The influence of consequential ethics as an ethical framework (the greatest good for the greatest
number) opposes the ethical principle of deontology (i.e., the rightness of an act itself determines what
is right). Both of these impact the nursing profession. Modern social exchange theories are based on the
principle of utility. Read the assumptions of social exchange theory and consider how these would affect
the nurse-patient relationship, compared to how these impact the nurse within the health care
environment. To what extent are all theories ethical? Is social exchange theory compatible with the
values of the nursing profession?
The basis of the social exchange theory is that if a person receives a positive response from an exchange
with another person, then they are more likely to repeat the behavior. If a negative response is received,
then the person will most likely not repeat the behavior (McEwen & Wills, 2014). A person thinks about
the benefits and risks of a relationship and then tries to decide whether the relationship should continue
or be terminated (ThoughtCo, 2018). According to the assumptions of the social exchange theory,
humans look to receive some sort of positive outcome from social interactions with others and compete
with one another. Another assumption is that humans do not always have full knowledge of a situation,
however, they have some kind of an idea which helps them to weigh the pros and the cons of a
situation.
Based on the social exchange theory, a nurse has several interactions with a patient in which responses
are exchanged. This can include providing education, resources, medications, and services. In return, the
nurse expects positive feedback from the patient such as acknowledgement of the learning process by
practicing self-efficacy. If the nurse receives a negative response, such as a patient or family member
that is unappreciative, then the nurse may be less likely to devote more time to that particular
patient.The patient provides several things to the nurse as well, their time, personal space, and person
information. In return, the patient expects to receive individualized care and to feel listened too and
respected. If a patient receives a negative response from the nurse, this could lead to mistrust and
eventually the patient may not seek out medical assistance when needed.
Overall, I feel that the social exchange theory is ethical. However, if the nurse expects something from
the patient such as monetary or gift rewards, then the nurse would be using the relationship unethically.
Likewise, if the patient is expecting something in return from the nurse such as a prescription or supplies
the nurse is unable to provide, then this would be unethical as well. If used appropriately, the social
exchange theory is compatible with nursing. The theory provides insight into nurse-patient relationships
and can provide the nurse with an understanding into why a patient may not be practicing self-efficacy.
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