Caring Based Nursing Leadership Revisited

Guest Blogger – Dr. Anne Boykin

The other day, a colleague mentioned to me that she felt that caring based nursing leadership is needed in today’s environment more than ever. I am republishing a guest blog written a number of years ago by Dr. Anne Boykin.

Anne is former Dean and Professor Emeritus in the Christine E. Lynn College of Nursing at Florida Atlantic University in Boca Raton Florida. Dr. Boykin is recognized internationally and nationally for her scholarship on Caring. She has co-authored and edited several books including Nursing as Caring:A Model for Transforming Practice and Living a Caring Based Program. She has also authored numerous book chapters and articles focused on caring, spirituality, nursing as a discipline and story as method for study of nursing. Dr. Boykin is past President of the International Association for Human Caring, and has served as a member of several boards at the international, national, state and local levels. She is retired and serves as consultant on nursing, nursing theory and transforming healthcare environments. She founded the Anne Boykin Institute for the advancement of caring.

What is Caring-Based Nursing Leadership?

Caring-based nursing leadership is a commitment by nurse leaders to use caring to guide all decisions that he or she makes with the intention to create, maintain and sustain environments where nurses can truly nurse. In these environments, nurses feel nurtured and are able to respond to the calls for nursing in their unique way. To do this, nurse leaders must be grounded in caring values and directly connected to the stories of nurses at the bedside.

Developing Oneself as a Caring Nursing Leader

Most nurses do think that caring is the essence of our discipline. As I began my own journey in the study of caring, I never really understood what that meant. I knew that for me, caring was an essential domain for nursing that needed to be studied. It is hard to talk about knowing others as caring until we really understand what it means to know ourselves as caring. I found that Mayeroff’s book On Caring helped me to reflect on what caring is and how I live it as a leader. It helped me ask important questions about the ingredients discussed by Mayeroff such as:

How do I live my knowing?
How do I live my trust?
How do I live my courage?
How do I live my humility every day?
How do I live hope?
How do I live patience?

When we see colleagues, it is important to try and have a lens that’s not ever about judging others but it’s about trying to know the other as caring person. When we see things, we may feel tempted to label behaviors or actions. If instead we come from the lens of caring, we come to understand what we see as a different expression of caring. When we are able to create an environment that honors and respects others and once this is very explicit, it enables us to set expectations about how we expect our staff to be. We can then call out and try to understand things that don’t reflect that. Being able to ask questions such as Help me to know, Help me to understand how this reflects caring is important. It needs to be done in a way that honors the knowing of others and establishes a culture of caring in the organization.

In my work, I use the symbol of the Dance of Caring Persons. It is simply a circle with various people coming and going in this circle, but the commonness is everybody in that circle is there with the commitment to the person being care for. And so everybody in that circle brings special gifts to the work that they do to make that care experience the best possible.

The Impact of Caring-Based Leadership

One thing that I’ve learned through my research ,which will sound familiar to those of you in practice, is when you watch nurses practicing today you often see nurses running in and out of rooms. There is a lack of time, and the things that are paid attention to are tasks. One of the most important roles of a nurse leader is to help practicing nurses re-engage in the soul of nursing. This can happen when nurse leaders take the time to listen to the stories of their nurses. If a nurse says that they don’t have time to get the stories, then the nurse leader’s responsibility is to help them to reframe what they do when they go in a person’s room so that they are always nursing. I may walk into Mr. Jones room with these things to do, but my reason for being there as nurse is to offer my caring service while I do these things. My reason for being there as nurse is to understand the story of the person entrusted to my care so that I can respond to what matters most to that person, because that is why I am there as a nurse.

Helping staff to share their stories is a way that nurse leaders can help keep that focus of nursing alive, and remain connected to nurses at the bedside from a distance. It helps nurse leaders to know their happiness and reminds them why they became a nurse. We want to help our nurses and ourselves to think about every action that we take, and ask whether it is grounded in caring and are we living out a caring value. If not, what ought I to be doing? When nurses are able to do this, their satisfaction improves and the satisfaction of their patient is also higher.

To grow on their leadership journey, emerging nursing leaders should spend time and study the literature on caring in nursing administration. It is an essential domain of nursing knowledge, which most of us never studied in school yet can reconnect us to our discipline and make our careers as leaders much more satisfying.

Interview with Dr. Anne Boykin – An Audio Interview

Read to Lead

Boykin, A., & Schoenhofer, S.O. (2001). Nursing as caring: A model for transforming practice. Sudbury, CT: Jones & Bartlett Publications.

Pross, E., Boykin, A., & Rigg, C., (2011). Transforming an organization through caring values. Nursing Management, October, 25-30.

Boykin, A., & Schoenhofer, S. O. (2001). The role of nursing leadership in creating caring environments in health care delivery systems. Nursing Administration Quarterly, 25(3), 1-7.

Mayerhoff, M. (1990). On Caring. New York: HarperCollins Publishers.