The Contrary Ideals of Individualism and Nursing Value of Care
Katims, Ide Rn, PhD, Scholarly Inquiry for Nursing Practice
Despite the relational worldview that underpins nursing caring, the cultural value of individualism remains firmly embedded in nursing's conceptual systems. Individualism forms the basis of notions such as autonomy, self-reliance, personal rights and entitlement. When nurses concomitantly espouse the value of care, an orientation that stands in contrast to the predominant societal motif of the autonomous individual, they find themselves having to reconcile contrary ideals. The significance of the coexistence of the values of individualism and care rests upon the capability of each to contrast and sharpen our understanding of the other. The convergent outcome is the empowerment of nurses to refine their understanding of the human condition in illness and health, and to articulate a public practice of care that would temper the fundamental mark of noninterference in the traditional notion of individualism in American culture.
Cultural values shape people's conception of self and social relationships. These conceptions manifest in a variety of ways in American society. Despite the strength of worldviews rooted in relational and collectivist values?especially those signifying women's experiences and, not coincidentally, embraced by the nursing profession?the dominant American social character remains individualistic. The philosophical tradition supporting these individualistic values is rich, extending from the natural rights theorists to contemporary liberalism. The conceptual forces underlying the individualistic ethos shape the values and actions, and therefore the experiences, of people who live within the society. Nurses' own personal cultural experiences are no different.
In their professional lives, even though most are women and cognizant of their unique orientation of care and relatedness, nurses remain products of an individualistic culture. Indeed, the Social Policy Statement describes nursing as "an essential part of society out of which it grew and with which it has been evolving" (American Nurses Association, 1980, p. 3). The result of this membership is an inevitable embodiment of the pervading worldview in the value system of professional nursing. Hence, the individualistic value of our society, expressed in nursing primarily through the notions of autonomy, self-determination and selfcare, serves as one of the lenses through which nurses view their practice of caregiving and the rights and interests of themselves and of the people to whom they give care.
Along with individualistic values, nurses also espouse the ideology of human interconnectedness and care. Do, then, the cultural values of individualism and the nursing professional value of care pose different, perhaps at times even contradictory, ideals? Are these divergent values capable of demonstrating some degree of philosophical compatibility so that they form a coherent belief system that underpins nursing practice? This paper suggests that nursing's caring ideal stands in contrast to the predominant societal motif of the autonomous, individualistic person. The values of individualism are philosophically incommensurable with the value of care. These contrary tenets bring into sharp focus the nursing profession's need to seek some balance between the stresses and forces of autonomy and the value of care.
This paper, then, is an analytical reflection on nursing?a potential contribution to the emergent philosophical debate in which nurses collectively attempt to uncover the intrinsic intelligibility of a lifework of care and caregiving. The relationship between the values of individualism and care in nursing is explored. When clinical practice is mentioned, home care nursing, the practice in which the author is engaged, is used for illustration.
INDIVIDUALISM AS CULTURAL FOUNDATION
Classic versions of individualism, although at times rhetorical, nevertheless shape the American experience in important ways. For Americans, the existence of individual rights in nature, such as rights to life, liberty and property, and their a priori primacy and protection, constitute core beliefs as to the origin and purpose of civil society. …