Page 206 - Nursing: The Philosophy and Science of Caring

a dmi ni st ering sacr e d nu rs i ng a ct s
society, offer a necessary reinforcement value that is internally mean-
ingful to the individual. Rotter’s (1954) early classic Social Learning
Theory remains relevant. He posited:
Behavior potential is a function of Expectation plus Reinforcement Value
It can be framed as
BP = f (E + RV)
Within this view, there is an understanding that a person expects
that certain achievements will bring reinforcement he or she values,
which in turn will satisfy an internal standard of success or accom-
plishment. The self-approval needed from within and without may
change for a person who is ill or has an altered life situation. For exam-
ple, a man who has farmed all his life may be unable to perform the
degree of labor required for farming after a heart attack, surgery, and
so on. Thus, his expectations of former work and achievement goals
may be dramatically changed in ways that affect his self-approval, self-
esteem, and inner standards.
The practice of caring often involves helping others to (1) gain a
more realistic view of themselves and their expectations and (2) iden-
tify areas in which they can perform at a level they find satisfying. The
opportunity structure would therefore have to be considered, as would
shared social norms about expectation. Achievement is influenced by
the person’s expectations of success or failure in a given situation. If
past achievements are no longer realistic, the person has to experience
a repatterning of expectations as well as outcomes. Without a reap-
praisal and repatterning to create new expectations and new possibil-
ities, a sense of low self-esteem, helplessness, hopelessness, despair,
and depression can result. Compounding any personal life change in
one’s level of achievement are the sociocultural overlay and differ-
ent values and expectations among different cultures, socioeconomic
groups, geographic-climatic surroundings, and so on. Whether one is
exposed to and reinforced by values and expectations of achievement
or whether one is exposed to and reinforced by values and expectations
of failure will contribute to achievement behaviors. Different cultures
hold different values as to meanings of achievement. The Western
world increasingly defines success and achievement based on money,

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