Healthcare Policy Formation Healthcare Policy Research Proposal

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" (2007, p. 284) Smith asks if "the desire to eliminate health disparities by rooting out the social disease underlying them inspire nursing to find itself again?" (2007, p. 284) Smith also asks if health disparities, being despicable and laden with shame can somehow, through the response of nursing, actually "serve a higher purpose" through "reawakening the caring" aspect of nursing? (2007, p. 284) Indeed, it is held by Smith that nursing "the premier profession for caring" may have very well "become contaminated...infected by a selfishness that is gaining ground, credence and sanction" within the society of today. (Smith, 2007) Smith holds that selfishness is a disease that "...in a mild form" results in a "loss of social capital and community engagement in the United States." (2007, p. 284) Smith notes that the work of Krugman (2002) states very candidly that "we live in the new Gilded Age where 13,000 richest families have almost as much income as the 20 million poorest households." (Smith, 2007, p. 285) Krugman additionally relates that data are "deliberately reported in dubious ways to conceal the reality. Shapiro (1987) is noted by Smith has having stated: "We now confront a moment in history when our unifying moral and political commitments are deteriorating and when our obsession with expanding individual freedoms outruns our concerns for their appropriate use." (2007, p. 285) Smith writes that irony exists in the knowledge that "health disparities appear to have crept up higher on the national agenda whereas the principle of 'mutuality' has been slipping down in the national conscience.

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" (2007, p. 285) Smith relates that Duman (2002) provided a definition for the concept of 'mutuality' as: (1) committing ourselves to others - without the coercion of legal obligation; (2) maintaining human bonds - rather than eroding them; (3) serving the shared interests of the community - rather than only our own interests, and (4) placing our individuality voluntarily in the service of larger objectives." (Smith, 2007, p. 285) Smith states that it is quite true that what she has to relate "is likely not palatable or popular" however, there can be no progress made by nursing through maintaining a state of denial. Smith states the knowledge that she intends to convey concerning nursing are concerned with: (1) caring in nursing; (2) the underlying nature of health disparities; and (3) what nurses can do to bring caring to the forefront in both restoring the promise of the profession and fighting health disparities. (Smith, 2007, p. 285)

V. NURSING'S LOSS of CAPACITY for CARING

Smith (2007) states that when reflecting back over the 40 years spent in the nursing profession that what she views both "distresses and angers" her in that the nursing profession has become "so preoccupied with its own internal issues, its desire for improved status and nursing is the health profession best suited for leadership in reducing disparities." (p. 286)as nursing has made progress along status lines simultaneously, nursing has become "alienated from the needs of other oppressed groups." (Smith, 2007, p. 286) in fact, achievement in nursing of.....

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