NURSING
Basically, your plan is to become a financially stable individual. But of course you want to learn a lot of interesting and mind expanding things along the way and pursue your dream to become an artist because you really are good at drawing. Health care is the field that attracts you the most as it combines scientific knowledge and discoveries with humanitarian service to individuals in need. A career in nursing, you feel, is the most meaningful way to make a significant difference in people’s lives.
You anticipate having a family in the future and that means you would not only like to work in a profession that is interesting, but one where you can earn as much income as possible. And so you decide to be trained as a nurse where you can make good money and also enjoy the work.
You enroll in a CNA training program. You are a learner. But you also love to create things (and want to pursue art). You love learning about the mysteries of the universe and such. So, now you’re wondering, would it be better to pursue a degree in Nursing, or Psychology, after you have completed your CNA training. You’re afraid that you might not learn much about Psychology if you go for the RN degree. You’ve seen some overviews of courses for the RN program at universities and community colleges, and mostly it’s Sociology, Foreign Language(s), World Cultures, and a few more extra courses…..but you fear there’s not going to be much in the way of Physics and Psychology, and other “makes you think” science courses. And in addition, you wonder if it would be better to pursue art classes outside of school, or would it be a load to take this as another major/or minor alongside of RN or Psychology as your major. Or how about a double major. (RN + Painting/Drawing/or Art in general, or Psychology plus art)
Well here’s the story on nursing from my perspective, and I hope you’ll stay with me, and, stay in nursing. Nursing is a scientific discipline, yet perhaps the language of science cannot be freed from ambiquity anymore than poetry can; and perhaps no more exact in any ultimate and final sense than that of poetry. As a science, nursing is an application of the body of theoretical nursing knowledge, behavioral and natural science, the humanities, and the arts, all of which are employed in a caring, respectful manner. The arts consist of the nurse’s understanding of the meaning of a holistic health-illness experience and the perception of the moral and ethical significance of care, as well as the integration of technical skill with relevant theory.
During a time when educational standards are being reevaluated as to the content, clarity and purpose of the educational process, many fields are also undergoing refinement. When a particular field encounters a speed bump in its ongoing progress, like education, it is appropriate to reevaluate where the organization has been, where it is currently, and in what direction the field needs to be pointed in order to regain its effectiveness. The nursing field, a sector of the educational system, is currently suffering from a reduction in recruitment. Unfortunantely, the nursing field has long carried the stereotype of a career path that is less than a doctor’s status. This will change.
One is not born a nurse, but becomes one, as nursing has taken on far greater responsibility and depth. Modern medicine expands its horizons as people live longer and healthier lives. One major problem with even a brief overview of nursing and its professional status is that nursing is often seen as a woman’s field. Florence Nightingale, Clara Barton, even M*A*S*H’s Hot Lips Houlihan are symbols of women fighting in a man’s world- all too often in wartime or crisis.
With the advent of the feminist movement, the point of view is not so much that nursing offers great opportunities for women, but that there is a need to fight for equality- in pay as well as in status. To bring some sense into today’s nursing profession, one must look into the philosophy of that feminism.
There is a presumption of men’s participation, free agency, and functionality in whatever is the mainstream culture. Typically, the idea of asking whether men should be allowed to act in this manner does not arise. The male is the standard of participation, and differences from the standard are measures of women against that standard. Increasingly, not in spite of the contemporary subculture of women’s liberation but because of it, feminists question why that measure persists and whether it should. Myriad questions flow from the fundamental question about the absence of social equality for both sexes. Indeed, feminist literature questions the objectivity of much precedent scientific and social inquiry presented as objective and rational but (from the feminist standpoint) problematic because it does not acknowledge the depth of masculine bias informing it.
Regardless of gender, caring in the practice of nursing is a process of communicating by the nurse to the patient, and the patient’s family. Within this non-gender context, empathy, sympathy, love, and understanding may be viewed as components of caring. Nursing needs to be based on a theory of caring by the nurse. The underlying assumptions are that care and love comprise the primal and universal psychic energy, and care and love are requisite for our survival and the nourishment of humanity.
Changing social structures are leading to evolving approaches to the delivery of health care. The roles of the various professional providers of health care also are in a state of transition. Societal changes also are occurring that impact the ethical bases of the functioning of health care delivery systems. Throughout American society, such transitions are leading to a growing expression of a desire for holism. Holism refers to a totality in perspective, with sensitivity to all levels or parts that constitute the whole and to their interdependence and relatedness.
As a holistic conception of mind and body, nursing interventions related to human care are referred to as carative factors and include: (1) humanistic-altruistic system of values, (2) faith-hope, (3) sensitivity to self and others, (4) helping-trusting human care relationship, (5) expressing positive and negative feelings, (6) creative problem-solving caring process, (7) transpersonal teaching-learning, (8) supportive, protective, and/or corrective mental, physical, societal, and spiritual environment, (9) human needs assistance, and (10) existential-phenomenological spiritual forces. Goal attainment, a holistic perspective, patient autonomy, interaction between nurse and patient, and adaptation are common to all theories of nursing.
