Nursing--Philosophy

The purpose of this study was to examine nursing's values as they are lived day-to-day in nursing practice. A nurse's story, a reflective remembrance of a nursing situation, was explored for the illumination of nursing's values embedded in the service activities of the nurse. Using qualitative descriptive content analysis, the story was studied for significant statements depicting activities of the nurse and for the values guiding those activities. The analysis revealed three transcendent values, reflected in every activity: Caring, respect for the dignity of the other, and inner harmony. The analysis further revealed eight actualizing values, individually embodying the transcendent values: compassion, competence, courage, humility, honesty, commitment, trust and hope. The wholeness of the inquiry is presented using metaphor to illuminate the meaning of nursing's values in nursing practice.

This research explored the client's experience of nursing as the promotion of well-being. The question guiding the study was: What is the meaning of nursing as the promotion of well-being? Using a phenomenological-hermeneutical approach, eight participants described their experiences of the phenomenon. Three metathemes emerged and expressed nursing as the promotion of well-being: (1) Being There Conveys a Willingness to Relate; (2) Being With Enables the Feeling of Comfort; and (3) Being in Tune While Creating the Future. Further analysis led to the apprehension of a unity of meaning: An Emancipating Togetherness--The Creation of a Caring Synchrony that Empowers a New Meaning for Living. The metaphor, A Conspiracy of Caring, conveys a theory of the meaning of nursing as the promotion of well-being.

Concepts create our language and shape our world. Clarifying concepts will empower nurses to facilitate the changes needed in the future. Rodgers' (1989) evolutionary method of concept analysis was used to clarify the meaning of empower. This method was further developed to be congruent with the new processual paradigm foundational for this study. In order to examine the concept, a systematic random sample of 30 articles from the periodic literature of five disciplines was used (nursing, sociology, psychology, education, and business). Through a reflective analytic process twenty-nine attributes of the concept were identified and gathered into the five themes representing the concept. Two metathemes were identified, one for the concept and one for the context of the concept. To give, share, and/or have the ability to fully participate in life situations and experience well-being in the process is the definition of empower, as it emerged in the study.

The purpose of this study was to uncover the structure of the common lived experience of health of "the experience of feeling that you belong", using Parse's research methodology. The nursing perspective for this study is that of Parse's nursing theory of human becoming. The researcher used the processes of the methodology, participant selection, dialogical engagement, extraction-synthesis, and heuristic interpretation to evolve the structure of the lived experience of health: The experience of feeling that you belong. The structure of the experience of feeling that you belong, discovered in this research with four participants, is prizing equivalent differences while illuminating light within the darkness and discovering fullness of self in community. This study demonstrates Parse's research methodology and expands the knowledge base of nursing.

The phenomenon central to this study is "struggling in changing priorities," a universal lived experience of health. Parse's (1981, 1991) theory of human becoming was the lens through which all aspects of this study were seen. The participants were four young adults infected with the AIDS virus. Parse's research methodology consisting of the processes of participant selection, dialogical engagement, extraction-synthesis, and heuristic interpretation was used to uncover the structure of the lived experience. Struggling in changing priorities is inspiring new awareness while camouflaging the perilous evokes solace amid harmonizing opposing rhythms. When taken to a higher level of abstraction and linked with the major concepts of Parse's theory, the theoretical definition of struggling in changing priorities is imaging the revealing-concealing of transforming.

Nursing researchers studying the concept of caring in nursing have identified patient teaching as a valued nurse caring behavior. However, no research has been conducted that examines patient teaching as an expression of caring. The purpose of this study was to examine and describe the patient perspective of caring expressed by nurses through patient teaching. Twelve patients in a hospital setting shared their thoughts and feelings about caring expressed by nurses through 'explaining', as the participants preferred to call 'teaching,' during open-ended tape-recorded interviews or in writing. A qualitative descriptive content analysis method was used to analyze the descriptions. Twenty-six subcategories that emerged from the coded data were grouped into four broad categories defined as: Nurse's Way of Being; Nurse's Doing For Patient; Nurse's Being With Patient; and Nurse's Caring Affects Patient.

