Caring is viewed as the essence of nursing, discuss… Introduction Lenninger (1984) described caring as the “essence of nursing”. Over the years many nursing theorists and researchers have examined the concept of caring and written extensively on the importance of caring in nursing. Going back to the foundation of modern nursing Nightingale (1859) wrote that nursing’s most important work is caring. Despite the wealth of ground covered in these works the term “care”, is rarely defined as a theoretical concept in its own right and is often used interchangeably with the term nursing (Gaut, 1983).
In this article the author will explore the existing theoretical perspectives on caring. The author will attempt to show how nursing and caring are inherently linked and the important role that caring plays in job satisfaction for nurses as well as client satisfaction with the service provided. The article will also try to demonstrate the distinction between lay-caring and professional caring. Perspectives on caring Cognitive Lenninger (1981) defines care/caring as those assistive, supportive, or facilitative acts toward another individual with evident needs to improve their condition.
This view of caring as an act of doing something to help a person is shared by other authors too. Caring is considered a series of helping activities (McFarlane, 1976). This is in-line with Orem’s (1985) theory of self care, which identifies five methods of giving assistance to an individual including acting for or doing for another, guiding another, supporting another, providing an environment that promotes personal development and teaching another. Emotional Alternatively, caring is viewed as a therapeutic interpersonal process that can only be effectively practised interpersonally (Watson, 1979).
Benner (1984) agrees and identifies an instrumental and expressive role in nursing for the concept of caring. Dunlop (1986) warns not to define caring as a finite set of behaviours as to do so would likely end in a distortion of its true meaning. Adding to this train of thought Duke & Copp (1992) describe nursing care as synergistic. To them caring is viewed as the hidden ingredient of nursing, the common thread running through all we do as nurses. Moral Consequently the argument that there is more to caring than can be seen physically has prompted some authors to describe it as an ethic.
Kurtz & Wang (1991) indicate that there is a moral element to caring. Gadow (1985) regards caring as a moral ideal that entails a commitment to the protection and enhancement of human dignity. According to Fry (1988) in order for caring to serve as an ethical standard in nursing then it must be viewed as an overriding value to guide ones actions, it must be considered a universal value by all, caring must be other regarding and considered prescriptive, promoting empathy, support, compassion, protection etc. Caring is nursing Caring is nursing and nursing is caring” (Lenninger, 1984). Most professionals would agree completely that nursing and caring are intimately linked as illustrated by McFarlane (1976) who whilst defining care questioned weather it meant something different from nursing at all. Caring for people encompasses the humanistic trait of interacting with clients that demonstrates sincere care and concern for them simply because they are human beings. There is a variation between caring for people and with taking care of people.
The latter emphasises objective, professional care, such as the medical and psychological aspects of nursing (Paulson, 2004). To sustain hospital services in the current economic climate cost reduction measures are required. Paulson (2004) infers that cost-cutting has contributed to the problem of client dissatisfaction. The problem is that the clients complain of an environment where they are treated in an efficient manner, without care and concern by nurses.
She writes of a catch twenty two situation where the nurses themselves know they need to spend more time with individuals to show there caring side but they actually now have less time due to the cost reduction measures and emphasis on efficiency and sustainability. Duke & Copp (1992) likened caring to the string in a necklace; it holds all the beads together. However if it can be argued by Paulson (2004) that there is an increase in client dissatisfaction then that begs the question; are caring behaviours and attitudes decreasing amongst the modern workforce of nurses?
Paulson (2004) tells us that many nurses are surprised that service users perceive they receive unsatisfactory care. These nurses are sure that they are providing care in the precise manner that they were taught in nursing programs focused on caring for clients. Paulson (2004) has argued that there is a difference between taking care of and caring for service users. Remen (1980) points out that these two different approaches are often indistinct and when they are misunderstood, problems arise.
Nettina (2000) informs that nursing care concentrates on objective, physical care concerned with assessment, diagnosis, planning, implementation and evaluation. Paulson (2004) comments that taking care of clients objectively is necessary, but that this mode of care subtly encourages nurses to depersonalise the individuals in question. Bruce, Bowman & Brown (1998) reported that high satisfaction figures recorded by clients were directly linked to a caring and compassionate workforce.
Caring attitudes can be taught and should be taught to nurses where a caring deficit exists within the organisational culture. Through ongoing use of strategies that promote attitude change nurses can potentially increase client satisfaction along with their own fulfilment requirements (Judkins & Eldrige, 2001). Even though taking care of people entails years of training, caring for people calls only for nurses to undertake their work with an open and warm manner that connects with people (Banathy, 1996) Lay-caring versus professional caring
Henderson (1980) sees the provision of a twenty four hour, seven day a week service as a unique aspect of nursing that sets it apart from other health care professions. This commitment links nursing more closely to the type of surveillance and care given by a relative to a dependant person in the home. Despite the similarities in the values shared and activities performed by lay-carers and professional nurses, a distinction between them does exist. Kitson (1987) comments that both lay-carers and professional nurses share the same main attributes which include commitment, knowledge and skills and respect for the people they look after.
The difference is that professional nurses are set up as a specialist service to meet the needs of those who cannot care for themselves or be cared for by a lay-carer in an acceptable manner. Hirshfield (1983) noted that without emotional involvement between the lay-carer and the recipient of care, the relationship between them could not be maintained or developed in a manner acceptable to both parties. In the case where an emotional attachment is missing between the lay-carer and the care recipient Kitson (1987) interprets that the attribute of commitment can be lacking leading to breakdown in the relationship.
If the lay-carer simply cannot provide the skills and knowledge required to care for the person then that is another case where the purpose of the professional services can be fulfilled as they have the resources to match the requirements of the ill person. Conclusion In summary this article has shown the words caring and nursing can be linked together in a way that they are mutually interchangeable. Even though this is generally accepted as the case the author has also described the complex concept of care/caring.
It can be said that caring is belief that incorporates different theoretical interpretations including cognitive, emotional and ethical. The article has covered the important role that caring plays in nursing and the positive effects it has on care givers and receivers alike. The author has shown the similarities and the differences between caring as a lay person versus caring as a professional nurse.