Cultivating nurses’ potential to incorporate assessment and minimisation of the consequences of the effects of illness into presence

Abstract

Background: In 2006 a phenomenological study was completed which explored the experiences of 14 participants (supportive spouses) each of whom had a partner who was hospitalised in a non-local tertiary centre.

Methods: Data were gathered through unstructured interviews with the supportive spouse. Individual stories were analysed, underpinned by Heideggerian philosophy of understanding, and interviews with new participants continued until patterns of the experiences emerged. Three overall themes emerged from the research, ‘being in suspense’, ‘living day by day amid the unknown’, and juggling the unknown when the couples were separated emotionally from those who surrounded them; mainly because it was the everyday for hospital personnel, but unknown for the couples. Although they did not clearly articulate this, the catalyst for managing their non-local hospital experiences was bound in the readiness, or lack of readiness of nurses to engage in therapeutic interactions. This paper is focussing on the third of the overall research findings; that is of the importance of a therapeutic relationship.

Results: A catalyst for managing hospitalisation is bound in the readiness of nurses to engage in therapeutic interactions (presence). Patient groups recognise this phenomenon when they perceive the nurse can appreciate the patient’s world view. Despite theorists clearly identifying caring (and therefore presence) as the key concept of nursing practice, the concept of presence is no longer reflected in the everyday world of nursing. Increased technological demands on nurses have resulted in nursing losing sight of its unique characteristics. Nursing needs to move beyond being measured in terms of technical competency, and should ensure instead that nurses develop confidence in articulating what constitutes the holistic characteristics of care. On emphasising the need for greater emphasis of presence to practice, nurses need to be mindful of the value placed on care; a re-emphasis of presence in nursing education programmes; and, modelling of care in practice.

Conclusions: Academic and clinical nurses need to argue that presence is the defining principle of nursing care, and, therefore, must be included in assessments. The inclusion of presence as a competency will substantiate the argument that nursing is more than the technical-based frameworks and will underscore that presence is the key underpinning principle of optimal care.