Nursing: A Social Policy Statement was intended to provide nurses with
a fresh perspective on practice while providing society with a view of
nursing for the 1980s. The overall intent of this document was to call
to consciousness the linkages between the profession and society. While
the Social Policy Statement is considered by many (see, for example,
Rodgers, 1991; Packard & Polifroni, 1991; Allen, 1987; White, 1984) to
be outdated, we find the concept of the social contract to be useful
when studying the relationship of nurse to nursed. As the foundation
for professions, the social contract, while understood to be an
"hypothetical ideal" (Silva, 1983, p. 150), is also an expression of
a people recognizing (1) the presence of a basic need and (2) the
existence of greater knowledge and skill available to meet that need
than can be readily exercised by each member of the society. Society
at large then calls for commitment by a segment of society to the
acquisition and use of this knowledge and skill for the good of all.
Social goods are promised in return for this commitment.
Today, the profession of nursing is moving from a social contract
relationship toward a covenantal relationship between the nurse and
nursed. While the social contract implies an impersonal, legalistic
stance, the covenantal relationship emphasizes personal engagement and
ever present freedom to choose commitments. Cooper (1988), for example,
discusses her ideas on the relevance of covenantal relationships for
nursing ethics. She states "the promissory nature of the covenant
is contained in the willingness of individuals to enter a covenental
relationship" (p. 51) and it is within this context that obligations
arise. As caring persons, we "see" relationship (covenant) and honor
the bond between self and other. The ultimate knowledge gained from this
perspective is that we are related to one another (and to the universe)
and that harmony (brotherhood and sisterhood) is present as we live out
caring relationships.
Concepts of discipline and profession have been dismissed by critical
theorists as oppressive, anachronistic, and paternalistic (Allen, 1985;
Rodgers, 1991). In our study however, as we have explored essential
meanings of these concepts, we have found that they express fundamental
values congruent with cherished nursing values. Although we can agree
with critical theorists that discipline and profession have been
misused, perhaps too frequently, as tools of social elitism and
oppression, this misuse remains inappropriate because it violates the
covenantal nature of discipline and profession.
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