Journal of Clinical Nursing 1992; 1: 293

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In the late 1980s there was a campaign to highlight the value of nursing to Britishhealth care which emphasized its contribution as one of caring rather than curing.The way in which the campaign was orchestrated led some doctors to challengewhat they perceived as the nursing profession trying to claim a monopoly oncaring. Rightly, the nursing profession was reminded that other health-careprofessionals regarded caring as central to their roles. I can find no evidence inthe literature that any nurse re-emphasized the curing role of nursing at that time,rather, there appears to have been at least a tacit conviction that nursing primarilyinvolved caring.

Editing this Journal during its first year has led me to conclude that nursing,through a variety of actions, is contributing towards the curing process. This isevident from published papers which have examined diverse areas of nurses'work including cardiac rehabilitation, mental-health promotion and supportingsick children and their families.

Clearly, although caring can be viewed as an end in itself clinical nurses aredeveloping and examining the relationships between prevention, cure and care.Caring has been described as having at least four components in any situation:surveillance, nurturing, protection and prevention. Leininger (1990) suggestedthat professional care was a natural derivation from generic care and that theformer was important in assisting people in maintaining health and recoveringfrom illness. This definition of professional care applied to nursing is specificabout the aim of that care in terms of influencing health outcomes.

There are millions of informal carers throughout the world successfullysupporting sick and disabled people. Nurses must be able to explain that whilecaring is central to their work, so too are knowledge and skill. The need todifferentiate between a professional role and one of a friend or relative is not newin nursing. Peplau used the term 'professional closeness' when describing thedifference between supporting a distressed patient as opposed to a distressedfriend. Both roles she argued, required an involvement, a commitment toanother, but that the boundaries in terms of what could and should be expectedwould be quite different depending on the roles of the individuals involved. Some40 years later nurses are publishing clinical notes, research reports and longerpapers that indicate that we are still grappling with the issue concerning thenature of the caring which involves interpersonal relationships between nursesand patients.

Nurses must continue to examine how nursing care and caring can heal,preserve life and promote healthy life-styles (Leininger, 1990, p.28). If it can bedemonstrated that therapeutic nursing, in terms of contributing towards bothhealth promotion and cure, develops as a result of cohesive caring relationshipsbetween nurses and patients, the value of primary nursing will be explicit. Caringin itself is not enough; the application of knowledge and the examination of caringin nursing is essential if nursing as we know it is to survive. : .

MARY WATKINSSeptember 1992

Editor,Beeches, Crapstone,Yelverton, ' ' • . -v i

Devon PL20 7PW, UK

Reference

Leininger M. (1990) Historic and epistemologic dimensions of care and caring with futuredirections. In Knowledge about Care and Caring. State of the Art and Future Developments(Stevenson J.S. & Tripp-Reimer T., eds). American Academy of Nursing, Kansas City, pp.19-31.

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