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Page 14 • nevada RNformation May, June, July 2015 The Ethics of Caring John Malek, PhD, MSN, APRN While there are many key concepts within the framework of nursing, caring is a central construct within the discipline of our profession. As such, we should be concerned about the ethical implications of caring, its application and effect on our practice. Discussion on the theory of ethics of care has been well documented since the early 1980’s beginning with the work of Dr. Jean Watson. Among the early conceptual frameworks in nursing, Dr. Watson’s Theory of Caring is described as a moral ideal that involves mind, body, and soul engagement with another. Most of us consider caring to be something of a moral obligation to our patients from which action emanates. The ethics of care considers three distinct elements that not only involve actions, but also a focus on relationships between power and caring practices as well as addressing the question, “What is the best way to care for this patient at this time?” Tronto (1993) postulates four elements of caring that include attentiveness, responsibility, competence, and responsiveness of the care receiver. Focusing on each element individually and collectively we can understand how caring is ethically responsible. REGISTERED NURSES Full-time positions available for: ICU, Emergency Room, Med/Surg, Operating Room, Labor & Delivery RN or LPN, Skilled Nursing Facility Nevada license required. We offer competitive salary DOE; excellent benefits including Public Employees Retirement, group insurance benefits, accrued PTO & Sick Leave. Contact HR Director Humboldt General Hospital 118 E. Haskell Street, Winnemucca, NV 89445 rose@hghospital.ws • Fax (775) 623-5904 EOE Employer Non-smoking facility, non-smoker preferred. Carson Tahoe Health provides a complete continuum of care with: · Three Hospitals · Two Urgent Care facilities · Comprehensive provider network · 22 locations covering Carson City & surrounding areas We offer: · Competitive Salaries · Medical Benefit Package · PTO · Sick Leave · Paid Holidays · Education Assistance · Generous 401(k) Visit our website for current nursing opportunities www.carsontahoe.com Recruiter: 775.445.8678 Job hot line: 888.547.9357 Carson City, Nevada (Located in Northern Nevada, near Lake Tahoe and Reno) EOE Caring is a feeling that also requires an action. According to Lachman (2009), “caring lies on a continuum, with different levels of emotional involvement for individuals in a caring relationship.” An illustrative example would be caring for your pet versus caring for an ailing relative. So the question is, “How can we meet the responsibility of caring?” There are four distinct phases within the ethics of caring model: (1) caring about, (2) taking care of, (3) care giving, and (4) care receiving. • Caring about implies recognizing a need. An example would be identifying/ relating to what a patient needs at this particular time such as chills, fever, nausea, vomiting, pain, emotional distress, and includes obtaining a thorough history. • Taking care of implies a responsibility to take action. Responsibilities include providing reassurance and explanations, ordering diagnostic tests, starting IVs, preparing medication to be administered. In addition, these responsibilities include conducting a physical exam. • Examples of care giving include administering medications(s), providing warmth, keeping patients and families informed, and providing education. Taking action implies suggesting or implementing a change. • In care receiving we assess the success of a particular intervention. Collectively, these strategies involve an interrelationship between cognition, emotion, and actions. For many of us this may represent the essence of the nursing process. However, for the RNs Needed at Community Health Alliance One Supervisor/Chronic Care Send CV to careers@chanevada.org www.tchealth.org • 928-283-2432 TCRHCCHR@tchealth.org patient to actually experience the ethics of caring, this can only be achieved by the implementation of the stated strategies listed. Effective care is based upon our knowledge, skills, abilities, and attitudes. As you can see, a lack of any of these elements raises ethical issues that correlate directly to competency. Failing to acknowledge a lack of competency in a given situation could result in action against a nurse’s