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(Download PDF) Caring Matters Most The Ethical Significance of Nursing 1St Edition Lazenby Online Ebook All Chapter PDF
(Download PDF) Caring Matters Most The Ethical Significance of Nursing 1St Edition Lazenby Online Ebook All Chapter PDF
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A
“This ‘little book’ details the big ideas that form the foundation of
the nursing profession. It is a must read for those new to the profes-
sion and those long in the profession alike. In simple but powerful
prose Mark Lazenby reminds us why we nurse and what it means
to be a nurse.”
—Judith B. Krauss, MSN, RN, FAAN, Dean and Professor Emerita,
Yale University, School of Nursing
B
By
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ii
3
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.
This material is not intended to be, and should not be considered, a substitute for medical or
other professional advice. Treatment for the conditions described in this material is highly
dependent on the individual circumstances. And, while this material is designed to offer
accurate information with respect to the subject matter covered and to be current as of the
time it was written, research and knowledge about medical and health issues is constantly
evolving and dose schedules for medications are being revised continually, with new side
effects recognized and accounted for regularly. Readers must therefore always check the
product information and clinical procedures with the most up-to-date published product
information and data sheets provided by the manufacturers and the most recent codes of
conduct and safety regulation. The publisher and the authors make no representations or
warranties to readers, express or implied, as to the accuracy or completeness of this material.
Without limiting the foregoing, the publisher and the authors make no representations or
warranties as to the accuracy or efficacy of the drug dosages mentioned in the material. The
authors and the publisher do not accept, and expressly disclaim, any responsibility for any
liability, loss or risk that may be claimed or incurred as a consequence of the use
and/or application of any of the contents of this material.
1 3 5 7 9 8 6 4 2
Printed by WebCom, Inc., Canada
iii
DISCL AIMER
The clinical stories I have told in this book are faithful to my expe-
riences and to what I have been told by other nurses, but I have
changed the particularities of real events such that they would not be
recognizable, except those stories that are about me and my family.
vi
vii
CONTENTS
Foreword ix
Preface xv
Acknowledgments xix
Epigraph xxi
PART I
THE ETHICAL SIGNIFICANCE OF NURSING
Contents
PART II
THE ETHICAL SIGNIFICANCE OF NURSES’ LIVES
Notes 131
Bibliography 139
Discussion Questions and Exercises 143
Index 149
viii
ix
FOREWORD
Foreword
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Foreword
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Foreword
positive growth for patients and nurses in the midst of illness and
vulnerability. By seeing beauty in the aliveness of patients, their
strengths and imagination for living in the midst of vulnerability,
we find one of the most pervasive moral sources for imagination in
nursing practice. As Lazenby writes in Chapter 1,
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xiii
Foreword
We find few authors willing to tackle the task of putting into words
the moral sources and ideals of nursing practice through examples
of the best nursing practice as well as examples of our best prac-
tices in the midst of imperfect worlds of practice. In the examples
and stories, the ideal and real are not split in oppositional ways but
rather integrated. Lazenby takes on the imperfect work environ-
ments and unreasonable demands encountered by nurses, from the
stance of a nurse who has experienced these demands firsthand.
In the midst of the unreasonable demands Lazenby calls on imagi-
nation. I am reminded that skydivers seldom complain about the
terrors and dangers of their craft. Instead, they focus on the highs
of flying above the Earth, the challenges, and the amazing vistas.
Meeting others in our common humanity of vulnerabilities, enliv-
ening beauty, and strength is a privilege. I am inspired to be a better
nurse by reading this book.
I hope that Caring Matters Most: The Ethical Significance of
Nursing will become the essential text for an ethic of caring taught
in all nursing schools.
Patricia Benner, RN, PhD, FAAN
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T h e E t h ic a l Si g n ific a n c e o f N u r s i n g
4
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"Up onto the foc's'le-head," he cried angrily. "Git a move on, yew
blasted farmers, or yew won't know what struck yew."
It was Black Davis, the mate of the Higgins, one of the most
notorious of buckos.
Broncho opened his mouth to reply, but Jack Derringer shoved him
up the topgallant ladder with a grip of iron, and, directly they were
out of earshot, said:
"That man with the eyebrows is kind of sheriff of this outfit—mate,
sailors call it. He's a bad 'un from away back, but he's got the drop
on us, old son, and we've got to jump around lively without any
tongue-wagging, or he's liable to make things red hot."
