Could we remedy the 'crisis of care' by incorporating mandatory group psychotherapy in nurse education?

This paper suggests a tentative proposal for nurse education that may go some way to remedying the 'crisis of care' described by Judge Francis and others. Any viable strategy to improve caring attitudes in nursing students must involve activities across the curriculum that foster self-awareness and empathy. It is suggested that the best way to do this is for all undergraduate nursing students to participate in regular, supervised group psychotherapy sessions as a mandated requirement for registration. This strategy would be helpful in at least two main ways. First, it would be enormously beneficial in terms of promoting emotional intelligence - a necessary requirement for providing ethical, person-centred care. Second, it would also serve as an excellent form of student support, which would likely improve student retention rates. This is because individuals with strong group support systems are less likely to become mentally or physically ill and are, therefore, more resilient. Finally, some possible objections to this proposal are considered.

A role for virtue in unifying the 'knowledge' and 'caring' discourses in nursing theory.

A critical examination of contemporary nursing theory suggests that two distinct discourses coexist within this field. On the one hand, proponents of the 'knowledge discourse' argue that nurses should drop the 'virtue script' and focus on the scientific and technical aspects of their work. On the other hand, proponents of the 'caring discourse' promote a view of nursing that embodies humanistic qualities such as compassion, empathy and mutuality. In view of this, we suggest a way to reconcile both discourses despite the fact that they appear to be at odds theoretically and practically. To that end, we argue that nursing theory must give a prominent role to the Aristotelian conception of virtue, and we offer an account that includes both character and intellectual virtues. This account allows for a focus on moral competence but also accommodates the demands for discipline-specific knowledge. Our account incorporates the caring discourse by suggesting a way for individuals to cultivate the conditions within themselves that make 'caring in nursing' possible, while the knowledge discourse is accommodated via the acquisition of the intellectual virtues. The process for achieving both these ends is the same: an intention to consistently develop, hone and exercise certain character traits over time.

Schizophrenia and the estranged self.

How does schizophrenia affect a subject's sense of self? In this paper, we discuss the experience of alienation of mental states and actions that can take place in schizophrenia. We begin by highlighting this experience in delusions of thought insertion and delusions of made feelings, impulses and actions. Next, we offer a proposal about the nature of this experience by utilizing some of the current philosophical research on self-knowledge. The proposal is that the experience of thoughts, feelings, impulses and actions as not being one's own is the experience of regarding those states as not being responsive to reasons. Then, we put forward a hypothesis about why schizophrenia can lead to this experience by drawing on the psychiatric literature on the disorder. The hypothesis is that subjects who suffer the four delusions are unable to regard some of their thoughts, feelings, impulses and actions as being responsive to reasons because they suffer from a tendency to focus their attention on their own perceptual experiences, as opposed to focusing it on the world. The lesson to draw from the alienation of mental states and actions caused by schizophrenia will be, finally, that two separate components normally make up our sense of self; two components that turn out to be dissociated in the four schizophrenic delusions discussed. These are, on the one hand, the self as the bearer, or host, of mental states and actions and, on the other hand, the self as the owner and agent, respectively, of those mental states and actions.