Saturday, June 26, 2010

Caring

We had a 1 day education inservice (thank you big pharmaceutical for providing unrestricted educational grant) and one of the topics was on caring.

We spent a lot of time on this topic when I was in school-what exactly is it, how do nurses do it, and what happens when it is not being done?

It is central to nursing-and I find it a fascinating topic. The presentation was based on the presenter's research on how nurses care while in stressful situations. Her research showed that caring is a choice that people consciously choose and that though environment plays a part, that it does come down to the individual's decision. Her thought and I would agree, is that nurses who are able to engage in this are happier and can provide quality care despite various circumstances.

I was discussion this a colleague, who is a social worker, he said that though he enjoyed the presentation, that his perspective tended to be more on the environment and how that impacted care. Makes sense when you also consider that nursing tends towards individualized interactions, whereas social work tends towards looking more at systems. Both of course frequently move in and out of those frames of reference.

Naturally both play a role, but I do think that it does come down to more of a conscious choice in the particular workplace I am in. It is easy to get caught up in the idea that we don't have enough money, there is not enough time, there are too many patients. But when compared to most health care systems in the rest of the world, we are far and away able to offer superior care. So why does it seem that it is not enough?

What would be enough?

Yes, I would like to be able to ensure that more people with mental illness have access to timely, prevention focused care, and I agree that we are often stretched to do this, but I can't say that I go home at night feeling that people have not received good care-and honestly when I do, it is more likely to be as a result of what I see as uncaring nursing. On an individual basis.

I never really thought of myself as being someone who sees things as more individual responsibility, with my patients, I encourage people to act within their ability to change, but also strongly believe that societal systems have hugely impacted the onset of mental illness and ability to manage mental illness.

But it seems with nurses working, that I do see their behaviour and actions in terms of individual choice. What is the difference for me then?

I suppose because though nurses have in the past (before the 1980's?) been a devalued group, now they are not. They wield a great deal of power within the healthcare system-without nursing, healthcare does not function. we are paid well-I would venture to say, very well. We are professionals-well educated, and self regulating. Generally we are well respected-depending upon which study you look at, nursing is at the top or near the top of the lists ranking professionals who are trusted.

Why are we still acting in ways that seem to take the stance that the system works against us, that we don't have control, that we are not respected then? I think that this sometimes victim focused mentality leads to uncaring nursing. Because if I am a victim too, why should I have to put so much effort into doing a caring act? How can I gather enough energy to care for others if I am being trampled on?

I think that we need to recognize and acknowledge that we have power within the health care system and that we need to be using that power respectfully-whether interacting with the health authority, each other, and above all with patients. Would that help?

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