Self-deception and poor patient care: A big idea from a Sartrean perspective

Self-Deception in Clinical Nursing Practice: A Concept Analysis

In this paper, we explore the phenomenon of "self-deception" within the context of nursing, focusing on how nurses employ this coping mechanism when faced with dissonance, distress, and conflicting situations in clinical settings. Our primary objective is to examine the phenomenon of self-deception using Rodgers' evolutionary method of concept analysis. Focusing on nurses' experiences in challenging situations, our analysis highlights how self-deception is often employed as a coping strategy. According to our conceptual analysis, self-deception in nursing clinical practice highlights tensions between different paradigms and expectations in healthcare settings. These tensions stem from the power dynamics and subservience that nurses often face, which can hinder their ability to advocate for themselves, their patients, and the nursing profession.

Poor Care: A Walker and Avant Concept Analysis

Introduction: Care is the fundamental fact of nursing. In recent years, poor care is discussed frequently in articles and newspapers, however health care providers do not have a common understanding of this concept. Therefore the purpose of this paper was to clarify the concept of poor care in nursing and highlight the importance of tackling this issue. Methods: The concept was analyzed using the 8-step Walker and Avant's method. The SCOPUS, PubMed, ISI, and Embase databases were searched with the keywords "poor care" and "poor nursing care" in the titles and abstracts of articles. Of 550 sources found in the initial survey, 32 articles were finally included in the study. Results: Poor care attributes include poor evaluation, inadequate or inappropriate patient management, and delay, treating, and referring patients to other departments. These attributes are caused by antecedents of nursing workload, the complexity of patient conditions, inappropriate interactions, insufficient workforce, and educational and organizational factors. Conclusion: Poor care is a general concept that includes undesirable and unacceptable standards for receiving or providing clinical and interpersonal health services. Poor care includes eliminating planned activities or performing unplanned activities that are experienced by the patient, health care workers, or caregivers.

Failure to report poor care as a breach of moral and professional expectation

Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients, the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here, we build on this work but specifically foreground the responsibilities of registrants and students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and, sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when "real-world" cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations.