Lydia Hall was born in New York City on September 21, 1906 and grew up in Pennsylvania. Graduated at York Hospital School of Nursing on1927, Bachelors in Public Health Nursing on 1932, and earns a Master of Arts degree in 1942 at Teacher’s College, Columbia University. She was an innovator, motivator, and mentor to nurses in all phases of their careers, and advocate for the chronically ill patient. She promoted involvement of the community in health-care issues. She derived from her knowledge of psychiatry and nursing experiences in the Loeb Center the framework she used in formulating her theory of nursing. These experiences might have given her insight in on the distinct roles of nurses in providing care for the patients and how the nurses can be of utmost importance in caring for these patients.
CARE, CURE, AND CORE
Hall enumerated three aspects of the person as patient: the person (core), the body (care), and the disease (cure). These aspects were envisioned as overlapping circles that influence each other.
Hall clearly stated that the focus of nursing is the provision of intimate bodily care. She reflected that the public has long recognized this as belonging exclusively to nursing. Being expert in the area of body involved more than simply knowing how to provide intimate bodily care. To be expert, the nurse must know how to modify care depending on the pathology and treatment while considering the unique needs and personality of the patient.
Based on her view of the person as patient, Hall conceptualized nursing as having three aspects, and delineated the area that is the specific domain of nursing, as well as those areas that are shared with other professions. Hall believed that this model reflected the nature as a professional interpersonal process. She visualized each of the three overlapping circles as an aspect of the nursing process related to the patient, to the supporting sciences, and to the underlying philosophical dynamics. The circles overlap and change in size as the patient progresses through a medical crisis to the rehabilitative phase of the illness. In the acute care phase, the cure is the largest. During the evaluation and follow-up phase, the care circle is predominant.
This is the part of the model reserved for nurses, and focused on performing that noble task of nurturing the patients, meaning the component of this model is the “motherly” care provided by nurses, which may include, but is not limited to provision of comfort measures, provision of patient teaching activities and helping the patient meet their needs where help is needed. This aspect provided the opportunity for closeness and required seeing the process as an interpersonal relationship. Hands on care for patients produces an environment of comfort and trust and promotes open communication between nurses and patients.
The second aspect of the nursing process is shared with medicine and is labeled as the “cure”. Hall comments on the two ways that this medical aspect of nursing may be viewed; it may be viewed as the nurse assisting the doctor by assuming medical tasks or functions. The other view of this aspect of nursing is to see the nurse helping the patient through his or her medical, surgical, and rehabilitative care in the role of comforter and nurturer.
The third are that nursing shares with all of the helping professions is that of using relationships for therapeutic effect – the core. This area emphasizes the social, emotional, spiritual, and intellectual needs of the patient in relation to family, institution, community and the world. Knowledge foundational to the core was based on the social sciences and therapeutic use of self. Through the closeness offered by the provision of intimate bodily care, the patient will feel comfortable enough to explore with the nurse “who he is, where he is, where he wants to go and will take or refuse help in getting there – the patient will make amazingly rapid progress toward recovery and rehabilitation”. Hall believed that through this process, the patient would emerge as a whole person.