The circle of caring: a transformative model of advanced practice nursing

This article presents a new and original approach to advanced practice nursing. A transformative model, the Circle of Caring is described. Using a template that builds on both nursing and medicine, this model provides a synthesized approach to practice. The traditional medical model is reviewed, as well as the evolution of the nursing process. In response to changing societal need, the scope of nursing practice is constantly challenged and expanded. New elements of practice emerge. In an effort to clarify and elaborate the current realities of advanced practice nursing, the Circle of Caring was conceptualized. Components of traditional medical practice are combined with elements of traditional nursing practice; both are situated in an elemental nursing model of caring. Although a linear representation, the Circle of Caring encompasses process pieces taken in part from a theory of caring (Boykin & Schoenhofer, 1993; Mayerhoff, 1971). An underlying purpose of this model is to highlight in a concrete way the inclusion of nursing's voice in the new and emerging--and rapidly changing--healthcare system. It is theorized that this approach to practice will yield more positive outcomes for patients, families, and communities.