534489
research-article2014
NSQXXX10.1177/0894318414534489Nursing Science QuarterlyNursing Science QuarterlyRosa / Letter to the Editor
Letter to the Editor Nursing Science Quarterly 2014, Vol. 27(3) 265–266 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0894318414534489 nsq.sagepub.com
Letter to the Editor: It Is Unethical Not to Care William Rosa, RN; MSN1 Dear Editor, I was moved to comment on the article “A Case Study Based on Watson’s Theory of Human Caring: Being an Infertile Woman in Turkey” in the October 2013 issue of Nursing Science Quarterly. This case study illustrates that it is beyond indifference not to cultivate human caring as the core of nursing practice. Given the evidence of the possible effects of compassion, kindness, and love that can have on another fellow human, it has become unethical not to care. Choosing not to care about the spiritually embodied patient or colleague has become an all too common norm among the bureaucratic dictates and administrative constraints of dayto-day nursing. It is beyond time that we reclaim our mission as a collective, substantiating human caring as our purpose, taking the culture-specific scenario presented by Ozkan, Okumus, Buldukoglu, and Watson (2013) and actualizing it throughout the globe. Patients stand before us with rich life histories and future possibilities that often present in the context of vulnerability and suffering; the question then becomes, who are we not to care? I speak not of caring as a puppies and rainbows notion or a fleetingly hand-holding act of sympathy, but as an intentional consciousness that is based on a moral commitment to human dignity rooted in an ethical ontology of universal interconnectedness (Watson, 1999, 2005, 2008). Who are we if not the protectors, advocates, and givers of precious human caring to patients? How are we to be in this world as mentors, teachers, role models, and caring-healing practitioners, if not literate in a science of human caring? Are we to abbreviate our endless disciplinary potential to become technicians and skilled attendants, or simply individuals certified by a national organization or state board who happen to be nurses? There is no just happening to be a nurse. Even Nightingale (1969) suggested that there is a sacred calling to this act of human caring. Within the response to said calling we make the active choice to show up fully with a clear and authentic sense of caring-healing, or we fail to actualize the virtuous possibilities of our own legacy and we become passive nurses. I, for one, do not believe passivity is an option when looking into the eyes of the human being at the bedside or a fellow nurse across the hall. I see myself in the other; I care for my spirit in caring for the other’s. When adopting human caring science (Watson, 2012) as a nursing model of professional care delivery, a major
Midwest hospital showed institution-wide improvements in several performance areas that cultivate and support a flourishing human condition for patients and nurses. Between 2011 and 2012, after involving staff with a caring-science inspired approach, Adventist Midwest Health demonstrated significant increases in nurse job and practice environment satisfaction, massive improvements in nurse manager ability, leadership, and support of nurses, and between 2012 and 2013, there was a 48% decrease in lateral violence among nursing staff. Adventist Midwest’s Hospital Consumer Assessment of Healthcare Providers and Systems’ (HCAHPS) surveys continue to soar above the national averages of nursing-specific categories in the wake of a human caring cornerstone of practice. What’s more, caring can be measured. It has been noted that nurses who never considered loving kindness as a part of their job experienced encouraging personal shifts in their own caring competence and witnessed improved perceptions of pain in their patients when integrating intentional caring behaviors (Herbst, 2012). It has even been recently suggested that the presence or lack of a nurse caring may play a crucial role in pressure ulcer prevalence (Paull, Hanson, Hasenau, & Dunn, 2013). In fact, some nurse researchers concluded that utilizing a caring leadership model may “play an important role in developing leaders who are eager to engage with staff and colleagues and adept at creating space for authenticity and mutual respect” (McDowell, Williams, & Kautz, 2013, p. 50). And so it is suggested herein that choosing a human caring lens and a corresponding way of being with patients and colleagues is the better ethical choice. Truthfully, it is the only choice. Within this sacred calling named nursing, it is not permissible to be idle in our commitments to better preserve and ensure human dignity, human safety, human wellbeing, human healing, and human betterment. Caring is the ideal of the profession; the defining individual and collective factor of who we are. This societal contribution, unique to the nursing profession, is foremost and foundational not peripheral and optional. In fact, in light of noted literature that strongly affirms improved human conditions when intentionally integrating an informed human caring framework into practice, it becomes unsafe, unfair, and unethical not to embrace it. 1
Caritas coach
266 References Herbst, A. (2012). Impact of intentional caring behaviors on nurses’ perceptions of caring in the workplace, nurses’ intent to stay, and patients’ perceptions of being cared for. In J. Nelson & J. Watson (Eds.), Measuring caring: International research on caritas as healing (pp. 173-194). New York, NY: Springer. McDowell, J. B., Williams, R.L., & Kautz, D. D. (2013). Teaching the core values of caring leadership. International Journal for Human Caring, 17(4), p. 43-51. Nightingale, F. (1969). Notes on nursing: What it is and what it is not. New York: Dover. Ozkan, I., Hulya, O., Buldukoglu, K., & Watson, J. (2013). A case-based study on Watson’s theory of human caring: Being an infertile woman in Turkey. Nursing Science Quarterly, 26, 352-359.
