Number of replies: 0 Marlaine Smith’s Theory of Unitary Caring (TUC) was developed with a unitary perspective, focusing on the mutual relationship of caring between the nurse and person needing care (Smith, 2020). There are five major theoretical concepts in this theory; they are manifesting intentions, appreciating patterns, attuning to dynamic flow, experiencing the infinite, and inviting creative emergence (Nursology, 2022). Manifesting intentions prepares oneself to participate in actions that further well-being, health, and healing of another person.
Number of replies: 0
Marlaine Smith’s Theory of Unitary Caring (TUC) was developed with a unitary perspective, focusing on the mutual relationship of caring between the nurse and person needing care (Smith, 2020). There are five major theoretical concepts in this theory; they are manifesting intentions, appreciating patterns, attuning to dynamic flow, experiencing the infinite, and inviting creative emergence (Nursology, 2022).
Manifesting intentions prepares oneself to participate in actions that further well-being, health, and healing of another person. This step allows caring to be directed toward creating a healing environment while preserving dignity, and having an authentic presence. To facilitate a healing environment, Nurse’s thoughts and intentions should focus on the well-being of the patient (Smith, 2020).
Appreciating patterns is a process of finding human wholeness through the perception of fragmentation. The goal is to not seek to changing patterns, but to embrace and “come to know” the uniqueness of the individual (Smith, p.498, 2020). This can be accomplished through active listening in a non-judgmental nature.
Attuning to dynamic flow focuses on being truly present in the nurse-patient interaction. Nurses must use this intuition to deliver empathy through crying, laughing, joking, or embracing the individual in need to show that they are mutually engaged in the healing process (Smith, 2020). The goal is not to tell a patient what to do, but to be a healing presence for the patient while along the journey with them.
Experiencing the infinite focuses on the spiritual connection in human relations. This concept appreciates the infinite power that comes from love and caring. There are periods of grace as the spirits of the nurse and the individual transcend physicality in an awareness of a multidimensional human experience (Smith, 2020).
Lastly, inviting creative emergence appreciates the individuals timing in growth. Individuals recognize their potential for new patterns and emerge into new roles in their own time along the journey. The process of caring must be patient, trusting, and encouraging to facilitate individuals’ growth and emergence (Smith, 2020).
Application of the Metaparadigm of Nursing
In TUC the person is seen as irreducible or a unitary being. Health extends beyond the absence of disease and illness, it includes transcendence, and a connection that extends beyond physicality. The environment is viewed as the nurse-patient relationship. This relationship is seen as a safe, nurturing, and facilitates growth and emergence into new patterns that enable healing to take place. Nursing’s purpose is to create a healing environment supportive of individuality, and recognizes the wholeness of individuals through caring relationships.
Implementing into Practice
Patients with complex physiological and psychosocial needs are frequently encountered in the critical care setting. One clinical situation I recently experienced was I had a patient who was admitted to ICU for end stage Heart Failure. The patient was deemed not a candidate for an LVAD or transplant and was being managed medically with a poor prognosis. The patient expressed fears to dying and seemed to be at most ease whenever I was present in the room. Later in the day, the patient complained of difficulty breathing, was making an audible wheezing sound, and was breathing very fast and shallow. Upon assessment the patient’s vital signs were all stable and his lungs were clear to auscultation. I explained these findings to him and he was still adamant something was wrong. The provider came and informed the patient it was anxiety but hearing that wasn’t comforting to the patient. After the time I spent talking with the patient and being a reassuring presence, his symptoms resolved. This patient was experiencing a panic attack, didn’t want to be alone, and needed emotional support and guidance to overcome this. Being present, supportive, and empathetic, created a safe healing environment. Attuning to dynamic flow provides patients with the power of healing through caring. Maybe the situation could have been avoided to by proactively finding ways to keep the patients anxiety at ease to hopefully prevent a panic attack. It is important to use the TUC concepts to focus consideration of the whole individual, to transcend the healing process.
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