Saturday, February 20, 2010

A bunch of theories

The correct answer is "nine."

I’m very much looking forward to a couple of upcoming events – specifically the AAHPM/HPNA Annual Assembly in Boston, and my next online grad school course.

I’m only attending the Assembly on Friday, but it promises to be an active day with an early start, a late finish, and a chosen emphasis on the intersection of end of life care/nursing education with social networking technology.

With regard to my next online course, I’m not sure if I’ll be signing up to start in early April or early May. But it’ll be on theories and conceptual models. I like that kind of head work, and am completely up for it.

I’ve been attracted to several models and theories over the years, and have incorporated them into my evolving practice with varying degrees of success. The course will be an opportunity to explore them in greater depth, as well as a chance to learn about others.

The following theories and models resonate with me for different reasons, and they appear in no particular order:

Robert Altemeyer’s work on authoritarianism is a useful way to examine and understand the motivations and behaviors of people and groups. Altemeyer has identified the characteristics of people who need to be told what to do, and who approach life’s challenges in very stark, explicitly black/white terms. Rules are not just important for such people, who he describes as ‘authoritarian followers,’ they’re essential. Altemeyer also looks at those who exploit these followers, calling them ‘authoritarian leaders.’

Robert Hare’s work on psychopathy is as chilling as you might imagine. Psychopaths aren’t nice people, but unfortunately they’re out here in the real world, and they’re out here in surprisingly large numbers.

I’ll spend more time applying the work of both to the nursing profession. At best, I believe it’s important to understand the extremes, if only to better understand the milder pathological forms we encounter. That said, my professional path has most certainly crossed with colleagues whose actions and attitudes more closely fit Altemeyer’s and Hare’s prototypes.

A professor of nursing at a local undergraduate program has done work on the hostile workplace and bullying behavior in nurses. That’s another topic of great personal interest, and this professor’s publications have directed me to several theorists whose works form a good foundation for exploring the phenomenon. For starters, I’ve just ordered Behind the Mask, by Dana Crowley Jack a book that explores violence and aggression in women.

This focus also leads me to the broader field of feminist theory, and to Jo Ann Ashley, author of Hospitals, Paternalism, and the Role of the Nurse.

I think Richard Schwartz’s Internal Family Systems model is a useful framework for understanding our own psychodynamics. I think it also has value for approaching and developing relationships with colleagues and patients.

I recently stumbled upon the Tidal Model developed by Poppy Buchanan-Barker and Phillip Barker. Wow. I’ll be poking around with this one for quite some time.

Finally, in a post here last November I pointed to Human Relationships at the End of Life: An Ethical Ontology for Practice by David Wright, Susan Brajtman, and Vasiliki Bitzas. Their basic message is useful without further explanation, namely that we can be confident of having a sound ethical foundation for our decision making if we engage with patients on the basis of a compassionate relationship. But I welcome the chance to dig more deeply into this thought.

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