Nursing Science Quarterly 27(3) Paull, J. C., Hanson, P., Hasenau, S., & Dunn, D. (2013). An examination of nurse caring and hospital acquired pressure ulcers. International Journal for Human Caring, 17(4), 32-42. Ryan, L. (2013, October). Intentional Integration of Caring Theory. Power point presented at the annual meeting of the 19th International Caritas Consortium, Chicago, IL. Watson, J. (1999). Postmodern nursing and beyond. Edinburgh, Scotland: Churchill Livingstone/ Harcourt-Brace. Watson, J. (2005). Caring science as sacred science. Philadelphia, PA: F.A. Davis. Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). Boulder, CO: University Press of Colorado. Watson, J. (2012) Human caring science: A theory of nursing. Sudbury, MA: Jones & Bartlett.
Copyright of Nursing Science Quarterly is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
research-article2014
NSQXXX10.1177/0894318414534489Nursing Science QuarterlyNursing Science QuarterlyRosa / Letter to the Editor
Letter to the Editor Nursing Science Quarterly 2014, Vol. 27(3) 265–266 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0894318414534489 nsq.sagepub.com
Letter to the Editor: It Is Unethical Not to Care William Rosa, RN; MSN1 Dear Editor, I was moved to comment on the article “A Case Study Based on Watson’s Theory of Human Caring: Being an Infertile Woman in Turkey” in the October 2013 issue of Nursing Science Quarterly. This case study illustrates that it is beyond indifference not to cultivate human caring as the core of nursing practice. Given the evidence of the possible effects of compassion, kindness, and love that can have on another fellow human, it has become unethical not to care. Choosing not to care about the spiritually embodied patient or colleague has become an all too common norm among the bureaucratic dictates and administrative constraints of dayto-day nursing. It is beyond time that we reclaim our mission as a collective, substantiating human caring as our purpose, taking the culture-specific scenario presented by Ozkan, Okumus, Buldukoglu, and Watson (2013) and actualizing it throughout the globe. Patients stand before us with rich life histories and future possibilities that often present in the context of vulnerability and suffering; the question then becomes, who are we not to care? I speak not of caring as a puppies and rainbows notion or a fleetingly hand-holding act of sympathy, but as an intentional consciousness that is based on a moral commitment to human dignity rooted in an ethical ontology of universal interconnectedness (Watson, 1999, 2005, 2008). Who are we if not the protectors, advocates, and givers of precious human caring to patients? How are we to be in this world as mentors, teachers, role models, and caring-healing practitioners, if not literate in a science of human caring? Are we to abbreviate our endless disciplinary potential to become technicians and skilled attendants, or simply individuals certified by a national organization or state board who happen to be nurses? There is no just happening to be a nurse. Even Nightingale (1969) suggested that there is a sacred calling to this act of human caring. Within the response to said calling we make the active choice to show up fully with a clear and authentic sense of caring-healing, or we fail to actualize the virtuous possibilities of our own legacy and we become passive nurses. I, for one, do not believe passivity is an option when looking into the eyes of the human being at the bedside or a fellow nurse across the hall. I see myself in the other; I care for my spirit in caring for the other’s. When adopting human caring science (Watson, 2012) as a nursing model of professional care delivery, a major
