Employee attitudes to change are key predictors of organizational change success. In this article, change engagement is defined as the extent to which employees are enthusiastic about change, and willing to actively involve themselves in ongoing organizational change. A model is tested showing how change-related organizational resources influence change engagement, in part through their influence on change-related job resources. Confirmatory Factor Analysis and Structural Equations Modeling results yielded good fit to the data in two independent samples: 225 Australian working professionals, (...) and 201 employees from a Prolific sample. As proposed, change-related organizational resources were positively associated with higher order change-related job resources. Change-related job resources were positively associated with change engagement. In contrast to expectations, organizational resources were not directly associated with change engagement. Instead, change-related job resources fully mediated the relationship. Overall, the study provides empirical support for new measures of organizational change resources and employee change engagement. By drawing from well-established models in the change and engagement literatures, the study provides a promising research direction for those interested in further understanding positive employee attitudes to organizational change. Practical implications and future research opportunities are discussed. (shrink)

Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more than good hospitals and public (...) health departments. -/- Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that define this relatively new field. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health’s “upstream” causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scientific practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. -/- Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health—from public health students to professional philosophers. (shrink)

Most large companies and many smaller ones have adopted ethics codes, but the evidence is mixed as to whether they have a positive impact on the behavior of employees. We suggest that one way that ethics codes could contribute to ethical behavior is by influencing the perceptions that employees have about the ethical values of organizations. We examine whether a group of sales professionals in organizations with ethics codes perceive that their organizational context is more supportive of ethical behavior than (...) sales professionals in companies without codes. After accounting for the effect of several covariates, our results indicated that sales professionals employed in organizations with codes of ethics perceived their work environments to have more positive ethical values than did other sales professionals. (shrink)

Humans can attribute beliefs to others. However, it is unknown to what extent this ability results from an innate biological endowment or from experience accrued through child development, particularly exposure to language describing others' mental states. We test the viability of the language exposure hypothesis by assessing whether models exposed to large quantities of human language display sensitivity to the implied knowledge states of characters in written passages. In pre‐registered analyses, we present a linguistic version of the False Belief Task (...) to both human participants and a large language model, GPT‐3. Both are sensitive to others' beliefs, but while the language model significantly exceeds chance behavior, it does not perform as well as the humans nor does it explain the full extent of their behavior—despite being exposed to more language than a human would in a lifetime. This suggests that while statistical learning from language exposure may in part explain how humans develop the ability to reason about the mental states of others, other mechanisms are also responsible. (shrink)

This study assesses the relationships among unethical corporate values, bullying experiences, psychopathy, and selling professionals’ ethical evaluations of bullying. Information was collected from national/regional samples of selling professionals. Results indicated that unethical values, bullying, and psychopathy were positively interrelated. Psychopathy and unethical values were negatively associated with moral intensity, while moral intensity was positively related to ethical issue importance. Psychopathy and unethical values were negatively related to issue importance, and issue importance and moral intensity were positively related to ethical judgment. (...) Finally, ethical judgment and moral intensity were positively linked to ethical intention; psychopathy was negatively associated with ethical intention. (shrink)

While a number of studies have examined the impact of gender/sex on ethical decision-making, the findings of this body of research do not provide consistent answers. Furthermore, very few of these studies have incorporated cross-cultural samples. Consequently, this study of 222 American and Spanish business executives explored sex differences in ethical judgments and intentions to act ethically. While no significant differences between males and females were found with respect to ethical judgments, females exhibited higher intentions to act more ethically than (...) males. This difference was true of both U.S. and Spanish executives. Further research is warranted to develop a clearer understanding of the linkage between ethical judgment and intention to act in an ethical manner. These findings have implications for global firms, particularly regarding codes of conduct and ethics training. (shrink)