"Gaud blimy, but h'I should sye so," remarked a cockney, who was
shipping a capstan-bar close to them. "'E's a bloomin' devil from the
word go, is that blawsted swine. H'I done a passage with 'im afore,
an' I knows 'im, h'I does, the black-'arted 'ound."
They had no time for further reminiscences of Black Davis, however,
for he now appeared on the foc's'le head in company with the big
hairy bosun.
"Never see'd sich a crowd o' hayseeds—not two sailormen among
'em, I don't expec'," said the bosun.
"Deadbeats and hoboes, every doggoned one of them," growled the
mate; "not a chanty in 'em, neither."
All hands were now tramping steadily round the capstan.
"Heave an' bust her!" sang out the big bosun. "Heave an' she
comes!"
Presently a slim young Englishman with curly hair struck up the well-
known chanty, "Away, Rio."
As the hoarse voices echoed over the calm waters of the bay, the
crews of two large British barques came to the rail, hooting and
jeering at the notorious hell-ship.
"Cut his black liver out, boys!" came a stentorian voice across the
water.
"H'I bloomin' well will, one o' these fine dyes," muttered the cockney
under his breath, with a murderous glance at the bucko mate.
Jack Derringer, who was a great exponent of chanties, followed the
lead of the curly-headed one, and in a clean, strong baritone broke
out with:
"As I was walking out one day
Down by the Albert Docks."
There were evidently more sailormen aboard than either the bosun
or Black Davis had calculated on, for the chorus came with a roar:
"Heave a-way, my Johnnies, heave a-way!"
FOOTNOTES:
[1] "Old woman," a cattle-ranging term for the cook.
[2] Cinch. The cinch corresponds in an American saddle to the
English girth. To cinch a girth up is to draw it tight by means of
several turns of strap or rope between the ring of the girth and a
ring on the saddle, and from this the word has come to being
used in a variety of ways; for instance, Cinch on to that—catch on
to that; It's a cinch that—it's a certainty that; What a cinch!—what
a good thing! what an easy thing!
[3] True.
CHAPTER III
"THE USE OF A SHEATH-KNIFE"
Contrary to the astronomical prophet's forecast, the Higgins
was lucky in carrying the northerly breeze until she picked up the
"trades," and the third day out all hands were turned to shifting sail.
By this time Broncho was beginning to feel his feet. He was fortunate
in having such a useful friend as Jack Derringer, who showed him
the right way to set about his work and saved him from many a
trouble.
It is to be doubted if Broncho's untamed cowboy spirit would have
put up with Barker's bullying and insulting tongue if it had not been
for Jack's strong influence and keen common-sense way of viewing
and explaining everything.
The rolling-stone, except for strange spells of melancholy, when he
seemed to be lost in gloomy thoughts and was hard to get a word
out of, had a way of looking at everything from a comic point of view,
and his infectious smile and cool comments time and again turned
Broncho's smouldering wrath into mirth.
The cowboy prided himself on his philosophical way of taking fate.
His strong points were his virile manhood, his fortitude against
misfortune, and his daredevil bravery, and in these traits he found an
equal, if not a superior, in the cool, self-possessed Britisher.
Only once was the cowpuncher ever heard to discuss his friend, and
that was in one of his queer outbursts of thought.
"This world is shore like a poker game. Some parties is mean an' no
account, like an ace high or pair of deuces; some's middlin', an' has
their good an' bad p'ints, like a pair o' bullets or two low pair in a
Jack-pot; some gents outhold the rest as a general play, like three of
a kind; but is likewise downed themselves by sech superior persons
who, like flushes an' full houses, is bang full o' sand, sense, an'
'nitiative; but thar's only one sport I ever rounds up against who's got
all the vartues of a four of a kind, an' that man's Derringer Jack—he's
shore four aces an' the joker."
Shifting sail started off smoothly enough, chiefly owing to the bosun,
who knew how to get work out of men without using a belaying-pin.
An old Blackwall rigger, he was the very beau ideal of what a bosun
ought to be, and the sight of his spars and rigging was as good for
the old man's liver as a ten-knot breeze astern.
One day the man at the wheel overheard Captain Bob commenting
aloud to himself after a keen look round his ship.
"Me mates be all right as long as it's thumpin' men an' ship-cleaning
as is the ticket; but when it comes to marlin-spike an' riggers work,
that 'ere durned lime-juicer kin give 'em cards an' spades."
The bosun, however, was far from being popular with the bucko
mates, as his methods of enforcing discipline were much too tame to
gain their approval.
