Theory of Bureaucratic Caring: Marilyn Anne Ray

Seven concepts are arranged around the central concept of spiritual–ethical caring:

Educational factors include formal and informal education programs as well as other forms of teaching and sharing of information

Physical factors are related to physical state of being, including both biological and mental patterns

Overview of the Theory of Bureaucratic Caring

Sociocultural factors include ethnicity and family structures, friends and family relationships, communication, social interaction and support, intimacy, and structures of cultural groups, community, and society

Legal factors include responsibility and accountability, rules and principles to guide behaviors, rights, and the practice of defensive medicine and nursing

Overview of the Theory of Bureaucratic Caring

Technological factors include nonhuman resources such as machinery used in patient care, diagnostic tests, and pharmaceutical agents, as well as the skill needed to use the resources

Economic factors include budgets, insurance systems, limitations and guidelines imposed by managed care organizations, and allocation of resources as necessary to maintain the economic viability of the organization

Overview of the Theory of Bureaucratic Caring

Political factors and the structure within healthcare administration influence how nursing is viewed and influence patterns of communication and decision making in the organization

An additional issue within the political factor is trust or lack of trust, which can lead to disillusionment and decreased loyalty to the organization

Major Concepts of Nursing Based on the Theory of Bureaucratic Caring

Person: a spiritual and cultural being

Environmental: a complex spiritual, ethical, ecological, and cultural phenomenon

Health: not simply the consequence of a physical state of being but rather it provides a pattern of meaning for individuals, families, and communities

Major Concepts of Nursing Based on the Theory of Bureaucratic Caring

Nursing: a holistic, relational, spiritual, and ethical caring that seeks the good of self and others in complex community, organizational, and bureaucratic cultures

Assumptions of the Theory of Bureaucratic Caring

The meaning of caring is highly differential, depending on its structures (i.e., sociocultural, educational, political, economic, physical, technological, and legal)

Caring is bureaucratic as well as spiritual/ethical

Caring is the primordial construct and consciousness of nursing

Propositions of the Theory of Bureaucratic Caring

Nursing and caring are experiential and contextual, and are influenced by the social structure or the culture in the organization

Caring can positively influence surrounding structures

The Theory of Bureaucratic Caring as a Framework for Nursing Care

Assessment: team effort with focus depending on the internal or external forces precipitating assessment; considers the physical, socio-cultural, educational, legal, political, economic, and technological structural factors and their interconnections and is conducted in manner grounded in caring, with goal of promoting the good of others within the organization

The Theory of Bureaucratic Caring as a Framework for Nursing Care

Planning: data analyzed in each structure area

Implementation: strategies directed at specific structural areas; mindful of the interconnected-ness of these areas and the centrality and interconnectedness of spiritual–ethical caring

Evaluation: based on the patterns of meaning ascribed to the process and outcomes by the members of the organization

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ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.