Relationship between Caring and Trust in the Helping Profession a Concept of Analysis - Essay Example

Running Head: Theoretical/Conceptual Framework in Nursing A Study on the Relationship between Caring and Trust in the Helping Profession A Concept ofAnalysis Name Course Title Name of Professor Date of Submission Introduction Caring and trust are fundamental and complex concepts related with the helping profession, or nursing. As defined by the American Nurses Association (2003), nursing is “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (as cited in Santiago, 2009, para 1). Embedded in each of these processes is the acknowledgment and consideration of, caring and trust in a nurse-patient relationship. Good nursing care is distinguished by the maintenance of trust (Santiago 2009). Hence, maintaining patients’ trust is an essential feature of nursing care, and an important general aspect of quality health care. This study will describe the concepts of caring and trust as it relates to the nurse-patient relationship in the framework of sustaining the intactness, or fullness, of the health status of patients. The examination of caring and trust as virtue concepts, as in line with a person’s personality or integrity, will only be taken into account as it relates to those decisions and actions of the health care provider that have the possibility of influencing forces affecting the health reliability of the nurse-patient relationship. The objective of this study is to provide a greater understanding and knowledge of what it implies for the role of the professional nurse in providing care and protecting patients’ trust as fundamental components of any helping profession. The research questions of the study are the following: 1) What is the definition of the concept of caring in the nursing profession? 2) What is the definition of the concept of trust in the nursing profession? 3) What is the relationship between the concepts of caring and trust in the nursing profession? Review of Related Literature Concept of Caring The concept analysis of caring has shown that it evolved and became increasingly complicated in its use and application as time progresses. For a number of helping professions, such as nursing, performing from a caring framework has been a way through which patients can realize optimal health and wellbeing. This is achieved by cultivating within the helping professional an awareness of caring that improves the quality of relationship and transaction between the patient and the health service provider. The concept of ‘caring’ is indefinite and debatable. Part of the dilemma is that the concept has been applied in varied ways that its core meaning is by now endangered. According to some scholars, conceptualizing ‘caring’ entails an effort to encompass the political and social economy within which it is implanted (Halstead & Wagner, 2002). If the concept will be used as a general form of analysis with regard to the profession of nursing, one should discover a way of sustaining its potential to disclose significant aspects of women’s lives and simultaneously encompass more common features of societal agreements around individual needs and wellbeing (Ferreira & Bosworth, 2000). In examining the concept of caring, an essential concern surfaces in terms of the inherent against the gained character of caring. Bateson (1990) analyzed the argument between those who view individuals as social egotists in opposition to those who see individuals as having a potential for compassion and selflessness. He advocated the perception of individuals as having the capacity to care for others to satisfy unselfish needs, not merely self-centered intentions. Others have discovered selfless actions in children aged 1 to 2 (Eisenberg, 1992). These discoveries signify that individuals are born with the predisposition for moral conduct and, therefore, to be caring human beings. Certainly, Hemmings (1991) argues that moral conduct developed as part of the individual need for mutual aid, which reinforced the odds for survival. Concept of Trust Trust, as a concept, is defined as “dependence on others’ competence and eagerness to look after, rather than harm, the things that people is concerned about” (Kim & Kollak, 2006, 52). Alternatively, Lynn-McHale and Deatrick (2000 as cited in Kim & Kollak, 2006) furthers that even though trust between nurses and clients comprise different levels, it should be shared or mutual. The trust of clients in the nurses is possibly the most fundamental of trusts, and it entails the confidence of clients that the nurses will understand, value, and respect them. The breach of that trusts can have significant impact on patients and subsequent future admissions (Daly, Speedy, Jackson, Lambert, & Lambert, 2005). Attaining and preserving trust have been assumed to be necessary to increase the gains that the nurse-patient relationship brings to patients, health care providers and health care as a whole. In order to prevent doubt and distrust, trust should be strengthened between the health care provider and the patient (Daly et al., 2005). Even though trust is generally recognized as an important feature in nurse-patient relationships, a recognized determinant of the concept has yet to be created. Dedication and truthfulness in caring should be present for a trusting relationship to grow. Trust appears to be imperative where there is mistrust and a degree of risk, be it low, modest, or high (Rousseau, Sitkin, Burt, & Camerer, 1998). This aspect of risk arise from the distrust of an individual concerning nurses, nurses’ motives and future nurses’ actions on which the individual is dependent upon. Trust is assumed to be mainly important to the condition of health care, due to the fact that it is a circumstance typified by doubt and hence risks (Kim & Kollak, 2006). Trust is the foundation of mutual aid, and it takes time to build. Interactions between the nurses and patients are intricate, as these two have their own values and beliefs. These