Nurse and patient

This research study, utilizing Colaizzi's phenomenological method, explored the lived experience of connectedness as experienced by nurses practicing in an acute care setting. Eight currently-practicing nurses described their experiences of connectedness with a patient. Based on the significant statements which were formulated into meanings and then grouped into themes, five common themes emerged. These themes revealed that connectedness occurs with death or during near-death situations, when the nurse identifies with the patient, provides an authentic presence in the nursing situation, utilizes non-verbal communication, creating a pleasant and exhilarating experience. Through providing a better understanding of this phenomenon, nurses may experience a greater fulfillment in nursing.

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.

The problem of the study was to understand the experience of being cared for by a nurse during labor and delivery. The review of literature for the study examined research focusing on adolescents in labor and delivery, caring and adolescent pregnancy and caring from current nursing literature perspective. Recalled labor and delivery experiences were analyzed phenomenologically in order to extract the meaning of the experience. Five recently delivered primiparous mothers were interviewed. Interviews followed guidelines designed to elicit descriptions of nurse caring. Interviews were tape recorded and transcribed. Data were reduced through a search for themes, and analyzed using guidelines of Colaizzi (1978). The findings were discussed with four of the participants and they all agreed that their perceptions of the experience had been described. Results of the study produced an exhaustive description and fundamental structure of nurse caring.

This is a phenomenological research study of the adolescent's experience of being accepted by a nurse. Six adolescents were selected who acknowledged and articulated their experience of being accepted by a nurse. The conceptual framework is derived from Paterson and Zderad's (1988) Humanistic Theory of Nursing. van Manen's (1984) approach to phenomenology was used to guide this inquiry. Data were generated using exploratory, in-depth, face-to-face interviews. The adolescent's experience of being accepted by a nurse is expressed by three metathemes: (1) the nurse is a friend; (2) the nurse's caring helps the adolescent feel better; and (3) the adolescent feels comfortable with the nurse. The implications of acceptance for nursing education, practice, and research are discussed.

The purpose of this study was to identify nursing values from lived experiences of six nurses during interactions with patients. Nurses employed by nursing agencies were asked: "describe an interaction you have experienced with a patient that best represents your nursing values". Giorgi's method of interpretation for phenomenological studies was used to analyze the stories. From each participant's specific values a general description of the structure of all participants' values was generated. Caring was the predominant value that emerged and encompasses nursing practice and the compassionate action it teaches. Concepts emerging from the study are living and learning of values, unpretentious presence, and caring as the ascendent value in nursing practice. Recommendations for future study include exploration of these concepts toward development of a value based nursing practice to increase job satisfaction and self-esteem for nurses recognizing their values.

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 purpose of this study was to determine the relationships between the nurses' decision making model, frequency of Rapid Response Team (RRT) activation, and the nurse's skill at the early recognition of clinical deterioration. A descriptive, cross sectional quantitative design was used. The participants in this study were 167 acute care registered nurses who had activated the RRT at least once in the preceding 12 months. The participants first were asked to recall a time when they had made the decision to activate the RRT and then were asked to complete the instruments used in this study. Using the Nurse Decision-Making Instrument, the participant's decision making model then was categorized as analytic, intuitive, or mixed. The skill at early recognition of clinical deterioration was measured with the Manifestations of Early Recognition Instrument. Participant scores on the two instruments were significantly correlated with each other as well as to their frequency of RRT activation over the preceding 12 months. The findings of this study indicated that nurses who used analytical decision making activated the RRT with greater frequency than either the intuitive or mixed decision makers. In addition, registered nurses who used analytical decision making to activate the RRT tended to have higher levels of skill in the early recognition of clinical deterioration, as measured by the MER, than either the intuitive or mixed decision makers. Another finding of this study was that RNs with higher levels of skill in the early recognition of clinical deterioration tended to activate the RRT more frequently than RNs with lower levels of this skill. The implications of this study are that the use of analytical decision making may result in more frequent activation of the RRT.

Within the current context of the healthcare environment, the charge nurse role has become very important for safety and positive outcomes. There is little known about the role from the perspective of the charge nurse. This qualitative descriptive exploratory study examined the experience of being a charge nurse in acute care practice, and describes how charge nurses live caring in their support of nurses and patients. Ray's (1989, 2006) theory of Bureaucratic Caring, Swanson's (2008) caring attributes and leadership, and Boykin and Schoenhofer's (2001) theory of Nursing as Caring provided the theoretical lenses through which study findings were viewed. Semi-structured interviews were conducted with 20 charge nurses in 4 acute care facilities. Eight themes emerged from an inductive analysis of the data describing the experience of being a charge nurse in acute care practice: Creating a Safety Net, Monitoring for Quality, Showing the Way, Completing the Puzzle, Managing the Flow, Mak ing a Difference, Putting Out Fires, and Keeping Patients Happy. Participants also were asked questions about how they provide support to staff nurses and patients. Themes that reflected how charge nurses live caring in their support of staff and patients were: Jumping in the Trenches, Nurturing Staff Growth, Offering Authentic Presence, and Looking after Nurses. Additionally, the researcher used methods of narrative inquiry to get the participants to share stories of how they lived caring in their support of nurses and patients. Recommendations included the need to elevate the visibility of the charge nurse role and its importance to the organization, and provide support for leadership development. Job descriptions and competencies for charge nurses must reflect the complexity of the environment.