Change Resistance as Practicing Moral Authenticity: A Qualitative Study

Background and purposeOrganizational changes are increasingly rapid and continuous in health care as organizations strive to meet multiple external pressures. Much change in health care fails and nurse resistance is commonly blamed for such failure. Nurse resistance to organizational change is often described as overt behaviours and are deemed destructive to the change process. Much of the literature describing organizational change comes from the perspectives of administrators, there is little known about nurses’ experiences of organizational change. The purpose of this inquiry was to explore the nature of frontline nurses’ experiences of rapid and continuous change.MethodsA qualitative critical hermeneutic design was applied. 14 Registered Nurses participated in face-to-face interviews. Openended questions were used. The setting was an urban pediatric teaching hospital located in Canada. Research ethics board approval was obtained as required. Member reflections ensured accurate portrayals of participant’s experiences.ResultsThe findings from this study suggest that acts of resistance to change are not overt, but rather covert behaviors in micro-ethical moments. Nurses engaged in resistance as means to provide morally authentic care at the bedside. These acts were utilized to take back power over their practice amidst feelings of powerlessness, however, paradoxically, when participants described the concept of power, they understood it solely in the context of feeling powerless within the planning, implementation and evaluation of organizational change initiatives. Nurses engagement with resistant behaviours in the context of organizational change demonstrated ethical action and political agency that enabled morally authentic nursing practice.Implications for practiceThe findings from this study offer new understandings of a well-established concept in nursing and can be used when considering the ethical dimensions of nursing work amidst rapidly changing health care institutions.

A Light in Students’ Lives: K-12 Teachers’ Experiences (Re)Building Caring Relationships During Remote Learning

This study illuminates the experiences of K-12 educators as they strove to (re)build caring relationships with students during the COVID-19 pandemic. The study was conducted during a graduate course for experienced K-12 teachers in the spring of 2020 at a four-year comprehensive university in the United States. Data was collected from reflective learning journals and asynchronous peer discussions, which captured educators’ experiences as they transitioned to remote learning in real-time. Qualitative content analysis was used to identify pertinent themes. Findings suggest that remote learning revealed relationships in need of repair. Educators practiced authentic care and cultivated connectedness by 1) acting as warm demanders, 2) responding to students’ social-emotional needs, and 3) trying to bridge the digital divide. The article concludes with implications for practice and areas for future research as schools, districts, states, and countries consider the “new normal” in K-12 schooling.

Spoken Body

The linguistic, rhetorical, and metaphorical powers of language profoundly influence events of health care. Physicians are professionalized into their own isolating language at the cost of fluency in their native tongue. Translation is always inadequate. Physicians resort to ironizing detachment from patients to delude themselves that they will not sicken and die. David Foster Wallace’s Infinite Jest and the Wittgensteinian and enactive/embodied cognitive and phenomenological concepts that support his work offer models for clinicians committed to authentic care of patients.

Love, Trust, and Camaraderie: Teachers’ Perspectives of Care in an Urban High School

Many scholars have found that student–teacher relationships are an integral part to student success in schools. The quality of relationships has implications for student engagement and performance. The most successful student–teacher relationships have characteristics of the ethic of care. The purpose of this qualitative study was to examine the perspectives of care of two teachers within a peer learning structured STEM (science, technology, engineering, and mathematics) classroom in an urban high school. In the Peer Enabled Restructured Class (PERC), student facilitators work with teachers to lead instruction. The findings indicated that teachers saw themselves as caring, but their articulations of care varied from authentic care to aesthetic care. The study has implications for teacher preparation and practice as teachers who are prepared and knowledgeable about the importance of relationships and care have the potential for better success with their students.

The meaning of the care of hospitalized children: experiences of nursing professionals

ABSTRACT Objective: to understand the meaning of the care of hospitalized children for the nursing professionals of a pediatric unit. Method: phenomenological study, based on the existential phenomenology of Martin Heidegger. Ten nursing professionals were interviewed with the guiding question: “What is the care of hospitalized children for you? Tell me, in detail, your experience with taking care of hospitalized children.” Results: the meaning of the care of hospitalized children materializes between the profession and the various ways of preoccupation. By engaging in/worrying about the ways of being of everyday life, the professionals tend to improperness when trying to mediate and level all possibilities of being. However, when they extrapolate reassurance and do not get caught up in themselves, they achieve empathy, respect, and indulgence. Final Considerations: it is necessary to reassess the teaching and practice of care, so that authentic care is offered to children and their families in the context of hospitalization.

Pedagogy of Authenticity in the Online Learning Environment

Genuineness, or authenticity, has long been established as the core attribute of excellent teachers. To reach their diverse learners, caring educators build genuine connections. Congruence has been described as the core condition for a meaningful learning and restorative growth, along with unconditional positive regard and empathetic understanding. While ample research has been generated on effectiveness in online education, few studies have focused on the notion and transferability of genuineness in the virtual classroom. This chapter presents a review of the interdisciplinary literature on authenticity, explores its link to diversity, and discusses the ways of cultivating authenticity online. It explores how faculty integrate the holistic self into course content, the virtual environment, and student interaction, and concludes with a review of best practices in course design and facilitation that convey authentic care for students online.

Turning toward Suffering Together

In chapter three, the philosophical work of Heidegger, Levinas, Charles Taylor, and Mikhail Bakhtin is drawn together to illustrate that in turning away from vulnerability, illness, and death in the name of objectivity and “clinical detachment,” physicians not only offer compromised care to their patients but also diminish their own practice and their own being. What is more, the argument is made that it is only through a response to the call of the face of suffering that one can offer authentic care. For it is through facing the reality of their own finitude and potentiality-for-suffering that physicians’ subjectivity is deepened and that they begin to recognize and respond to the call for care issued forth by the patient. In authentically responding to this call from the other, the doctor comes to see that she needs the patient, not only to determine how to help him, but she also needs the patient in a more fundamental way: she needs the patient in order to heal, in order to be a healer. As Heidegger would say, she needs the patient and his call outward toward her in order to become who she already is.

Reimagining Critical Care and Problematizing Sense of School Belonging as a Response to Inequality for Immigrants and Children of Immigrants

This chapter examines the factors that contribute to a sense of school belonging for immigrant and immigrant-origin youth. Through a review of the education research on critical care, the authors propose a framework informed by cariño conscientizado—critically conscious and authentic care—as central to reconceptualizing notions of school belonging. Research studies on teacher–student and peer relationships, student agency, and organizing are reviewed to identify how they function to disrupt structural factors that maintain educational inequities. Belonging as a concept is problematized through a re-envisioning of curriculum, pedagogy, and school–community relationships as a means to reduce inequality for immigrant and immigrant-origin youth and children.

Demographic Profile of Electrical Burns in a Tertiary Burn Care Centre

<div><p><em> Electrical burn injuries are challenging burns that require multi disciplinary approach. It is a major cause of morbidity among burn victims and requires more number of interventions and hospital stay. Certain unique features that are to be kept in mind while treating electrical burn patients are the differences in fluid requirement, assessment of cardiac involvement, other associated injuries like head spine or bony injuries and renal damage. Aim of treatment of these victims is to prevent infection, to achieve skin cover to allow early mobilization, to optimize function and to minimize long term scarring. Special effective authentic care and proper rehabilitation can make the electrical burn victim a useful productive member of the family/society.</em></p></div>