Having a decreased sense of security leads to unnecessary suffering and distress for patients. Establishing trust is critical for nurses to promote a patient's sense of security, consistent with trauma‐informed care. Research regarding nursing action, trust, and sense of security is wide‐ranging but fragmented. We used theory synthesis to organize the disparate existing knowledge into a testable middle‐range theory encompassing these concepts in hospitals. The resulting model illustrates how individuals are admitted to the hospital with some predisposition to trust or (...) mistrust the healthcare system and/or personnel. Patients encounter circumstances increasing their emotional and/or physical vulnerability to harm, leading to experiences of fear and anxiety. Without intervention, fear and anxiety lead to a decreased sense of security, increased distress, and suffering. Nurse action can ameliorate these effects by increasing a hospitalized person's sense of security or by promoting the development of interpersonal trust, also leading to an increased sense of security. Increased sense of security results in diminished anxiety and fear, and increased hopefulness, confidence, calm, sense of value, and sense of control. The consequences of a decreased sense of security are harmful to patients and nurses should know that they can intervene in ways that both increase interpersonal trust and sense of security. (shrink)

The aim of this paper is discussion of a new middle‐range theory of patient safety goal priming via safety culture communication. Bedside nurses are key to safe care, but there is little theory about how organizations can influence nursing behavior through safety culture to improve patient safety outcomes. We theorize patient safety goal priming via safety culture communication may support organizations in this endeavor. According to this theory, hospital safety culture communication activates a previously held patient safety goal and increases (...) the perceived value of actions nurses can take to achieve that goal. Nurses subsequently prioritize and are motivated to perform tasks and risk assessment related to achieving patient safety. These efforts continue until nurses mitigate or ameliorate identified risks and hazards during the patient care encounter. Critically, this process requires nurses to have a previously held safety goal associated with a repertoire of appropriate actions. This theory suggests undergraduate educators should foster an outcomes focus emphasizing the connections between nursing interventions and safety outcomes, hospitals should strategically structure patient safety primes into communicative activities, and organizations should support professional development including new skills and the latest evidence supporting nursing practice for patient safety. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Poems Ancient and Contemporary HELAINE L. SMITH On the cover of Like: Poems by A. E. Stallings is a double photograph of a double image: two ancient carved heads, in profile and facing each other, of the pole horses of a quadriga, a four-horse chariot, dated about 570 BC, and currently in the collection of The Acropolis Museum. The marble horse in profile on the right side of the (...) cover, looking to the left, has a longer neck and face, and is undamaged except for a hairline crack at the neck. Its counterpart has a broader cheek, with light chipping above the nostril and an ear broken off. But they so mirror each other, they are so “like,” that at first glance one might suppose the photographs to be the right and left sides of the same horse. The bottom half of the cover of Like is an exact replica of the top, but the tinting is different, the heads in the top band cream-colored, in the arion 27.1 spring/summer 2019 Like: Poems by A. E. Stallings was published in 2018 by Farrar, Straus and Giroux, New York. Stallings’s earlier books of poetry include Archaic Smile (1999), Hapax (2006), Olives (2012), and a verse translation of Lucretius’ The Nature of Things (2007). bottom a delicate ochre or sand. There is, then, on the very cover of Like a promise of complex correspondence and subtle variation within the volume itself. Stallings’s title suggests poetry as the art of locating and articulating likeness or as the act of finding one thing in another. And in Stallings’s delicate, robust, witty, and humane use of the past, “like” also and most significantly means that they—the figures of ancient myth—and we are alike in our shared experience and shared humanity. Stallings sometimes presents classical and mythological references glancingly, and that is part of the delight—catching the joke in Hermes’ epithet, “lord of florists,”1 finding in “The Rosehead Nail” that the local blacksmith in Monteagle, Tennessee, “was a god / Before... the tasks / That had been craft were jobbed out to machine.” Likeness is, of course, the mode of Homeric simile, and in “Selvage” Stallings turns the simile of Odyssey 22.468–73, in which Homer compares the hanged maids to thrushes caught in a net, into a different but contextually relevant parallel: “they hang... From the warp like a dozen ancient loom weights,” a likeness that evolves from Stallings’s double entendre in line seven describing the maids as “spinsters of their own doom,” an allusion both to the task, properly theirs, of weaving and to their disclosure to their lovers of Penelope’s secret unravelling. Stallings can expand as well as adapt Homeric similes. At Iliad 2.87–2.90 Homer likens the Achaians’ assembly at Agamemnon’s command to arm and attack Troy to bees leaving the hive: Like the swarm of clustering bees that issue forever in fresh bursts from the hollow in the stone, and hang like bunched grapes as they hover beneath the flowers in springtime fluttering in swarms together this way and that way so the many nations of men from the ships and the shelters along the front of the deep sea beach marched in order by companies to the assembly2 178 poems ancient and contemporary Homer finds likeness in the orderly setting forth—of bees, of men—to do what is required. This, on the other hand, is what Stallings does: Colony Collapse Disorder (Iliad, 2.87–2.90) Just as a swarm pours from a hollow rock In one long beeline for the wild thyme, Alighting in clusters on this purple and that, But is stricken with a mass amnesia That disorients the compass of the sun, And they forget the steps to traditional dances, And each helicopters into a different dimness Taking their saddlebags of sweetness with them, And the hive goes dark, the queen is left to starve, And the drones humbug the whimper of the world, And the palace falls to ruins, broken into By vandals who would loot the golden stores Left in the brittle wax hexameters, Just so... And “so” her... (shrink)