A growing body of literature has engaged with mass incarceration as a public health problem. This article reviews some of that literature, illustrating why and how bioethicists can and should engage with the problem of mass incarceration as a remediable cause of health inequities. “Mass incarceration” refers to a phenomenon that emerged in the United States fifty years ago: imprisoning a vastly larger proportion of the population than peer countries do, with a greatly disproportionate number of incarcerated people being members (...) of marginalized racial and ethnic groups. Bioethicists have long engaged with questions of health justice for incarcerated people, including consent issues for those participating in research and access to health care. This article provides an overview of the individual and public health impacts of mass incarceration. The article argues that mass incarceration is a bioethics issue that should be addressed in medical education, identifies opportunities for bioethicists to guide hospitals’ interactions with law enforcement officials, and calls on bioethicists to be in conversation with medical and nursing students and health care professionals about these groups’ advocacy efforts concerning structural racism, police violence, and mass incarceration. (shrink)

The famous ethological maxim known as “Morgan’s Canon” continues to be the subject of interpretive controversy. I reconsider Morgan’s canon in light of two questions: First, what did Morgan intend? Second, is this, or perhaps some re-interpretation of the canon, useful within cognitive ethology? As for the first issue, Morgan’s distinction between higher and lower faculties is suggestive of an early supervenience concept. As for the second, both the canon in its original form, and various recent re-readings, offer nothing useful (...) to cognitive ethology. (shrink)

More ethics research needs to explore the global differences in ethical evaluations. This study explored the relationships among nationality, teleological evaluations, ethical judgments, and ethical intentions using a sample of 222 American and Spanish business professionals. The path analysis indicated that teleological evaluations were related to ethical judgments and that both ethical judgments and teleological evaluations were related to ethical intentions. Executive nationality was related to teleological evaluations and ethical intentions with American individuals having higher teleological assessments and intentions to (...) act ethically than the Spanish individuals. These findings have implications for global companies, which are presented along with the study's limitations and future research suggestions. (shrink)

The purpose of this study was to investigate the relationship between organizational ethical context and the individual ethical decision-making process. In addition, a new statistical approach combining cluster and discriminant analyses was developed to overcome violations of regression assumptions, which are commonly not identified and/or ignored in behavioral and psychological research. Using regressions and this new alternative method, the findings indicated that ethical context does indeed influence the various components of ethical reasoning. However, social desirability was the strongest predictor of (...) ethical decision making, which raises new concerns about how this bias can confound business ethics research. Finally, the findings showed that the alternative method provided more useful and interpretive results, indicating that it has the capacity to influence future empirical work in the field of business ethics, particularly when dealing with data that do not satisfy regression assumptions. The implications and limitations of the study are discussed, and several noteworthy suggestions for future research are provided. (shrink)

Utilizing a national sample of 106 attorneys and hierarchical regression analysis, this study identified several individual tendencies that could adversely affect women attorneys' career experiences. The findings indicated that self-esteem was negatively associated with a traditional gender outlook, and that Machiavellianism was positively associated with conservative beliefs about gender. Tolerance for diversity was negatively related to a traditional gender outlook, while work-based social agency was positively related to the preference for established gender roles. The results imply that confidence brings about (...) greater acceptance of women's organizational roles, and that self-serving tendencies lower individuals' tolerance of women's employment. Diversity tolerance appears to prompt a nontraditional gender outlook, while social agency seems to prompt a traditional gender outlook. The organizational implications of the results are discussed along with the research limitations and recommendations for future inquiry. (shrink)

This dissertation treats two themes crucial for the emergence of modern aesthetics. First, it considers the "aesthetic consciousness," which results from a rejection of the Aristotelian mimesis doctrine, and which seeks to establish art as independent from either morality or nature. Second, it treats the "historical consciousness," required to bring about the aesthetic consciousness, and eventually to raise it to the level of a moral ideal. Thus, the dissertation begins by considering that version of the mimetic argument rejected by the (...) moderns: it treats Lessing's moral interpretation of dramatic catharsis. Lessing's moral interpretation of catharsis, it is argued, jeopardizes the harmony between nature, morality and art on which the mimetic argument rests. Thus, the second chapter treats the first decisive challenge to the mimetic tradition: Rousseau's attack on the moral interpretation of catharsis. This attack follows two steps. First, Rousseau argues that the arts efface man's natural moral character. Second, Rousseau's developmental/historical account of man supports this opposition between art, on the one hand, and nature and morality, on the other. Rousseau, thus, is seen to be the first to introduce a historical consciousness of development into discussions of art, which revises the traditional links between art, nature and morality, and established a direction for Kant and Schiller. ;In light of Lessing and Rousseau, Kant's foundation of an aesthetic consciousness can be more clearly understood. Thus, the third chapter considers Kant's argument for aesthetic by considering three themes: first, Kant's notion of autonomy; second, Kant's analysis of the disinterestedness of the aesthetic judgement; third, his account of genius as the cause of fine art. ;Kant's argument, however, suggests that the aesthetic consciousness supercedes morality. Although Kant himself never pursues this suggestion, Schiller does. Thus, the final chapter treats Schiller's attempt to retrieve the moral and the natural without sacrificing the autonomy of the fine arts. Schiller does this by bringing Rousseau's historical consciousness of the human as a development beyond nature with Kant's aesthetic consciousness. This chapter, therefore, treats three themes. First, it considers how Schiller's distinction between naive and sentimental poetry translates into historical categories: ancient and modern. Second, it shows how the goal of the sentimental poet is a "moral unity" between art and nature, the necessity of which is unknown to the naive poet. Third, it considers how, through the search for a moral unity achieved only through a historical consciousness of progress from naive to sentimental, the nature of art becomes, for the first time, a function of human history. The dissertation concludes with a summary of these themes in terms of the distinction between the good and the beautiful. (shrink)

Philosophy of epidemiology has recently emerged as a distinct branch of philosophy. The field will surely benefit from pluralism, reflected in the broad range of topics and perspectives in this special issue. Here, I argue that a healthy pluralistic field of philosophy of epidemiology has social responsibilities that require the field as a whole to engage actively with research on social determinants of health and health disparities. Practicing epidemiologists and the broader community of public health scientists have gradually acknowledged that (...) much of their attention ought to be paid to these, i.e. inequitable between-population health variations that largely reflect the world’s inequitable distribution of resources and social conditions. The paper illustrates how and why health disparities and social determinants of health, through no ill will, become de facto secondary concerns in Alex Broadbent’s field-defining Philosophy of Epidemiology, showing the ease with which these topics can be incidentally sidelined. As means for philosophy of epidemiology to meet its social responsibility obligations, I suggest philosophy of epidemiology expand its attention to two particular lines research. First, the paper discusses Geoffrey Rose’s concept of “causes of incidence”—causes of disparities between populations—and argues for the importance of engaging with these causes. Second, the paper argues for the value of engaging with Bruce Link and Jo Phelan’s “fundamental causes” model of how flexible social resources serve as buffers from harms, generating a plethora of shifting and locally-contingent health effects. (shrink)

This empirical investigation showed that contrary to the popular notion that apologies signify weakness, the victims of mistakes made by leaders consistently perceived leaders who apologized as more transformational than those who did not apologize. In a field experiment (Study 1), male referees who were perceived as having apologized for mistakes made officiating hockey games were rated by male coaches (n = 93) as more transformational than when no apology was made. Studies 2 (n = 50) and 3 (n = (...) 224) replicated this effect in two vignette studies to enhance internal and ecological validity. Contrary to expectations in Study 3, there were no apology×leader gender interactions. Theoretical and practical implications are discussed. (shrink)

This paper is about the actual and potential development of an ethics that is appropriate to the practices and institutions of biobanking, the question being how best to develop a framework within which the relevant ethical questions are first identified and then addressed in the right ways. It begins with ways in which a standard approach in bioethics – namely upholding a principle of indivi-dual autonomy via the practice of gaining donors’ informed consent – is an inadequate ethical framework for (...) biobanking. In donating material to a biobank, the individual donor relinquishes a degree of control and knowledge over the way their material is used in large-scale and typically open ended projects; and the identifying nature of genetic material means that third parties have rights and interests which must be taken into account as well as those of the individual donor. After discussing the problems for informed consent in the biobanking context, the paper then considers three emerging alternative approaches which, broadly speaking, conceptualize the subject of biobanking ethics in communal or co-operative terms: one version sees participants in biobanking research as ‘shareholders’ whilst the other expands on the notion of participation to include the wider public beneficiaries of biobanking as ‘stakeholders’. It concludes by outlining a third view, on which the biobanking institution itself is conceived as an ethical subject whose defining function can do useful normative work in guiding and evaluating its activities. (shrink)

RÉSUMÉ: Je me demande ici si les conceptions pragmatiques de la vérité peuvent être réconciliées avec les intuitions ordinaires quant à la portée de la bivalence. Je soutiens que les pragmatistes sont conduits à accepter une distinction du genre «type/occurrence» entre les formes d’une investigation et ses instanciations particulières, sous peine de banaliser leur vérificationnisme. Néanmoins, même la conception révisée que j’examine échoue à sauver les approches épistémiques de la vérité de certaines conséquences peu plausibles.

