Careful nursing: a model for contemporary nursing practice.

BACKGROUND Careful nursing, a system of nursing developed in Ireland by Catherine McAuley in the early years of the 19th century and used by Irish nurses at the Crimean war, has been described as Ireland's legacy to nursing. Although records of careful nursing have been preserved, it has received little attention in the nursing literature. AIM The purpose of this study was to conduct a preliminary content analysis of the mainly primary source historical documentation of the careful nursing system and present it within the structure of a contemporary conceptual model of nursing. METHODS The documents describing the careful nursing system were studied and re-studied to gain understanding of the philosophical assumptions underlying careful nursing and of the thinking, attitudes, actions and practice of the nurses. Content relating to the four central nursing concepts was identified and summarized. RESULTS Careful nursing definitions of person, environment, health and nursing are presented. Ten key concepts of careful nursing practice are identified as disinterested love, contagious calmness, creation of a restorative environment, 'perfect' skill in fostering safety and comfort, nursing interventions, health education, participatory-authoritative management, trustworthy collaboration, power derived from service and nurses' care for themselves. The spiritual dimension of human life and the spiritual in nursing emerge as important characteristics of the model. CONCLUSIONS The results of this preliminary analysis require further verification and critical examination. However, the careful nursing model illuminates important aspects of professional nursing and could be further developed to conceptualize and guide nursing practice.