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Advancing the Theory of Technological Competency As Caring in Nursing: the Universal Technological Domain Rozzano C

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Advancing the Theory of Technological Competency As Caring in Nursing: the Universal Technological Domain Rozzano C Advancing the Theory of Technological Competency as Caring in Nursing: The Universal Technological Domain Rozzano C. Locsin, RN, PhD, FAAN, Florida Atlantic University and Tokushima University; Marguerite Purnell, RN, PhD, AHN-BC, Florida Atlantic University Abstract related groups (DRGs), instead of their expert, Sophisticated technologies are accepted as integral with contemporary life, occupying a nursing appraisals for human care. The threat to universal technological domain that is coextensive with humans and their environment . preserving humanness is constant. Nurses often In human healthcare, the risk for depersonalization of persons receiving care renders the lose the view of the person as natural and whole. preservation of humanness as essential, particularly in technology-dense arenas . Nurses Practicing within the theoretic lens of the TCCN are challenged to sustain their caring nursing practice while responding to the complex in Nursing allows nurses to reclaim this technological demands of modern healthcare . This paper explicates a further development fundamental value: Nurses are able to see the of the theory of technological competency as caring in nursing (TCCN) that embraces the person as whole again. universal domain of technology . Within the theoretic lens of the TCCN, 3 key elements Against the backdrop of technological demonstrate the fundamental process of knowing persons within the universal technological dominance and dependency in healthcare and domain: technological knowing, designing, and participative engaging . Underpinning this the imperative in nursing education to advance process of nursing are concepts of human naturalness, human wholeness, and nursing theory-based practice, the following question is technology connoisseurship . From the perspective of the TCCN, the nurse appreciates and cogent: Can a theory-based practice of nursing knows persons more fully as active participants in their care rather than as passive recipients preserve humanness in an overwhelmingly of care, and thereby advances the preservation of humanness . technological world of human healthcare? Preservation of humanness in contemporary and future nursing practice is essential to maintain Keywords: technological knowing, human and caring. This practice theory is focused the critical value, meaning, and practice of naturalness, technological connoisseurship, on “knowing persons,” with key elements of human healthcare. universal technological domain, human technological knowing, designing, and naturalness, human wholeness participative engaging. Purposes Nurse satisfaction with enacting theory-based The purposes of this theoretical paper are, Introduction nursing through technological knowing is (a) to explicate the nursing practice process of Sophisticated technologies are now accepted envisioned to contribute to improved nurse knowing persons within the theoretic lens of the as integral with contemporary life, occupying a retention in high tech environments. Through the TCCN (Locsin, 2001, 2005, 2009, 2010; Locsin universal technological domain (Figure 1) that is theory of TCCN, nurses can more easily bridge & Barnard, 2007), and (b) to describe the coextensive with humans and their environment. the advancing world of technology while practice implications of maintaining humanness This paper explicates further development of the preserving the humanness of their patients. in a technological healthcare environment, in theory of technological competency as caring in Patient satisfaction as an outcome of enhanced which the technological environments of persons nursing (TCCN) that embraces the universal practice grounded in the theory affirms nursing are coextensive, coexisting, and cocreated domain of technology, a contemporary reality. In as a professional practice that fosters ideal (Purnell, 2005) within the universal technological healthcare, specialized technologies are patient well-being. domain (Figure 1). ubiquitous and routinely infiltrate all environments The concept of humanness that is often of care. The risk for depersonalization of persons Background reflected in healthcare is an essential ingredient receiving care is great and renders the The issue of preserving humanness may well in the practice of nursing grounded in caring. preservation of humanness as essential in be an increasing concern in modern society. In Critical to preserving humanness in nursing technology dense healthcare arenas. Nurses are healthcare, particularly, the need is critical to practice is the theoretic lens of the nurse. As challenged to sustain their caring nursing preserve humanness amid the saturation of human healthcare technologies facilitate the practice while attempting to respond to the routinely invasive technologies of care. Nowhere realization of efficient and quality nursing, it befits complex and competing technological demands is this felt more keenly than in nursing practice, nurses to practice their nursing caring, rooted of modern day healthcare. A theory of nursing where nurses are faced with enacting caring as and grounded in an explicit theory of nursing. that is focused on knowing persons across the foundational to their practice within a “high tech” Persons are living human beings who have universal technological domain is crucial to aid milieu stretching from hospitals and other primary hopes, dreams, and aspirations (Boykin & nurses in their practice and help preserve the care institutions, to the home. Schoenhofer, 2001). Human beings have the humanness of the persons in their care. For nurses practicing in high-technological capacity to think, imagine, innovate, and create, Within this domain, expert nurses are environments, the tension is palpable between and are unpredictable. Within the high-tech informed through the process of technological the need to preserve humanness through caring nursing situation, the liminal, dynamic space of knowing in nursing. The view of competent nurturance and the demands of the technology the technological environment (Figure 1) in which nurses as technological connoisseurs, especially for attention, interpretation, and action. opportunities for human caring become manifest in “high tech” arenas, is celebrated with their Polkinghorne (2004) notes that “technification” and evolve, the question of how technology expertise grounded in technological knowing. (p. 25) occurs when the technological worldview facilitates the nurse’s knowing of the person This enables them to fully know their patients as has thoroughly permeated culture where the challenges understandings of how persons, persons and to realize the value of their skilled scientific method serves as a basis for thinking. in their humanness, come to know each other nursing practice. The TCCN (Locsin, 2005) is the Nurses operate under the tension-filled dictums naturally, without technological artifice or tool. only middle-range nursing theory that specifically of improving cost effective outcomes based on These philosophical and disciplinary questions addresses technological knowing within the prescriptive, measurable strategies, and reducing are bound up in the realities of practice: As harmonious coexistence of nursing, technology, hospital stays for patients according to diagnostic technological connoisseurs, expert nurses are 50 International Journal for Human Caring Advancing the Theory of Technological Competency as Caring in Nursing: The Universal Technological Domain so skilled as to make the technology seem their care, rather than simply as objects demonstration of intentional, deliberate, and invisible and almost natural. They are at one of care. authentic encounters of knowing persons in with their technological environment. • Nursing as a discipline and a technologically demanding nursing practice professional practice (Boykin & settings, particularly those in environments The Theory of Technological Competency Schoenhofer, 2001) provides the essential requiring specialized and substantial as Caring in Nursing opportunity for engagement in the technological expertise. From the perspective Technology, wherever and in whatever scholarship of practice grounded in caring of the theory, three multidimensional elements environment it is embedded, can result in within the universal technological domain. serve to guide nurses in their practice. These mediating and transforming the dimensions These assumptions provide essential elements inform each other as aspects of a and quality of care for the nurse and the person elements of the theory of TCCN that guide the whole, and are described as technological being nursed. A realistic practice model for nurse in the practice of nursing as knowing knowing, designing, and participative engaging. contemporary nursing is one in which persons as wholes through the proficient use technological competency is expressed as caring of technologies for human care. Technological Technological Knowing in nursing (Locsin, 2005, 2009, 2010). According knowing (Locsin, 2009) is a way of understanding Technological knowing is the shaping of to the TCCN (2005), being technologically persons through the use of technologies of deliberate understanding of persons guided by competent is being caring. Clearly, it matters health and human care and provides nurses the revelations of technology. In this process, whether or not the expert nurse is competent an “other” way of knowing persons. the understanding of the person is magnified in the use of care technologies. The following five
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