing the other scientifically

Separateness from what is known
The nurse gains scientific knowledge of
the patient by (phenomenological
process) pondering, analyzing, sorting,
comparing, contrasting, relating,
interpreting, naming, and categorizing
data (therapeutic techniques:
clarification and verification)
Collect information about the patient, for
example age, pulse and blood pressure

Nurse complementarily synthesizing

known others
The nurse combines the subjective and
objective information to gain perspective
on the situation
Nurse as noetic loci or knowing places.
The nurse examines the communication
with the patient and the information
collected in light of her education
(theoretical foundation) and personal
experience. The nurse uses all the
information from the patient and from her
experiences to form a conclusion. For
example, maybe the nurse had a patient
before who had the same complaint.

 Succession

within the nurse from

the many to the paradoxical one
The nurse arrives at a new truth, a
concept that includes all the
information gained, refined into a
descriptive construct (Kleiman, 2006)
The nurse makes a conclusion about
what is the best way to improve the
patients well-being.
Paradoxical one: descriptive theoretical
construct of nursing

NURSING
METAPARADIGM

 NURSING
Is a nurturing response of one person to
another in a time of need that aims toward
the development of well-being and more
being

Helping to increase responsible choices

Nursing is concerned with the individuals
unique being and striving towards
becoming, focusing on the whole
Is a lived dialogue that incorporates the
intersubjective in which a nurse and a
patient meet, relate, and are totally present
in an existential way that includes intimacy
and mutuality

 HEALTH

Matter of personal survival. It is a process of

experiencing ones potential for well-being
and more-being, a quality of living and dying.
well-being: steady state (maintenance of
quality) or more than absence of disease
more well-being: process of becoming all
that is humanly possible
Finding meaning in life

 MAN

Human beings are characterized as

being capable, open to options,
person with values, and the unique
manifestation of their past, present,
and future

 ENVIRONMENT

Community: The phenomenon of

society or environment
Two or more persons struggling
together toward a center
It is only through our community
that we are able to reach our full
potential

CONCEPTUAL MODEL

CONCEPTUAL
FRAMEWORK

EVIDENCE BASED
PRACTICE

Humanistic Nursing Theory: application

to hospice and palliative care.
Wu HL, Volker DL.
Nursing Department, Meiho University
Neipu,
Pingtung, Taiwan.
2011 Jul 20
ABSTRACT
AIM:
This article presents a discussion of the
relevance of Humanistic Nursing Theory to
hospice and palliative care nursing.

BACKGROUND:
The World Health Organization has
characterized the need for expert, palliative
and end-of-life care as a top priority for
global health care. The specialty of hospice
and palliative care nursing embraces a
humanistic caring and holistic approach to
patient care. As this resonates with
Paterson and Zderad's Humanistic Nursing
Theory, an understanding of hospice
nurses' experiences can be investigated by
application of relevant constructs in the
theory.

DATA SOURCES:
This article is based on Paterson and
Zderad's publications and other theoretical
and research articles and books focused on
Humanistic Nursing Theory (1976-2009), and
data from a phenomenological study of the
lived experience of Taiwanese hospice
nurses conducted in 2007.

DISCUSSION:
Theoretical concepts relevant to hospice and
palliative nursing included call-and-response,
inter-subjective transaction, and uniquenessotherness.

IMPLICATIONS FOR NURSING:

The philosophical perspectives of Humanistic
Nursing Theory are relevant to the practice of
hospice and palliative care nursing. By 'being
with and doing with', hospice and palliative
nurses can work with patients to achieve their
final goals in the last phase of life.

CONCLUSION:
Use of core concepts from Humanistic Nursing
Theory can provide a unifying language for
planning care and describing interventions.
Future research efforts in hospice and palliative
nursing should define and evaluate these
concepts for efficacy in practice settings.

Training nurses in a humanistic approach to

caring for patients with dementia
Author: Leonard L. Sarff
January 2013
Abstract: This study applied a humanistic
perspective to nursing care for people with
dementia. A formal training program was designed
to help Registered Nurses, Licensed Practical
Nurses, and Certified Nursing Assistants understand
the etiology and progression of dementia, followed
by hands-on training addressing the behavioral
challenges in these residents. This training taught
the nurses to explore not only the medical aspects
of dementia but more importantly to see the person
suffering from dementia as a whole person who had
a life of experiences, dreams, loves, and aspirations
for their lives, and what has made the resident a
unique individual. The principal question this
exploratory case study examined was:

Does training nurses to use a

humanistic approach lead to a
higher quality of care and improve
the personal experiences of the
caregiver? A semi-structured
interview with one Registered Nurse,
one Licensed Practical Nurse, and
one Certified Nursing Assistant, a
subset of those who attended the
training, supplemented a survey of
16 participants as well as
observations of staff-patient
interactions by the investigator. A
survey completed by the
participants

asked them to compare their own work

orientations before training with
changes following the training. Training
the staff to use a humanistic approach
led to 15 out of 16 participants reporting
that their participation in the program
contributed to one or more aspects of
improved personalized care for their
patients, benefiting not only the
residents but themselves as well.
Participants reported feeling more
satisfaction with the work they were
doing and an increased ability to have a
greater impact on the lives of the
residents they were treating.

THANK
YOU!