Since early in the Covid-19 pandemic, there have been wide disparities observed between different US racial groups’ rates of Covid-19 infections and deaths. This challenges physicians and patients to untangle what these race-associated risks mean for an individual patient. I argue that this task of providing individualized risk advice requires physicians to apply two skills: structural competency and epistemic humility.

Common monogenic genetic diseases, ones that have unexpectedly high frequencies in certain populations, have attracted a great number of conflicting evolutionary explanations. This paper will attempt to explain the mystery of why two particularly extensively studied common genetic diseases, Tay Sachs disease and cystic fibrosis, remain evolutionary mysteries despite decades of research. I review the most commonly cited evolutionary processes used to explain common genetic diseases: reproductive compensation, random genetic drift (in the context of founder effect), and especially heterozygote advantage. (...) The latter process has drawn a particularly large amount of attention, having so successfully explained the elevated frequency of sickle cell anemia in malaria-endemic areas. However, the empirical evidence for heterozygote advantage in other common genetic diseases is quite weak. I introduce and illustrate the significance of a hierarchy of genetic disease phenomena found within the genetic disease explanations, which include the phenomena: single mutation variants of a common genetic disease, single genetic diseases, and classes of diseases with related phenotypic effects. I demonstrate that some of the confusion over the explanations of common genetic diseases can be traced back to confusions over which phenomena are being explained. I proceed to briefly evaluate the existing evidence for two common human genetic diseases: Tay Sachs disease and cystic fibrosis. The above considerations will ultimately shed light on why these diseases’ evolutionary explanations remain so deeply unresolved after so such a great volume of research. (shrink)

Competitive pressures, resource constraints, high shareholder/stakeholder expectations, and other dynamics may lead to organizations putting pressure on employees to act unethically to meet goals. Yet, the effects of this pressure on employee health and factors that can abate it are unclear. Based on the job demands-resources model, this study examines whether, how, and when organizational ethical pressure harms employees' psychological and physical health and what factors can buffer its negative effects. According to the findings of a two-wave lagged data study (...) involving 212 healthcare employees, results show that organizational ethical pressure causes ethical strain in employees, resulting in both psychological and physical health problems, with these effects less pronounced when employees have higher levels of ethical efficacy. An integrated effect was also discovered, in which employees' ethical efficacy increases when led by a more ethical leader, thereby buffering the effect of ethical pressure on ethical strain and health problems. Overall, our research identifies organizational ethical pressure as a significant threat to employee health and provides preliminary approaches to mitigate its effects. (shrink)

Descartes’s Discourse on Method proposes a radically democratic goal, science on behalf of the common good of humanity, and an equally radical elitism, wherein strong minds, possessed of true virtue, direct the efforts of weak minds. In this respect the argument of the Discourse entails what we might call a “revised Averroism”: a distinction between the few and the many intended not to protect the faith of the many, but to suborn it on behalf of the new science Descartes proposes. (...) The goal of this essay is henceforth threefold. First, the essay attempts to show how a distinction between strong and weak minds emerges in the argument of the Discourse; second, it indicates the use toward which Descartes puts this distinction; and finally, it attempts to clarify Descartes’s own relationship to both strong and weak minds. The essay concludes with some thoughts concerning the significance of Descartes’ “revised Averroism.”. (shrink)

ECOG data obtained from a patient under conditions of resting brain, sleep and epileptic seizure were analyzed. Contrary to some theorists, the seizure state was found to be informationally the most complex of the three states. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}.

