Needing permission: The experience of self-care and self-compassion in nursing: A constructivist grounded theory study

Background Healthcare is delivered in a culture of ongoing change, with many nurses highlighting the impact of this on their own wellbeing. However, there is a dearth of literature focusing on how nurses care for themselves as they try to provide compassionate care in a challenging job. Objectives This study explored nurses’ experience of self-care and self-compassion and how this may relate to compassionate care giving towards patients. Design A constructivist grounded theory approach was used to develop a theoretical understanding of nurses’ experience. Settings This study included participants from two National Health Service (NHS) Trusts within the United Kingdom (UK). Participants Purposive and theoretical sampling were used to recruit general, mental health and learning disability nurses, at different levels of seniority. Method Between September 2015 and March 2016 semi-structured interviews were conducted. Analysis was completed in line with the process set out within constructivist grounded theory. Using constant comparison and memo writing, analysis moved from initial coding to focused coding, through to theoretical coding, resulting in the production of core concepts and categories, and theory development. Results Thirty participants were included in the study. Three concepts were derived from the data: (1) ‘Hardwired to be caregivers’ – vocation versus role, (2) needing a stable base, (3) Managing the emotions of caring. All three concepts linked to a core process: needing permission to self-care and be self-compassionate. Nurses needed permission from others and from themselves to be self-caring and self-compassionate. An inability to do this affected their wellbeing and compassionate care giving to others. Interviewees described how they struggled particularly with self-compassion. Helping nurses to be proactively more self-caring and self-compassionate may increase their ability to manage emotions and prevent some of the negative consequences of nursing such as burnout and compassion fatigue. A conceptual framework is proposed which identifies that formal permission (e.g., within nursing guidance) may be necessary for some nurses to look after themselves. Conclusion Findings identified the need for permission as key in enabling nurses to self-care and be self-compassionate, which may facilitate them to address patients’ needs. The study highlights the importance of self-care and self-compassion within nursing education and nursing guidance

Guilty Confessions

Recent work on blameworthiness has prominently featured discussions of guilt. The philosophers who develop guilt-based views of blameworthiness do an excellent job of attending to the evaluative and affective features of feeling guilty. However, these philosophers have been less attentive to guilt’s characteristic action tendencies and the role admissions of guilt play in our blaming practices. This paper focuses on the nature of guilty confession and argues that it illuminates an important function of blame that has been overlooked in the recent work on guilt as it relates to blameworthiness: Blame can communicate respect

Hypercrisy and standing to self-blame

In a 2020 article in Analysis, Lippert-Rasmussen argues that the moral equality account of the hypocrite’s lack of standing to blame fails. To object to this account, Lippert-Rasmussen considers the contrary of hypocrisy: hypercrisy. In this article, I show that if hypercrisy is a problem for the moral equality account, it is also a problem for Lippert-Rasmussen’s own account of why hypocrites lack standing to blame. I then reflect on the hypocrite’s and hypercrite’s standing to self-blame, which reveals that the challenge hypercrisy poses for accounts of standing is different from the challenge Lippert-Rasmussen articulates

Don't Suffer in Silence: A Self-Help Guide to Self-Blame

There are better and worse ways to blame others. Likewise, there are better and worse ways to blame yourself. And though there is an ever-expanding literature on the norms that govern our blaming practices, relatively little attention has been paid to the norms that govern expressions of self-blame. In this essay, I argue that when we blame ourselves, we ought not do so privately. Rather, we should, ceteris paribus, express our self-blame to those we have wronged. I then explore how this norm can contribute to our understanding of the ethics of self-blame as well as the nature of blameworthiness itself

Don't Burst My Blame Bubble

Blame abounds in our everyday lives, perhaps no more so than on social media. With the rise of social networking platforms, we have access to more information about others’ blameworthy behaviour and larger audiences to whom we can express our blame. But these audiences, while large, are typically not diverse. Social media tends to create what I call “blame bubbles”: systems in which expressions of blame are shared amongst agents with similar moral outlooks while dissenting views are excluded. Many have criticised the blame expressed on social media, arguing that it is often unfitting, excessive, and counterproductive. In this talk, I’ll argue that while blame bubbles can be guilty of these charges, they are also well placed to do important moral work. I’ll then attempt to identify the causal source of these bad-making features and explore potential structural interventions that can make blame bubbles better at performing their moral function and less likely to generate harmful consequences

Freedom, Moral Responsibility, and the Failure of Universal Defeat

Proponents of manipulation arguments against compatibilism hold that manipulation scope (how many agents are manipulated) and manipulation type (whether the manipulator intends that an agent perform a particular action) do not impact judgments about free will and moral responsibility. Many opponents of manipulation arguments agree that manipulation scope has no impact but hold that manipulation type does. Recent work by Latham and Tierney (2021, 2022) found that people’s judgments were sensitive to manipulation scope: people judged that an agent was less free and responsible when a manipulation was existential (impacting at least one but not all agents) than when the manipulation was universal (impacting every agent). This study examines people’s judgements about existential and universal manipulation cases that involve both intentional and non-intentional outcomes. We found that manipulation scope also affects people’s free will and responsibility judgments in manipulation cases involving both intentional and non-intentional outcomes. Interestingly, we also found that manipulation type influences the effect that manipulation scope has on people’s free will judgments but not their moral responsibility judgments, which indicates that people’s free will and responsibility judgments can come apart. This puts pressure on the prevalent assumption that judgments about free will and moral responsibility are conceptually bound together