Caring, Empathy, and Ethics in Evidence-Based Nursing

Introduction

The article reviewed here focuses on three interrelated pillars of nursing — caring, empathy, and ethics. Lachman (2012) uses numerous examples to show the positive impacts of caring. Drawing on theories advanced by prominent scholars and examining real ethical decisions nurses must face, the paper explores morality, competence, and the reciprocal relationships between nurses and their patients. Caring for a patient is described as reciprocal because when the needs of the patient are met, there is reciprocity — the giving of care and the receiving and acknowledgment of that caregiving.

Summary of Key Points

On page 113, Lachman references several leading theorists and scholars who have contributed important research on nursing ethics and the caring concepts introduced earlier. Dr. Jean Watson's caring theory (112) has three main components: (a) carative factors; (b) the "transpersonal caring relationship"; and (c) the "caring occasion/caring moment." Regarding carative factors, Watson explains that this involves developing and sustaining an "authentic…helping-trusting…caring relationship," which should lead to a "connection with the deeper spirit of self" within the relationship (Lachman, 112). In the second element, the transpersonal caring relationship, the nurse must make a "moral commitment" to connect with the patient. The third component, the "caring occasion/caring moment," refers to that space and time during which the nurse bonds with the patient and caring takes place (Lachman, 112).

Joan C. Tronto, an author and recognized expert on nursing and caring concepts, also plays a significant role in this paper. In 1993, Tronto defined care — an important point — as a "species activity" that encompasses anything and everything relating to maintaining, continuing, and repairing the "world" around us, including "…our bodies, ourselves and our environment" (Lachman, 113). In other words, for a nurse, part of his or her environment is the patient and the patient's body, both of which must be cared for.

Tronto's four phases of caring are central to this article: (a) caring about; (b) taking care of; (c) caregiving; and (d) care receiving (Lachman, 113). While these may seem redundant on the surface, Tronto is describing phases rather than simple applications of caring. Perhaps more significant are Tronto's four elements of caring:

(a) Attentiveness — a nurse steps away from his or her own learning and "preference system" and steps into the patient's shoes, which is the true definition of empathy; (b) Responsibility — the Code of Ethics for Nurses, according to the American Nurses Association, asserts that all nurses are responsible for patients under their care, so there can be "no ambiguity" whatsoever in that regard; (c) Competence — this means managing patients based on learned skills, being efficient and accurate in caregiving, while also recognizing that the nurse has a responsibility to "update competence continuously"; and (d) Responsiveness of the care receiver — this is where reciprocity enters the picture; the nurse must receive a positive and healthy response from the patient in order to know whether what the nurse did was effective in resolving the health issue (Lachman, 113–114).

Another key point in this article is Dr. Watson's emphasis on the fact that the patient should "never be used as a means to an end of self-gratification" (Lachman, 114). The care given to a patient should occur "…within the framework of a relationship between the nurse and the patient," which closely resembles the meaning of reciprocity. A relationship does and should exist — not in the traditional sense of the word, of course — but there should be a sincere and important "interchange," and it must be based on meeting the care needs of both the patient and the patient's family (Lachman, 114).

Conclusion

Nurses and patients benefit when nurses keep up with every new medical research discovery, which is part of their ongoing education and keeps them current as medical advancements continually emerge. This paper references the ethical standards nurses are expected to uphold, examines the definition of caring through the theories of well-known scholars in the field, and raises the expectations patients hold regarding the competence and compassion of those providing their care. There is a critical moral psychology at the heart of nursing, operating on biological, social, medical, and psychological levels simultaneously.

French, Peter. (1999). The development of evidence-based nursing. Journal of Advanced Nursing, 29(1), 72–78.

Lachman, Vicki D. (2012). Applying the ethics of care to your nursing practice. Ethics, Law, and Policy, 21(2), 112–115.