Nancy Fraser has elaborated a framework for analyzing different forms of oppression using the categories of redistribution and recognition. This framework has come under criticism from Iris Marion Young and Judith Butler, despite the fact that all three theorists similarly insist that justice is not reducible solely to economic justice and that struggles against ‘cultural’ forms of oppression are equally important. Drawing on the debate between these theorists, in this article I examine the ways in which their respective theoretical frameworks (...) are potentially problematic or do not go far enough in theorizing the complex interconnections among economics, politics and culture. For example, Fraser’s binary economy/culture and Young’s distinction between culture and structure are overly broad and potentially misleading. Butler and Fraser also appear to adopt undertheorized and economistic conceptualizations of ‘the economy’ and capitalism. In the course of my critique, I propose a somewhat different approach to analyzing the causes of various forms of oppression and the relation between different emancipatory struggles. Among other things, I argue that social relationships need to be disaggregated further, into more than just two categories, and that the economic and the cultural (as well as the political) should be analyzed as always complexly overdetermining each other. (shrink)

The year 2020 has yielded twin crises in the United States: a global pandemic and a public reckoning with racism brought about by a series of publicized instances of police violence toward Black men and women. Current data indicate that nationally, Black Americans are three times more likely than White Americans to contract Covid-19, a pattern that underscores the more general phenomenon of health disparity among Black and White Americans. Once exposed, Black Americans are twice as likely to die of (...) the virus. Unsurprisingly, Black Americans report higher levels of fear of Covid-19 than their White peers, but they also report higher levels of hesitancy toward a Covid-19 vaccine. This paper explores why this apparent discrepancy exists. It also provides practical recommendations for how government and public health leaders might address vaccine hesitancy in the context of the twin crises of 2020. (shrink)

Although oppressive social practices like capitalism are often portrayed as static, totalizing social 'structures' with 'logics' and 'imperatives' that must be accommodated politically and economically, such portrayals are problematic both theoretically and politically. They rest on determinist and essentialist conceptions of social practices, and they curtail the scope of politics, government regulation, and human action and creativity. Fortunately, social practices can instead be conceptualized as thoroughly social, historical, and contingent, and thus susceptible to political intervention and reworking, as many feminist, (...) post-structuralist, and anti-economistic Marxian theorists do. Attempting to build on such alternative conceptualizations, I argue that Judith Butler's concept of reiteration provides a particularly useful, in-depth theorization of power, the mechanisms enabling social practices to endure and change, and the role of the individual and collectivities in perpetuating and challenging social practices such as capitalism. In so doing, the concept of reiteration offers a compelling and detailed non-voluntaristic account of human agency. Butler's work is thus helpful in theorizing and empirically investigating both the obstacles to and the possibilities for resisting exploitation and altering unjust social practices. (shrink)

Like Kant's Critique of Pure Reason, we now have both an A- and a substantially revised B-edition of Henry Allison's commentary to and defence of that work: Kant's Transcendental Idealism: An Interpretation and Defense . Unlike Kant's Critique, however, Allison's first edition is unlikely to persist as an occasional rival to the second, since reviewers rightly consider the second to have superseded the landmark scholarship of the first. Nevertheless, before Allison's first edition is entirely supplanted, I would like to save (...) a neglected insight from its treatment of the B-deduction that is not retained in the second edition. (shrink)

Stimulating, thought-provoking analysis of a number of the most interesting intellectual inconsistencies in mathematics, physics and language. Delightful elucidations of methods for misunderstanding the real world of experiment (Aristotle’s Circle paradox), being led astray by algebra (De Morgan’s paradox) and other mind-benders. Some high school algebra and geometry is assumed; any other math needed is developed in text. Reprint of 1982 ed.

High technology and nursing: ethical dilemmas nurses and physicians face on high‐technology units in Norway Results from two studies of ethical dilemmas nurses and doctors experience on two high‐technology units are compared and discussed. The qualitative comparative methodology of grounded theory was used to generate theoretical frameworks grounded in the empirical realities of the units. The ethical dilemmas they faced were related to: treating the one vs. the common good; end of life questions; and resource allocations with inadequate staffing. Similarities (...) were related to intensity and urgency of nursing care and patient treatment, clear nursing ideologies based on treating humans within a framework of hope, embracing technology and scarce resources. Differences between the two study units were patient diagnosis, hierarchical structure on one unit while one had a vertical structure and decision‐making processes, and finally how nursing knowledge and autonomy were used. The two studies demonstrated that clinical, ethical and administrative interactions and decisions are highly compounded, stressful and intertwined. (shrink)

Surprisingly often Kant asserts that it is possible to behave in such a degrading way that one ‘throws oneself away’ and turns oneself ‘into a thing’, as a result of which others may treat one ‘as they please’. Rather than dismiss these claims out of hand, I argue that they force us to reconsider what is meant and required by ‘respect for humanity’. I argue that to ‘throw away’ humanity is not to lose or extinguish it, but rather to refuse (...) or otherwise fail to claim the respect that it authorizes one to claim. If I refuse or fail to make this claim, there is a sense in which I become a thing, and I leave others no choice but to treat me as such. This is compatible with their respect for humanity in my person. (shrink)

Gains in moral judgement, as measured by the Defining Issues Test (DIT), correlate strongly with advancing education. Curricula that are strongly biblically based may not promote, and students with a strong fundamentalist orientation may not demonstrate, such moral growth. Students at an interdenominational, but very conservative seminary, completed the DIT before and after ethics courses conducted in three different formats. Those students who spent 30 hours in small‐group discussions of ethical dilemmas improved their moral reasoning scores, while those who had (...) fewer hours of discussion or lectures did not. It would appear that small group discussions, shown to improve moral reasoning scores in other educational settings, are also successful in a strongly biblical environment. (shrink)

Ms. Johnson’s case highlights a number of the ethical challenges that can arise when treating anorexia nervosa, including uncertainty about a patient’s decisional capacity, the limitations of treat...

I argue that Kant’s own views—his commitment to happiness as part of a transcendent highest good, his view of the afterlife as a place of moral striving, and his conception of the “absolute unity” of rational and animal natures in a human person—commit him to belief in an embodied afterlife. This belief is just as necessary for conceiving the possibility of the highest good as the beliefs in personal immortality, freedom, and God’s existence, and thus it too is a “practical (...) postulate” in Kant’s sense. (shrink)

