Online instruction has been approached with caution by nursing. Concerns range from unfamiliarity with online pedagogy to the potential for decreased student connectedness. Being unfamiliar with the online format can be overcome through a series of self-training, taking courses online, and dedication to the process. Student connectedness is basic to nursing and a caring and compassionate profession. It has been argued that an online format will create an atmosphere of disconnectedness and isolation. To combat this disconnectedness and isolation, an atmosphere of caring is required in the online classroom. This article considers the basics of both creating an atmosphere of caring and concepts that support the online pedagogy. Caring is the essence of nursing and should be conveyed in the instruction of nurses. Online instruction can facilitate a caring atmosphere, when done properly, and promote growth for student nurses. Grounding this notion is a brief discussion of various nursing concepts and theories on caring, and how the key elements of some of these theories relate directly to the outcomes of online instruction. In addition to the concept of caring and relating this to online instruction, a connection to the supporting concepts of trust and professional nurse autonomy are intimately connecting to caring and online instruction. This connection illustrates the foundational results of online instruction and how these are indeed the same elements of the concept of caring.
Background: Caring Theory And Concept
Caring is the very essence of nursing (Watson, 1999). A caring atmosphere demonstrates to student nurses the importance of caring in all aspects of nursing practice, including nursing courses. In a meta-analysis of theories of caring in nursing, McCance, McKenna and Boore (1999) discuss the work of Leininger, Watson, Roach, and Boykin and Schoenhofer. They conclude that a human element is present in all of these theories. Roach focuses on the five Cs of caring; compassion, competence, confidence, conscience, and commitment (McCance et al., 1999). Boykin and Schoenhofer stress the importance of truly knowing another, as well as identifying unique forms of caring (McCance et al., 1999). The concepts outlined by Boykin and Schoenhofer, as well as Roach, connect nicely with online instruction.
In addition to the theories of caring, studies of how students learn and perceive caring in nursing have been studied. The students identified caring as a process, and as a connection through lived experiences (Wilkin & Slevin, 2003). Watson and Lea (1997) quantitatively define caring with their caring dimensions inventory [CDI], and specifically found a high level of validity and reliability to items that relate to the connectedness achieved in both patient-nurse relationships, and these coincide with the online faculty-student, student-student relationships. These items were “listening to the patient,” “getting to know the patient as a person,” “involving the patient with his or her care,” and “explaining a clinical procedure” (Watson & Lea, 1997, pp. 88, 91). These are all items that are important aspects to caring in nursing, and can translate well to the online instructional environment.
Key Terms in this Chapter
Mentor: Someone who guides another to excel.
Professional Nurse Autonomy: “A belief in the centrality of the client when making responsible discretionary decisions, both independently and interdependently, that reflect advocacy for the client” (Wade, 1999, p. 310).
Caring: The human element of a nursing interaction or act that include compassion, competence, confidence, conscience, and commitment.
Competence: “The state of having the knowledge, judgment, skills, energy, experience and motivation required to respond adequately” (McCanceet al., 1999, p. 1391).
Trust: A relationship between individuals or a group of individuals that includes a dependency on another individual to have a need met or a choice or willingness to take some risk as a part of the relationship.
Compassion: “A way of living born out of an awareness of one’s relationship to all living creatures…a quality of presence which allows one to share with and make room for the other” (McCance et al., 1999, p. 1391).
Connectedness: The feeling of being linked to or joined with an individual or group of individuals; this feeling is associated with the building of a relationship.