Tronto suggested there is a pre-existing moral relation- ship between people; therefore, the question is, “How can I meet my caring responsibility?” Tronto’s model propos- es four phases of caring and four elements of care. The phases are not necessarily in sequential order and often they overlap. The elements of care are considered the fun- damentals necessary in order to demonstrate caring.
Four phases of caring. Meeting Tronto’s (1993) four phases of caring for patients involves cognitive, emotion- al, and action strategies:
1. caring about
2. taking care of
3. caregiving 4. care receiving (p. 165)
In Mr. Jones’s case, the nurse in phase one (caring about) recognized the need for increased pain medication in the assessment of the patient’s pain. In phase two (tak- ing care of), the nurse saw a responsibility to respond to the level of pain the patient was experiencing. Therefore, in phase three (caregiving), the nurse took action to call the physician for a change in the analgesia order, and the morphine dose was increased. This is the work of reacting to a patient’s needs. Facing conflict with this physician is a necessary part of care