This article proposes the concept of blind visuality as a response to the injunction to look differently at both visual images, and vision itself, posed by Bruce Horak’s exhibition Through a Tired Eye. The brightly colored impressionistic paintings suggest an artist who revels in the domain of the visual, yet he describes his practice as a representation of blindness. This accessible exposition of blind visuality speaks to the broad question of what critical disability arts contribute to discourses about vision, visuality (...) and spectatorship in the arts. I analyze Horak’s paintings as examples of blind epistemology and haptic visuality, showing that this work evokes a way of seeing that blurs the boundaries between vision and embodied feeling. I argue that by expanding understandings of vision and multi-sensory knowledge, deconstructing the separation between vision and haptic perception, and challenging western ocularcentricism, blind visuality poses an alternative economy of looking that reflects disability aesthetics, shifts from individualism to relationality, and challenges understandings of perception/knowledge as a form of mastery. (shrink)

In the original publication, the sentence “Most notable and famous are the Tuskegee syphilis experiments that occurred from 1932–1972, in which Black men in Macon County, AL were infected with syphilis under the guise of free health care.” under the section “Drivers of Mistrust of Motives” was published incorrectly. The correct one is “Most notable and famous are the Tuskegee syphilis experiments that occurred from 1932–1972, in which Black men in Macon County, AL many of whom had latent syphilis, were (...) misled into believing that they would receive free health care in exchange for their participation. (shrink)

Autism spectrum disorder affects an estimated 1 in 54 children aged 8 years in the United States. For many of these children, there are concomitant eating and/or behavioral challenges that can make managing their nutritional health challenging. This commentary responds to a particularly challenging case in which a pediatric patient with ASD presented to the local hospital’s emergency department with severe weight loss and malnutrition.

This interesting and important contribution to scholarship on Kant’s account of sublime feeling develops an argument that the author first makes in an article, “Kant’s Consistency Regarding the Regime Change in France” (Philosophy and Social Criticism 32 [2006]: 443–60). The heart of the argument, presented in chapters 2 through 5, concludes that aesthetic enthusiasm (Enthusiasm, which Clewis distinguishes from Schwärmerei, or fanaticism) is a kind of sublime feeling, which can indirectly support morality and thus elicit an interest of reason (as (...) Kant claims the beautiful does). In chapter 6, Clewis uses the foregoing analysis to resolve an apparent inconsistency between Kant’s remarks on the enthusiasm of .. (shrink)

