Living nursing values: A collective case study

<p>Distinctive humanistic values are foundational in professional nursing practice, commonly shared by members of the profession and the mainstay of how nurses act. The foundational values of the nursing discipline are balanced with clinical knowledge and technical skill. Nursing values presuppose nurses’ responsibility to nurture and protect, to heal, to cultivate healthy behaviours and attitudes, and to be present (physically and intellectually) during times of vulnerability, illness or injury. The rationale for this study came from the recognition that nursing has changed, so too have the characteristics of patients and the way healthcare is operationalised. Nurses are challenged on a daily basis to negotiate between meeting the complex needs of patients whilst addressing healthcare priorities and attending to their own personal and professional requirements. There is a growing philosophical debate about whether the healthcare climate is dehumanising health care professionals’ encounters with patients, including those of nurses, and creating a culture where enacted values are inconsistent with professionalism. The purpose of the research was to explore the values of professional nurses practicing in medical ward environments and how these values are lived in day-to-day practice. Case Study methodology was used to capture the contextual conditions of nursing values in nurses’ daily practice. Data collection was carried out in three medical wards in New Zealand; data were triangulated using observations, focus groups, interviews, burnout survey and theoretical application. The major theoretical and philosophical influences on the research, which were used to explore the data, were those of Isabel Menzies’ defences against anxiety and Edith Stein’s phenomenological theory of motivation and value. Key findings indicate that healthcare environments obstruct the enactment of humanistic nursing values stimulating value dissonance for nurses between how they want to practice and how they actually practice. Conflict arises from nurses experiencing systems that foster managerialism and cultures of anxiety. In order to cope with value dissonance, nurses enact unconscious defence mechanisms; resulting in constrained nursing practice, exhaustion, cynicism and burnout. This thesis challenges the nursing profession to acknowledge and address the visibility of nursing values in contemporary practice, as well as acknowledge the dissonance that exists between the values of nursing and the values that drive healthcare delivery. Humanistic nursing values remain important to practicing nurses. This study identifies in detail the every-day difficulties nurses face in seeking to enact their values and the managerial challenges that confront them. This information offers a trustworthy analysis of the challenges the nursing profession faces in addressing this problem. It also offers a basis for developing approaches that could strengthen nurses’ ability to enact the humanistic values they are professionally committed to provide. It is critical that any attempt to embed nursing values into clinical nursing practice is founded on a strategy that recognises and mitigates against dysfunctional organisations and organisational constraints. Drawing on findings from this thesis, it is recommended that the articulation and development of nursing values in acute clinical environments is responsive to organisational factors. Through this, the nursing community can develop, articulate and operationalise nursing values.</p>

Nation Branding in Two Major Serbian Music Festivals, Exit and Guča

This article looks into the nation branding phenomenon surrounding two major Serbian music festivals, Exit and Guča, in the post-Milošević era. The departure point of analysis is the once-dominant national identity narrative of Two Serbias, by which Exit (as a purveyor of Western-style popular music) and Guča (as the self-proclaimed guardian of the Serbian brass-band tradition) were pitted against one another as representatives of Two Serbias, one looking towards the West, and the other towards the East. Moving away from this obsolete model of interpretation, this article examines the effects that the inception of nation branding in Serbian public discourse has produced on the local perception of each festival as well as on Serbian national identity within the broader contexts of post-socialist transition, the EU integration, and globalization. It also analyzes the ways in which the principles of market economy and branding practice are being “bastardized” in both festivals, resulting in what Mladen Lazić (2003) calls normative-value dissonance. Nation branding has forged a more unified view of Exit and Guča as national brands that ostensibly improve the international image of the country but which in reality deplete both festivals of their initial cultural and political potency. Ultimately, however, the proof of normative-value dissonance in Exit and Guča supports the argument that nation branding in these two festivals feeds back into earlier Balkanist discourse on Serbia’s indeterminate position between West and East; and it does so in a way that provides little hope for alternative visions of the nation’s future.

The Stabilisation of the Capitalist Order and Liberal Value Orientations in Serbia

Based on research data from 2003, 2012, and 2018, the authors examine the extent to which capitalist social relations in Serbia have determined liberal value orientations. The change of the social order in Serbia after 1990 brought about a radical change of the basis upon which values are constituted. To interpret the relationship between structural and value changes, the authors employ the theory of normative-value dissonance. Special attention in the analysis is paid to the interpretation of value changes based on the distinction between intra- and inter-systemic normative-value dissonance. In the first part of their study, the authors examine changes in the acceptance of liberal values over the period of consolidation of capitalism in Serbia, while in the second part they focus on the 2018 data and specific predictors of political and economic liberalism.