Nursing: A call to careNursing: A call to care

Comparing the current Comparing the current practice with the history and practice with the history and

theory of nursing. theory of nursing.

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ObjectivesObjectives• To critique the current practice To critique the current practice

using theory and literature using theory and literature • To bring attention to the majesty of To bring attention to the majesty of

the art of caringthe art of caring• To encourage nurses to have To encourage nurses to have

unlimited creativity and use the unlimited creativity and use the tools available to advocate excellent tools available to advocate excellent care. care.

Overview of HistoryOverview of History• B.C. B.C.

“If the spot on his skin “If the spot on his skin is white but does not is white but does not appear to be more appear to be more than skin deep and the than skin deep and the hair in it has not turned hair in it has not turned white, the priest is to white, the priest is to put the infected person put the infected person in isolation for seven in isolation for seven days.”days.”

• Leviticus 13:4Leviticus 13:4

www.cdphe.state.co.us/.../images/skin.htm

History B.C.History B.C.• The laws expressed concern for a The laws expressed concern for a

holistic type of health and include holistic type of health and include exhortations for rest, care for the exhortations for rest, care for the poor, and justicepoor, and justice

• Early type of health promotionEarly type of health promotion• Function of the “science” or Function of the “science” or

knowledge was for care and knowledge was for care and flourishingflourishing

Limitations of Other Limitations of Other CulturesCultures

• ““From the standpoint of humanity From the standpoint of humanity and the care of the afflicted the Jews and the care of the afflicted the Jews have an unbroken and glorious have an unbroken and glorious record” (Nutting and Dock, 2000, p. record” (Nutting and Dock, 2000, p. 64). 64).

• Other cultures muddled knowledge Other cultures muddled knowledge with superstitionwith superstition

• Most knowledge was on cures not Most knowledge was on cures not health promotion health promotion

History A.D.History A.D.• ““The early Christian church and the The early Christian church and the

teachings of Jesus Christ expressed teachings of Jesus Christ expressed succor to orphans, the poor, travelers, succor to orphans, the poor, travelers, and above all, the sick. The and above all, the sick. The deaconesses of the early church deaconesses of the early church visited the sick, much like modern visited the sick, much like modern visiting nurses or home health nurses” visiting nurses or home health nurses”

• Deloughery, p.3, 1991 Deloughery, p.3, 1991

History A.D.History A.D.• “ “For I was hungry and you gave For I was hungry and you gave

me something to eat… I was a me something to eat… I was a stranger and you invited me in, I stranger and you invited me in, I needed clothes and you clothed needed clothes and you clothed me, I was sick and you looked after me, I was sick and you looked after me, I was in prison and you came me, I was in prison and you came to visit me” to visit me”

• Matthew 25:35-36Matthew 25:35-36

XenodochiumXenodochium

• Impress your Impress your friends with this friends with this big word!big word!

www.ostia-antica.org/regio3/1/1-4.htm

History – A Sad DeclineHistory – A Sad Decline• Nursing was given over to women Nursing was given over to women

“who were too old, too weak, too “who were too old, too weak, too drunken, too dirty, too stolid, or drunken, too dirty, too stolid, or too bad to do anything else” too bad to do anything else”

• Reverby 1987 p. 22Reverby 1987 p. 22

A Pivotal PointA Pivotal Point• Florence Nightengale Florence Nightengale • She started a focus on education She started a focus on education

and knowledge base to bring up and knowledge base to bring up nursing from the “gutter” so to nursing from the “gutter” so to speakspeak

• This emphasis on knowledge and This emphasis on knowledge and professionalism has sharpened into professionalism has sharpened into the drive for technology and higher the drive for technology and higher learning as we see it todaylearning as we see it today

Problems With the Problems With the Current Practice of Current Practice of

NursingNursing• Main problem – sin in the form of Main problem – sin in the form of

selfishness. People just don’t care selfishness. People just don’t care about others. about others.

