Abstract

This critical theory study explores caring in nursing through the lens of Habermas' theory of moral consciousness and communicative action. This theory provides three claims to normative validity: the claim to truth, or factual "assertoric" knowledge; the claim to truthfulness, or the intrasubjective self; and the claim to rightness, or the intersubjective interaction. The interaction is identified as moral, because social dialogue or discourse requires a "considerateness" of each for the other. Habermas draws on Kohlberg's and Selman's work to develop three levels of moral maturity of communication. These are identified as: preconventional, conventional, and post conventional. When each of the three validity claims are met and there is genuine "considerateness" in the interaction, there is communicative action. The reverse is strategic action, where the communication is coercive. ;The study attempts to uncover the unquestioned acceptance of traditional ontology, epistemology, moral dimensions, methodology, comforting, and outcomes of nursing caring; question the false consciousness; and identify the gaps in the traditional ethos of nursing. Having developed a theoretical template for analysis, ten "expert" nurses with either advanced nurse practitioner degrees or doctorates were interviewed, in loosely structured interviews. The results suggested that there was a limited recognition of the vulnerability of the personal self of the patient or the nurse. The focus was on the illness needs of the patient, and the nurses "knew" what those expectations were. Meeting these needs propelled the ought of nursing care. While "ordinary things" were acknowledged as what the patient wanted, they were not the emphasis. The data also indicated that nurses do not readily acknowledge their own personal self, the professional self is that which is central. Nevertheless, the experts did acknowledge the importance of validation in the role of nurse by the patient, which gave a sense of "specialness." Caring in nursing is offered as a different paradigm of understanding of nursing caring, where the vulnerability of the personal side of both patient and nurse are recognized as an equal part of the interaction. The Spirit of Open Egalitarianism was offered as a model for the practice of caring in nursing. Quadrangular Dialogue was offered as a caring in nursing education model