Marlaine Smith’s Nursing Theory of Unitary Caring


In the case under analysis, a nurse must address the needs of a woman who has recently lost her husband to a heart attack. After a sudden heart failure, the man was brought to the hospital but died almost instantly. It was expected that his wife would say goodbye to him in the confinements of a private room and leave, yet she cannot let go of her dead husband’s hand. At present, the goal of a nurse might seem to concern solely making the woman leave, yet, on closer inspection, one will realize that a nurse also has to offer the woman psychological comfort. By adopting the principles of the Unitary Caring Theory and combining them with the concept of the human being as a unitary phenomenon transcending theories, one will help the patient to reconcile with the loss of her husband. In addition, with the help of the Unitary Caring Model, a nurse can increase the woman’s chances of coping with her grief.

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In the suggested scenario, using the principles of the Unitary Caring Theory seems to be the most sensible choice since it will allow focusing on the patient’s unique characteristics, thus helping her cope with distress. The Nursing Theory of Unitary Caring (NTUC) was pioneered by Marlaine Smith, who offered to view a patient as an agent that transcends the existing nursing frameworks (Adams et al., 2014). NTUC allows generating knowledge about the concept of caring as it pertains to patients from different socio-cultural backgrounds and different levels of emotional trauma complexity (Hines, Wardell, Engebretson, Zahourek, & Smith, 2015). By its design, NTUC implies embracing the diversity and complexity of care to multiply caring knowledge and, thus, provide patients with the services of improved quality and increased efficiency.

Furthermore, the NTUC framework imbues the process of caring with a more profound nature based on manifesting intentions and using ethical standards as the platform for decision-making in the context of a healthcare setting. The strong connection to ethical principles of clarity and transparency allows promoting the philosophy of a patient-centered approach and encourages nurses to develop better contact with patients from different socio-cultural backgrounds (Sofhauser, 2016). Caring is seen as a means of sustaining wholeness and setting the course for healing as the key nursing goal (Mgbekem, Ojong, Lukpata, Armon, & Kalu, 2016). As a result, the quality of care is expected to rise.

Finally, the NTUC introduces the concept of meta-analysis into the realm of nursing, thus, increasing the quality of services and encouraging nurses to develop an in-depth understanding of the nursing process. The somewhat formalistic approach to care, which the focus on meta-analysis suggests, is balanced with the emphasis on addressing the emotional needs of a patient and creating a bond between them and a nurse (Dyess, Prestia, & Smith, 2015). With an in-depth understanding of caring as a phenomenon, its implications, and limitations, a nurse can ensure a rise in the quality of care (Bramley & Matiti, 2014). Additionally, the identified characteristic of the NTUC allows the process of caring to intersect with other areas of managing patients’ needs, leading to the creation of a multidisciplinary framework for addressing patients’ health concerns (Eastland, 2017). The identified features of NTUC make it especially important in the context of diverse contemporary communities.


Because of the opportunity of establishing a strong emotional bond with a patient, NTUC should be seen as an essential theoretical framework to be applied to the case under analysis. Affected profoundly by the death of her husband, the woman is experiencing massive shock and emotional distress, which exacerbates her sorrow. As a result, she is incapable of thinking rationally at the moment and, instead, requires emotional support and understanding. By using the NTUC approach of manifesting intentions and promoting an open conversation, a nurse will have to address the cultural and psychological aspects of care in order to launch the therapy process. Simultaneously, spiritual and social elements thereof will also have to be addressed to help the woman overcome the trauma. Specifically, the woman’s cultural, social, and religious background will have to be identified prior to choosing an intervention technique.

Afterward, a nurse will have to help the woman receive the support of her family members. Particularly, a nurse may need to contact the woman’s relatives and create an intervention in the course of which the emotional bond between them and the widow will be reinforced. As a result, a self-sustaining support system for the woman will be created. The specified step will lead to the next stage of implementing the NTUC approach, at which a nurse will have to suggest a coping strategy to the widow. Depending on the woman’s cultural background, the identified stage may also involve the promotion of the techniques of spiritual nature.