Holistic nursing encompasses balancing the intuitive art of nursing with scientific knowledge and technical competence. If nurses are committed to practices that respect, nurture, and enhance the bio-psycho-socio-spiritual well-being of individuals, families, and theirself, holistic nursing can help them learn how to actively participate in the healing process.
Knowledgeable and compassionate caring has biopsychosocial-spiritual correlates. There is scientific evidence to support that caregiving interventions have quantifiable, reproducible physiologic effects. If caring for patients is to be sustained by nurses, however, the nurse must understand the role of healer and recognize that they themselves do not create the change in others but rather participate in the process. Those who care must also recognize that, for knowledgeable and compassionate caring to be sustained, they must be willing to care for themselves and capable of doing so. In other words, they must be willing to awaken their healer within. Within a holistic context, nursing interventions such as therapeutic touch and therapeutic massage can be used with patients who are unable to participate actively in learning and practicing relaxation exercises.
Showing respect and interest in a patient and what they do when they are not in the hospital also helps develop trust in the nurse-client relationship. When nurses respect what their patients do, they have a more trusting relationship, and their patients can establish more of a trusting relationship with them. Really listening to what a patient says, and giving them credit for knowing what they are talking about is important in developing trust. Brushing aside what a patient says as if it is not important does not help develop trust, as when a patient feels their nurse is not paying attention to what they are saying, they will not be forthcoming with information which might be vital to their proper care. Talking to a patient as an equal is important in developing trust in a relationship.
Ethnic diversity in America has always been regarded as a good thing, but it leads to serious problems where patients in hospitals are concerned. It is the duty of the health care personnel to understand folk medicine and adjust to its practice, without letting herbal cures and remedies interfere with what the doctor orders. Nurses must understand, for example, why Asian patients rarely ask for pain medication and Mediterranean patients want it for the slightest discomfort, and why some Middle Eastern cultures will not allow a male physician to examine their women, and others will.
Nurses must be capable of identifying the threats to patient autonomy, and must be able to respond effectively as an advocate for the patient. To be able to act as an advocate for the patient, the nurse must be able and willing to overcome her or his own individual value-based objections to a patient’s decision or condition. Strong value systems are essential for health care providers, yet such value structures, however, must not be permitted to diminish the quality of care provided.
A personal and professional organizational communication philosophy and code of ethics, serves the nurse well, as the foundation of an ethical human being as well as an ethical communications professional. Simply stated, the essence of this code of ethics is accountability. For a nurse, a whole variety of corollary standards of ethical conduct are intrinsic to this philosophy. They include concepts of honesty, responsibility, reliability, integrity, and character. Each of these abstract moral concepts have consequences for actual nursing behavior, and are concepts that, at times, can be very difficult to live up to when one considers that the prime realities of nearly all organizations, including medical centers, are money and power, and that these considerations have likely, to some degree, corrupted the moral climate of the very organization you as a nurse, might encounter to a greater or lesser degree.
That is why codes of conduct are not worth the paper they are written on unless one takes the bottom line of truth as seriously as the traditional bottom line. Honesty is essential to all the other ideal virtues mentioned above. Without it, none of them can exist. A lie destroys honesty, reliability, and responsibility, and corrupts integrity and character.
Because the practce of nursing is in itself a mystery to be lived, some of nursing’s problems are not ones that can easily be solved. How can we understand this mystery well enough to have it valued, esteemed, “seen”, developed, and incorporated into nursing education, practice, and research? The human care process in nursing is connected to human struggles, and the intensely human process of nursing can be a struggle for the professional nurse during a time of scientism and high technology.
Nursing would do well to move beyond objectivism, verification, relationships, context, and patterns, and concern itself more with the pursuit of hidden truths and new insights, developments of knowledge, in relation to human behavior in health and illness, and to make new discoveries of how to be in a professional human caring relationship with individuals to serve society.
Nursing’s challenge of the day is to exit the system of preoccupation with procedures, facts per se, rigid definitions, strict rationalism, operation, variable manipulation, and so forth, and recognize other ways of knowing and atternative views of science. Nursing needs to develop the advancement of knowledge about the lived world of human experience. As noted before, nursing is both a human science and an art, and as such it cannot be considered qualitatively continuous with traditional, reductionistic, scientific methodology.
The new model of nursing for education, research, and practice is that of a scholor clinician. Quality nursing and health care today demand a humanistic respect for the funtional unity of the human being. The phenomena of health-illness must be approached from a broad conceptual base, which connects with and serves people, which, in turn, advances society’s knowledge of human conditions and advances nursing’s contribution to the welfare of society.
These views hopefully might help you and others to view nursing in a new or different way, perhaps to develop or to attempt a new starting point, to use a new lens when focusing on the phenomena of human behavior in health and illness.