Professional caring: a contradiction in terms?

The caring activities which are traditionally associated with the nursing and midwifery professions comprise two essential and inseparable elements: the instrumental and expressive. Yet the former appears to be attracting an emphasis which threatens the integrity of the whole. In this paper, the reduction in altruistic values in society is identified as one possible cause, and examples of practice which fall short of the ideal are identified. Also, the ways in which current educational, professional and organizational goals appear detrimental to expressive caring, while endorsing the instrumental component, are discussed. It is argued that in order for caring, in its traditional sense, to be perpetuated in practice, there is need for increased educational focus, the ability of practitioners to identify the implications of current changes in the United Kingdom for practice and the commitment to maintain caring as a central value.