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Open Access Economism, Efficiency, and the Moral Ecology of Good Nursing Practice Les notions d'économisme, d'efficacité et d'écologie morale dans le cadre de pratiques infirmières saines

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Abstract:

The free-market rhetoric dominating health-policy discussions today frames health-care goods and services as commodities that consumers will or will not buy at a given price. Health-care systems are being redesigned and hospitals restructured with a view to increased efficiency and productivity. Drawing on the experiences of clinical nurses in the United States, this paper shows how the application of economism to nursing may severely disrupt the ecology of good practice, leading to difficulties in meeting minimal standards of nursing care and severely constraining the acts of compassion called for by the human experiences of illness, loss, and death. Concerns about moral responsibility and conflicts between institutional and nursing goals are described. Increasing mistrust of health-care systems on the part of practitioners, patients, and families suggests that it is time to attend closely to the moral ecology of caring practices.

French
La rhétorique du marché concurrentiel qui domine les discussions en matière de politiques de santé aujourd'hui identifie les produits et les services médicaux comme des commodités destinées à être consommées par le public, qui les achète ou ne les achète pas, selon le prix. Les systèmes de soins sont révisés et les hôpitaux restructurés sous l'angle de l'accroissement de l'efficacité et de la productivité. À partir des expériences des infirmières cliniciennes æuvrant aux États-Unis, cet article démontre comment l'application de la notion d'économisme à la profession peut gravement porter atteinte à l'écologie d'une pratique infirmière saine et rend difficile le maintien de normes de soins minimales. De plus, elle limite sérieusement les gestes de compassion qui doivent être posés lorsque les gens vivent la maladie, la perte et la mort. Des préoccupations portant sur la responsabilité morale et les oppositions entre objectifs institutionnels et objectifs infirmiers sont émises. La présence d'une méfiance de plus en plus grande face aux systèmes de santé de la part des praticiens, des patients et des familles suggère que le temps est venu de se pencher attentivement sur la question de l'écologie morale dans le domaine des soins infirmiers.

Document Type: Research Article

Publication date: March 1, 2009

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  • CJNR is a peer-reviewed, quarterly journal published by the McGill University School of Nursing since 1969. With world-wide circulation, CJNR's primary mandate is to publish original nursing research that develops basic knowledge for the discipline and examines the application of the knowledge in practice. Research related to education and history is also welcomed, as are methodological, theoretical, and review papers that advance nursing science. Letters or commentaries about published articles are encouraged. Learn more.
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