This chapter provides a classification scheme for artificial intelligence (AI) predictions, and tools for analyzing their reliability and uncertainties. It presents a series of brief case studies of some of the most famous AI predictions: the initial Dartmouth AI conference; Hubert Dreyfus' criticism of AI; Ray Kurzweil's predictions in The Age of Spiritual Machines; and Stephen Omohundro's AI Drives. The chapter takes every falsifiable statement about future AI to be a prediction. Thus the following four categories are all predictions: Timelines (...) and outcome predictions, Scenarios, Plans, and Issues and metastatements. The following schema was suggested by a review of the AI predictions literature : Causal models, Non‐causal models, The outside view, Philosophical arguments, and Expert judgment. The chapter looks at four prominent AI predictions, and analyses their accuracy, attempting to gain insights that will be useful for assessing future prediction. (shrink)

Internalism is the view that the truth of normative propositions depends solely upon elements which are internal to subjects. In this dissertation I argue that we should reject the primary rationale for taking an internalist line in various areas of normative assessment, namely a principle known as the Internalism Requirement. In the first part of the dissertation I focus on epistemology, and argue that we should reject the internalism requirement on epistemic reasons, i.e., the claim that reasons for believing must (...) be such that agents will believe for those reasons, at least insofar as they are rational. In the process of making this argument, I indicate why particular internalist positions in the epistemic realm--internalism about justification and internalism about reasons--ought to be rejected. The second part of my thesis focuses on rejecting the internalism requirement as applied to practical reasons, i.e., the claim that reasons for acting must be such as to motivate rational agents. The arguments here take the form of showing how, on any plausible theory of practical reasons, there will be considerations which fail to motivate rational agents. Again, my arguments indicate why we should also reject particular internalist views in the practical sphere. I conclude the dissertation with remarks indicating how rejection of the internalism requirement on practical reasons affects normative moral theory. (shrink)

Review of "Reclaiming Enchantment: Humanity In A Creative Universe" by Stuart Kauffman NY: OUP, 2016.

The ethics of biobanking is one of the most controversial issues in current bioethics and public health debates. For some, biobanks offer the possibility of unprecedented advances which will revolutionise research and improve the health of future generations. For others they are worrying repositories of personal information and tissue which will be used without sufficient respect for those from whom they came. Wherever one stands on this spectrum, from an ethics perspective biobanks are revolutionary. Traditional ethical safeguards of informed consent (...) and confidentiality, for example, simply don’t work for the governance of biobanks and as a result new ethical structures are required. Thus it is not too great a claim to say that biobanks require a rethinking of our ethical assumptions and frameworks which we have applied generally to other issues in ethics. This paper maps the key challenges and controversies of biobanking ethics; it considers; informed consent (its problems in biobanking and possibilities of participants’ withdrawal), broad consent, the problems of confidentiality, ownership, property and comercialisation issues, feedback to participants and the ethics of re-contact. (shrink)

This study explores the ability of career satisfaction to mediate the relationship between corporate ethical values and altruism. Using a sample of individuals employed in a four-campus, regional health science center, it was determined that individual career satisfaction fully mediated the positive relationship between perceptions of corporate ethical values and self-reported altruism. The findings imply that companies dedicating attention to positive corporate ethical values can enhance employee attitudes and altruistic behaviors, especially when individuals experience a high degree of career satisfaction.

The science fiction series of the '70's, Star Trek, began all its telecastings with the announcement "Space: The Final Frontier." Star Trek chronicled the voyage of a crew navigating their way through space. For the travelers, space seemed like the last unknown entity that needed to be investigated. As they journeyed, they learned of the boundless nature of space. Each episode portrayed a group of folks encountering new situations, attempting to solve another problem, or strategizing how to overcome an obstacle.While (...) few people will ever have a chance to travel in a spaceship to discover the universe, most have trekked through cyberspace. Cyberspace is the coined term for the computer world. Little would the Star Trek's producer, Gene Roddenberry, know what expansive limits the computer age would usher in. With the advent of the computer age, we recognize that we have not even begun to identify the powerful magnitude of the computer. At each juncture or moment of discovery a new question is raised, impact is assessed and plans are strategically mapped out. (shrink)

It is not uncommon for advertisers to present required product disclaimers quickly at the end of advertisements. We show that fast disclaimers greatly reduce consumer comprehension of product risks and benefits, creating implications for social responsibility. In addition, across two studies, we found that disclaimer speed and brand familiarity interact to predict brand trust and purchase intention, and that brand trust mediated the interactive effect of brand familiarity and disclaimer speed on purchase intention. Our results indicate that fast disclaimers actually (...) reduce brand trust and purchase intention for unfamiliar brands, suggesting that there are both economic and social responsibility reasons to use less rapid disclaimers for unfamiliar brands. Conversely, disclaimer speed had no negative effects on brand trust and purchase intention for highly familiar brands, presenting ethical tensions between economic interests (e.g., an efficient use of advertisement time) and social responsibility. We discuss the implications of our framework for advertising ethics, for corporate social performance, and for corporate social responsibility. (shrink)

This article examines the temporal dimension of contemporary architecture, particularly in light of the climate crisis. Mikhail Bakhtin’s category of “adventure-time” is redeployed to describe the general chronotope of postmodernism, one in which contingency and spatiotemporal disjunctions are dominant. In contrast, this essay argues for a new emphasis on duration as a means of attending to temporal continuity. Potential paths for expanding architecture’s critical engagement with duration are explored.

In lieu of an abstract, here is a brief excerpt of the content:Every Patient is a Teacher—Especially the "Difficult" Ones:Caring for Patients with Borderline Personality DisorderCara ConnaughtonNo one can teach you how to work with a patient living with borderline personality disorder quite like a patient living with borderline personality disorder (BPD). The lesson [End Page E9] isn't on how to be the perfect caregiver or how to meet all the patient's needs. The lesson is to notice that the quality (...) of care and the patient's response are not always mutually dependent and that holding ourselves to impossible standards will only lead to resentment, job dissatisfaction, and potentially burnout.I had a very good teacher on this subject and her name was Sandra.1 Sandra was admitted to our hospital unit with end stage cervical cancer. She had attempted to treat her illness by using only homeopathic remedies, which hadn't abated the disease. While at the hospital, Sandra was intensely controlling over her medications as well as when and how she took them. Sandra had also been diagnosed with BPD. One symptom of her disorder manifested in staff splitting: she saw staff members as either good or bad and treated them as such—her thinking was very black and white. She would talk very badly about other nurses to the current nurse working or talk very well about her favorite nurse in a way that made me and other nurses feel that we weren't measuring up. Sandra also exhibited intense anger toward most staff and had unexpected mood swings—I didn't know what I was going to get when I walked into her room but was fairly certain it would include berating and belittling comments. This same treatment was given to most staff nurses except for one. Sandra's favorite nurse was Bonnie; Bonnie couldn't understand why the rest of the nursing staff found Sandra difficult since she was always treated very well by this patient.I dreaded coming to work to find Sandra as part of my patient assignment for the day. I knew that day would be full of cutting remarks and disappointment from Sandra, no matter how hard I tried to provide compassionate and quality care. Further, trying to meet her seemingly endless needs took away from the care that I could provide for the other patients on my assignment. I could easily spend an hour in Sandra's room doing various tasks while she expressed frustration and anger toward me—I couldn't seem to do anything right.I have cared for many "difficult" patients throughout my years as a bedside nurse—including those who were physically and verbally aggressive—but Sandra always stands out as the most "difficult" because her words and behavior cut right through me. Even the briefest interactions with Sandra left me questioning my competence as a nurse, something I hadn't experienced when caring for other "difficult" patients.A turning point in how I related to Sandra's behavior occurred one day shift when she was part of my patient assignment. Sandra had been off the unit for a treatment from before I'd even started my shift at 7 am. At 11 am, Sandra arrived back on the unit. A few minutes later, I brought her 9 am medications to her room. The medications were technically late, but of course, it would have been impossible for me to bring them to her on time as she wasn't even present on the unit. She said angrily, "These are late! Bonnie never brings my medications late!" At that moment, something switched in my mind—it wasn't me! What a relief. I had to let go of the idea that I needed to make this patient happy in order to be a good nurse. Prior to this incident, I determined how good of a job I was doing based on how happy my patient appeared with their care. I realized that a patient's satisfaction wasn't always dependent on the quality of the care I provided.All of us provided the best care that we could for Sandra. To help us do this while maintaining our own mental wellness, we rotated... (shrink)