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The ideas presented in Stegmeir's article provide a positive stimulus for nurses to think carefully about the worldviews underlying nursing theories. She points out important differences between Christian and secular, humanistic worldviews and nursing theories, and explains why these disparities are problematic for the Christian. However, despite these differences, Stegmeir suggests that we can take some aspects of Watson's, Parse's and Newman's theories and adjust them for our own nursing and faith practices. I believe that as Christians we should not utilize theories with worldviews contrary to the Christian view as taught in the Bible, nor should we feel the need to do so or apologize for being different. I also would suggest that we need to go further in understanding the critical differences between Christian and humanistic worldviews.

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Many Christian nurses take a modify and apply approach when attempting to choose a nursing theory for research and practice and try to incorporate or adjust aspects of the theories to fit Christian thinking. But this methodology becomes problematic when the underlying philosophical base of the theory is antithetical to the Bible and does not accept God as the exclusive, divine Creator and Sustainer of the universe-as with Watson's and other postmodern theories.


For example, how does the Christian understanding of relationships differ from Watson's description of the transpersonal relationship? The difference between Watson's theory and Christian theology is much greater than ignoring the work of the Holy Spirit, as Stegmeir points out. Rather, Watson believes that healing can occur when the nurse manipulates energy within the nurse-client relationship. Christians believe that while there is a human spirit touching spirit in a therapeutic nurse-client interaction, it is the Holy Spirit who works in us, through us and in the world (Jn 14:16-17, 16:7-9). We believe that healing is under God's control and is not ours to manipulate, whether healing occurs through natural means, health care or divine interventions, or a combination of the three.1 One might consider this semantics and suggest that we're talking about the same thing in different ways, but there is a basic and, I would argue, a crucial difference.


Moreover, we cannot merely take some aspects of Watson's concept of human caring and adjust it for our nursing practice. First, this seems presumptuous because it assumes that we can adjust Watson's theory to make it right. Second, it also appears apologetic-as though we feel the need to use Watson's theory. Do we? Finally, it seems to imply that, even though we don't agree with Watson, since we don't have anything better to explain nursing (a Christian theory), we will simply adjust the theory of transpersonal caring and use it.


I have difficulty understanding why praying for Alfred is adjusting Watson's theory for Christian nursing practice. There is a fundamental difference between Watson's perception of where human caring comes from and the Christian understanding. In Watson's model, caring comes from tapping into the dimension of nursing and the self-the collective unconscious of "nursing's archetypal soul" to find our life-giving, life-enriching power. It's all about human potentiality.2


As Christians, we recognize that we are utterly sinful and helpless to care (Is 53:6; Rom 3:10-18, 23) and that "we love (care) because he first loved us" (1 Jn 4:19). So, why isn't praying for Alfred a basic spiritual care we learn from Scripture? Couldn't this beautiful story be included as an example of caring from a Christian worldview that appears similar to Watson's transpersonal caring but not an adjustment of her theory for Christian nursing practice?


The key point is that while we can find elements of truth in humanistic, secular nursing theories that help us think about, and even better understand, some truths, our practice must be based on a biblical understanding of the person and human relationships. Perhaps we can increase our understanding of caring by studying Watson's theory, but our caring is derived from a different place. We can find elements of truth in these theories that correspond with Christian belief, but we need to be thinking critically about the implications of our beliefs rather than trying to adjust models built upon worldviews different from Christianity.


After suggesting that the Christian view of spirituality is given in the work of Stoll, Carson, Hess, Roach, O'Brien, Shelly and Miller, Stegmeir states, "The challenge remains to develop an appropriate Christian alternative to the current energy-based and transcendent theories available in nursing education today."


Frankly, I see Shelly and Miller's Called to Care: A Christian Theology of Nursing3 as an answer to that challenge. Although their Christian theology of nursing is not a fully-developed, tested and widely accepted theory, Shelly and Miller have provided a solid Christian, biblical basis for thinking critically about foundational nursing concepts.


I wonder if it is truly a problem for Christians that there isn't a "Christian theory of nursing." I agree with Shelly and Miller's suggestion that we need a theology rather than a philosophy or theory of nursing.4 We need ways of talking about nursing from a Christian perspective, but I'm not sure we need a mainstream theory just because it is the current trend in nursing. Perhaps it is time for Christians to become trendsetters.


What do you think about the role of nursing theories? What criteria do you use to evaluate nursing theories? What theories do you use and why? Have you used Shelly and Miller as a conceptual model for nursing? How has it worked? Let your voice be heard!! Log on tohttp://www.ncf-jcn.organd speak out on the "Nursing Theories Discussion" page.


1 For a discussion of the biblical view of healing compared to the postmodern view, see "The Subtle Allure of Therapeutic Touch," by Donal P. O'Mathuna and accompanying sidebar articles, pp. 4-13 in the Journal of Christian Nursing, winter 1998. [Context Link]


2 Jean Watson, Postmodern Nursing and Beyond (Edinburgh: Churchill Livingstone, 1999). [Context Link]


3 Judith Allen Shelly and Arlene B. Miller, Called to Care: A Christian Theology of Nursing (Downers Grove, Ill.: InterVarsity Press, 1999). [Context Link]


4 Shelly and Miller, chap. 3. [Context Link]