later she says “Vulnerability is a vehicle for practicing authentic nursing” (ibid). This
use of the idea of ‘authenticity’ betrays the existential origins of the approach and its
proponents argue against the attempts of nurses to distance themselves from the
suffering of patients. On this account to practice nursing while distancing oneself from
the suffering and vulnerability of patients is to nurse ‘ Inauthentically’. Those who
subscribe to this view consider it necessary for each nurse to acknowledge her or his
vulnerability as this is essential for good patient care. As Daniel puts it:
... if we deny the opportunity to participate in vulnerability, we deny the
opportunity to participate in humanness which then permits us to practice
dehumanizing acts.
(ibid)
Whether or not this is true, it is accepted that to bear witness to the vulnerability of
others is generally stressful. In being ordinarily vulnerable like everyone else, some, but
not all, nurses will succumb to the effects of the stress this constant exposure to the
suffering of others brings with it. And, like everyone else, the manifestations of stress
will follow the general patterns of stress-related disorders. Bumout is considered to be
common among nurses.
It affects the physical and mental health of the nurse and may carry costs for the
employing organization through absenteeism, staff conflict and rapid
turnover.. .Bumout may also affect the quality of nursing care provided to
patients and their families
(Payne 2001 p. 397)
And it is the last point here that is of particular significance as anything that impinges
on the ability of a nurse to provide protection adds to the increased vulnerability of
patients. Interestingly, proponents of the ‘nurses need to embrace their own
vulnerability’ approach claim that becoming more involved with patients suffering can
reduce the likelihood of burnout.
Nurses working in palliative care might be supposed to be amongst those who will most
often bear witness to the suffering of others. Yet, it is not clear that palliative care
nurses come to any more harm than other nurses. One reason for this may lie in
recognizing the risks of working with people who are dying. Once the risks are
identified actions can be taken to minimize the potential of those risks to cause harm.
Although it should be recognized that this effectively amounts to an acceptance of the
idea that nurses do need to become comfortable with their own vulnerability if they are
to be in a position to provide professional nursing to those in their care.
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