Awareness of power imbalances needed.

After much thought and discussion at work, I have decided to write a letter about the emotive and evocative photographic essay titled "Who Cares". As a registered nurse, I value the caregiving, compassion and commitment that caregivers give to our elderly, and support the call for fair pay for these very special people who choose to do this specialty work. As a keen photographer of "people/humanity" myself, I thought some of the images were simply moving, capturing the essence of the caring relationship fostered between caregiver and residents. However, the majority of the images left me feeling uncomfortable, even disturbed.

As health professionals, it is an honour to perform the many intimate tasks required of us. Because of this, we must also be aware of the power imbalances between health care workers and our clients. I acknowledge the photo essay stated that consent was gained from residents (or their families), but surely we have more than just a legal obligation here. If we are to nurse holistically, we must ensure that some basic fundamentals are upheld in our "duty of care". Under the Health and Disability Commissioner's Code of Rights, 1996, the rights of consumers and the duties of providers includes, among others, the right of patients to be treated with respect and dignity and to be free from exploitation. I do wonder whether we have done our best in publishing photos of this much sensitivity in our journal. I think not.

Bronwen Neely, RN, Christchurch