beliefs may be similar or dissimilar. Regardless of differences in beliefs and values, a relationship can be built when concerned individuals value the viewpoint and judgment of one another (Daly et al., 2005). Robinson (1996 as cited in Daly et al., 2005) discovered that the relationship between nurses and patients were vital for families with a member experiencing chronic illness. Because of this well-founded empirical evidence, therapeutic nursing care was discovered to be successful and gratifying for both the patient and the family. Day and Stannard (1999 as cited in Kim & Kollak, 2006) assumed from the disparity of relational ethics and principle-based ethic that the emergence of a trusting nurse-patient relationship relied on the family, the patient, the nurse, and the situation itself. These two investigations assumed that both nurses and family members have to be open and eager to build a capably trusting relationship with each other so as to encourage a health care culture beneficial to the growth of trust. Discussion The word ‘caring’ is defined in a number of ways in Dictionary.com (2009): 1) to be worried, concerned or considerate; have attention or respect; 2) to be thoughtful or have a particular inclination; 3) and to have a propensity, preference, attachment, or fondness. On the other hand, the word ‘trust’ is defined by Merriam-Webster Dictionary (2009) in two ways: 1) an obligation required in confidence or reliance as a prerequisite of some relationship; (2) and, something entrusted to an individual to be cared for in the benefit and wellbeing of another. The definitions and salient characteristics of caring relate to the self-awareness, powers, and personalities of the patient that should be unharmed before trust can be attained. With regard to the nurse-patient relationship, there also should be a relationship that takes place, which functions as a means to create the outcome of that response, that being the implications. A caring relationship, as argued by Noddings (1992), “involves a ‘feeling with’ that she calls ‘engrossment’, a temporary state in which the ‘one-caring’ receives the ‘cared for’ into her/himself, and sees and feels with the other” (p. 30). Hence, caring is a “way of being in relation, not a set of specific behaviors” (Noddings, 1992, 17). Caring entails commitment, determination, patience, sincerity, confidence, optimism and courage. These characteristics should be employed to assist the cared-for mature toward helpful self-actualization. Caring is a basic human nature. Our knowledge of the concept is indefinable, partly because it surfaces in quite numerous contexts and perspectives. Caring is a wide-ranging concept generally applied to indicate a broad array of behaviors and attitudes. Caring, as well, is applied as an equivalent for other terms, such as empathy, prosocial behavior, compassion, and helping. Caring will cease to exist in isolation; the concept consistently thrives with regard to a ‘cared for’ (Ferreira & Bosworth, 2000). On the other hand, the concept of trust has been widely examined by various disciplines, such as the social sciences. The breadth of this concept presents rich ideas, and this is acknowledged in the general components that emerge in the definition of trust. For instance, Rousseau and her associates (1998) provide the following definition: “Trust is a psychological state comprising the intention to accept vulnerability based upon positive expectations of the intentions or behavior of another” (p. 394). Likewise, Lewicki and his associates (1998) define trust as “an individual’s belief in, and willingness to act on the basis of, the words, actions, and decisions of another” (p. 439). The necessity for trust surfaces from people’s interdependence with others. Individuals usually rely on other individuals to help them acquire, or at least not to discourage, the results individuals value. As individuals’ concerns with others are interrelated, they also should acknowledge that there is an involved component of risk insofar as people usually experience circumstances in which they cannot force the cooperation they seek (Rousseau et al., 1998). Hence, trust can be quite helpful in social relationships. Trust has been classified as a major component of effectual dispute or conflict resolution. This is not unusual insofar as confidence or trust is related with improved mutual aid, problem solving, and knowledge sharing (Rousseau et al., 1998). Theoretical Framework This section explores theories that relate to the concepts of caring and trust from both philosophical and nursing points of view. Relational Communication This theory puts emphasis on evaluations of a relationship instead of the individual during a specified communication, such as communication is the relationship. Knowledge of the ‘command aspect’ and the ‘report aspect’ is indispensable to the assumption of relational communication. The command aspect focuses on the relationship of communicating parties, the report aspect is the message’s content (Daly et al., 2005). For instance, a hospital clerk might request from a patient their insurance card. Though the message’s content is clear, the patient and clerk will also initiate a method of communication which will affect how the patient sees or feels about the health care organization. Relying on the relational components of the communication, the patient could feel valued, cared for, or taken for granted. It is interesting to emphasize that the relational components of communication are more evident in an unhealthy relationship than in a good one. Nonetheless, every behavior has a message important and thus one is consistently communicating something. This relates to the field of health care in that every interaction, relationship, and/or behavior between patients and nurses are understood as either caring or non-caring, or trusting or non-trusting (Daly et al., 2005). Metacommunication This is a relational communication’s concept which denotes any discussion or