The Inseparable Link of Nursing and Caring

Caring is a human instinct. Especially with people that are close to our hearts, people would not hesitate to care for their general well-being. More so, people whose duty is in the service sector, they are more enjoined to care for their customers. This is why “caring” is both a duty and a responsibility to people involved in the health care profession. As defined by Mosby's Medical, Nursing and Allied Health Dictionary (2002), caring means the actions characteristic of concern for the well-being, such as sensitivity, comforting, attentive listening, and honesty for the patient.

One of the frequent reminders offered to health care professionals is that “patients are people”. This is not because health care professionals do not know this or, worse, do not care about the status of their patients. It is simply that in the cut and thrust of decision making in relation to the clinical management of a patient’s condition, the human side of health care can be overshadowed by its technical aspects.

No doubt, to become a successful nurse, one must not only learn to deal with their patients as clients, caring for them is important to assure their recovery from any maladies. Since the days of Florence Nightingale, there has been a direct link between nursing and service to others (Kearney, 2001). When a child is asked why they want to become a doctor or a nurse, they often respond, “To help other people”.  This response partially defines caring because caring cannot occur if others are not involved. Caring requires a recipient.

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Several theorists have developed conceptual models based on caring. One of them is Dorthea Orem, who developed the Self-Care Deficit Model (1995). Orem believed that all individuals desire to care for and meet their personal care needs and that each person has varied abilities to participate in meeting his personal self-care needs.

The nurse attempts to meet the client's self-care needs in an effort to reduce the client's self-care deficits. On the other hand, Watson (1999) believed that caring is a moral ideal and that nursing is a caring art and science. The client is the center of human caring. Finally, Leininger (2001) purported that nursing is a learned art focused on caring in accord with an individual’s culture. To these theorists, caring definitely is a vital component of nursing.

Moreover, Bertero (1999) deemed that caring includes “all aspects of delivering nursing care to patients” (p. 414). Thus, caring is the essence and the unifying core of nursing. In her book, Leininger proposed that caring is the trademark of nursing practice: “Care is the essence and the central unifying and dominant domain to characterize nursing. Care has also been postulated to be an essential human need for the full development, health maintenance, and survival of human beings in all world cultures” (1988, p. 3). These statements imply that caring is both the duty and responsibility of all nurses as members of the health care profession..

Indeed, the central aim of both nursing and medicine is to act in the best interests of the patient. This is such an obvious statement that it is hardly worth setting down on the page. However, the old adage ‘easier said than done’ springs readily to mind once we begin to think out the practicalities of acting in the patient’s best interests. Most difficult, perhaps, is the question of how we know what the patient would say these are.

The place of advance directives is relevant here as they present a very clear example of situations where the patient’s interests are known, yet they still lead to complex discussions about the validity of the patient’s view on their situation. The problem is that nurses have to be sure that the circumstances they face are the ones anticipated by the patient when the advance directive was made.

With all the stress and challenges of being a nurse, coupled with the management of extended workloads and staff shortages within already restricted finances, it is not surprising that the focus of nursing and caring gets lost within the biomedical emphasis. The advent of clinical supervision focused on reflective practice has promoted a refocusing of the emphasis towards patient-centered care and caring as central to nursing. It provides a structure within which any nurse can develop both personally and professionally, maximizing their therapeutic potential to improve patient care while balancing all challenges with caring for their patients.

Although some nurses see their profession as a stepping stone for financial reward, others see nursing profession as a vocation  that provides self-satisfaction or self-fulfillment. Whatever intentions they might have in mind, nursing defines who they are. Nursing, to a professional, is a career plan, a central part of his core being; and caring is the behavioral outcome.

The concepts of essential relationships and self-reward may comprise care of others and care of self. “Components of this service ideal include a profound sense of purpose, a true sense of capability, and a deep concern for others demonstrated as caring” (Hood & Leddy, 2003, p. 32). Service to others provides a meaningful life purpose. Service gives the individual feelings of competence in the ability to perform a task. Service is the link between concern for others and action in response to concern.

Definitely, nurses would be able to meet a client's needs when provide services with care and concern. Caring is a commitment by the nurse to become involved, and its character is relational. Fact is that nurses entered into this relationship with their whole being as they chose to venture in this kind of profession (Bertero, 1999, p. 415). To realize that caring is more than a physical presence, nurses should promote a relational concern for the patient’s well-being. It is essential that there is an active commitment for both the process of healing for the patient and to the furtherance of our nursing knowledge. Thus, there should be a union of caring and competence and the link should be seen as the ultimate goal of the nursing practice.

References

Bertero, C. (1999). Caring For and About Cancer Patients: Identifying the Meaning of the Phenomenon “Caring” through Narratives. Cancer Nursing, 22(6): 414–420.

Hood, L. and Leddy, S. (2003). Leddy and Pepper's Conceptual Bases of Professional Nursing (5th ed.). Philadelphia: Lippincott .

Kearney, R. (2001). Advancing Your Career: Concepts of Professional Nursing. Philadelphia: F.A. Davis Company Leininger, M. (1988). Care: The Essence of Nursing and Health. Detroit, MI: Wayne State University Press.

Leininger, M. (2001). Culture Care Diversity and Universality: A Theory of Nursing. Boston: Jones and Bartlett.

Mosby's Medical, Nursing and Allied Health Dictionary. (2002). Caring. Retrieved 27 October 2006, from xreferplus.

Orem, D. (1995). Nursing: Concepts of Practice (5th ed.). St. Louis: Mosby.

Watson, J. (1999). Nursing: Human Science and Human Care (3rd ed.). Norwalk, CT: Appleton-Century-Crofts.

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