"Them doggoned lemon-pelters never could handle men; they
coddles em an' spiles 'em. Human nature requires whippin', an' if
them skulkin' 'possums don't get a sort o' warnin' pretty frequent,
they're liable to get thinkin' they've got the bulge on us," remarked
Black Davis to Barker one morning in disgust, as he watched the
bosun, Jack, and Paddy chatting amiably together whilst they were
at work patching a fair-weather topsail on the maindeck.
These two bullies spent their time looking for trouble. Their one
delight seemed to be to haze the men and knock them about; they
had already beaten every bit of spirit out of those two poor
greenhorns, Pinto and Jimmy Green, whilst Sam, the great buck
nigger, who topped Black Davis by at least half a foot, and Barker by
more, fairly rolled his eyes in terror when either one of these
worthies approached or spoke to him; they knocked the cowards
about unmercifully, and even such gluttons for a fight as Pat and the
cockney got their fair share of hard usage.
But neither Jack Derringer nor the cowboy had been touched since
the towing out.
It was a mystery to all hands why Jack escaped so easily. It was not
by reason of his muscle, which was not so apparent on the surface
as that of the big nigger. It was not because they liked him, for any
one could see with half an eye that the pair fairly detested him, and
yet their mysterious fear of the rolling-stone seemed greater than
their hate. It was not a ferocity of manner or a desperado air that
caused this fear, for although Jack had a quiet way of taking the lead
and ordering others about which had already made him cock of the
foc's'le, his rule forward was far from being that of a despot; it was
rather that of an easy-going, level-headed man, gentle but firm.
Being also the only educated man forward except the young English
apprentice, his advice and counsel were in constant demand.
Even he, however, could not understand his freedom from ill-
treatment. Several times he complained in the foc's'le with a queer
grin that he was not getting his fair share of belaying-pin soup. It
actually seemed to annoy him, and he began to air his wit on the
buckos in such an insolent, daring fashion that the men, hearing him,
shook in their shoes at his temerity.
There was no mystery forward, however, about Broncho's escape
from brutality.
It was known aft, of course, that he was a cowboy from the south-
west, and Jack, with infinite cunning, had made Broncho out to the
bosun a terrible desperado:
"One of the most noted 'bad men' of the West," he declared. "Known
and feared from Arizona to the Kootenay, from Texas to the Pacific
slope, with more notches on his six-shooter than years to his life."
This precious character, together with several blood-curdling
episodes of his career, invented on the spur of the moment by the
rover's fertile brain, was in due course passed on to the after gang,
with the result that Broncho was treated with a strange deference by
the buckos, much to the amusement of the hands forward who were
in the know.
Barker took care that all the easiest work came the desperado's way,
and often he would favour him in small ways, and even yarn with
him, when the old man was below, in the hopes of hearing from his
own lips one of his many deeds of blood. But all the time the bucko
was nervous and ill at ease; his own gory record seemed mean and
petty compared to the cowboy's wholesale butcheries. One night he
buttonholed the cowpuncher whilst he was coiling up gear on the
poop, and asked him to spin the yarn of how he killed the seven
greasers at Tombstone, and Broncho had a chance of giving free
rein to his inventive powers.
The nickname also of Bucking Broncho, which had long replaced the
cowboy's real name, helped to promote the deception, which
occasioned much unholy joy in the starboard foc's'le.
Thus it was that the buckos treated Broncho with almost servility,
though they daily did their best to arouse every passion of hate,
revenge, and murder in the rest of the ship's company.
But the sand in the time-glass of fate was nearly run out for one of
them.
Whilst the bosun and some hands were busy bending the fore-
topsails, the second mate went aloft on the main with Jack, Broncho,
Ben Sluice, Pedro, and Sam.
They had just hoisted up the main upper-topsail ready for bending.
Barker took his post at the bunt, Jack going out to the weather
earing, with Broncho next to him, and Pedro inside next to Barker;
whilst Ben and Sam went out on to the lee yardarm, where they were
in a short time joined by Curly, who had been waiting below to let go
the spilling-lines.
The head of the sail was spread out along the yard, the earings
passed, and they were all busy making it fast to the jackstay.
Suddenly Barker, who had been watching for an opportunity to raise
trouble, noticed that Pedro had skipped a roving.
"Yew mongrel skunk——" he began, raising his fist to strike the
dago; but the sentence was never finished and the blow never fell,