MARILYN ANNE (DEE) RAY
PHD, RN, CTN-A
FLORIDA ATLANTIC UNIVERSITY
EMERITUS PROFESSOR
Linda Cassidy MSN, EdM, APRN-CNS, CCNS, CCRN-CSC
EARLY LIFE EXPERIENCE
• Born in Hamilton, Ontario, Canada
• Family of six children
• Age 15, a nurse saved her father while
hospitalized for a serious illness
• Influenced decision to be a nurse
EDUCATION – EXPERIENCE
• Nursing Diploma (Registered Nurse), St. Joseph's
Hospital School of Nursing Hamilton, Canada 1958
• University of California Medical Center, Los Angeles
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Obstetrics and gynecology
Emergency department
Cardiac and critical care (adults and children)
Developed interest in diverse cultures
• Bachelor of Science (BSN), Nursing, University of
Colorado School of Nursing Denver, Colorado 1968
EDUCATION –EXPERIENCE
• Master of Science (MS), Maternal/Child Nursing, University of
Colorado School of Nursing Denver, Colorado 1969
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Met Dr. Madeline Leininger (first nurse anthropologist)
Developed interest in anthropology
Studied children’s hospital as a small culture
Clinical Practice – children and adults
• Critical care
• Renal dialysis
• First teaching position:
• University of California San Francisco
• Dr. Barney Glaser and Dr. Anselm Strauss
• Grounded Theory
• Developed interest in qualitative research
• 1971 – traveled to Mexico to study anthropology and health –
field work in small villages (learned of life of aboriginal people)
• 1972 – returned to Canada to be close to family
• Occupational health
• Neonatal Intensive care
EDUCATION – EXPERIENCE
• Master of Arts (MA), Cultural Anthropology,
McMaster University Hamilton, Canada 1978
• Studied:
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human relationships
decision making
Conflict
Hospital as an organizational culture
• Doctor of Philosophy (PhD), Transcultural Nursing,
University of Utah College of Nursing Salt Lake City,
Utah, 1981
• First transcultural doctoral program in the US
• Doctoral Dissertation “A Study of Caring Within An Institutional
Culture”
EDUCATION – EXPERIENCE
• One of the co-founders of International Association
for Human Caring (IAHC) 1978
• University of Colorado 1981
• Jean Watson
• Developed interest in phenomenology
• Dissertation Chair for Dr. Alice Davidson
• Science of Complexity
• Florida Atlantic University 1989
• Retired 2004
• Professor Emerita
MILITARY SERVICE
• Mid 1960s – US Citizen
• Joined USAF Reserve, Nurse Corp
• Graduated as flight nurse from School of Aerospace
Medicine – Brooks Air Force Base, San Antonio, Tx
• Aeromedical evacuation nurse – served in the Vietnam
war...“our job was to bring the boys home”
• Served in Air Force for over 30 years
• 1990 – First nurse to go to Soviet Union with Aerospace
Medical Association
• 1991 – called to active duty during first Persian Gulf War
• Retired as Colonial
MAJOR INFLUENCES
Scholars from many disciplines:
• Nursing (Watson, Boykin, etc.)
• Anthropology (Leininger and many in program)
• Sociology (Glasser and Strauss)
• Economics
• Physics
• Philosophy (Hegel, Husserl, Weber, etc.)
James (Jim) Droesbeke - inspiration, friend, soul mate,
and the love of her life.
THE PHILOSOPHY OF HEGEL
• Greatly influenced Ray’s Work
• Hegel’s dialectic (way of reasoning) – “interrelationship
between thesis, antithesis, and synthesis”
• Thesis of being
• Antithesis (opposite) non-being
• Reconciled emerging (synthesis) into a unitive form of being
• Ray’s theory
• Implies that there is a dialectical relationship (thesis, antithesis, and
synthesis)between:
• Thesis of Caring: Human (person and nurse dimensions of spiritual –
ethical caring
• Antithesis of Caring: Organizational (bureaucracy) culture –
technological, economic, political, legal, social
• Synthesized into bureaucratic theory (process is a transformation and it
continues to repeat itself – continually changing, emerging and
transforming)
RAY’S THEORY OF BUREAUCRATIC CARING
• Originated as a grounded theory
• Differential caring emerged as a substantive theory
• Caring in organizations is complex
• The meaning of caring is contextual – it varies depending on
department and depending upon unit within nursing
• Caring has different meanings depending on specific goals and
values
• Bureaucratic caring emerged as formal theory – represents the
dynamic structure of caring within the complex organization
• Dissertation Research (1981)involved the use of:
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Grounded theory methodology to generate theories
Phenomenology to determining meaning of the experience
Ethnography to study patterns in organizational culture
Question – “What is the meaning of caring to you”
RAY’S THEORIES
Differential Caring
Bureaucratic Caring
• Caring varies by area or
practice
• Dynamic structure of caring
within complex organization
• Continually evolving and
transforming
• “The logical connectedness
of caring to the
cosmopolitan social order
demonstrates that the
Theory of Bureaucratic is
unifying rather than
alienating” (Ray, 2013)
• Nurses in ICU value
technological caring
• Nurses in oncology value
humanistic or spiritual
caring
• Nurses value caring in
terms of relationship
• Administrators value caring
in terms of economics,
legality, politics etc.
A Study of Caring
Within An Institutional
Culture
Marilyn Anne Ray
1981
Original Grounded
Theory
THEORY OF BUREAUCRATIC CARING
1989
COMPLEX ORGANIZATIONAL CULTURES
RAY’S THEORY OF BUREAUCRATIC CARING
Present Model:
Holographic
“interconnectedness
of all things”
SPIRITUAL –ETHICAL CARING
• Holism and integration of body, mind, spirit
• Spirituality of Caring
• Creativity
• Choice
• Revealed in attachment, love, community
• Ethics of Caring
• Moral obligation to others
• Not treating people as a means to an end but rather as people
who have the capacity to make choices (Turkel, 2007)
RAY’S ONGOING WORK
• Requests from all over the world to use Bureaucratic
Theory in professional practice models
• Ongoing developing of Theory of Bureaucratic
Caring
• Complexity Science/Complexity Theory
• Transcultural nursing
• Technological caring
• Continual enhancement of nursing scholarship
• Mentorship of others
MARILYN (DEE) RAY
Caring and love are synonymous. Inquiring about
caring touches the heart and translates through the
soul, the "speaking together" between the one caring
and the one cared for, the shifting of consciousness
from a focus on "they" or "I" to a compassionate “we”.
www.marilynray.com
REFERENCES
• Personal correspondence July 6, 2013
• Coffman, S. (2010). Theory of bureaucratic caring. In
Alligood, M.A. & Tomey, A.M. (Eds.), Nursing theorists and
their work, (pp. 113-134). Maryland Heights, Missouri:
Mosby Elsevier.
• Davidson, A.W., Ray, M.A. & Turkel, M.C. (2011). Nursing
caring and complexity science. New York, NY.: Springer
Publishing Company.
• Ray, M.A. (2013). The theory of bureaucratic caring for
nursing practice in organizational culture. In Smith, M.C.,
Turkel, M.C. & Wolf, A.R., Caring in nursing classics, (pp.
309-320). New York, N.Y.: Springer Publishing Co.
REFERENCES
• Ray, M.A. (2010/1981). A study of caring within an
institutional culture. USA: LAP Lambert Academic
Publishing.
• Turkel, M.C. (2007). Dr. Marilyn Ray’s theory of
bureaucratic caring. International Journal for
Human Caring, 11, 57-69.