This chapter presents an overview of the state of the art ethnographies conducted by nurses and highlights a few works by the early generation. An extensive search of the literature was conducted to identify ethnographies completed by nurses. Nursing knowledge was a common thread throughout the literature reviewed. The literature review revealed the progress nursing is making in recognizing this gap and attempting to close it. Nursing knowledge is essential in patient care. Using the ethnographic method of inquiry, nurses have been able to identify areas of need both in knowledge and practice and make recommendations for enhanced practice. Caring and patient advocacy were other common themes in the literature. Caring is the essence of nursing and consequently should be incorporated in nursing research. The common purpose of the ethnographic studies reviewed was to explain or understand a phenomenon to increase nursing knowledge.

The use of nursing theories helps to better define the focus of the CARES tool and to establish the intent for the tool’s usage. Two nursing theories helped to guide the development of the CARES tool and provided the desired focus on communication and hope that the CARES tool was designed to emphasize. The developmental phenomenon of self-transcendence is essential for the maintenance of mental health at the end of life. The dying must identify that they are so much more than their disease. Evidence-based symptom management must be provided for individuals to focus their energies on achieving this meaning and to strive for self-transcendence. There are five common caring processes or features to this theory that identify components of a caring relationship. The five components are maintaining belief, knowing, being with, doing for, and enabling.

The author, Mary Rockwood Lane, discovered that her life as a woman, nurse, artist, activist, and writer was her destiny and spiritual journey. It all seemed to come together on a single day, when she felt a profound inner shift that revealed her true essence; the day that made her realize why she became a nurse in the first place. Lane’s research study showed that creativity helped patients find love and compassion. The research revealed themes that creativity helped patients get in touch with their inner wisdom, with their soul or spirit. Lane believed in caring and forgiveness. She began to understand why caring was actually the choice for peace and war was not. Our ability to live in peace comes from our authenticity as human beings. Peace is the cornerstone of wholeness and health and Caritas is an ethical and philosophical foundation for creating peace.

This chapter addresses partnerships manifested at the global level, although the approach to global partnership and lessons learned from our global partners may also be relevant to partnerships within our own diverse communities. Regardless of borders, it shares a common humanity with varying expressions of caring and manifestations of partnership, but all are grounded within Watson’s Caritas Processes. The exemplars of Haiti and Rwanda, two vastly different countries, demonstrate Caritas Processes in action. Choices were made in Haiti when 80 people instead of 15 people elected to participate in the beginning of a community change process. Caring opportunities were created in Rwanda that would benefit all partners representing large organizations that spanned the globe. In both exemplars, caring was rooted in the individual but impacted an entire community and even nations. Caring partnerships begin with each of us as fully committed individuals who practice our altruism through kindness and caring.

Caring is a universal principle. Traditionally, the African concept of caring involves all the members of the village or community, family, relatives, tribe, and ancestors. This chapter looks at Watson’s Caring Theory (WCT) through an African lens and an African ontology, namely ubuntu. Ubuntu epitomizes the promotion of standards of moral behavior while living the central philosophy of interaction between people and how relationships are manifested. The chapter compares the values and ethics of ubuntu with those of WCT to show how the principles of ubuntu can be integrated with WCT to develop an African ontology of caring. This is done through a critical discussion and critique of the general concepts, values, and ethics of WCT compared with ubuntu. The chapter helps the caring-healing nurse to develop an individualized plan for caring based on ubuntu and Watson’s Caritas Theory.

Holding altruistic values related to nonharming and having a desire to help wherever possible is foundational to caring in nursing, as is the practice of lovingkindness with others. Lovingkindness consists of varying behavioral expressions that all arise from one thing; a deeply held desire to love and to care in whatever ways are meaningful and helpful in a given moment, within a given situation. This chapter presents three examples of caring science knowledge development from scholarly sources. These examples include the first Caritas Process and also may encompass one or more of the other Caritas Processes. Sitzman analyzed caring online communication patterns from six studies that examined the process of caring in online nursing classrooms. Six communicative elements emerged from this analysis. These six communicative elements illustrated key aspects of Watson’s Caring Science in practice. They also corresponded with mindfulness practice in the tradition of Thich Nhat Hanh.

Orature is the method that is the link to the blood memory, a calling back. This chapter is an orature of the authors' recorded conversations on how they bring life to caring within their own practices and within their own work environments. Their intention is to describe caring in keeping with indigenous ways of knowing and collective responsibility. Caring practices are relational and rooted in authenticity, accountability, antiracism, and activism. Nursing has an important opportunity to co-create wellness opportunities through relationships with indigenous peoples and respectfully engage with indigenous knowledges. The chapter represents the crossroads at which the authors' often find themselves acknowledge the gifts that they bring to the circle of nurses. Caring is a relational accountability to the self, to each other, to the nursing profession, and to creation as a part of the humanness where we reside as nurses in caring for indigenous peoples.

This chapter outlines the basic information for assessing, managing, and discharging the normal newborn. There is growing evidence to support the need for neonatal nurses to have a better understanding of the normal newborn as they care for the sick and/or preterm infant. The nurse caring for the newborn plays a unique role in not only providing care to the newborn but also in assisting in the integration of the baby into the family. Understanding of the newborn is optimized when information related to the mother and family is known. The information from the maternal history, which includes previous health issues, prenatal, intrapartum, and postpartum histories, is critical for assessing adaptation to extrauterine life. This information gives insight into the environment from which the newborn has come and therefore helps determine the nurse’s plan of care.

This Caritas Process acknowledges the mystery surrounding life itself. It challenges Caritas nurses to cultivate awareness of this mystery, and to allow/facilitate others in expressing their mystical experiences without reservation. The practice of looking deeply at simple things will cultivate caring and appreciation for the deep interconnection evident in even the most mundane things. Hebdon, Clayton, and Sitzman conducted a study to evaluate caring intentions of students who completed a massive open online course (MOOC) on mindfulness and caring. An inductive qualitative analysis approach yielded five themes with accompanying sub-themes. Sitzman, Jensen, and Chan examined the usefulness of a MOOC on caring and mindfulness to a widely varied audience that included nurses, allied health professionals and others from all over the world. The success of this MOOC illustrates the interconnectedness of humanity across distance and culture in relation to foundational human concerns like caring (Caritas Process 10).

Nurses who regularly work with people who are dying know that there is always a last dose, a last meal, a last word, a last breath. Although caring for dying patients and their loved ones offers nurses a chance to develop and provide sustaining memories at the most vulnerable times in people’s lives, many nurses are not equipped with the necessary skills to deal with dying and death. There are many purposeful actions that can be taken to help one feel more prepared to care for the dying and their loved ones. The patient whose life nurses are trying to save, even if futile, the one with all of the life-saving and life-preserving procedures, equipment, and medication, is perceived to be higher acuity than the patient who we have accepted is in his or her final hours or days transitioning from life to death.