International Association for Human Caring Conference 2012: Part II

June 3, 2012 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 4 Comments

On the second day of the conference, the key note speaker was Dr. Sigridur Halldorsdottir. My knowledge of Dr. Halldorsdottir’s work was that it is based in caring, but I found myself truly appreciative of the amazing work she has done to define what caring is. Her Speech was entitled, Caring or Uncaring: What nursing is and what it is not- Revisited. Those of you familiar with Florence Nightingale’s work will recognize the idea of “what nursing is and is not”.

Sigridur provided us with a model that stated that love is the essence of caring. Caring is supported by the nurse’s courage, wisdom, authenticity, generosity of heart, and self knowledge. Patients can sense when caring is genuine and hospitals need to value caring to support nurses in their work.

Dr. Halldorsdottir also listed 9 competencies for caring. The competencies include caring in the sense of the existential, real caring, the ability to educate, ethical approaches, cultural competence, interpersonal communication, education, empowerment, and self development.The idea of being able to align caring with specific competencies demonstrates the advances we are making in developing a caring science of nursing. The downside which cannot be ignored is that if a caring nurse is placed in an uncaring environment, she will most likely leave that environment. This could be part of the body of evidence as to why so many nurses leave the profession.

It is difficult to capture here the essence of Dr. Halldorsdottir’s caring presence as she presented these ideas; she threaded some healing pictures from her homeland of Iceland throughout the presentation, but I was honored to be able to experience her heartfelt wisdom.

Redefining the meta-language of nursing science

February 15, 2012January 4, 2017 / Olga F. Jarrín / 3 Comments

Due to technical difficulties with my webinar last week I decided to make a recording of my presentation that is now available as a YouTube video. The length is just under 30 minutes. I hope you will join me for “lunch” or “tea” to experience the video, and share your thoughts and critique here or on the Advances in Nursing Science Journal blog.

This presentation covers some of the ideas from my recent paper “The Integrality of Situated Caring in Nursing and the Environment” published in the current issue of Advances in Nursing Science. I sincerely look forward to the dialogue that I hope this presentation and paper will provoke. Don’t be shy, please share your thoughts.

Nurses striking: is it effective?

September 24, 2011 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 4 Comments

As many of you have likely heard, the nurses employed by Sutter Health in Northern California staged a strike on Thursday September 22, 2011 in protest over an increase in benefits costs and decreases to sick and vacation leave. ofhttp://www.forbes.com/feeds/ap/2011/09/23/general-us-calif-nurses-strike_8696370.html

While the non-profit Sutter Health has real profits in the near billion dollar range, we are left wondering why it is the nurses’ benefits are being cut even as the heads of the organization walk home with millions of dollars of “bonuses” each year.

http://www.bizjournals.com/sanfrancisco/news/2011/03/25/sutter-healths-2010-profits-surge-30.html

I think the nurses are in some respects justified in taking this stance and going on strike; they are working together to stand in solidarity (though up to 40% of the nurses at the various hospitals crossed the picket lines and reported to work). On the other hand, I feel that the strike does not create an atmosphere for discussion and dialogue that might be meaningful. This action in and of itself seems unlikely to create a path for communication between administrators, decision makers, and the nurses. The union itself also prevents much of this direct communication and may prevent the working nurses from communicating their concerns outside of the union’s presence.The strike does create some obstacles and safety concerns for patients, administrators, nurses crossing the strike line, and the replacement nurses.

I have thought a mass exodus of the nurses, or many immediate resignations, would be more effective, though highly unlikely to happen for obvious financial reasons. For each nurse who quit, Sutter would lose at least $60, 000 in training a new nurse to replace them. These expenses could add up very quickly if a good chunk of the nurses walked away from their positions. Sutter may have problems with hiring new nurses in relation to the higher costs of benefits, the reduction in vacation pay, and the elimination of paid sick leave. Paid sick leave can help to stop the spread of illnesses like the flu (have we already forgotten H1N1?), but perhaps I am digressing a bit here.

It would be interesting to poll the public and get their perception of striking nurses, professionalism, empowerment, and the image of nurses. From the current state of the media coverage, it is difficult to tell where the public stands on this.

We do know that the nurses have now been locked out until Tuesday, as at least two of the hospitals have a minimum contract of five days for their temporary staff contracts. These contracts are likely very expensive and in no way are saving Sutter any money, which was the reason given for changes in the benefits. http://www.baycitizen.org/blogs/quality-of-life/nurses-who-went-strike-told-not-come/

The issue of unions, strikes and walk-outs is prime for nursing researchers to continue to explore: what are the outcomes of strikes, do the nurses feel or experience a sense of empowerment through the process, what is the public’s perception of nurses’ unions and strikes, and so on.

To Challenge and to Cooperate

September 15, 2011September 15, 2011 / Peggy L Chinn / 8 Comments

Most readers of this blog are already aware of the IOM/Robert Wood Johnson report on the Future of Nursing that was issued in October of 2010. You may recall my post about the report last June – in fact, there were 16 replies to that post – a record for this fledgling blog! The replies were thoughtful and brought to the fore exactly what is most badly needed in nursing – challenges about not only the report, but the assumptions underlying it. So I would like for us to focus once again on this initiative, not simply because of the terrific discussion it raised on this blog, but because it is generating a substantial degree of action. Part of the action component is built into the funding plan that accompanied the original report, which actually strengthen the possibility that something will come of it! But of course the action components need to be watched closely. The challenge for me, and I suspect for many others who entered the discussion in June, has to do with a fundamental question: “Who benefits?”