communication of a particular communication incident. Individuals also have to be conscious of the dissimilarity between analogical and digital communication. Analogical communication implies embodying something with a ‘similarity’ and involves non-verbal communication. Digital communication implies making use of symbols, such as words (Kim & Kollak, 2006). For instance, “I care for you” is the communication’s digital form, whereas hugging and other thoughtful actions would be the analogical communication of caring. In the field of health care a great deal of communication is inherently analogical; caring for the nurse while trust for the patient (Kim & Kollak, 2006). The notion of confirmation is also important to discuss at this point. Essentially confirmation entails the appreciation of another and recognizing another’s communication through appropriate response (Kim & Kollak, 2006). For instance a patient experiencing Alzheimer’s disease attempted to touch anyone passing by. Even though most employees attempted to avoid this patient, a nursing apprentice was able to acknowledge the existence of the patient by positively reacting to the patient’s actions. She would respond to the touch of the patient by taking her arms and taking her for a stroll, providing recognition and legitimacy to the patient as a person. Empathy is a notion of communication normally employed to understand the contribution of the professional in the nurse-patient relationship. Normally it has been anticipated that the health care provider would sort of enthusiastically unite with the sentiments of the patient and then retract so as to sustain objectivity. This perspective has been disapproved by a number of scholars in the field of communication who advocate a broader perspective (Daly et al., 2005). There appears to be some uncertainty or conflict as to what limitations are relevant in a healthcare context. Possibly limitations which are relevant in a psychoanalytic context are overly limiting in the healthcare context (Daly et al., 2005). Feminist psychology provides more ideas into subject matters of relational communication. In this field it is believed that ‘masculine’ themes such as independence are excessively emphasized. Even though male psychological development requires an enhancement of distance from the main love objective, generally the mother; psychological development of females entails recognition with the mother and underlines relationships and affections instead of independence. Feminist psychology believes that the importance of these attributes has been not just marginalized but stigmatized (Hummelvoll, 1996). Justification of the natural tendency to become concerned with the issues of others is the main point raised by the feminist point of view with regard to caring and trust (Hummelvoll, 1996). Furthermore, there are theories of caring and trust which have been formulated in the disciplines of philosophy and nursing which are pertinent to the communication attribute of caring and trust. The philosopher Milton Mayerhoff perceived caring as an existential point which gives meaning and harmony to life (Daly et al., 2005). Mayerhoff provides the main imperative components to caring: (1) awareness- to care people should have awareness of the needs of others so as to respond appropriately to them; (2) Adaptive rhythms- a form of dance as an individual adjusts behavior in reaction to the situations and the other; (3) patience- entails facilitating the growth of an individual in their own space and time; (4) sincerity- caring for others as they truly are in contrast to how one would want them to be; (5) and, trust- involves having confidence in the capability of others in self-actualizing in their own means, space and time (Daly et al., 2005). Lastly, the theory of Watson integrates a metaphysical component which is specifically relevant with regard to the nurse-patient relationship. The relationship between the nurse and the patient entails a mutual compassion and weakness, the experience of which enables them to feel and think that they are part of a greater thing than themselves (Kim & Kollak, 2006). Caring and trust enables both parties to contact a greater force than them, consequently producing a transpersonal unity, which can in fact enable the self-healing mechanism (Kim & Kollak, 2006). Conclusions The patient should have independence and power over their setting in order for trust to be attained. The patient shows trust when caring is perceived and felt. Trust is founded on a patient’s faith in his/her professional nurses and mutual trust between the nurse and the patient. When the nurse views and treats a patient with care and respect and the limits of private domain are recognized, the patients show trust in their care and capabilities. A relationship between nurse and patient that provides for confidence and trust of self decisively brings about patient having the ability to sustain self-identity, and to preserve self integrity. These implications are important in that they may result in improved health and overall wellbeing as the patient is capable of achieving a higher degree of fullness and harmony of their systems. References Bateson, C. (1990). How social and animal? The human capacity for caring. American Psychologist , 45 (3), 336-346. Daly, J., Speedy, S., Jackson, D., Lambert, V.A., & Lambert, C.E. (eds.). (2005). Professional Nursing: Concepts, Issues and Challenges. New YOrk: Springer. Eisenberg, N. (1992). The Caring Child. Cambridge, MA: Harvard University Press. Ferreira, M. M. & Bosworth, K. (2000). Context as a Critical Factor in Young Adolescents Concepts of Caring. Journal of Research in Childhood Education , 117+. Halstead, R. W. & Wagner, L.D. (2002). Counselors Conceptualizations of Caring in the Counseling Relationship. Counseling and Values , 34+. Hemmings, J. (1991). The physiology of moral maturity. Journal of Moral Education , 127-137. Hummelvoll, J. K. (1996). 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