discussion nursing
anisley1992
Chapter31.pptxTheory of Bureaucratic Caring: Marilyn Anne Ray
Chapter 31
Overview of the Theory of Bureaucratic Caring
Seven concepts are arranged around the central concept of spiritual–ethical caring:
Educational factors include formal and informal education programs as well as other forms of teaching and sharing of information
Physical factors are related to physical state of being, including both biological and mental patterns
Overview of the Theory of Bureaucratic Caring
Sociocultural factors include ethnicity and family structures, friends and family relationships, communication, social interaction and support, intimacy, and structures of cultural groups, community, and society
Legal factors include responsibility and accountability, rules and principles to guide behaviors, rights, and the practice of defensive medicine and nursing
Overview of the Theory of Bureaucratic Caring
Technological factors include nonhuman resources such as machinery used in patient care, diagnostic tests, and pharmaceutical agents, as well as the skill needed to use the resources
Economic factors include budgets, insurance systems, limitations and guidelines imposed by managed care organizations, and allocation of resources as necessary to maintain the economic viability of the organization
Overview of the Theory of Bureaucratic Caring
Political factors and the structure within healthcare administration influence how nursing is viewed and influence patterns of communication and decision making in the organization
An additional issue within the political factor is trust or lack of trust, which can lead to disillusionment and decreased loyalty to the organization
Major Concepts of Nursing Based on the Theory of Bureaucratic Caring
Person: a spiritual and cultural being
Environmental: a complex spiritual, ethical, ecological, and cultural phenomenon
Health: not simply the consequence of a physical state of being but rather it provides a pattern of meaning for individuals, families, and communities
Major Concepts of Nursing Based on the Theory of Bureaucratic Caring
Nursing: a holistic, relational, spiritual, and ethical caring that seeks the good of self and others in complex community, organizational, and bureaucratic cultures
Assumptions of the Theory of Bureaucratic Caring
The meaning of caring is highly differential, depending on its structures (i.e., sociocultural, educational, political, economic, physical, technological, and legal)
Caring is bureaucratic as well as spiritual/ethical
Caring is the primordial construct and consciousness of nursing
Propositions of the Theory of Bureaucratic Caring
Nursing and caring are experiential and contextual, and are influenced by the social structure or the culture in the organization
Caring can positively influence surrounding structures
The Theory of Bureaucratic Caring as a Framework for Nursing Care
Assessment: team effort with focus depending on the internal or external forces precipitating assessment; considers the physical, socio-cultural, educational, legal, political, economic, and technological structural factors and their interconnections and is conducted in manner grounded in caring, with goal of promoting the good of others within the organization
The Theory of Bureaucratic Caring as a Framework for Nursing Care
Planning: data analyzed in each structure area
Implementation: strategies directed at specific structural areas; mindful of the interconnected-ness of these areas and the centrality and interconnectedness of spiritual–ethical caring
Evaluation: based on the patterns of meaning ascribed to the process and outcomes by the members of the organization
