A new perspective on nursing and caring in a corporate context

An understanding of how the corporatization of the health care system has influenced the social context of health workers is essential as nurses attempt to implement an ethic of caring. Since the 1960s, the US health care system has been moving toward increased competition between providers and toward care-avoidance incentives. These incentives created by the Medicare Prospective Payment Systems based on diagnosis related groups, health maintenance organizations, and preferred provider organizations reward the minimization of service. In this context, nurses are not rewarded for trying to care. However, nurses can employ various strategies in nursing education, health care policy formation, and social activism to insist that caring is a nonnegotiable component of nursing work.