Showing empathy for the widow is especially important for the promotion of a positive outcome. Being the foundation of the NTUC idea of care, empathy must serve as the platform for the emotional connection between a patient and a nurse. It will be crucial to validate the woman’s feelings and help her express the emotions that she has been restraining. Without the identified step, the woman is likely to develop severe depression that will cause massive adverse effects, including the possibility of suicidal thoughts (Dionne-Odom et al., 2015). Therefore, a nurse must be empathetic and show a profound understanding of the woman’s loss.

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Finally, a nurse will need to maintain a connection with the woman over a certain period of time to prevent instances of delayed depression and other possible mental health issues. Because of the traumatic experience, the woman will need consistent support from nurses and family members. Therefore, it will be crucial to check whether the chosen intervention method delivers the expected results. Thus, a nurse-patient dialogue will have to be maintained and encouraged within the next month.


Based primarily on the concept of empathy, the NTUC framework incorporates a vast array of ideas and notions that can improve the quality of care significantly. Because of the inclusion of meta-analysis, empathy, and interdisciplinary communication into the NTUC, one can use it to address other health issues as well. For example, the NTUC can be deployed to manage the needs of patients in a palliative care setting (Sofhauser, 2016). Similarly, the strategy can be utilized to provide nursing services to people from diverse cultural and social backgrounds.

With its concept of manifesting intentions, the NTUC enables a nurse to create an emotional bond with a patient and use the available information about the latter to design an intervention for managing current health issues. However, what makes the model especially valuable is that it gives a nurse the opportunity to provide active patient support. The emphasis that it places on the role of a patient’s family, the spiritual aspects of her life, and other important factors defining a patient’s emotional well-being help to make the recovery process faster. Thus, the NTUC must be applied to handle health issues in other areas of nursing.


Adams, J. A., Anderson, R. A., Docherty, S. L., Tulsky, J. A., Steinhauser, K. E., & Bailey Jr, D. E. (2014). Nursing strategies to support family members of ICU patients at high risk of dying. Heart & Lung: The Journal of Acute and Critical Care, 43(5), 406-415. Web.

Bramley, L., & Matiti, M. (2014). How does it really feel to be in my shoes? Patients’ experiences of compassion within nursing care and their perceptions of developing compassionate nurses. Journal of Clinical Nursing, 23(19-20), 2790-2799. Web.

Dionne-Odom, J. N., Azuero, A., Lyons, K. D., Hull, J. G., Tosteson, T., Li, Z.,… Hegel, M. T. (2015). Benefits of early versus delayed palliative care to informal family caregivers of patients with advanced cancer: Outcomes from the ENABLE III randomized controlled trial. Journal of Clinical Oncology, 33(13), 1446-1452. Web.

Dyess, S. M. L., Prestia, A. S., & Smith, M. C. (2015). Support for caring and resiliency among successful nurse leaders. Nursing Administration Quarterly, 39(2), 104-116. Web.

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Eastland, T. Y. (2017). A book review of Nursing Theories and Nursing Theories (4th ed.), by Marlaine C. Smith and Marilyn E. Parker (2015). Philadelphia, PA: FA Davis. Nursing Science Quarterly, 30(2), 183-185. Web.

Hines, E. M., Wardell, D. W., Engebretson, J., Zahourek, R., & Smith, M. C. (2015). Holistic nurses’ stories of healing of another. Journal of Holistic Nursing, 33(1), 27-45. Web.

Mgbekem, M. A., Ojong, I. N., Lukpata, F. E., Armon, M., & Kalu, V. (2016). Middle range theory evaluation: Bridging the theory-practice gap. Global Journal of Pure and Applied Sciences, 22(2), 249-254. Web.

Sofhauser, C. (2016). Intention in nursing practice. Nursing Science Quarterly, 29(1), 31-34. Web.

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