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Caritas Coaches at UHealth: Bringing Caring Science to Patient Care

Nursing Professional Practice Model (PPM)

The nurses at UHealth have a deep-rooted commitment to transforming the health of patients and their families and the communities we serve. With remarkable resilience and compassion, the Department of Nursing demonstrates collaborative, holistic personal caring to others with purpose, cultural humility, and intentionality. These values are the essence of the Caring Science Theory developed by Dr. Jean Watson, and the nurses at UHealth have selected the Caring Science theory as their framework for practice. UHealth has become a proud and active leader in Caring Science and is one of approximately 15 organizations nationally designated a Caring Science affiliate of the Watson Caring Science Institute. Dr. Elizabeth Vieito-Smith’s vision for the Department of Nursing and Caring Science are closely aligned. With pride, Vieito-Smith stated, “we know that caring, compassionate nursing care is personally and professionally enriching, and our efforts to underpin nursing practice with Caring Science has brought a new level of teamwork, presence, and authenticity to our work. Each nurse leader has recently completed The Caritas Leadership program.”

The essence of Caring Science is embedded in ten Caritas Processes:

  1. Sustaining humanistic-altruistic values by practice of loving-kindness, compassion, and equanimity with self/others.
  2. Being authentically present, enabling faith/hope/belief system; honoring subjective inner, life-world of self/others.
  3. Being sensitive to self and others by cultivating own spiritual practices; beyond ego self to transpersonal presence.
  4. Developing and sustaining loving, trusting-caring relationships.
  5. Allowing for expression of positive and negative feelings - authentically listening to another person's story.
  6. Creatively problem-solving-'solution-seeking' through caring process; full use of self and artistry of caring-healing practices via use of all ways of knowing/being/doing/becoming.
  7. Engaging in transpersonal teaching and learning within context of caring relationship; staying within other's frame of reference-shift toward coaching model for expanded health/wellness.
  8. Creating a healing environment at all levels; subtle environment for energetic authentic caring presence.
  9. Reverentially assisting with basic needs as sacred acts, touching mindbodyspirit of spirit of other; sustaining human dignity.
  10. Opening to spiritual, mystery, unknowns-allowing for miracles.(Watson Caring

The theory for practice work began with a scholarly gap assessment of caring practices throughout the organization. The analysis will serve as a basis for implementing nursing interventions that promote and respect the sacred space of transpersonal caring at the bedside. Hilda Brito, MSN, RN, NPD-BC, Executive Director of Professional Development, and Deborah Piehl, MSN, RN, Executive Director of Professional Practice, organized the assessment and shared their work as a poster presentation for the completion of their Caritas Coach Education Program in March 2021.

“Caritas Coaches”- staff nurses and nurse leaders across the organization- are studying the philosophies of caring science through a unique six-month professional development program. The program will be ongoing and encourages nurses interested in the transpersonal, transformative, mind-body-spirit care within the healing environment to become involved. The Caritas Coaches give voice and help translate caring science into their practice setting and are the essence for system adoption of Caring Science as the UHealth framework for practice.

Sylvia Mendez, BSN, RN, CPHON, CPN, Nurse Specialist in Pediatric Hematology and Oncology, is one of UHealth’s Caritas Coaches. She speaks openly and with ease about its influence on both her personal wellbeing and on the patient care she delivers, “it has been an incredible six months of personal work and growth, and I have no doubt that it has strengthened my capacity to be authentically present every day, for every patient.” As a Caritas Coach, Mendez implemented a project at the Daly Family Clinic for Childhood Cancer & Blood Disorders to educate the staff about Caring Science, including transpersonal caring and providing an overview of the 10 Caritas Processes. The objective was to increase the integration of Caring Science into the staff’s daily care to create an environment that helps the patient heal physically and spiritually by developing transpersonal relationships.

Jeannette Garcia Slanker, MSN, APRN, FNP, PMHNP, CPON® Associate Chief Nursing Officer, shared that oncology staff “now share a caring narrative at staff meetings and discuss the encounter in the framework of the Caritas Processes.” Dr. Smith added, “We encourage these types of reflective practice activities throughout the Department of Nursing so that Caring Science is visible and tangible.”

Mendez and Slanker join Hilda Brito, MSN, RN, NPD-BC; Olga-Maria Diaz, Mona El-Shazly, Marcia Johnson, Javier Marcelo, Debbie Piehl, MSN-Adm/Ed, RN; Cathy Rosenberg, MSN, APRN, ACNP-BC; and Elizabeth Smith, DNP, RN, as the initial Caritas Coaches at UHealth and look forward to a growing group of colleagues to share in the work of Caring Science. Stephanie Ahmed, DNP, RN, Associate Chief Executive, and the Watson Science Scholar in Residence, is mentoring the Coaches in their efforts.

In addition to enhancing the healing presence nurses commit to their patients, an essential value of Caring Science is “care of self.” As members of a profession serving humanity, “we traditionally have given to others at the sacrifice of self…we need to do better on this…If we aren’t physically and spiritually healthy ourselves, we can’t be fully present for our patients” said Cathy Rosenberg MSN, APRN, AC NP-BC, AVP of Neurological Surgery and Orthopaedics, University of Miami Hospital and Clinics UHealth Tower. “We must instill important self-care practices into our next generations of nurses,” said Hilda Brito. Brito reflected on the experience of becoming a Caritas Coach, “it has been enlightening, life-changing.” Caring Science is now incorporated into nursing orientation at UHealth, and Brito envisions it becoming a component during annual competency validation.

Over the last year, with many challenges related to the pandemic, focusing on promoting caring science served as a shared mental model for the Department of Nursing. Jean Watson recently acknowledged the efforts of the UHealth family, “During this time of upheaval and turmoil for our healthcare providers, it is refreshing to know of the committed staff nurses and their leaders at the University of Miami Health - nurses devoted to creating communities of Caring, honoring self-caring, and caring-healing for all of its staff, patients, families, and community. It is an honor and privilege to participate and support the University of Miami’s commitment to authentic Caring Science models and programs of Human Caring during this crisis-of-care era."