Human beings with unmet needs related to their health and illnesses are the central focus of the domain of nursing. It is proposed in this column that nurses who conduct their practice from a nursing theory base, while assisting individuals and families to meet their health needs, are more likely to provide comprehensive, individualized care that exemplifies best practices. The Neuman systems model has been widely acclaimed to guide practice, yet specific examples are few in the published literature. The purpose of this column is to present two case studies based upon Neuman systems model; one case is directed toward family care, and the other demonstrates care with an individual. Theory-based exemplars serve as teaching tools for students and practicing nurses. These case studies illustrate how nurses' actions, directed by Neuman's wholistic principles, integrate evidence-based practice and generate high quality care.

Thesis advisor: Jane M. Flanagan / Purpose: The purpose of this study was to explore nurses’ experiences of Watson’s Theory of Human Caring Caritas Process Three: Cultivation of One’s Own Spiritual Practices and Transpersonal Self, Beyond Ego-Self. Background: There is currently an inadequacy of spiritual care provided to patients and families in the ICU despite a significant articulated need. Nurses report discomfort with and a lack of preparation in providing spiritual care competently. Nurses with strong personal spiritual development are more likely to report comfort with spiritual caregiving and provide spiritual care. Watson’s Theory of Human Caring Caritas Process Three; Cultivation of One’s Own Spiritual Practice and Transpersonal Self, Going Beyond Ego-Self makes explicit the primacy of relationship between nurse spiritual development and transpersonal spiritual nursing care. However, the nature of spiritual development of nurses in the ICU remains unknown. Methods: A qualitative descriptive methodology with directed content analysis applying Watson’s Caritas Process Three was used to analyze data for this study. Results: Ten ICU Nurses provided evidence of the experience of Caritas Process Three. Five themes were identified in the analysis of data: Caritas nurses vary in their ability to move beyond ego-self, Personal spiritual practices serve as a barrier and/or facilitator to nurses’ ability to provide spiritual care, Critical illness as experienced by patients and families provided the opportunity for nurses to explore spirituality with other, The care environment serves as a barrier and/or facilitator to nurses’ personal spiritual growth, and Cultivation of spiritual practice and spiritual identity is integral to a life-long process of consciousness evolution. Conclusions: The findings of this study extend and inform Caritas Process Three of Watson’s Theory of Human Caring. Nurses in this study provide evidence for the primacy of personal spiritual development for the delivery of spiritual and transpersonal care for patients in the ICU. / Thesis (PhD) — Boston College, 2019. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.