This paper elaborates a theory of ‘unbecoming’ to explore how a queering of the subject might transform oppressive social conditions. In this analysis of the subject’s deconstructive relation to the law I take up the interpellation scenario forwarded by Louis Althusser and Judith Butler’s theory of performativity to argue that being ‘unbecoming’ potentially not only alters subjectivity, it also alters the very law that hails the subject into being. First, I deconstruct both subject and law in their relation to each (...) other as performatives, for it is at this threshold of undecidability that the possibilities for political transformation emerge. Second, I demonstrate the creative and transformative political force of queer performativity to show that our agency as political beings lies not merely in affirmative representations of identity. Political agency also emerges in the creative force of a becoming that is also an unbecoming, where in and through our abjection from the social order we critique and transform it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Good Work: Christian Ethics in the Workplace by Esther D. ReedWilton BunchGood Work: Christian Ethics in the Workplace Esther D. Reed Waco, TX: Baylor University Press, 2010. 132pp. $18.96Work has become a political football. There are laws defining who can work and who cannot. And there are laws that stipulate who can receive and who is eliminated from what were formerly standard benefits. There are even laws, as (...) in the state of Alabama, that define what work ministers can do for the poor, the needy, and those who are ill. Given the many issues affecting what occurs in workplaces—where most working people spend most of their time—there is a need for an integrated perspective on work. Esther Reed’s Good Work provides just that: a broader context for understanding the significance of our work.Many people understand “work” to be the energy they expend in order to receive something they can then spend. Such an understanding of work, Reed observes, reflects the assumptions of a capitalist society in which people are valued in terms of what they do and how much money they make. From this standpoint, cardiac surgeons are valued much more highly than garbage collectors, even though societies could not function without garbage removal but did, in fact, survive for centuries before cardiac surgeons. In a similar vein, in the supposedly egalitarian halls of academe, the grossly underpaid adjunct professor is dismissed and discounted even though she spends much more time with students than does her tenured counterpart. [End Page 196]Yet there are other ways of defining work. Reed reminds us that the same Hebrew word translated as “hard work” (‘abad) can also mean priestly service in the Tabernacle (12). The work (or liturgy) of tabernacle worship was understood to be service to God. Likewise, Jesus described his ministry as work and even spoke of the Father as still working: “My Father is still working, and I also am working (Greek ergazetai/ergazomai; John 5:17)” (13). The work of Jesus and his Father had to do with salvation and blessing for human beings. From this standpoint, work clearly has a spiritual dimension.The framework Reed develops for establishing a Christian ethic of work is rooted in the resurrection of Jesus Christ from the dead. What we say about work, she contends, will depend on what we say about the resurrection. Indeed, she argues, reflection on the resurrection can orient (or reorient) the working lives of Christian in important ways (2). An understanding of work rooted in the resurrection, Reed argues, is cultivated by participating in the liturgy of a worshipping community. Many Christian liturgies begin with praise to God for the salvation that comes through Jesus Christ. By beginning worship in this way, the community is able to concentrate on a kind of work that enables them to go beyond their individual lives and become part of something larger—a community in praise of God. In turn, the bread and wine that is blessed during the Eucharistic celebration contains not only the fruits of creation but also the fruits of human labor. As the Spirit of God infuses the bread and wine with the presence of Jesus Christ, crucified and raised from the dead, it also sanctifies our labor. And as we receive the bread and wine, and as we meditate on Christ’s passion and resurrection, we become hungry for enacting justice and mercy in all realms of our lives—including the realm of work. Indeed, through this encounter with the Triune God and with one another in worship, we gain a renewed appreciation of who we are as human beings. More profoundly, we become those who can, in fact, not only work and love but also—through the Spirit’s power—renew everything we do and encounter, including the curse of work.Central to Reed’s argument is the claim that work entails a dimension of justice. Persons have rights to work and to rest because they are created in the image of God, which means they have intrinsic worth. Such rights, she argues, must be closely linked with liberties that are understood not merely negatively... (shrink)

The study presented in this article is based on field observations over one year on a critical care unit in Norway. Data were analysed according to Glaser’s grounded theory and generated a theory of hidden and emerging drama in the context of ambiguity while the nurses routinized the handling of complex technology. To the untrained eye the unit presented a picture of calm competence, while under the surface one finds hidden drama full of difficult interacting clinical and ethical problems. The (...) nurses identified six ethical dilemmas: (1) end of life issues; (2) whether there should be an age limit for coronary surgery; (3) distributing limited resources; (4) resource allocation in terms of better staffing; (5) situations in which is it more harmful than beneficial to continue treatment; and (6) transferring patients to other facilities. The six problems overlap and have clinical as well as ethical components, but it was the ethical dimensions that the nurses identified and discussed. The significance for nursing is the importance of well-educated and well-qualified nurses and how they find viable solutions to complex ethical and clinical problems. (shrink)

Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of (...) ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Good Work: Christian Ethics in the Workplace by Esther D. ReedWilton BunchGood Work: Christian Ethics in the Workplace Esther D. Reed Waco, TX: Baylor University Press, 2010. 132pp. $18.96Work has become a political football. There are laws defining who can work and who cannot. And there are laws that stipulate who can receive and who is eliminated from what were formerly standard benefits. There are even laws, as (...) in the state of Alabama, that define what work ministers can do for the poor, the needy, and those who are ill. Given the many issues affecting what occurs in workplaces—where most working people spend most of their time—there is a need for an integrated perspective on work. Esther Reed’s Good Work provides just that: a broader context for understanding the significance of our work.Many people understand “work” to be the energy they expend in order to receive something they can then spend. Such an understanding of work, Reed observes, reflects the assumptions of a capitalist society in which people are valued in terms of what they do and how much money they make. From this standpoint, cardiac surgeons are valued much more highly than garbage collectors, even though societies could not function without garbage removal but did, in fact, survive for centuries before cardiac surgeons. In a similar vein, in the supposedly egalitarian halls of academe, the grossly underpaid adjunct professor is dismissed and discounted even though she spends much more time with students than does her tenured counterpart. [End Page 196]Yet there are other ways of defining work. Reed reminds us that the same Hebrew word translated as “hard work” (‘abad) can also mean priestly service in the Tabernacle (12). The work (or liturgy) of tabernacle worship was understood to be service to God. Likewise, Jesus described his ministry as work and even spoke of the Father as still working: “My Father is still working, and I also am working (Greek ergazetai/ergazomai; John 5:17)” (13). The work of Jesus and his Father had to do with salvation and blessing for human beings. From this standpoint, work clearly has a spiritual dimension.The framework Reed develops for establishing a Christian ethic of work is rooted in the resurrection of Jesus Christ from the dead. What we say about work, she contends, will depend on what we say about the resurrection. Indeed, she argues, reflection on the resurrection can orient (or reorient) the working lives of Christian in important ways (2). An understanding of work rooted in the resurrection, Reed argues, is cultivated by participating in the liturgy of a worshipping community. Many Christian liturgies begin with praise to God for the salvation that comes through Jesus Christ. By beginning worship in this way, the community is able to concentrate on a kind of work that enables them to go beyond their individual lives and become part of something larger—a community in praise of God. In turn, the bread and wine that is blessed during the Eucharistic celebration contains not only the fruits of creation but also the fruits of human labor. As the Spirit of God infuses the bread and wine with the presence of Jesus Christ, crucified and raised from the dead, it also sanctifies our labor. And as we receive the bread and wine, and as we meditate on Christ’s passion and resurrection, we become hungry for enacting justice and mercy in all realms of our lives—including the realm of work. Indeed, through this encounter with the Triune God and with one another in worship, we gain a renewed appreciation of who we are as human beings. More profoundly, we become those who can, in fact, not only work and love but also—through the Spirit’s power—renew everything we do and encounter, including the curse of work.Central to Reed’s argument is the claim that work entails a dimension of justice. Persons have rights to work and to rest because they are created in the image of God, which means they have intrinsic worth. Such rights, she argues, must be closely linked with liberties that are understood not merely negatively... (shrink)

This book closely examines our commonly held beliefs about human suffering, and offers unique insights into God's role in why we suffer. Dr. Perri critically examines what it means to be human from a Judeo-Christian perspective, and extrapolates from the work of Carl Gustav Jung showing a deeply complex development of human transcendence in human suffering. On an interpersonal level, Dr. Perri elaborates on the work of Martin Buber and Emanuel Levinas and shows how our suffering can be shared and (...) lessened by our unconditionality and presence for the other. Scriptural passages are quoted from both the Hebrew and New Testament texts, and are used to depict the suffering of humankind as seen in the face of Job. It was this face, according to Perri, that Jesus saw in the faces of those He came to redeem, and that ultimately brought Him to the crucifix of redemption. Dr. Perri challenges Sartre's position that our existence precedes our essence, and draws on the work of Abraham Joshua Heschel and Christian theology in this regard. He further elaborates a neurodevelopmental paradigm that creates essence as the basis of our freedom to choose. This book can be read and studied by both professionals in the helping and healing professions, and lay persons seeking to better understand our suffering, and how to better help those who suffer. Dr. Perri offers specific ways in how to be present for those who suffer, how to read and receive the hidden language of human suffering, and how to use silence as a communication skill. (shrink)

William McNeill and Nicholas Walker provide an excellent translation of Die Grundbegriffe der Metaphysik, the text of a lecture course delivered in 1929-30 and originally published in 1983 as volume 29/30 of Heidegger's Gesamtausgabe. In this text, which is crucial to understanding the transition from Heidegger's earlier to his later thinking, readers will find a helpful overview of Heidegger's conception of metaphysics, a brilliant phenomenological analysis of boredom, an investigation of the essence of life and animality, and an analysis of (...) the structure of the propositional statement. (shrink)