Nursing and society. Humanism, service and quality.

Antonio Arribas Cachá

Abstract

That Nursing has solid humanistic foundations and a clear vocational spirit of attention to the care of the person through a holistic vision, constitute objective and recognized realities in the different professional, academic, social or institutional environments. These elements underlie and constitute basic parameters of the conceptual framework that supports its existence according to the current conception.

That these foundations have generated the existence of basic principles (ethical, professional and educational) deeply rooted in the nursing discipline, is another reality that has been permanently present since its inception and throughout its existence, evolving and adapting at every moment depending on the context and the existing situation.

That the influence of these principles is essential is an empirical fact, easily observable.

These principles intervene as essential pillars of Nursing at the conceptual and theoretical level, facilitating the explanation and understanding of the reason for its existence and its current conception. They provide general answers to the question "What is nursing", and provide specific guidance on the correct approach to the training of new professionals.

But these principles also intervene as essential elements at the practical level, acting as modulating filters in professional development. They constitute two elements that professionals must always take into consideration in the design and implementation of their interventions in practice, so that they must always be reflected in their performance.

But if the presence of these two principles is clear and evident in Nursing, the spirit of service to society in the attention to its social and health care needs is no less evident.

This spirit is what has led Nursing to be a pioneer in the implementation of social and health care measures for the most vulnerable populations at all times (poor, incarcerated, home care, ...) and in special, critical or emergency situations (wars, catastrophes, epidemics, ...), adapting to these situations and developing strategies to respond to the needs required at all times for the benefit of the population.

Humanity is currently experiencing one of these special situations, in which all programs and priorities for action have been altered to respond to the needs arising in the population as a result of the COVID19 pandemic.

Nursing, as could not be otherwise, has responded to this situation in a clear and forceful manner, assuming the execution of the tasks considered necessary for the population at any given moment.

To this end, it has replaced the planned execution of the socio-health interventions it was developing at the time, with the execution of immediate socio-health actions in the population following the typical pattern of "action-reaction". Given the existence of a stimulus, problem or situation, an immediate action is taken to respond to it.

This pattern of action allows rapid responses to serious or critical situations that require immediate action, although its use should not be prolonged over time or carried out on a regular basis, since the level of quality control of the care process achieved with this pattern of action is basic. An example of the application of this pattern of action is: "If there is itching, scratch it".

In this sense, it should be remembered that in addition to the basic principles associated with Nursing since its inception, it also has other principles acquired as a scientific discipline. The reflective character must be present in all its actions through reasoning and critical thinking processes.

The typical pattern in this case would be "action-processing-reaction". Given the existence of a stimulus, problem or situation, a reasoned action is analyzed and executed.

This action pattern allows quality responses, considered in terms of safety and efficacy, to be given in the presence of problems, and should therefore constitute the usual pattern of action. Example: "if there is itching, the cause and characteristics are analyzed and the most effective and safe measure is taken".

For this reason, it is important to bear in mind that the immediate adaptation and response of Nursing to the COVID19 crisis cannot serve as a basis for the performance of its work to be altered and lose part of its own identity.

Nursing cannot limit itself to "work by tasks" focusing its attention on the mere execution of techniques and health interventions (triage, cures, analytical,...) since it would mean a regression to a previous stage of development already overcome, with the serious consequences that would entail both for Nursing and for the population under its care.

To ignore the basic principles that underlie this profession (humanistic, focused on the care of the person with a holistic vision, with a vocation of service to society in the care of their health and social needs), reflective in nature), would mean its disappearance according to its current conception and its transformation into another different profession that should redefine the principles of its new paradigm.

In terms of its impact on society, it would mean a reduction and limitation of the levels of health and wellbeing achieved by the population through the attention to their social and health care needs by focusing on the attention to their pathologies.

Antonio Arribas Cachá