This research is a qualitative study using the phenomenological method to gain insight into the meaning of caring for the patient. Many nurse leaders have described caring as the essence of nursing (Benner & Wrubel, 1989,; Leininger, 1981, 1984a, 1988; Watson, 1985a, 1988b). The purpose of the study was to address the meaning of caring from the patient's perspective. The specific phenomenological method used was based on the work of Max van Manen (1984). A purposive sample of 8 adults, 6 women and 2 men, in an acute care setting was selected. An unstructured interview technique was used. Through structured reflection the process of caring emerged as themes. These included: nurse's knowledge, nurse's presence, involvement and commitment. Expressions of caring emerged as subthemes. The subthemes included: decision making, competent clinical skills, nurse's true presence, nurse's availability, accepting, understanding, helping and informing. A model of caring from the patient's perspective was developed.

Caring has been identified as an essential value for baccalaureate education across all programs of study. The purpose of this phenomenological research study was to investigate the lived experience of students learning caring in a college of nursing grounded in a caring philosophy. The question guiding the research was: "What is the student's experience of learning caring in a college of nursing that has caring as a central tenet in its philosophy?" This study was guided by the caring theories of Boykin and Schoenhofer (2001), Roach (2002), and the philosopher Mayeroff (1971). The researcher interviewed seven senior baccalaureate student nurses attending a public university. The nursing program at this university was grounded in a caring philosophy. The research questions explored the students' experiences of learning caring at this school of nursing. One student shared this thought with the researcher, "I knew who I was and I knew I could care about people, but I didn't know how to use caring in nursing. The educational process helped me to transfer caring to nursing." Transcripts of the audiotaped interviews were analyzed using Colaizzi's seven-step methodology. Two major themes and six sub-themes related to learning caring emerged and an exhaustive description of the students learning of caring in a caring based curriculum was developed. The two major themes identified were: Innate Knowing of Self as Caring, and Caring in the Curriculum. The first major theme of Innate Knowing of Self as Caring is supported by the sub-themes: Being present for the patient, Being open to reshape the patient's experience, and Enhanced capacity to care. The second major theme of Caring in the Curriculum is supported by the sub-themes: Clinical experiences are valuable to learning, Doing little things to express caring, and Learning activities facilitated understanding caring. Descriptions of the two major themes and six sub-themes were portrayed with verbatim stories told to the researcher by the student participants. Finally, implications for nursing education, research, practice, theory, and policy are presented for the reader.

The nursing leader's challenging position in today's work environment may lead to an experience of stress, over-commitment, and overdoing. The purpose of this phenomenological study was to examine the meaning of caring for self by registered nurse leaders who had participated in a caring for self project in a community hospital setting. This group of 10 nursing leaders had participated in a caring for self project and had experience in nursing ranging from 18 to 32 years. One year after taking part in the caring for self project the 10 nursing leaders participated in individual taped interviews to explore the meaning of caring for self. Hermeneutic phenomenology (van Manen, 1990) was the method used for the interpretation of this research study. The depth of the lived experience of caring for self was described by each nursing leader. A metaphor of climbing a mountain to the peak of wisdom, being on the path and staying on the path regarding care of self, came from the words of the participants. In their words, the leaders communicate four common themes: Reflections on the Journey, Why Care for Self on the Journey, How to Care for Self on the Journey, and the Wisdom Learned Along the Path. Based on their reflections, recommendations include implementing creative ways to encourage care of self are for the hospital environment and educational methods to reinforce care of self for nurse leaders in the educational curriculum. A focus on care of self described by the leaders in this study may improve personal health, add to personal growth, assist in communication skills, allow for role modeling care of self to others, support setting priorities and boundaries, contribute to flexibility, and promote a work-life balance. These qualities would assist in creating a positive work environment and may influence the retention of nurses and contribute to recruiting new nursing leaders. Caring for self by nursing leaders is an important way for caring nursing theory to be brought to the practice setting. By role modeling a work-life balance nursing leaders bring the circle of caring out to others, beginning with care of self.