Nursing--Philosophy

This dissertation analyzes a nursing artifact: the infant/invalid feeder. A material
culture analysis, developed by the author, is utilized for the in depth study of 12 feeders.
This work assumes that Caring is the core value of what constitutes nursing and nursing
practice. The expression of the aesthetics of nursing through the act of feeding and use of
infant/invalid feeders, aesthetic knowing and expression of that knowing, links caring and
caring presence.
The act of feeding another, whether sick or infant has been the domestic sphere of
women throughout history and is also considered one of the most important duties of the
nurse. For centuries women have provided nourishment to others. Much of this has been
accomplished through the use of utensils designed specifically for the purpose of feeding
those too ill or young to independently do so themselves. Material culture study, a method of examining artifacts and the cultural messages
that they contain is employed as the methodology for research. A detailed investigation
of the nursing literature reveals that there have been no material culture studies of
nursing's artifacts to date. In this dissertation the author designed and utilized her own
model for the analysis of 12 invalid feeders.
The material culture analysis of the twelve feeders leads to a greater
understanding of the history and evolution of nursing practice in the United States.
Significance and recognition of feeders in England and their continued use versus their
obscurity and unfamiliarity in the United States serves an example of the changes and
differences that have occurred within the social context of the culture as a whole and
nursing culture in particular.
Feeding of patients with feeders by nurses serves as an example of the
complexities of human caring and the aesthetic practice of nursing. Nurses can gain from
the material culture studies of nursing artifacts, paying greater attention to the ways that
make us human and humane. This work has related the caring and the aesthetic of
nursing practice to the everyday act of feeding and challenges nurses to continue to find
ways to demonstrate nurturing and caring to those we have the privilege to nurse.

Nursing care is considered a primary predictor of patient assessment of the overall
hospital experience. Yet, quality nursing care remains difficult to define. Limited
research about nurse or patient perspectives on what constitutes quality nursing care in
hospital settings prevents the identification of a shared description or insight into their
possible interrelationship. Research about nurse and patient descriptions is needed to
establish behaviors, attributes, and activities associated with quality nursing care to
improve the health and well-being of hospitalized patients.

The purpose of this study was to evolve a description of values of nurses who were recent graduates of associate degree nursing programs. Six new nurses who were employed in hospitals were asked for illustrations of nursing situations that described values important to their practice. Giorgi's method of interpretation for phenomenological studies was utilized for data analysis. Caring was the value that emerged as central to nursing. New graduates expressed this value as caring promoting growth. Subsumed within the value of caring for new nurses are hope, conscience, courage, honesty, humility, empathy and human connectedness.

This study examines authentic presence. Authentic presence, as identified in the study, comes from a theory of nursing developed by Anne Boykin and Savina Schoenhofer, Nursing as Caring: A Model for Transforming Practice. Authentic presence must be viewed in a philosophical context in order to be fully understood in practice. This analysis of Nursing as Caring reveals philosophical underpinnings in the theory's foundation. The primary texts of Soren Kierkegaard and Gaston Bachelard, both philosophers, are used to develop a foundation upon which is built a preliminary aesthetic framework to guide the examination of authentic presence. It is proposed that this framework reflects the meaning of the essence of abstract concepts and is demonstrated in an analysis of two poetic expressions.

Tensions exist between the ideology of caring as a nursing practice ideal, and the corporately managed health care settings in which nurses work. The objective of this critical feminist ethnography was to understand these tensions by grounding them in nurses' experiences and perceptions. Data was gathered through ethnographic interviewing and participant-observations of a nurse key informant and her co-workers in the pediatric unit of a corporately managed acute care hospital. The data were analyzed according to the coding procedures and comparative method described by Strauss and Corbin (1990). Four characteristics of the corporate health care culture that conflict with nurses' practice ideals were identified: The Corporate Productivity Motive; The Priority of a Medical Regime Over Nursing Care; The Tolerance of Risk to Patient Safety; and The Hospitality Perspective. A critique of the patriarchal value structure that influences the health care system and recommendations for nursing practice, education, and research is provided.

Marvin Weisbord's (1992) Future Search Conference model is an innovative organizational planning method recently employed by the College of Nursing at Florida Atlantic University in the preliminary stages of the Global Environmental Project for Healing and Health. The purpose of this grounded theory study was to identify the basic social process (BSP) of a particular social world: the future search conference. A purposive sample of six participants volunteered to describe their perspective on "what happened" and "what was going on" at the conference entitled, "Discovering Common Ground: The Future of Health, Healing and Environment," February 23-25, 1995. Glaser and Strauss' (1967) constant comparative method of data analysis was used to identify the BSP, "Finding Common Ground." This enabled conference participants to cope with the unique conditions of a future search conference (sequestration, diverse population, and self-management) while accomplishing the goals of the conference.

This research explored the patient in the intensive care units experience of care from a phenomenological perspective. The question guiding the study was: What is the meaning of care for patients in the intensive care unit? Using a phenomenological approach, six participants described their experiences of the phenomenon of care. The eight essential themes that emerged from the analysis of the descriptions of care for the patients in ICU are: (1) Being connected; (2) Feeling watched over; (3) Feeling the presence; (4) Feeling commitment; (5) Receiving Compassion; (6) Feeling valued as a person; (7) Receiving comfort; and (8) Experiencing Competence. Further analysis lead to the thematic phrase: The Essence of Isolation-Union while feeling the Presence and Competency of others. The unity of meaning was then discovered from analysis of the essential themes and thematic phrase. The unity of meaning which captures the experience of care for a person in the ICU setting is: The Illumination of the Human Spirit in the Celebration of Life.

The purpose of this study was to describe caring attributes of nursing staff as rated by nursing students. A convenience sample of 166 second year associate degree nursing students was asked to rate caring attributes of nursing staff using the Nyberg Caring Assessment Scale, a twenty item 5-point Likert scale instrument. One hundred and thirty-seven nursing students volunteered to participate in the study. The caring attribute "communicate a helping, trusting attitude toward others" was rated as extremely important by the participants. The participants rated "remains committed to a continuing relationship" and "considers relationship before rules" as slightly important. The remaining items were rated as somewhat important to very important. The study adds to the literature of caring in nursing education and practice.

This is a historical research study of the influence of feminism on nursing and nursing education from 1970 to 1994. Historical research contributes to the knowledge of the underpinnings of nursing education practices and the socialization process of nurses as a profession within the male, patriarchal system of medicine. This inquiry identifies select nurse-woman leaders and their contributions in incorporating a new value system for education and nursing based on feminist principles. The implications of this paradigm shift for nursing education, practice and research are discussed.

The aim of this investigation is twofold: first, to describe the lived experience of hearing the call for nursing, from the perspective of the nurse; and, second, to illuminate nursing knowledge through an interpretation of the phenomenon's meaning in nursing practice. Phenomenological hermeneutical inquiry, as applied by van Manen (1990) and modified by Munhall (1990) guided the investigation. Expressions of the lived experience of seven participants were ultimately captured by the researcher in the form of hermeneutic phenomenologic writings. The findings of the research are discussed with their subsequent relevance, implications, and significance for the art and science of nursing practice. Hearing being mutually sharing meaning with human vulnerability revealing feeling nursing.