Question

marilyn anne ray nursing philosphies

Answer 1

Answers :

Marilyn Anne Ray :

Marilyn Anne Ray, Canadian nursing educator, researcher. Registered Nurse Florida, certified transcultural nurse, CTN-A. Recipient Leininger award, 1989, Distinguished Alumni award, University Utah College Nursing, 2007; Transcultural Nursing scholar, 2005.

Theory of Bureaucratic Caring

The theory was generated from qualitative research involving health professionals and patients in the hospital setting.

The theory implies that there is a dialectical relationship (thesis, antithesis, synthesis) between the human (person & nurse) dimension of spiritual-ethical caring and the structural (nursing, environment) dimensions of the bureaucracy or organizational culture (technological, economic, political, legal and social).

The Model is holographic, illuminating the holistic nature of caring & synthesis of the humanistic systems and technologic, economic, political, legal systems.

Major Concepts :

The theory first originated as a grounded theory from a qualitative study of caring within the context of healthcare culture from Ray's dissertation study (Figure 1a). The research revealed that nurses and other healthcare professionals struggled with the paradox of serving the corporate needs of the bureaucracy while serving the caring needs of human beings specially patients. Differential caring emerge as the substantive theory and showed that caring within the organization was complex and complicated. Furthermore, caring was differentiated in terms of meaning and to areas of practice or nursing units.

The concept of differential caring within a bureaucratic caring structure   or culture within the organizations. Caring in nursing is contextual and is influenced by the organizational structure or culture. The theory was re-conceptualized in terms of holography. In the revised theoretical model, everything is infused with spiritual-ethical caring by its relational connection to the structures of the organization. Spiritual-caring serves as the choice point for communication within cultures, communities and organizations.   The model demonstrates the integration of spiritual ethical caring with the political, economic, technological, legal, educational, physical and socio-cultural systems of the organization

DEFINITION OF CONCEPTS

Caring

Is defined as a complex, transcultural, relational process, grounded in an ethical, spiritual context. Caring is inevitable within a culture or society, such as, personal culture, hospital organizational culture, and society culture.

Spiritual-ethical caring

This pertains a holistic integration of the body, mind and spirit. Spiritual-ethical caring for nursing focuses on the facilitation of alternatives for the good of others can or should be attained.

Education

Education both formal and informal programs make use of audiovisual media to disseminate information, and also other forms of teaching and relaying information are factors related to defining care.

Physical

This factor is related to the physical state of being, which includes, biological and psychological patterns. The reason is that, both the human mind and body are interrelated,   showing a pattern that influences the other.

Socio-cultural

Social and cultural aspects are factors related to ethnicity and structures of the family; intimacy with friends and family; communication; interaction and support with a social group, community and society.

Legal

Definition of caring in terms of legal factors are responsibility and accountability; rules and principles as guidance of one’s behavior, such as policies and procedures; informed consent; rights to privacy; malpractice and liability issues; client, family, and professional rights; and the practice of defensive medicine and nursing.

Technological

Factors relating to technology such as non-human resources, like the use of machines to sustain physiological well-being of the patient, diagnostic investigations, pharmaceutical agents, and also the knowledge and skills required to operate the resources.

Economic

Related factors of the definition of caring include money, budget, insurance systems, limitations, and guidelines imposed by managed care. Caring as an interpersonal resource should be considered like goods, money, and services.

Political

How nursing is viewed within a healthcare administration is influenced by political and the power structure. This included the communication patterns, decision making within the organization, role gender stratification among nurses, physicians, and administrators; union activities including negotiation and confrontation; government and insurance company influences; uses of power, prestige, and privileged are, in general, competition for scares human and material resources.