Specific Application of Categories (Concepts, Domains) within the Theory of Bureaucratic Caring Related to the COVID 19 Pandemic (By Colonel Marcia Potter, USAF, NC, DNP, Chief Primary Care Nurse, Adjunct Professor Uniformed Services University of the Health Sciences, Department of Defense, USA)
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Technology:
Use of phone, text, other social media, teleconferencing/distance learning platforms for engagement while maintaining social distance.
The impact and professional ability of nurses, physicians, respiratory therapists, EMTs, cleaning personnel, and others (all frontline workers) for understanding the COVID 19 illness, the use of ventilators, and medications to facilitate life.
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Education:
Provision of evidence-based and creative knowledge/advice to patients, staff, and general public after learning more about the symptoms, course and distribution of virus, mitigation, containment, treatment, and predictions of pandemic on local, national, and global perspective levels. Application of new care approaches to COVID 19 patients, such as respiratory care and placing patients in prone position for relief and improved lung capacity. Appreciation of all education undertaken by teachers remotely.
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Social-cultural:
Understanding the “new” culture of COVID 19 where traditional practices, rituals, symbols have to be performed in new ways.
Redefinition of the meaning of local and global culture, community, faith, and family. Re-understanding of the culture of aging and illness.
Understanding diverse cultural ethnicities and environmental situations and their impact on health and wellbeing.
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Political:
Resources, authority, policy, power, and “power of caring”, and personal influence impacting engagement in human-human relationships and bonding.
Sensitivity to needs of all for the creation of new policy for all, especially, the most vulnerable. Assistance of all branches of the military to the civilian sector for application of technical help and provision of human resources for care of the sick.
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Economic:
Financial resources being poured into caring for people on a massive, unprecedented scale in manufacturing of life-saving technologies, scientific and medication developments, and preservation of the economic well being of people and organizations.
Shifting of manufacturing and design to immediate financial support to individuals , families, communities, and businesses, illuminating the economic power of caring that is leveraged daily to improve health, lives, rescue and the sustaining communities. Shift of some primary care resources to tertiary care during COVID 19.
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Legal:
Attention to assuring the highest quality of standards for care yet relaxing some, in order to ensure that resources can be applied as broadly as possible.
New latitude given to conducting tele-health, transfer of state licensure requirements for professionals to serve in other states; use of volunteers to work in health care; enabling of governments to leverage power for the good of all.
Physical:
In time of social distancing for the sake of life, nurses and other health care professionals, and other essential personnel are placing themselves at risk to care for the needs of the sick and to keep people well. This ultimate sacrifice cannot be overlooked or underestimated.
Spiritual-Ethical:
At the center of every decision (related to the categories (concepts, domains)) in the BCT, the very essence of humanity, the desire to do good, to place another person’s welfare before one’s own In the deepest, most fundamental essence of being, is finding our connection to the Spiritual-the Holy. This connection compels us to rise above our fears, and self-centeredness to bring this holiness into life and action to instill, often through prayer, faith, courage, hope, love, and light to self and others. Creating new ways of caring for the dying in isolation from family and friends (caring ways to say goodbye) by the use of the soft and compassionate voice of nurses whispering in ears, holding hands though gloved, and using social media so patients can hear or perhaps, even see their loved ones. Spiritual-ethical caring is sharing in the joys of returning patients to health through all means available; and nurses and other professionals sharing with families and friends in the sorrows and prayers of dying and death.
