The Culture of Caring: AIDS and the Nursing Profession

Abstract

Caring for persons with AIDS calls upon a range of physical, psychological, social, and spiritual interventions that, in the absence of a cure, can make a palpable difference for patients. The "culture of caring" that nurses bring to bear on the epidemic is shaped by their education and socialization, and by shared background characteristics. The nursing profession has been among the leaders in organizing AIDS care; such care entails stress for individuals at a time when the profession and the health care system are facing a generalized crisis, but nurses have testified to the redeeming significance they find in performing their work. It remains to be seen whether the contribution nurses and their ethos of caring have made will endure to influence the relative status of this profession.

Reconsidering Detached Concern: The Case of Intensive-Care Nurses

“…They are also concerned and emotionally attuned to some in ways that need to be more clearly brought back into scholarly conversations about detached concern. Broader themes related to physical touch, family connections, holistic care, and education appear to be central to the ways in which groups of nurses care (Fox, Aiken, and Messikomer 1990). Therefore, rather than seeing detachment and concern as dichotomous, they should be viewed as dualities that are negotiated in ongoing ways by a wide range of health-care providers.…”

“…They also expressed concern for many patients and, in some instances, they developed memorable emotional bonds. As Fox and colleagues describe in an article focused on how nurses cared for AIDS patients in the early years of the disease, these emotional bonds reflect the daily physical care nurses provide for patients, the intimate body fluids with which they are in contact, their roles as educators about health and the hospital as an institution, and-mostly prominently-their work not just with patients but with their families (Fox, Aiken, and Messikomer 1990). Nurses provide care for patients in these situations because of the ways they are professionally trained and socialized within distinct nursing cultures of care, and they express concern in these situations not because they fail to be detached or to control their emotions, but because concern is also an integral, if not daily, component of their work.…”

“…Since the 1970s, the amount of attention directed to care has increased in the nursing profession, as evident in textbooks, monographs, and throughout the work of nursing scholars. However, nursing shortages, increasingly sophisticated technology, burnout, and other factors continue to present barriers to nurses' expressing concern, and many nurses must negotiate these barriers throughout their work (Bishop and Scudder 1990;Chambliss 1996;Fairman and Lynaugh 1998;Fox, Aiken, and Messikomer 1990;Seymour 2001).…”

“…Compared to physicians, nurses typically have been socialized into a distinct culture of care. Many, however, work in institutional environments that may, for reasons of time, money, technology, or other factors, make it difficult for them to express concern for patients (Bone 2002;Fox, Aiken, and Messikomer 1990;McQueen 2000;Olesen and Bone 1998). Studies of intensive-care nurses present contradictory evidence about the extent to which and ways in which nurses express concern.…”

Dimensions of Nurse Caring

“…Riemen (1986) noted that patients who were asked to describe caring described nursing actions that are not caring. Nurses who view caring as a key element of nursing have encouraged others to describe nurses' caring, so that the caring part of nursing will become more distinct for its practitioners (Fox. Aiken, & Messikomer, 1990;Leininger, 1980Leininger, , 1984.…”