Ethical concerns arose within education and nursing also. The caring construct, the other tributary, garnered interest in education and nursing. Mayeroff (1971) explored caring of educators for students, the arts, and the environment. Early leaders of the National League for Nursing worked to eliminate behaviorism in nursing education due to behaviorism’s failure to acknowledge the mental and emotional variables in human interaction (Bevis, 1989; Nelms, 1989). Caring theory grew within nursing once educational and other various requirements for nursing practice afforded recognition of nursing as a profession. Yet, nursing professionals still labor under the heavy, though justifiable, performance burdens of competency and licensure, and the stress of tending the needs of increasingly ill populations. Roach (2002), who considered caring as the “human mode of being,” cautioned that competence without compassion could be “…brutal and inhumane” (p. 54).
Wade and Kasper (2006) posited, “When students perceive the climate of nursing education as caring, they learn a professional way of being” (p. 16). Human interaction in the nursing workplace, though defined by the American Nurses Association (ANA) Code of Ethics and Interpretive Statements (2015), is modeled within nursing education where novice nurses learn inside environments valuing empirical data and clinical treatment over unquantifiable human relationship and transpersonal caring (Bevis, 1989; Boychuk-Duchscher, 2000; Tanner, 1988). Therefore, nursing faculty are ethically obligated to model transpersonal practices of self-care and care for others in support of nursing students as they become caring professionals (Clark, 2016). Faculty incivility impairs professional formation in nursing students predisposing them to unhealthy behaviors upon entry into professional practice.
Servant leadership and caring bear remarkable similarities. A healthy workplace resulting from service to and caring for the Other, whether peer or patient, possesses the potential to bring to healthcare desirable outcomes of patient and healthcare employee satisfaction with all inherent benefits. Servant leadership characteristics include 1) listening, 2) empathy, 3) healing, 4) awareness, 5) persuasion, 6) conceptualization, 7) foresight, 8) stewardship, 9) commitment to the growth of others, and 10) building community (Spears, 2004). Caring presented by Watson (1979) included 1) instillation of faith and hope, 2) cultivation of sensitivity to self and others, 3) development of a helping-trust relationship, 4) promotion and acceptance of the expression of positive or negative feelings, and 5) provision for a supportive, protective or corrective mental, physical, socio-cultural and spiritual environment. Powerfully connecting the tributaries of servant leadership and caring, Noddings (1988) established the growth of one cared for as an outcome of caring. Greenleaf (2002), a career businessman, characterized the test of servant leadership: “Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely to become servants?” (p. 27)
Service industries outside healthcare have repeatedly shown the benefit of transformational, situational, and servant leadership in improving health of valuable human resources within organizations. Servant leadership offers a grounded framework by which to begin correction of dysfunction in the nursing profession. The model of servant leadership embodies serving the highest needs of others to help them achieve goals. Schwartz and Tumblin (2002) offered a concise review of leadership literature for physicians, acknowledging the service nature of healthcare, and advocating transformation of health-care organizations into learning organizations (Senge, 1990) which are generative and adaptive when led by leaders who demonstrate emotional intelligence, ethical behavior, and technical competencies. Servant leadership overlapping with effective communication, builds trust between health care providers and patients (Trastek, Hamilton, & Niles, 2014), a principal well suited to workplace relationships.
Cabral, Hanson, and Reilly (2016) demonstrate how leaders of differing generations might apply a caring attitude in growing and retaining a healthy, multi-generational nursing workforce which flows smoothly over generations of healthcare providers and recipients. How might nursing leaders bridge the gap in thinking of and interacting with multiple generations? Servant leadership with focus upon meeting the needs of the one(s) served and modeling value for diverse others provides the necessary framework for creating such a helping, healing workplace.