A chasm within nursing remains wide.
And at a time when I would think nursing leadership would be looking deeper for sweeping solutions to some critical healthcare and nursing issues, like:
- Patient trust
- Patient experience / satisfaction
- Nurse trust
- Nurse satisfaction
- Compassion fatigue, etc
- Nursing shortage
I know the bandwidth for changes is narrow for nurse leaders on the ground. Got it.
And the IOM Future of Nursing rolled out a robust road map for nursing, seizing long awaited opportunities; all inspiring and catapulting for the future of nursing.
Nurse leaders who are our national voice in leadership literature likely believe in the same vision and philosophy of nursing as other nurses.
We all come to nursing with the desire to help people, to have an impact on people’s lives.
But all caring is not equal.
Not recognizing this in the leadership conversations and literature is paralyzing the nurses and leaders in the work settings.
The race to high patient satisfaction numbers has driven program development and research to focus on what Halldorsdottir (1991) defined in her work as “bioactive” caring. This is where the nurse is kind, concerned and responsive. This is the classic description of a good nurse-patient relationship.
And this is where the bar has been set in current leadership literature for program development and even research.
But it is the “biogenic” caring, where the patient feels accepted, safe and understood, that is the gold standard for the nurse. This brings a sense of wellbeing and even patient healing, extended from the nurse. This experience reaps high satisfaction for both the patient and the nurse, and yes, maybe a DAISY Award.
But, almost more importantly, these are the experiences that bring meaning to nurses’ work and sustain nurses’ careers.
By not focusing on this “biogenic” level of caring in program development on an equal status with patient outcomes, we are dismissing it as “sweet” and marginalizing it. This sends a confusing message to nurses and nurse leaders.
The “biogenic” experiences for the nurse are what brought them to nursing. The focus on the “bioactive” caring standards they learn in the work setting are routine and limiting, and distract from their desire and efforts to achieve authentic caring, “biogenic” caring.
The current programs and literature communicate that all caring comes from committees and leadership. There is a feeling of institutional caring. And what is even worse is the notion that caring can be scripted and mandated by programs and protocols, and that accountability must be built into the programs.
Imagine if nurses’ inner aptitudes for caring were unleashed in healthcare today through system wide conversations recognizing nurses’ full professional contribution to organizational culture and caring program development and integration.
The science already exists on which to build these programs and transform organizational cultures.
This would be a disruptive innovation that would indeed build deep trust and satisfaction among patients and nurses, and by the way, reduce nurse burnout and attrition.
Halldorsdottir, S. (1991). Five basic modes of being with another. In D.A. Gaut & M Leininger (Eds.), Caring: The compassionate healer. New York: National League for Nursing Press.