Resources for Download

Presentations for Download:

Marilyn Ray, Career History, Theory of Bureaucratic Caring, Powerpoint 2013

Marilyn Anne (Dee) Ray Presentation of Theory of Bureaucratic Caring, July 2013 by Linda Cassidy, PhD FAU

Ray Chaos & Complexity Science Presentation Nov 2012

Marilyn Anne Ray, Caring Inquiry, Florida Atlantic University

Research for Download:

Thoughts on Bureaucracy: Bureaucratic Caring Theory Concept of Bureaucracy Holistic Nursing Association Conference June 2015

Publications for Download:

A Transtheoretical Evolution of Caring Within Complex Systems
Posted with permission from Dr. Zane Wolf, Editor, International Journal of Human Caring.

Theory of Bureaucratic Caring

Ray Bureaucratic Caring Theory, Nursing Theories & Nursing Practice, Ray & Turkel, 2010

Questionnaires for download:

Users should notify Dr. Marilyn Ray and Dr. Marian Turkel at email if using the below questionnaires. These questionnaires are referenced in the article and chapter respectively in the following:
Ray, M. &Turkel, M. (2012).

A transtheoretical evolution of caring science within complex systems. International Journal for Human Caring, 16 (2), 28-49.

The narrative data analysis related to the questionnaires is published in the following:
Ray, M & Turkel, M. (2009). Relational caring questionnaires. In J. Watson (Ed.), Assessing and measuring caring in nursing and health sciences. New York: Springer Publishing Company.

Download Relational Caring Questionnaire – Professional

Download Relational Caring Questionnaire – Patient


Books by Dr. Marilyn Dee Ray


Nursing, Caring, and Complexity Science

“This collected scholarship…will inform the personal/professional evolution of caring and nursing into this century and beyond, inviting new visions of the evolved human in the world of practice, education, research, administration, and clinical care. It is truly a visionary futuristic manifesto for this time in nursing and health sciences at all levels.”
Jean Watson, PhD, RN, AHN-BC, FAAN
University of Colorado Denver College of Nursing
Founder: Watson Caring Science Institute, Boulder, Colorado
(From the Reflection)


This book is an innovative volume that explores nursing, caring science and complexity science/s and investigates how they relate in philosophy, theory, research, education, leadership, administration, and practice. The book examines the best methods for using complex systems, with expert contributing authors from nursing, sociology/anthropology, science, mathematics, informatics, and business. Each author is actively involved in the study of and application of complexity science in diverse populations and settings. Complex systems are explored in nursing scholarship and education, and within health care organizations or community health networks. Each chapter concludes with a response written by a nursing scholar, administrator, or practitioner focusing on the chapter concepts relevant to complex systems seen in nursing. The chapters facilitate a greater understanding of human caring relationships and ethical choice-making through the lens of complex healthcare organizations/systems. Examples are provided about how to create and implement complex systems models in philosophies of science, quantitative and qualitative research, education, organizational healthcare systems, and informatics and robotics.

This book won the 2011 Book of the Year award for professional development and issues in nursing.

Book is available on or from Springer Publishing Company.

Key Features

  • Presents the central concepts of complexity science as they relate to nursing
  • Facilitates greater understanding of human caring relationships through the lens of complex organizational systems
  • Provides examples of how to create and implement complex systems models that enhance care for individuals, and in leadership roles, organizational caring, nursing informatics, and research methods


Transcultural Caring Dynamics in Nursing and Health Care

he dynamics meaning of culture and transcultural caring awareness and understanding of relational caring experiences for health, healing, and well-being are presented in this book. The five dimensional conceptual model of Ray’s, “Transcultural Caring in Nursing and Health Care” will illuminate knowledge for understanding how each individual is a “cultural being” and how cultures influence one another through transcultural caring relationships in the local and global environment. The Dimensions are:

  • Essence of caring(the action of compassion and love as the mediating force to guide moral caring behavior and facilitate right action within the dynamics of culture. caring beliefs and values, transcultural caring ethics (moral foundations of respect for persons, cultural rights), transcultural context, and universal sources (religious/spiritual dimensions);
  • Transcultural Caring Ethics(the ethical knowledge of respect, fidelity, integrity, beneficence, human rights, cultural rights, the rights of nature and so forth that shapes moral caring experience that facilitates transcultural ethical caring;
  • Transcultural Contextilluminates the person in the sociocultural context, including political, economic, technological, legal, ecological and health care systems–the diverse identities and personal/ethnic/cultural/multicultural values, beliefs and attitudes about relationships, symbols, rituals guiding transcultural experience in social, communal, health care and global cultural systems;
  • Universal Sourceshighlight select religions and/or spiritual relationships and beliefs and the universal mind, and identify how standards of spiritual and religious traditions shape transcultural caring experience.
  • Transcultural Caring Awareness, Understanding and Choiceis the center of this dynamic model which illuminates the process of transcultural caring inquiry–the processes of knowledge of transcultural caring evidence and cultural competence–the dynamics of the essence of caring, transcultural caring ethics, transcultural context, and universal sources to make responsible mutual choice-making incorporating tools of assessment and evaluation for transcultural communicative spiritual-ethical caring in health, healing, and well-being.
    • Real world” examples of transcultural caring experiences are presented at the end of each chapter in Section 1, and Chapters 7-26 in Section 2 of the book to help master transcultural assessment and caring techniques. An Instructor Guide with learning tools and examination questions and powerpoints written by Drs. Anne Vitale and Marilyn Ray is available from F. A. Davis Company to facilitate both in-class and on line instruction.

The Cover: Sunflower World
By H.Lea Barbato Gaydos, PhD, RN

Sunflower World is about the interconnectedness of all things. It is in the tradition of a mandala, the Sanskrit word for “whole world” or “healing circle.” Mandalas are usually very colorful and found in many spiritual traditions. The purpose of a mandala is to provide a focus for medication and reflection. There are three symbolic elements for reflection in Sunflower World.

First, in this work, the earth is encompassed by the sunflower, which is meant to symbolize the beauty and harmony of the world as it exists in nature. Second, the mosaic background represents the multiplicity of peoples and cultures that inhabit our world, different in color, shape, and tradition, but essentially the same in our humanity. Like the sunflower that follows the light, we must look to our intrinsic nature and compassionate caring to transcend our differences and find our wholeness as human beings in relationship with others. Third, the green bars that bisect the image horizontally and vertically represent the four directions: they resemble a ribbon, suggesting a gift, the gift of life.

The aesthetic for this piece was inspired by the work of Lily Yeh, Founder and Director of Barefoot Artists, Inc. and her work with people in Africa who had experienced genocide. With the community of survivors, she created a healing garden memorial to the dead where before they had only a mass grave of concrete.


A Study of Caring Within An Institutional Culture

Scholarship related to the concept of caring within the discipline of nursing has increased exponentially in the last thirty years. A significant body of knowledge has advanced from philosophical and quantitative and qualitative inquiry. Ray conducted one of the first research studies to illuminate the meaning, generate categories, and discover substantive and formal theories of caring in the hospital culture. In this study, comparative data of different social units of persons, professional roles, clinical units, and documents formed the basis from which a classification system and theoretical frames of reference were discovered. A substantive theory of Differential Caring was discovered from the meaning of patterns of caring in different hospital units, and using an Hegelian approach, a formal theory Bureaucratic Caring was synthesized. The future of nursing now depends on how well the nature of the Theory of Bureaucratic Caring is understood and applied in complex healthcare organizations to facilitate improvement in quality of care. See Ray and Turkel”s further research on the study of Bureaucratic Caring Theory in the additional Reference List supplied in this book.







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