During the August conference of INANE (International Academy of Nursing Journal Editors) in San Francisco, the 130+ nursing journal editors and publishers heard a presentation by Susan Hassmiller, the Senior Advisor for Nursing for the Center to Champion Nursing in America. In response to her presentation, the group decided to initiate a coordinated effort across as many nursing journals as possible, to further the possibilities for the achievement of the report’s recommendations. So far, the INANE web site has a listing of editorials and resources that have appeared in various nursing journals over the past year or so; in the spring of 2012, many of the journals will carry focused messages about the report, articles, and other content that provides evidence and resources for their readers in moving forward. I would encourage folks to browse this list … it is impressive, and many of the editorials are well worth looking up and reading. Also, if you want to see Susan Hassmiller’s presentation from the INANE conference, you can find it here (scroll down to the Friday 8:00 session).

So my question for readers of the Nurse Manifest blog: can we both challenge and cooperate? I fully agree with many of the challenges that came forward in our discussion in June, including skepticism about the source of the report, and the fact that the report’s recommendations are in fact what we might call “lame.” However, the cold hard truth is that the recommendations of the report, which of course should already be reality, are far from real. If we were to achieve the report recommendations as reality, do we not have a better outlook for achieving not only the fundamental goal of better health care and better nursing care, but also the ideal of seeing nursing at the center of health care policy-making. If we simply sit on the sidelines and challenge the report, then we isolate ourselves from the places where mainstream change might be possible. If we simply cooperate with the report without questioning some of the assumptions and directions, then we ourselves may all too easily be drawn into an abyss of the status quo. So bottom line, to me, there is no simple way forward. But I favor moving forward, challenging ideas and actions where possible to be heard, and with as much cooperation as possible with those who follow a more mainstream path than many of us follow!

Examining the Nurse Manifesto: Identifying with the Past and Future

August 12, 2011 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

Now, seeking meaningful avenues for action, we choose to identify ourselves with the heritage and future of nurses. From nursing history we have learned the fullness of our own potential as nurses, the strength of nurses, the effect of nurses in communities and to individuals. We have seen our own common self interest, and common oppression. Having found these authentic bonds as nurses, we realize we can rely on each other as we seek conscience-based action to shape a new future for nursing and for health care (Cowling, Chinn, & Hagedorn, 2000, paragraph 4).

This is another excerpt form the Nurse Manifesto, a document that calls us as nurses to create avenues of change for the future of the profession. As I reflect upon this excerpt, and our identity as a profession. Where did we come from and where are we headed? How can history inform the future of our profession, and how is it we can come together to create meaningful change?

Nurses Honor the Past By Wearing Caps For A Day

In 2002, I wrote an article about the nursing shortage and how in some respects, the profession has created our oppressive cycle by not coming together to empower ourselves and take control of future and our practices (Clark, 2002). Perhaps reflective of the greater culture, we tend to enact lateral violence, and repeat actions that keep us divided over our differences versus united in the quest to provide the greatest healing opportunities for our patients. We see that our own oppression grows, as we widen the gaps between administration/ managers and practicing nurses, and the dominance of nurse educators over students. Focusing on our differences, creating small factions, failing to care for ourselves, not committing to being lifelong learners, and spreading ourselves thin all contribute to our professional oppression and keep us from focusing on our common goals.

I believe that we can each start right where we are at. The first step is caring for yourself that you may also better for care for others, patients and colleagues alike. Creating work environments of healing and caring is a common goal we can share and explore together on the local level. We can commit to creating a consciousness for change in nursing and healthcare.

As the over-arching professional organization, it would be wonderful if the American Nurses Association could begin to bring us together on a national level. It seems the state nursing associations on many levels are more likely to create local action, but they also need assistance in gaining participation and increasing membership numbers. In my small state of Maine at our statewide meeting last year a quorum was not established as there simply were not enough members present to meet that mark.

I imagine a professional world where each donate some of our time every year toward taking action on the local-statewide level, whether that is writing a letter to congressional representatives, or serving our larger communities, or perhaps sharing our expertise about the human experience. I have served on the local school board, where I helped to foster much-needed changes in the kitchen and the nutritional program, and now I serve on the early education advisory council in my town, where I share and learn about childhood development and teaching and evaluation skills. Churches are another great place to provide healing services and demonstrate your expertise as a nurse. Serving in communities helps us to unit with the community and our patients; this unification process can also foster change as we grow our partnerships and empower communities and individuals toward creating the healthcare system of the future.

One great way to come together is to join a specialty nurses association and attend their conference. I have found great comfort, support, and enthusiasm in the American Holistic Nurses Association; it is rejuvenating to leave the conference and begin to take action based on what was learned there. I have found that the AHNA has a great commitment to changing the future of the nursing profession, and empowering nurses on a meaningful manner.

Lastly, how do we empower the future nurses to realize the potential of our profession? They must understand the path that nursing has traveled, the change process, self-care, and their potential contribution to the unveiling of the new paradigm of healing in our future.