Beliefs, Attitudes, and Values on Nursing

To be sure, the literature reflects long-run concern with such(prenominal) uncomplaining-cargon problems as the clinical autonomy and relation back institutional authority of nurses, physicians, nurses' aides, hospital management, and the restructuring of the wellness-care system as a whole (Shindul-Rothschild, 1996; Cullen, 1995; Shindul-Rothschild, Berry, & Long-Middleton, 1996). Additionally, there is evidence of tension within treat between the moral and clinical priorities of patient care loveseat the priorities of bureaucratic institutions and health insurers: Some nurses have been disciplined for documenting patient requests for treatment beyond insurance policy-covered conditions, and others appear to have been co-opted into the practice of delivering health care by the (HMO) numbers (Gordon & Fagin, 1996), although injunctions toward compassionate interaction with patients and families await first principles of care for (Czerwiec, 1996). One voice urges home-health-care nurses to make a project of accommodating and adapting to transcultural or multicultural health-care issues, e.g., ethnic, religious, and educational factors influencing effective nursing care (Grossman, 1996). Another expresses alarm at the ways in which nurses have relinquished their position as patient-care advocates in the clinical setting and instead been positioned by insurance and hospital bureaucracies as gatekeepers against costly health-care options (Gordon & Fagin, 1996). And at

Czerwiec, M. (1996, May). When a loved one is dying: families talk about nursing care. American journal of Nursing, 96, 32-6.

Gordon, S., & Fagin, C. M. (1996, March). Preserving the moral exalted ground. American Journal of Nursing, 96, 31-2.

Levine, M. E. (1995, Spring). Rhetoric of nursing theory. IMAGE: Journal of Nursing Scholarship, 27, 11-14.

Presumption of a nurse's obligation to have twain compassion and competence and to function solely as a support mechanism for what might be called "real" health-care spoken communication by doctors so dominates popular attitudes that it is the foundation for characterizations of nurses in such television programs as ER and Chicago Hope, where by and grand nurses engage in clinical support, whether on behalf of patients or doctors. no(prenominal) of the on-the-line tensions and priority pulls so familiar to nursing discourse are at issue on these programs. Cullen (1995) asserts that the demands of shifting health-care administrative factors, institutional, societal, and nursing systems together and separately "fail" nurses, and by extension patients, to the arcdegree they require much of and deliver little to nurses, resulting in skipper burnout. Shindul-Rothschild, Berry, and Long-Middleton cite a 13-percent rate of attrition

Buresh, B., & Gordon, S. Promote, don't protect. American Journal of Nursing, 96, 20-2.

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