What are nurse caring behaviors?

  • defining care and caring in nursing has been considered difficult, ambiguous, and elusive
  • caring may be used as a noun, verb, and adjective.
  • there is no agreement among researchers on a definition of care, caring, and caring behaviors5
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Caring behaviors defined

In the literature, there have been many attempts to define caring behaviors. Listed here are a few from over the years.

According to Kibret et al. (2022), nurse caring behaviors are:
  • an act
  • a behavior
  • mannerisms
  • enacted by professional nurses
  • convey concern
  • safety
  • give attention to patients6
Salimi & Azimpour (2013) suggested that caring behaviors are:
  • concerned with the patient's well-being
  • being sensitive, comforting, and nonjudgemental
  • include attentive listening
  • being honest with patients7
According to Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health (2003), caring is:
  • an interpersonal process
  • involves emotional commitments
  • advocates for the patient
  • a moral reflection but does not necessarily have a central moral principle.
  • the bioethics of caring focus on relationships, responsibilities, fidelity, and sensitivity
  • the emphasis is on what the healthcare provider does
  • how actions are performed, what motivates them, what underlies them and whether they promote or hinder a positive relationship8
Cronin and Harrison (1988) define nurse caring behaviors as...
  • the things that nurses say or do which communicate caring to a patient9
Larson (1983) defined nurse caring behaviors:
  • as acts, mannerism, and how the nurse acts as a professional nurse
  • conveys concern, safety, attention, and feeling cared for to the patient
  • a sensation of well-being
  • is the result of enacted behaviors10

28 million+

Nurses globally

Nurses account for 50%

of the global healthcare workforce

Knowing in nursing

Knowing in nursing:

  • is a dynamic process
  • is the result of personal reflection
  • is transformation
  • occurs due to experiences, awareness, and reflections


  • is the science of nursing
  • arise from systematic inquiry (experimental, naturalistic, or observational)
  • scientific studies that can be supported by evidence
  • evidence-based practice19
  • nurses demonstrate empirical knowing at the practice level and perform activities competently20


  • is being aware of the whole person
  • imitative learning and accumulation
  • is an awareness of the immediate situation
  • may be gained subjectively through observation
  • transformed into skills used in practice
  • transforms intuitive knowing (called the art of nursing)
  • expressed through empathy, appreciation, and inspiration
  • includes use of therapeutic self
  • due to enhanced perceptual sensibility21

Personal knowledge

  • interpersonal process
  • self-awareness: awareness, knowledge, and understanding about personal characteristics of self and others
  • put aside biases and prejudices about the patient
  • reflection
  • therapeutic use of self
  • building therapeutic relationship4


  • moral code that guides nursing conduct
  • respect for human life
  • obligations of what should be done to support life, lessen suffering, and promote health
  • justice, integrity, dignity, advocacy, and respect4

Emancipatory knowing

  • recognize and understanding social and political problems
  • create environments to promote health and well-being
  • remove barriers (social injustices and inequities) to change and improve lives21

A brief history

Florence Nightengale

  • was a nurse during the Crimean War (1853-1856)
  • is credited with facilitating views on the basic foundations for nursing practice
  • suggested that caring is a fundamental element of nursing practice
  • a moral disposition was essential for nurses22
  • nurse must use their brain, heart, and hands to create a healing environment
  • provide fresh air, pure water, food/nutrition, efficient drainage, cleanliness, and light for the patient’s body, mind, and sprit
  • defined caring as nursing’s most important work23

During the American Civil War (1861-1865) nurse caring was valued and was considered to be a labor of love.

American Civil War nurse caring provided

  • a foundation for examining American nurse caring in other periods
  • revealed the phenomenon of nurse caring, cultural and social forces that have shaped American nursing24

Post Civil War, nurses were being trained.24

In 1926, the American Nurses Association Code of Ethics for Nurses was developed and adopted in 1950:

  • nurses practice caring with compassion and
  • respect for everyone
  • alleviate human suffering

Post World War II (1939-1945) there was

  • an increase in technology in medicine
  • nursing looked at caring and technology24

In the late 1970s, there was an increase in nurse caring

  • theories
  • publications24

In the mid to late twentieth century, nursing care shifted from a

  • mechanistic paradigm
  • to a caring-healing paradigm25

In 1995, the American Nurses Association revised its definition and policy statement of nursing, to include caring.

