Recent years have witnessed the publication of numerous articles that draw a critical alignment between ethics and caring. In essence, this theme suggests that caring is a moral pursuit centred on the beneficent attention of one person shown to another. Yet, if such language is to have real poignancy, it must be geared towards an inclusive agenda that meets the needs of all within the community. Research evidence suggests that this is not always the case, especially in terms of the care offered to members of minority ethnic groups. This article will focus on the findings of a qualitative research study that explored the expectations and perceived experiences of nursing care among members of the Pakistani community in Bradford, West Yorkshire, UK. The findings suggest that nurses should develop a more informed narrative that readily reflects the needs of the Pakistani community.
• Nurses often make a link between spirituality and religion. This is evidenced in nursing documents when comments about the patient’s religious faith are placed in the space devoted to spirituality. • While religion may inform and offer direction to an individual’s spirituality the two concepts are not the same. In terms of analogy, hydrogen and oxygen combine to make water although each brings its own defining characteristics to balance the chemical equation. • Thus, there may be a synergy and symbiosis between religion and spirituality but the essence of each remains unique; indeed, a person’s spirituality can thrive irrespective of religious creed – orthodox or otherwise. • In this paper, we will develop a narrative that articulates and offers the defining characteristics of spirituality. This will be coupled with a framework that seeks to explain the workings and dynamics of spirituality in clinical nursing.
In the West, the term 'tender, loving care' (TLC) has traditionally been used as a defining term that characterizes nursing. When this expression informs practice, it can comfort the human spirit at times of fear and vulnerability. Such notions offer meaning and resonance to the 'lived experience' of giving and receiving care. This suggests that, in a nursing context, TLC is rooted firmly in relationship, that is, the dynamic that exists between carer and cared for. Despite this emphasis on relationship, there is a scarcity of literature that draws a connection between TLC and the moral challenge that is so much a part of human interaction. In this article we will address this deficit and present a narrative that places TLC at the centre of moral engagement between nurse and patient; in essence, we offer an alternative means of viewing relational ethics.
The aim of this ethnographic study was to explore retrospectively the grief experiences of 12 older people whose partners had recently died in hospital, following a period of terminal illness. The rationale was based upon developing an understanding of the grief experiences of newly bereaved older people. In doing so, it is important to consider that grief is not only shaped by culture and social context but also by the nature of the relationship between the mourner and the deceased. For most of this century, the dominant conceptualization relating to grief and the social experience of bereavement has been based on the psychoanalytical school of thought. This process is said to involve the mourner passing through a number of stages or phases and forms the basis of the 'grief work hypothesis'. Using in-depth ethnographic interviews, the mourner's reactions to and perceptions of the loss were explored. Tape-recorded interview data were analysed using the inductive process of both content analysis and discourse evaluation. The findings from this study shed light on an area of conjugal bereavement that has received little attention in the past and challenges traditional models of grief. The indications are that in the first year of bereavement, the bereaved retain and modify the emotional relationship with their deceased partners, through a range of symbolic behaviours. The discussion raises issues concerning the need to consider the extent to which contemporary conceptualizations of grief explain the reactions of older people whose grief experiences are shaped by their social situation. The study also highlights important issues concerning the need to understand the complexity of grief experiences and bereavement support for older people which has a number of implications for nurses in both hospital and community settings.
Intensive care units are challenging and technologically advanced environments. Dealing with situations that have an ethical dimension is an intrinsic part of working in such a milieu. When a moral dilemma emerges, it can cause anxiety and unease for all staff involved with it. Theoretical and abstract papers reveal that having to confront situations of ethical difficulty is a contributory factor to levels of poor morale and burnout among critical care staff. Despite this, there is a surprising dearth of published nursing research in the UK that investigates how staff deal with ethical issues in intensive care units. The purpose of this paper is to explore and discuss the development of a research framework designed to explore how staff deal with moral dilemmas in a British intensive care unit.
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