In the debate about the role of health professionals, two normative models have been placed in opposition - 'care vs. cure'. To many, the cure model has been associated with physicians, and the care model with nursing and the other allied health professions. As the shortcomings of a cure-orientated model have been recognized, particularly in dealing with chronic disease, more attention has been focused on care, with many writing as though the two were mutually exclusive. In this paper, we suggest that these models are instead end-points on a continuum which ideally should be used by all health providers, rather than being characteristic of different clinical professionals. This conceptualization places less concern on what should be done by doctors as opposed to nurses, and more on the needs of the particular situation. The resulting convergence among roles should not imply that nursing and the allied health professions will adopt the medical model, but that medicine, nursing and others will work together with patients for all members' mutual benefit. In this expanded continuum, the focus for decision making becomes the patient and family in partnership and collaboration with health professionals.
As you seek to imagine or reimagine solutions to the greatest problems of our time, harness the power of partnership… the power of those partnerships to bridge what seem like different worlds.~P aul Farmer.Although it is argued that social justice is a core concern for the discipline, nursing has not generally played a leadership role in the responses to many of the greatest social problems of our time. These include the accelerated rate of climate change, pandemic threats, systemic racism, growing health and social inequities, and the regulation of new technologies needed to ensure an inclusive and equitable future for all. Browne and Reimer-Kirkham (2014) examined the disjunctures
With unfolding human resource challenges in health care, little is known of the impact of changing work patterns and employment relationships on the organization and the nursing profession. Social Exchange Theory (perceived organizational support (POS) and psychological contracts) was used to gain understanding of the influence of nurse's employment patterns on employment relationships and individual, organizational and professional outcomes. The sample consisted of 650 randomly selected nurses employed in full-time, part-time, and casual positions across healthcare settings in Ontario, Canada. A cross-sectional survey design explored demographics, volition, POS, psychological contract, job satisfaction, career commitment, and job and career withdrawal. Work patterns and employment relationships are complex and cannot be examined in isolation of other variables such as volition and work congruence. Full-time nurses were found to have more of a relational psychological contract than part-time or casual nurses. The hypothesis was supported that the psychological contract has a direct effect on nurses' job satisfaction, job withdrawal, career commitment, and career withdrawal. Nurses want to work different work patterns depending on their age and work-life demands. The importance of fostering strong employment relationships and relational psychological contracts to address such issues as an ageing workforce, nursing shortages, and economic demands is highlighted.
Aim: This paper presents HAR as an expression of caring to create social justice within nursing and achieve a workforce that is representative of those being served.
Background: The lack of diversity within the health professions has been expressly linked in the literature to health disparities among underrepresented and marginalized groups.
Recommendations: Recognizing the value of diversity within healthcare has been the impetus for some health profession programs to use holistic admissions review (HAR) in the assessment and evaluation of applicant suitability. While current HAR recommendations in nursing broaden the lens on which criteria should be used to determine applicant suitability beyond standard academic metrics, existing models do not examine applicants' caring capacity.
Conclusion: Given caring is the essence of nursing, the authors offer a guiding framework to supplement the American Association of Colleges of Nursing criteria for HAR and a model by which nursing applicants are evaluated on their capacity to care.
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