• This is highlighted in an acute care This is highlighted in an acute care setting, but also perhaps setting, but also perhaps perpetuated by acute careperpetuated by acute care

Specific Problems Specific Problems Highlighted in Acute Care Highlighted in Acute Care

SettingsSettings• Efficiency becomes the end instead of Efficiency becomes the end instead of

the means to carethe means to care• Policies are driven by money Policies are driven by money • People are objectified and detached People are objectified and detached

from their environment from their environment • People are not considered sacredPeople are not considered sacred• Continuity of care is fractured Continuity of care is fractured • Time is limited which results in a lack of Time is limited which results in a lack of

many characteristics of true caremany characteristics of true care

Say No to Reinventing the Say No to Reinventing the WheelWheel• We do not necessarily need a We do not necessarily need a

new vision of nursing. new vision of nursing. Instead, we need to go back Instead, we need to go back to the fundamentals of to the fundamentals of nursing nursing

• I argue that care is the I argue that care is the essential piece of nursing essential piece of nursing that is missing – or at least that is missing – or at least not being included in the not being included in the translation into practicetranslation into practice

What is Care?What is Care?

• Caring about –need or vulnerabilityCaring about –need or vulnerability• Taking care of –assume Taking care of –assume

responsibilityresponsibility• Care-giving – direct action Care-giving – direct action • Care-receiving – positive responseCare-receiving – positive response

• Tronto, Doornbos, Groenhout, and Hotz,Tronto, Doornbos, Groenhout, and Hotz,

Person Person • Good care is dependent on how Good care is dependent on how

people are viewed. It can only people are viewed. It can only occur when:occur when:• People are considered holistically People are considered holistically • People are considered sacred or are People are considered sacred or are

respectedrespected

So What? So What? • We cannot change everything… We cannot change everything…

We have a system. We have We have a system. We have hospitals. Even if we change to a hospitals. Even if we change to a universal health plan there still universal health plan there still won’t be enough health care won’t be enough health care providers. What do we do?providers. What do we do?

Stir Up the ChurchStir Up the Church• The early church started this whole The early church started this whole

care thing, maybe it needs to get re-care thing, maybe it needs to get re-involvedinvolved

• What a partnership between church What a partnership between church and healthcare can look likeand healthcare can look like

• Christian nurses –you must exhort Christian nurses –you must exhort your congregations! your congregations!

• It all starts with individualsIt all starts with individuals

We Can Change…We Can Change…• Be an influence – (get on those Be an influence – (get on those

committees. I know it’s overwhelming, committees. I know it’s overwhelming, but if you’re committed to beneficence, but if you’re committed to beneficence, you will take action)you will take action)

• Care about the details – (hearing Care about the details – (hearing stories, getting cups of cold water etc)stories, getting cups of cold water etc)

• Critically think! (What drives you crazy? Critically think! (What drives you crazy? What would make things safer?) Give What would make things safer?) Give research examplesresearch examples

• Follow up care – the importance of Follow up care – the importance of holistic thinkingholistic thinking

ConclusionConclusion• So Remember…So Remember…

• BE CREATIVEBE CREATIVE• Guard your ability to careGuard your ability to care

• Do not grow weary of doing good…Do not grow weary of doing good…

Works CitedWorks Cited Baer, E. D. (2009). "Do trained nurses... work for love, or do they work for money? "Nursing and altruism in the twenty-first century. Nursing History

Review, 17, 28-46.Borsay, A. (2009). Nursing history: An irrelevance for nursing practice?

Nursing History Review, 17, 14-27.Chambliss, D. F. (1996). Beyond caring: Hospitals, nurses and the social

organization of ethics. (pp. 63-65). Chicago: The University of Chicago Press.Deloughery, G. L. (1998). Issues and trends in nursing (3rd ed., p. 3). St. Louis:

Mosby.Doornbos, M. M., Groenhout, R., & Holtz, K. (2005). Transforming care: Toward a Christian vision of nursing practice (pp. 20-93). Grand Rapids, MI: Eerdmans.

Marriner, A. (1986). Nursing theorists and their work (p. 82). St. Louis: C.V. Mosby Company.

Mohrmann, M. E. (1995). Medicine as ministry (p. 71). Cleveland, OH: The Pilgrim Press.

Nutting, M. A., & Dock, L. L. (2000). A history of nursing (Vol. 1, p. 64). Bristol, UK: Thoemmes Press.

Reverby, S. M. (1987). Ordered to care: The dilemma of American nursing, 1850-1945 (p. 1). New York: Cambridge University Press.

Smith, J. (October 10, 1999). C. S. Lewis on Man's Godly Potential. In Greater Things. Retrieved April 12, 2009, from http://

www.greaterthings.com/Topical/CS_Lewis_Godly.htm. Tronto, J. C. (1994). Moral boundaries: A political argument for an ethic of care

(pp. 106-108). London: Routledge, Chapman and Hall, Inc.