Caring first emerged as a concept of interest to nurses during the 1950s.26

Leininger  (1984, 1988)

  • was anthropologist
  • in the 1960s coined the concept of culturally congruent care
  • developed Theory of Culture Care diversity and universality
  • different cultures have different caring behaviors, different health and illness values, beliefs, and patterns of behaviors
  • caring is the essence of humanity
  • caring is essential for human growth and survival
  • caring is the central focus of nursing
  • nursing is a learned humanistic and scientific professions and discipline
  • nursing is focused on human care phenomena and activities to assist, support, and to facilitate a person/groups to maintain/regain their well-being/health in a culturally meaningful and beneficial way, to help face handicaps or death27

Leininger’s theory helped to define the nurse patient relationship. The nurse is the one who implements care and is caring for the patient’s.28

At about the same time, caring was termed as the essence and core of nursing.29

In the 1970s, Mayeroff identified philosophical aspects of caring:

  • knowing, trust, patience, honesty, humility, hope, and courage.30
  • three components of a caring relationship:
    - respect for another
    - relating through mutual trust
    - the transformation of the relationship31

Watson (1979) developed her theory, the Transpersonal Caring Theory

  • considered caring as the core of her work
  • caring is what nurses do,  nurses are ethical, and care for patients out of a sense of duty or moral obligation32
  • stated that “individually and collectively the nursing profession has a role to play in offering and sustaining collective acts of caring that have important consequences for human civilization”
  • placed emphasis on the nurse-patient relationship
  • developed 10 carative factors or cores of caring: humanistic-altruistic system of value; enabling faith; cultivation of sensitivity to self and other; helping-trusting, human care relationship; expressing positive and negative feelings; creative problem-solving caring process; transpersonal teaching-learning; supportive, protective, and or corrective mental, physical, societal, and spiritual environment; human needs assistance; and existential-phenomenological-spiritual forces.32
  • Watson created the Watson Caring Science Institute n 2008 to advance caring and healing in the healthcare system

In 1978, the first National Caring Research Conference was organized.

In 1988, the group became known as the International Association for Human Caring..

  • developed core philosophy
  • belief that caring is the essence of nursing
  • caring is unique and unifying focus of nursing33

In 1988 the term was first added to nursing’s core data base the Cumulative Index of Nursing and Allied Health (CINHAL).34

In 1991, paradigms for nursing practice were identified

  • particulate deterministic
  • interactive-integrative
  • unitary transformative
  • actualized caring across a continuum
  • focused on personal caring values within a worldview
  • since 2008, nurse caring approaches include holism and whole-person caring35

Boykin & Schoenhofer (1993) Theory of Nursing Caring

  • assumes that all persons are caring
  • assumptions include: persons are caring by virtue and humanness; persons are caring’ persons are whole; personhood is a process of living grounded in caring; personhood is enhanced through participating in nurturing; and nursing is a discipline and a profession36

Swanson’s (1991, 1999) middle range caring theory

  • is based on the idea that nurses demonstrating they care about patients
  • is concerned with patient well-being
  • includes clinical activities37

It considers and cares for the whole person and is the foundation for better healing and better care. It was used to define the care of patients and families.

  • contains 5 subcategories: knowing, being with, doing for, enabling, and maintaining belief38

In the 1990s, professional caring relationships that developed from affection and concern became important.39

Sister Simone Roach’s Theory on Caring

  • considered caring and its components to be moral virtues40
  • defines caring as the human mode of being (1992)
  • defines nursing as the professionalization of human care
  • caring is manifested through the 6Cs or behaviors of caring: compassion, competence, confidence, conscience, commitment and comportment.
  • knowledge, skills and experience that make caring unique41

Current research

April 27, 2023

Staff Nurses' Perceptions of Nurse Manager Caring Behaviors

As healthcare administration becomes more complex and financial challenges continue, the ability of nurse managers to lead patient care environments that...

April 27, 2023

The Patient Experience and Patient Satisfaction: Measurement of a Complex Dynamic

The concept of patient experience is surprisingly complex and generally linked with patient satisfaction. As reimbursement and performance policies have...

April 27, 2023

Increasing Quality and Patient Outcomes with Staff Engagement and Shared Governance

The shared governance structure is a nursing practice model which is a hallmark of engaging the front line team into the role of leading practice excellence...