Evolution of Ray's Theory of Bureaucratic Caring

An overview and evolution of caring and the theory of bureaucratic caring and interpretations of its central categories are described. Data and models representing its theoretical development, the concept of bureaucracy, and emergence of the theory as a holographic theory are included. Central tenets in the new sciences are explored along with Bohm's corresponding ideas of explicate and implicate orders (holistic science) and spiritual-ethical caring. The theory has broad implications for increasing the knowledge of caring inter-professionally, improving the health and well-being of people, and transforming healthcare bureaucratic organizations nationally and globally, with application in the military healthcare system.

Enculturation of Caring Behaviors in Clinical Simulation: An Integrative Review

There exists the evidence that clinical simulation can cultivate caring behaviors among nursing students. Despite this, there is an inadequate educational approach used in cultivating caring behaviors. This paper presents the enculturation practices use in cultivating caring in clinical simulation. An integrative review was conducted using primary research articles published between 2010 and 2020 from electronic databases and the web. In the context of simulation, enculturation is defined as an outcome of learning where the nursing student is immersed in a structured environment. Vehicles for cultivating caring behaviors are delivered intentionally or unintentionally through role modeling, didactics, verbal instruction, interactions, and socialization.

Ways of Knowing Nursing: A Discussion Forum Rubric for Distance Education

Distance education by its very nature implies physical separation and lack of connectedness among participants. Presented is a Discussion Forum Rubric that captures the multidimensionality of the study of nursing knowledge through participation expectations. This discussion rubric is designed to guide the dialogue of learners with faculty mentors to interpret nursing as an art and science with a theory-based foundation of: disciplinary knowing through critical inquiry; intentional knowing with genuine presence and attentiveness; dialogical knowing focusing on contextual learning within nursing situations; professional knowing through introspection and past experiences; and expressive knowing with articulation of ideas, thoughts, positions, and standards.

Applications of Theory of Bureaucratic Caring in the United States Air Force and Defense Health Agency

The theory of bureaucratic caring, generated from lived experiences of healthcare professionals and patients, synthesized the thesis of caring with the anti-thesis of bureaucracy (hospital). This author applied the theory in settings within the United States Air Force Medical Service and the Military Health System. Using categories of caring as spheres in which to leverage caring, the author developed projects on communication, self-efficacy, healthcare readiness, evidence-based practice, spiritual health, and education. The article describes applications of the theory across settings in the military. This author encourages others to apply the theory in their organizations as part of their nursing journey.

Mental Health Literacy: An Essential Tool for Caring Post-Secondary Educators

The mental health needs of post-secondary students have been steadily increasing. Educators, particularly those who work in caring disciplines like the social and health sciences, are often compelled to assist students with their mental health, but may lack confidence in our abilities to support students. Relationally, this uncertainty may prohibit us from engaging in the caring relationships so important for role modelling professionalism. This paper describes the baseline mental health literacy of 122 educators in higher education which provides a starting point for educators and researchers studying caring practices, specifically as they relate to student mental health.

New Graduate Nursing Retention in 2020: A Multifactorial Analysis

The issue of new graduates prematurely exiting the profession has a long-standing, complicated history in nursing. Current retention is further complicated by the COVID-19 pandemic. The state of the global workforce and transition shock theory situate this issue. Ray's theory of bureaucratic caring frames the analysis with proposed recommendations for individual nurses, healthcare organizations, and academia. The sociocultural and political domains of Ray's theory offer guidance for nurse leaders in academic and practice settings. The importance of a collaborative relationship between academic and practice settings is vital to mitigate the phenomenon of early exit of new graduates.

Healthcare Readiness and Primary Care Nursing Using the Theory of Bureaucratic Caring: Turning Never Into Now

The global COVID-19 pandemic of 2020 challenged primary care nursing as never before. Attention focused mainly on care within the inpatient realm, and guidance for these areas was predicated on existing plans for contingency response. In the primary care realm, few clinics plan for or practice readiness responses; thus patients and staff faced a daunting mission of ensuring continuation of services using nontraditional platforms. This article describes bureaucratic caring theory guidance for readiness activities, basic planning, and resources required for primary care clinics in contingency and crisis responses.

Research Brief: Changes in Empathy of Pre-Professional Healthcare Students From Matriculation to Graduation

In this research brief, researchers used a quantitative method, descriptive design, and cross-sequential grouping to investigate changes in empathy of pre-professional healthcare students over the course of their degree programs. Changes in empathy occurred; however, changes did not measure as statistically significant. Empathy overall increased; it decreased for certain majors and increased for others. The importance of empathy in the healthcare arena points to a need for specific efforts by educators toward increasing student empathy throughout these programs of study. This study showed that empathy is being maintained, but only just barely, over the course of these programs.

Supporting Students' Understanding of Caring Science as a Meaningful Basis for Practice

Caring science has been described as abstract, difficult to apply, or unscientific common sense. An alternative view is that caring science knowledge does not pose a greater challenge because it is abstract, but because it challenges caregivers' existence. No matter how nursing faculty perceive these challenges, it is crucial to create a context where students are supported in the integration of theoretical knowledge. This article addresses teachers' responsibility for creating a caring learning environment. It further proposes how reflections on perspectives and concepts can be linked to experiential learning to contribute to students' embodied understanding of caring science.