Introduction
In Nursing, person as caring is living caring uniquely and growing in caring in the moment, a person actively relating, participating, and experiencing the world. One avenue for coming to know the person as caring is the lens of technology. The viewpoints we offer here are grounded in two related nursing theoretical perspectives: Nursing As Caring (Boykin & Schoenhofer, 1993, 2001) and Technological Competency as Caring in Nursing (TCCN) (Locsin, 2005).
In Nursing As Caring (Boykin & Schoenhofer, 2001), we say that persons are caring because of their humanness. Persons are caring because, as Roach (1992) says, it is the human mode of being. Thus, persons are caring “period.” We have been thinking about this topic and realized that we would not want the nursing world to get into a “caring/noncaring” viewpoint; instead, we want them to recognize and relate to each person as caring person. We say that persons are caring because Leininger (1988) also says that caring is a distinguishing feature of a person. We say that persons have the capacity to grow in caring. Paterson and Zderad (1984) talk about “more being” - and if caring is the human mode of being, then “more being” means growing in caring.
What is caring? Loving, acting out of humanistic love in many ways, demonstrates that love, caring, is the gift of nursing. We would not want to make statements that would back us into a corner. Just some thoughts…that lean toward not going out on too many limbs trying to “define” what is meant by caring person. Rather, we work to communicate the lived meaning of caring, including recognizing ways in which caring may be lived in various cultures, for example, the Philippine “kapwa” (Enriquez, 1978) and the African/Nigerian “Ubuntu” (Kerkhof, 2024), culturally relevant ways of persons living caring.
How do caring, knowing, and technology come together in Nursing? Mayeroff (1971) lists knowing as one of the ingredients of caring. In his terms, knowing considers “knowing about” and “knowing directly.” Knowing as an ingredient of caring encompasses knowledge of empirical facts and circumstances as well as a deep awareness of person and meaning. Heidegger (1977) described technology as a means to an end, an instrument, as well as a human activity. Sandelowski (1993) cited Bush’s definition of technology as people, equipment, and procedures in established patterns of interactions for the purpose of accomplishing human goals. Technological knowing is a way of knowing in nursing, engaging the competent use of technologies of care to get to know patients as a whole. Caring, knowing, and technology come together in Nursing as explicated in TCCN (Locsin, 2005).
In the Nursing As Caring theory, nurses accept the privilege and duty of knowing their patients as caring persons. This commitment is not necessarily automatic nor easy, but as a central duty and privilege of nursing, to effectively provide the human service known as nursing, the nurse must make the effort to recognize the person as caring. Accomplishing this commitment requires intentionality and deliberate study to broaden our insights into an extensive range of ways of caring.
“Knowing person as caring” is the process of nursing grounded in the TCCN theory (Locsin, 2005). It illustrates theory-informed nursing practice, occurring in nursing situations presenting the opportunity as processes of technological knowing, mutual designing, and participative engaging (Locsin & Purnell, 2015) to expertly illuminate nursing persons within the Universal Technological Domain (UTD). This practice of nursing allows nurses to realize that persons are known as caring persons who live caring and grow in caring uniquely in the moment, and are participating and experiencing the world as caring persons.
A crucial element in the theory of TCCN is this: “the ultimate purpose of technology is to know persons more fully as caring.” This element is often misunderstood as simply using technology to know the “status” of the patient who is whole and complete person; however, understanding the whole person as caring through technology is more than knowing the “health state” of the person. It is knowing the person as caring, actively relating, participating, and experiencing the world. Given the dominant role of technology in healthcare today, a thorough understanding of this position can help nurses grasp the fullness of the professional service called Nursing – caring as the core action of that service.
The purpose of this editorial is to clarify the critical element of “knowing persons as caring through technology,” as more than knowing the health status of the person, and to fully understand nursing as knowing persons more fully as caring person.
