Despite this they firmly locate vulnerability as a subjective experience and risk as the
objective and external threat to well-being. Their construct allows them to suggest that
the function of nursing is to both act on the external environment (to reduce the risks)
and/or to assist the individual patient to feel less vulnerable (for example, by using
techniques developed from psychological theory to reduce the individual’s perception
of their own vulnerability). In this way it is claimed that nursing can affect the
transaction between the patient’s vulnerability and their exposure to risk thus enhancing
the patient's sense of well-being.
They are right insofar as they draw attention to the fact that to be vulnerable is to be
vulnerable to something and their recognition of vulnerability as a function of the
interaction between the person and the environment is important. It is also correct to say
that one proper function of nursing is to attempt to provide a safe environment in which
patients can be nursed and while this might reduce the risk of harm to an individual
patient it does not necessarily reduce their feelings of vulnerability. Their emphasis on
reducing patients' feelings of vulnerability is misguided although in doing so they
unwittingly illuminate the significant difference between perceptions of vulnerability on
the one hand and actually being vulnerable on the other. However in characterising
vulnerability as purely subjective they are unable to account for those whose capacity to
articulate their subjective experience is in some way compromised. Thus the three main
claims of Clarke and Driever's account require further consideration.
Claim 1: risk as objective and external.
While it is true to say that risk can be objective and external, neither is a necessary
condition. Risk can be also be subjective and internal: physical, psychological,
emotional, and so on. A physical internal risk may come from naturally occurring
bodily changes including an aneurysm, cancerous growth, and general degenerative
changes. A psychological risk might come from, for example, holding the false belief
that there is a risk of imminent collapse of a building. Assuming there to be no physical
evidence for this, and assuming that the structure is not built above the site of some
natural ‘disaster waiting to happen’ (for example, hidden and unknown mine workings),
then it would be difficult to say, in this case, that the perception of risk is either an
objective or an external phenomenon.
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