Learning Objective #1: Incorporate an affective awareness of the ethical conflicts experienced by PCHN’s, when struggling between an ethic of care and restrictions of third party insurance payers

Learning Objective #2: Incorporate an affective awareness of the explicit gap in quality of care for individuals with chronic and persistent mental illness

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This ethnographic study explored, described, and documented psychiatric community health nurse (PCHN) practices and practice issues that are influenced by an ethic of care. Nurses experience conflict when they engage in caring acts, but are confronted by strict regulatory mechanisms imposed by third party insurance payers. The PCHNs experienced moral distress and were acutely aware that many of their patients were not receiving necessary care. These nurses knew how to make a difference in the lives of individuals with chronic persistent mental illness. They also knew that ongoing and consistent quality care for this marginalized population is not well funded or even widely recognized as worthwhile supporting. Giving nurses a voice to express these ethically laden issues is imperative for initiating and supporting needed reform in this area. This dramatic monologue, performed by the researcher, serves to creatively and realistically engage the audience in the direct aesthetic experience of the nature of conflict these nurses encountered in practice. It can allow the voices of nurses who participated in this research study to be directly experienced in the conference setting. The dramatic monologue is best performed in front of an audience, but could be recorded if presentation restrictions necessitated this accommodation.