Reclaiming the Person as Caring Through Technological Knowing
When we were invited to review a survey instrument designed to measure technological competency as caring in nursing, we noticed that “person” was consistently referred to as whole and complete, but not characterized as caring. However, the middle range theory of TCCN (Locsin, 2005; Locsin & Purnell, 2015), substantively influenced by the theory of Nursing As Caring (Boykin & Schoenhofer, 1993, 2001), consistently acknowledges caring as a key attribute of person. Therefore, it is essential that when using the lens of Nursing As Caring and TCCN, to speak of the person being cared for as whole and complete in the moment, living caring uniquely and capable of growing in caring, actively participating/relating and experiencing the world as caring person.
The practice of nursing is personal, even when nursing is accomplished through technological modes of caring. Thus, using impersonal language sometimes heard in healthcare settings diminishes the fundamental nature of nursing as caring. For example, language like “knowledge of a person’s health status” is a distancing, depersonalizing language, concealing the true intent of nursing. Knowing the person as caring, as whole and complete in the moment, is more than merely knowing the patient’s status; it is knowing the patient as person who is living caring uniquely in the moment, and capable of growing in caring in “personal” ways that matter to the person.
So, how does technological knowing fit into this picture? As an integral component of knowing persons as caring, technological knowing is more than knowing laboratory and instrument readings. Physical monitoring devices tell us more than the person’s health status – they tell us something about how the person is experiencing the world, about the person’s relationship with the world in the moment. Thus, in addition to knowing indicators of norm-based impersonal health status, nurses can use those indicators to help us know how the person is living caring in the situation, how the person is being in relation to the situation in context.
Zeroing in on “status” dilutes the meaning of the theory of TCCN (Locsin, 2005), separating physical parameters from “being,” from “living caring uniquely.” For example, when a person’s temperature or blood pressure is elevated, or white blood cell count is low, those numbers are more fully interpreted as the person communicating a sense of existential threat or employing physiological systems for self-caring.
Our purpose here is to clarify the understanding that knowing the person through technology is more than knowing the person’s status, emphasizing the larger theoretical purpose underpinning the practice process of “technological knowing-persons-as-caring.” The use of devices and other forms of instrumental technology is directed towards knowing something about the person’s experience of being in the world, a way of intentionally knowing the person as caring person who remains whole and complete in the moment.
The perspective that physical readings are ways persons are communicating something about how they are living caring in the moment is a perspective advocated in the theories of Nursing As Caring and Technological Competency as Caring in Nursing. In knowing persons as caring, technological knowing involving the appreciation that all technology monitoring device readings are of value in human – not just physical – terms. What the results (descriptive numbers or words, for example) are trying to tell us are about how the person is living caring in the moment, and what calls for caring nurturance are being communicated in the moment.
Through the TCCN practice processes of technological knowing, mutual designing and participative engaging, the nurse enters the world of the nursed to intentionally know the other as caring person in the moment, to hear calls for caring, and to respond with effective ways of caring. Therefore, in Nursing, living caring and growing in caring uniquely in the moment is knowing the person as caring person actively participating, relating, experiencing the world. The importance of this understanding is that, rather than considering technology as something “other than nursing”, nurses can realize that the use of technologies in healthcare can and should be incorporated into the heart of nursing as caring.
Acknowledgment
None.
Funding Statement
FUNDing The authors received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Declaration of Conflicting Interest
No conflict of interest to declare.
Authors’ Contributions
RCL contributed to the manuscript’s conception and design, data acquisition, and data analysis, wrote the first draft of the manuscript, revised the final draft, and gave final approval of the version to be published. SOS contributed to the manuscript’s consequent content, design, additional data, analysis, and wrote and edited the subsequent draft of the manuscript, and gave final approval of the article.
Authors’ Biographies
Rozzano C. Locsin, RN, PhD, FAAN is Professor Emeritus at Florida Atlantic University, Christine E. Lynn College of Nursing, Boca Raton, Florida, USA.
Savina O. Schoenhofer, RN; PhD is a Nurse Consultant and is currently a member of the Anne Boykin Institute, Florida Atlantic University, Boca Raton, Florida.
Data Availability
Not applicable as no datasets were generated or analyzed.
Ethical Consideration
Not applicable.
Declaration of Use of AI in Scientific Writing
None to declare.
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Associated Data
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Data Availability Statement
Not applicable as no datasets were generated or analyzed.