Do You Know How Your Caring Behaviors Would Rate?


There are many tools that I have used along the way to help me “see”; see myself, see what’s going on around me, see my emotions and how they impact me and others, etc.

This has been a part of my own personal growth.

And it’s not over.

In my early days of reckoning with myself, I became aware of the times when I felt gut-grip after an event or conversation. These were emotions. I caught on that this gut-grip happened when my behaviors did not match my self-image. That’s when I started becoming more honest with myself. I was not handling situations as well as I thought I was.

Whoa! This rocked me to my core. Guilt and shame followed for a bit. Then I asked myself, How often? How bad is it?

To right myself, I created a self-assessment table that I kept in my journal. It was like this,



Situation description My goal behavior My behavior met goal My behavior- OK direction I really blew it


I have since learned that this is a good mechanism for gaining perspective. It helps expand self- awareness and uses mindfulness. It helps us change our mindset by opening the door to more details and thoughts. It helped me then and still does.

Caring Behaviors –

What if we had a tool to evaluate our caring behaviors, to see our behaviors in more detail, for clarity?

We all know, not all caring behaviors are equal.

Caring consciousness is a good place to start; it’s the energetic core of the nurse-patient relationship.

S. Halldorsdottir’s described the Development of the Nurse-Patient Relationship in 1991. Jean Watson (2012) has referenced Halldorsdottir’s work in her writings.

Watson used this classic clinical research on caring from a patient’s experiential view to explain the ideals, directions and consequences of caring. This research revealed a continuum from uncaring to caring (2012, p.45).

The AAACN uses this continuum as its theoretical construct in its CCTM (Care Coordination and Transition Management) core curriculum.

The reason this is important to me is that, as a nurse leader, tools to describe the concrete aspects of caring delivery from the patient’s perspective are needed to help us as nurses to see ourselves and grow.

Halldorsdottir’s work provides the levels of caring with concrete detail that illuminate what human caring is and is not to the patient.

Halldorsdottir’s nurse-patient relationship levels:


  • Biocidic: life destroying; leading to anger, despair, and decreased well-being
  • Biostatic: life restraining; patient experienced the nurses as cold and treatment as a nuisance
  • Biopassive: life neutral; nurse apathetic and detached (just doing the job)


  • Bioactive: life sustaining; reflected in the classic nurse-patient relationship and as kind, concerned benevolent, and responsive
  • Biogenic: highest level of human-to-human caring; life giving and life receiving for both nurses and patient    (Watson, 2012, p.45)


To apply this framework to practice, nurses seeking self-awareness can use this tool to evaluate your practice. It can help you see more details about yourself.

Date Work day description- % of time Biocidic % of time Biostatic % of time Biopassive % of time Bioactive % of time Biogenic


What it does is, it unpacks your caring behaviors and puts them on a continuum. It can help you see in more detail your caring behaviors. This can open up your world to noticing more about yourself, which is a good thing.


J Watson (2012) Human caring science, A theory of nursing (2nd ed). Sudbury, MA: Jones & Bartlett Learning.

6 thoughts on “Do You Know How Your Caring Behaviors Would Rate?

  1. Pat C says:

    This is a perfect tool for me to use in my own journey. I’ll also share this with my team as we are continue going through an Advance – Culture of Caring. Thank you, pmc!

    1. pmcclendon says:

      You bet. It’s quick and simple and personal.

  2. Jae Sanders says:

    This is value in the “I really blew it” journaling. I would add that sometimes, it’s reflecting back on situations that happened years ago and having an “ah ha” moment about it. Humility must join you in the conversation for it to be real….in my opinion 🙂
    Let’s talk about creating a link to this that I can reference in my book!!! LOVE this.

    1. pmcclendon says:

      Yes. It is valuable to deconstruct in your journaling those haunting “I blew it” situations. You’ll be one step closer to letting it go or hopefully permanently letting it go. Humility does heal. Love this!
      Guest blog on journaling and share your link, please ?

  3. Katherine M says:

    I’m a bit late in reading this one, but I love it! This post is great; this is a practical tool that 1) explains our bad feelings 2) lets us know that we are still good people despite the fact that our actions did not live up to who we believe we are (i.e., we are not bad people, we just acted badly) and 3) allows us to recognize and reflect on that point

    This post helped me to reflect on and move past some of my own “gut grip”.

    Thank you for sharing! 🙂

    1. pmcclendon says:

      Exactly !!!
      This is it… just seeing ourselves and what we do is the key… and knowing that we are good in spite of our self judgement.
      Thank you,
      love, mom

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