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Introduction

In healthcare, providing quality care extends beyond clinical proficiency; it encompasses a deep understanding of the individual's unique circumstances and an unwavering commitment to their well-being. This caring science embraces the exploration and reverence for the diverse aspects of human existence, including recognizing metaphysical elements like Spirit, the Sacred, Love, Consciousness, and Caring (Caritas) (Butcher, 2022). In the assessment, we will delve into the fundamental value assumptions discernible in the given case study and, subsequently, explore how the principles of transpersonal caring can be harnessed to enhance the quality of interactions and care delivery.

Part One

Value assumptions are fundamental beliefs about the world's present, past, or future state (Beckett et al., 2017). In the case study, we see two distinct sets of value-based assumptions: one demonstrated by the third-year nursing student and the other exhibited by the gossiping nurses. The student nurse shows respect for Kaisa's cultural background by acknowledging that she is from Thailand. This reflects the value assumption that cultural diversity should be acknowledged and respected in healthcare (Danso, 2018). The nurse approaches Kaisa with kindness and respect despite her situation. Assuming that every person deserves to be treated with dignity and without bias, this connotes a non-judgmental attitude. The nurse's emphasis on Kaisa's nursing studies and goals shows a dedication to patient-centered care. Here, it is assumed that the patient's objectives, preferences, and values should direct the treatment (Col et al., 2017). The caring attitude and emphasis on a caring-healing modality show that the nurse's approach is marked by empathy and compassion. This presumption highlights how crucial emotional connection, empathy, and comprehension are to giving effective care (Moudatsou et al., 2020). The nurse does not let the rumors and prejudices among the other nurses affect how they treat Kaisa. This implies that, regardless of a patient's circumstances or condition, all patients should receive the same care and attention.

The other nurses treat Kaisa in a stigmatizing and prejudiced manner. They spread rumors about her line of work and assume things about her sexual orientation and gender identity. This reflects a belief that particular ways of living or lines of work are morally superior or inferior, which can result in biased treatment. The nurses express a fatalistic outlook about Kaisa's condition, assuming that because she has HIV, she will inevitably die soon. This assumption ignores the advancements in HIV treatment and the potential for individuals with HIV to lead long, fulfilling lives with appropriate care and support. The nurses' comments about Kaisa's situation reveal negative stereotypes about sex work, HIV, and individuals who overstay visas. These assumptions are harmful and perpetuate social biases, leading to compromised care and a lack of empathy for Kaisa's unique circumstances (Cox et al., 2022). The other nurses do not seem to apply the principles of transpersonal teaching or consider individual needs and comprehension styles when interacting with Kaisa. This assumption neglects the importance of tailoring care and education to each patient's unique characteristics and preferences. Thus, both positive and negative value-based assumptions are observed in the case study.

Part Two

Watson's theory of Transpersonal caring entails forming a deep connection and acknowledging another person's essence or innermost being through the acts of caring and promoting healing, all within an authentic and present relationship (Devi et al., 2022). In this transpersonal relationship, the nurse's caring awareness and purposeful approach play a significant role as they step into the individual's world and are attuned to their state of existence at a profound level, reaching the soul or Spirit (Wei et al., 2021). It involves a keen emphasis on the distinctiveness of both the self and the other, as well as the distinctiveness of the current moment. This union is a shared and reciprocal experience, with each party fully immersed in the present while paradoxically being open to transcending it, welcoming new potentials.

In the case study, the principles of transpersonal caring can be implemented by forming nursing leaders known as Caring Advocates who embrace Watson's theory and can significantly enhance the interactions with Kaisa (Clark, 2016). Firstly, authentic presence can help improve interactions. Nurses should approach Kaisa with genuine sincerity, embodying the essence of caring and fostering trust instead of discriminatory behavior shown by other nurses. This aligns with the notion that caring and being cared for must be integral to nursing practice and education (Frisch & Rabinowitsch, 2019). To improve interactions, an all-encompassing nursing curriculum must be implemented in the medical ward, incorporating caring content through various methods, such as clinical practice, dialogue, modeling, and confirmation (Xiao & Men, 2022). Nurses must practice caring actions through clinical case studies, allowing them to apply theory to real-world scenarios. They can witness and learn how to perform caring interactions effectively through modeling. This approach enhances Kaisa's well-being and contributes to a more positive and practical healthcare experience.

