attachment, love, and community and compre-
hended within as intimacy and spirit (Harmon,
1998; Secretan, 1997). Secretan (p. 27) states: “Most
of us have an innate understanding of soul, even
though each of us might define it in a very different
and personal way.”
Fox (1994) calls for the theology of work—a re-
definition of work. Because of the crisis of our rela-
tionship to work, we are challenged to reinvent it.
For nursing, this is important because work puts us
in touch with others, not only in terms of personal
gain, but also at the level of service to humanity or
the community of clients and other professionals.
Work must be spiritual, with recognition of the
creative spirit at work in us. Thus, nurses must be
the “custodians of the human spirit” (Secretan,
1997, p. 27).
The ethical imperatives of caring that join with
the spiritual relate to questions or issues about our
moral obligations to others. The ethics of caring as
edifying the good through communication and in-
teraction involve never treating people simply as a
means to an end or as an end in themselves, but
rather as beings who have the capacity to make
choices about the meaning of life, health, and car-
ing. Ethical content—as principles of doing good,
doing no harm, allowing choice, being fair, and
promise-keeping—functions as the compass in our
decisions to sustain humanity in the context of po-
litical, economic, and technological situations
within organizations. Roach (2002) pointed out
that ethical caring is operative at the level of dis-
cernment of principles, in the commitment needed
to carry them out, and in the decisions or choices to
uphold human dignity through love and compas-
sion. Furthermore, Roach (2002) remarked that
health is a community responsibility, an idea that is
rooted in ancient Hebrew ethics. The expression of
human caring as an ethical act is inspired by spir-
itual traditions that emphasize charity. Spiritual/
ethical caring for nursing does not question
whether or not to care in complex systems but inti-
mates how sincere deliberations and ultimately the
facilitation of choices for the good of others can or
should be accomplished. The scientist Sheldrake
(1991, p. 207) remarks:
The recognition that we need to change the way we
live [work] is gaining ground. It is like waking up368 SECTION IV Nursing Theory: Illustrating Processes of Development
from a dream. It brings with it a spirit of repentance,
seeing in a new way, a change of heart. This conver-
sion is intensified by the sense that the end of the age
of oppression is at hand.As the twenty-first century is evolving, nurs-
ing in complex organizations has to evolve
as well. As the Theory of Bureaucratic Caring
has demonstrated, caring is the primordial
construct and consciousness of nursing.
Reenvisioning the theory as holographic
shows that through creativity and imagina-
tion, nursing can build the profession it
wants. Nurses are calling for expression of
their own spiritual and ethical existence.
The new scientific and spiritual approach
to nursing theory as holographic will have
positive effects. The union of science, ethics,
and spirit will engender a new sense of
hope for transformation in the work world.
This transformation toward relational caring
organization can occur in the economic and
politically driven atmosphere of today.
Nurses can reintroduce the spiritual and eth-
ical dimensions of caring. The deep values
that underlie choice to do good for the many
will be felt both inside and outside organiza-
tions. We must awaken our consciences and
act on this awareness and no longer surren-
der to injustices and oppressiveness of sys-
tems that focus primarily on the good of a
few. “Healing a sick society [work world] is a
part of the ministry of making whole” (Fox,
1994, p. 305). The holographic Theory of
Bureaucratic Caring—idealistic, yet practical;
visionary, yet real—can give direction and
impetus to lead the way.This transformation toward relational
caring organization can occur in the eco-
nomic and politically driven atmosphere
of today. Nurses can reintroduce the spiri-
tual and ethical dimensions of caring.