Journal Reading (Nursing is Caring)

Nursing is Caring Doing For the Patient
(an excerpt from the article of Kristen M. Swanson)
Nursing as Informed Caring for the Well-Being of Others by Kristen M. Swanson (1993), Journal of Nursing Scholarship, vol. 5, no. 4. p. 356

Virginia Henderson captured the essence of doing for in her often quoted definition of nursing:


The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.(Henderson, 1966).



Doing for, simply put, is doing for the other what they would do for themselves if it were at all possible. Doing for involves actions on the part of the nurse that are performed on behalf of the client's long term well-being. There is an efficaciousness to these actions, wherein the nurse acts ultimately to preserve the other's wholeness. Short-sighted, misplaced efficiency occurs when the actions are solely toward immediate preservation of the caregiver's time, energy or finances. Classic health care examples of not doing for include administering prematurely an episiotomy on behalf of the obstetrical care provider's over-booked schedule, quickly bathing and dressing an elderly client who is perfectly capable of slowly dressing herself or hastily hauling infants off to the newborn nursery versus leaving them in proximity to their mother's loving gaze, nurturing milk and bodily warmth.

Doing for includes comforting the other, anticipating their needs, performing competently and skillfully, protecting the other from undo harm and ultimately preserving the dignity of the one done for. Although it may appear that doing for actions are primarily psychomotor nursing ministrations, this is not always the case.

In the psychosocial realm of care, doing for generally involves not so much physical ministrations, per se, as the employment of interpersonal therapeutic communication skills as well as setting up opportunities, programs or systems that provide safe arenas within which people can bring about their own healing. When nurses set up groups for teen-age incest survivors, women who miscarry or bone marrow donors, they are doing for clients what they would do for themselves, if at all possible. Recently, a group of maternal-child public health nurses from the Seattle-King County area shared some beautiful examples of psychosocial doing for. They delineated levels of supportive assistance they perform on behalf of new mothers experiencing substance abuse problems. When mothers indicate the desire to "get clean," the nurses describe assessing how capable the woman is to act on her own behalf. If it is clear that the woman is in danger and that it took all the woman had within her to even voice a desire to "quit using." the nurse might dial the substance abuse hot line for her and hand her the phone (being aware that while the woman herself must talk, she needed that extra boost to access help). If, on the other hand, the woman states she is ready to quit and would like to know where to begin, the nurse might assess whether to offer the woman a narrow range of choices ("Here are pamphlets on two treatments programs within your city. I will check back tomorrow to see which one you called."); broad options ("Look in the yellow pages under "A" tor alcoholism. Call me Thursday morning and we can talk about your decisions."); or simply a wide open response, such as "How may I be of assistance to you?" In each case, the level of nurse directiveness is the result of balancing the nurse's recognition that the woman must act on her own behalf with an understanding of the demands, constraints, and resources offered by the woman's life and environment. Doing for in each of these public health nursing examples is a balancing act between doing for the woman what she would do for herself if she had the knowledge and/or resources to do so and facilitating the woman's ultimate desire to realize life long sobriety.




Note: this article is posted for the TFN students in requirement for journal reading. No content of this article is written by the user of the blog site.