license, malpractice acrtions, and detrimental outcomes for patients and families. According to the ANA (2001), “Continual professional growth, particularly in knowledge and skill, requires a commitment to lifelong learning.” Most nurses have been exposed to Watson’s caring theory, but many of us are not aware of the ethics of care. Dr. Watson’s caring theory contains three major elements: (1) the carative factors, (2) the transpersonal caring relationship, and (3) the caring occasion/caring moment. As we honor nursing’s work to care for patients, let us also remember that caring without action is essentially meaningless from an ethical perspective. References Allmark, P. Can there be an ethics of care? Retrieved from Journal of medical ethics 1995; 21: 19-24. http://jme. bmj.com/ Doi: 10.1136/jme.21.1.19 American Nurses Association (ANA). (2008). Guide to the code of ethics for nurses: interpretation and application. Silver Spring, MD: Author. Lachman, V.D. (2009). Ethical challenges in healthcare: Developing your moral compass. New York, NY: Springer. Tronto, J. (1993). Moral boundaries: A political argument for an ethic of care. New York, NY: Routledge FirstMed Health and Wellness Center Quality and affordable healthcare services for all. Our Services include: *Women’s Health and Prenatal Services *Pre-employment Physical *Free Enrollment to Medicaid Programs *Primary Care Provider *Pediatrics JOIN OUR TEAM! William Bee Ririe Hospital located in Ely, NV A friendly rural community in mountainous Eastern Nevada Relocation Bonus! Registered Nurses • OR RN We offer generous benefits; State retirement (PERS); very competitive salaries. William Bee Ririe Hospital shall abide by the requirements of 41 CFR 60-300.5(a) and CFR 60-741(a). Contact: Vicki Pearce, vicki@wbrhely.org 775-289-3467 Ext. 299 www.wbrhely.org $5 Off First Visit Bring Coupon CALL NOW: 702-731-0909 3343 S. Eastern Avenue Las Vegas, NV 89169 “We are on RTC Route 110”
May, June, July 2015 Nevada RNformation • Page 15 Creating Serendipity continued from page 13 there are things we can all do to have serendipity’s fickle limbs embrace our work and increase our likelihood for making great discoveries. 1. Be curious. Never stop asking questions. Always try to come up with connections. Ponder the “what ifs.” Dig deeper into the task at hand to find the core of the problem. Keep studying, learning, listening. 2. Be alert. Live in the moment. Try to be engaged. Pay close attention to what you’re doing. Focus. 3. Be open-minded. Don’t discount anything too early. Embrace flexibility. Think outside the box. 4. Be inclusive. Work in collaboration. Support your colleagues, and share your ideas freely. 5. Be tenacious. Do not fear failure or getting Semmelweised 6 (i.e. being ridiculed by your colleagues). The easy road is often the wrong one to take. 6. Be responsible. Work hard but don’t forget to take care of your basic needs. 7. Be wary of the status quo. If you’re not challenging the way things are by constantly asking yourself how things can be made faster, cheaper, easier, or better, then you won’t be mentally prepared when the opportunity strikes. Alexander Fleming never expected that mold found in stale bread could have anti-bacterial properties, but because he was already engaged in the pursuit of finding a substance that could kill off Staphylococcus in culture—and because he was curious, tenacious, and disciplined—he immediately recognized the significance of finding the halos of growth inhibition in the contaminated media. As Louis Pasteur, the scientist originally credited with confirming that bacteria causes disease, best put it: “Chance only favors the prepared mind.” 7 Reference available upon request. —Alberto Hazan is an emergency physician in Las Vegas and an assistant attending at St. Luke’s-Roosevelt/Mt. Sinai in New York City. He is the author of the medical thriller Dr. Vigilante and the preteen urban fantasy series The League of Freaks. RN Opportunities await you in our growing community! • Director Med/Surg/Peds-ICU • Director Emergency Department • Staff Development/Education Coordinator, RN • House Supervisor • Staffing Coordinator, RN • ED, RN • ICU, RN • Med/Surg/Peds, RN • Women’s Services, RN Click on the “CAREERS” tab to apply today! www.NNRHospital.com
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Nevada RNFORMATION

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