The Complexities of Care: Nursing Reconsidered

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"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions."—from the Introduction

In a series of provocative essays, The Complexities of Care rejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.

Contributors: Sanchia Aranda, University of Melbourne and Peter MacCallum Cancer Centre; Rosie Brown, University of Melbourne; Sean Clarke, University of Pennsylvania and University of Montreal; Suzanne Gordon; Marie Heartfield, University of South Australia; Tom Keighley, Royal College of Nursing; Diana J. Mason, American Journal of Nursing; Lydia L. Moland, Babson College; Sioban Nelson, University of Toronto; Dana Beth Weinberg, Queens College, CUNY

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Editorial Reviews

Library Journal
Nelson (nursing, Univ. of Toronto; Say Little, Do Much) and journalist Gordon (nursing, Univ. of California, San Francisco) present a collection of essays about nursing, written by nurses as well as journalists, a philosopher, and a sociologist. The editors suggest that what they call a virtue script has long dominated nursing's self-image, with powerful consequences for both nurses and patients. The research they present shows that nurses in all settings tend to describe their work as caring, emotional, and compassionate, consciously avoiding mention of the knowledge and skill that are equally essential to the job. Other essays try to assess why this is such a fiercely protected image, and the editor of the American Journal of Nursing describes the anger generated by published work challenging the "angel" icon. The consequences, suggested here and based largely on theorist Patricia Benner's work, include early burnout owing to mistaken expectations and the greater use of unskilled workers, who are seen as equally capable of providing emotional care. Sometimes complex but well written and provocative, this work complements such books as Dana Beth Weinberg's Code Green: Money-Driven Hospitals and the Dismantling of Nursing. Recommended for all medical libraries and academic libraries supporting nursing programs. Dick Maxwell, Porter Adventist Hosp. Lib., Denver Copyright 2006 Reed Business Information.
From the Publisher

"This collection of essays . . . shows that nurses in all settings tend to describe their work as caring, emotional, and compassionate, consciously avoiding mention of the knowledge and skill that are equally essential to the job. . . . The consequences . . . include early burnout owing to mistaken expectations and the greater use of unskilled workers, who are seen as equally capable of providing emotional care. . . . Well written and provocative."—Library Journal(15 October 2006)

"While the nursing profession has wrapped itself in care talk, has this hampered a more realistic basis for nurses' self identities and nursing's collective power? This hard-hitting collection faces this question head on. The book is a necessary antidote to more saccharine assessments of twenty-first-century nursing and a tough prescription for change in the health care system."—Susan M. Reverby, Wellesley College, author of Ordered to Care: The Dilemma of American Nursing

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Product Details

Meet the Author

Sioban Nelson is the Vice-Provost Academic Programs, University of Toronto. She is coauthor of Creating the Health Care Team of the Future and coeditor of Complexities of Care: Nursing Reconsidered and Notes on Nightingale: The Influence and Legacy of a Nursing Icon, all from Cornell. She is also the author of "Say Little Do Much": Nursing, Nuns and Hospitals in the Nineteenth Century.

Suzanne Gordon is coeditor of the Cornell University Press series, The Culture and Politics of Health Care Work, and was program leader of the Robert Wood Johnson-funded Nurse Manager in Action Program.

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Table of Contents

1 Moving beyond the virtue script in nursing : creating a knowledge-based identity for nurses 13
2 When little things are big things : the importance of relationships for nurses' professional practice 30
3 Pride and prejudice : nurses' struggle with reasoned debate 44
4 Moral integrity and regret in nursing 50
5 Ethical expertise and the problem of the good nurse 69
6 From sickness to health 88
7 The new cartesianism : dividing mind and body and thus disembodying care 104
8 Nurses must be clever to care 122
9 "You don't want to stay here" : surgical nursing and the disappearance of patient recovery time 143
10 Research on nurse staffing and its outcomes : the challenges and risks of grasping at shadows 161
Conclusion : nurses wanted : sentimental men and women need not apply 185
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