Midwest hospital showed institution-wide improvements in several performance areas that cultivate and support a flourishing human condition for patients and nurses. Between 2011 and 2012, after involving staff with a caring-science inspired approach, Adventist Midwest Health demonstrated significant increases in nurse job and practice environment satisfaction, massive improvements in nurse manager ability, leadership, and support of nurses, and between 2012 and 2013, there was a 48% decrease in lateral violence among nursing staff. Adventist Midwest’s Hospital Consumer Assessment of Healthcare Providers and Systems’ (HCAHPS) surveys continue to soar above the national averages of nursing-specific categories in the wake of a human caring cornerstone of practice. What’s more, caring can be measured. It has been noted that nurses who never considered loving kindness as a part of their job experienced encouraging personal shifts in their own caring competence and witnessed improved perceptions of pain in their patients when integrating intentional caring behaviors (Herbst, 2012). It has even been recently suggested that the presence or lack of a nurse caring may play a crucial role in pressure ulcer prevalence (Paull, Hanson, Hasenau, & Dunn, 2013). In fact, some nurse researchers concluded that utilizing a caring leadership model may “play an important role in developing leaders who are eager to engage with staff and colleagues and adept at creating space for authenticity and mutual respect” (McDowell, Williams, & Kautz, 2013, p. 50). And so it is suggested herein that choosing a human caring lens and a corresponding way of being with patients and colleagues is the better ethical choice. Truthfully, it is the only choice. Within this sacred calling named nursing, it is not permissible to be idle in our commitments to better preserve and ensure human dignity, human safety, human wellbeing, human healing, and human betterment. Caring is the ideal of the profession; the defining individual and collective factor of who we are. This societal contribution, unique to the nursing profession, is foremost and foundational not peripheral and optional. In fact, in light of noted literature that strongly affirms improved human conditions when intentionally integrating an informed human caring framework into practice, it becomes unsafe, unfair, and unethical not to embrace it. 1
Caritas coach
266 References Herbst, A. (2012). Impact of intentional caring behaviors on nurses’ perceptions of caring in the workplace, nurses’ intent to stay, and patients’ perceptions of being cared for. In J. Nelson & J. Watson (Eds.), Measuring caring: International research on caritas as healing (pp. 173-194). New York, NY: Springer. McDowell, J. B., Williams, R.L., & Kautz, D. D. (2013). Teaching the core values of caring leadership. International Journal for Human Caring, 17(4), p. 43-51. Nightingale, F. (1969). Notes on nursing: What it is and what it is not. New York: Dover. Ozkan, I., Hulya, O., Buldukoglu, K., & Watson, J. (2013). A case-based study on Watson’s theory of human caring: Being an infertile woman in Turkey. Nursing Science Quarterly, 26, 352-359.
Nursing Science Quarterly 27(3) Paull, J. C., Hanson, P., Hasenau, S., & Dunn, D. (2013). An examination of nurse caring and hospital acquired pressure ulcers. International Journal for Human Caring, 17(4), 32-42. Ryan, L. (2013, October). Intentional Integration of Caring Theory. Power point presented at the annual meeting of the 19th International Caritas Consortium, Chicago, IL. Watson, J. (1999). Postmodern nursing and beyond. Edinburgh, Scotland: Churchill Livingstone/ Harcourt-Brace. Watson, J. (2005). Caring science as sacred science. Philadelphia, PA: F.A. Davis. Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). Boulder, CO: University Press of Colorado. Watson, J. (2012) Human caring science: A theory of nursing. Sudbury, MA: Jones & Bartlett.
Copyright of Nursing Science Quarterly is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