The nurses must approach her with genuine authenticity to establish trust and open communication, which can improve their interactions (Kourkouta & Papathanasiou, 2014). Cultivating a caring consciousness rooted in true empathy and concern for Kaisa's well-being acknowledges her as an individual with distinct needs and experiences. Sensitivity to her spiritual and cultural beliefs is also useful, demonstrating respect for her unique identity (Cheraghi et al., 2014). Employing active listening to Kaisa's thoughts, concerns, and aspirations will foster a deeper understanding and validation of her experiences. Demonstrating empathy towards her immigration status and HIV diagnosis showcases a genuine compassion that resonates on a profound level, which will enhance the nurse-patient relationship. Recognizing and respecting her cultural background and involving Kaisa in her care decisions empower her as an active participant in her health journey, which will also help in this case (Chen et al., 2015). Finally, acknowledging that both the nurse and Kaisa have opportunities for growth and learning from each other's experiences enriches the therapeutic relationship.

The dynamic of transpersonal caring, characterized by healing, operates within each caring moment. This concept emphasizes the importance of the nurse's consciousness and heart-centered presence during these moments, as they directly influence the overall field of care. According to Watson, this holistic approach to nursing suggests several key points. Firstly, within a single caring moment, the entire caring, healing, and loving consciousness energy is encapsulated (Watson, 2018). This underscores the profound impact a single moment of genuine care can have on a patient's well-being. The interconnectedness between the one providing care and the one receiving it is also highlighted. The caring-healing process is not isolated but instead intricately linked with the individual being cared for, here Kaisa, and with the broader cosmic energy of the universe (Watson, 2018). This suggests that the nurse's heart-centered, caring, and loving consciousness must be effectively communicated to the patient, creating a powerful and nurturing connection, thus improving the interaction. Furthermore, this form of consciousness transcends time and space constraints, asserting its dominance over physical dimensions (Watson, 2018). This means that the influence of caring is enduring and can extend beyond immediate circumstances. The nurses, therefore, must establish a profound and transformative connection with Kaisa, providing care that transcends the physical realm and resonates on a deeply spiritual and emotional level. This approach fosters Kaisa's well-being and cultivates an environment of trust, empathy, and mutual understanding.

Transpersonal caring emphasizes the importance of the nurse's consciousness and intentionality as they enter Kaisa's life space at a soul and spirit level (Devi et al., 2022; Watson, 2018). This approach prioritizes recognizing and appreciating the uniqueness of both the nurse and Kaisa, as well as the distinctive nature of the present moment. The nurses must first acknowledge their differences to provide unbiased care to Kaisa. The coming together in this interaction is meant to be mutual and reciprocal, where both parties are fully present in the moment and open to new possibilities beyond it. Furthermore, transpersonal caring calls for the nurse's authentic and reflective presence, focusing on caring, healing, and overall well-being rather than solely on the disease or pathology ‌(Foss Durant et al., 2015). This indicates that nurses must not judge Kaisa, ignoring her care owing to her profession or defining her using just her disease. Instead, they must develop ontological caring competencies emphasizing personal growth and ways of being beyond technical skills to address Kaisa's needs. Engaging clinical Caritas consciousness at an ethical level is the foundation for this framework. The nurse must align with Kaisa's frame of reference, connecting with her inner world of meaning and Spirit (Wei & Watson, 2019). Together, they must embark on a shared journey in search of meaning and wholeness, aiming to facilitate comfort, pain management, a sense of well-being, and even spiritual transcendence in the face of suffering. This way of thinking sees Kaisa as a complete person, regardless of her condition or disease. These strategies promote Kaisa's well-being and cultivate an atmosphere of mutual respect and empathy.

Conclusion

The case study of Kaisa illustrates how transpersonal caring principles, such as emphasizing the significant influence of sincere, compassionate interactions in healthcare, are necessary for patient care and to remove value assumptions of caring. The development of a mutual and reciprocal connection is facilitated by accepting the individuality of the nurse and Kaisa and by appreciating each moment's importance. This method goes beyond the confines of the physical world and emphasizes holistic well-being rather than just pathology. Nurses can facilitate a transformative journey towards meaning and wholeness by emphasizing ontological caring competencies and practicing authentic, reflective presence. Kaisa is empowered in her pursuit of healthcare if she is seen as a complete person, regardless of her circumstances. Ultimately, these guidelines foster a climate of trust, sympathy, and understanding, vastly improving Kaisa's overall health and healthcare experience.

References

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