The following phenomenological hermeneutic study investigated the perception and modeling of caring by 13 experienced nurse educators toward nursing students within the classroom setting. Three influences in the nurse educator’s world were entitled versus engaged students, large versus small classrooms, and struggle versus support from the university. The following themes emerged from the textual analysis: embodied caring, why we care, developing a rhythm of caring, influences on caring, and caring communication. The unique contribution of this research brings a renewed perspective on caring. Caring is the essence of nursing and should be the focal point of nursing education.
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The aim of this article is to discuss the importance of theory development within caring science and whether abduction, as a distinctive type of inference, can contribute to this. We need to understand the role of theory in our discipline, the strategies used to develop it, the criteria used to critique it, and the possibilities for abductive reasoning to enhance theory development within caring science. Abduction paves the way for a deeper knowledge of understanding and is closely connected to the ontological questions
- Go to article: Ethical Issues Experienced by Community-Based Nurse Practitioners Addressing Health Disparities Among Vulnerable Populations
Ethical Issues Experienced by Community-Based Nurse Practitioners Addressing Health Disparities Among Vulnerable Populations
Health disparities are projected to increase as more individuals delay obtaining needed healthcare. Increasing vulnerability of these persons results when they are unable to access care. Community-based nurses, particularly nurse practitioners (NPs), are well-positioned to respond to these calls for nursing. In the process of responding, a variety of ethical issues have been identified. A naturalistic inquiry of community-based NPs was conducted in order to enhance understanding of these issues. A Level of Ethical Issues Framework emerged with the patient-nurse practitioner covenant as the core ethical value that guides the NPs’ care of vulnerable persons. By focusing on the covenant and by increasing our understanding about the needs of diverse communities, NPs and all nurses can develop appropriate responses to the widening disparities among vulnerable members of our communities.
- Go to article: The Caring Experience of Fetal Loss and Termination of Pregnancy Through the Eyes of Gynecological Medical and Surgical Nurses
The Caring Experience of Fetal Loss and Termination of Pregnancy Through the Eyes of Gynecological Medical and Surgical Nurses
Nurses care for women experiencing fetal loss as a result of elective or therapeutic termination of pregnancy or unexpected delivery of a nonviable infant. It is an emotional experience for the family and nurses. Investigators aimed to illuminate the experience of nurses caring for women experiencing a fetal loss and/or termination of pregnancy on a gynecological medical/surgical unit. The study used a qualitative, descriptive design approved by the Institutional Review Board. Semi-structured interviews were conducted with nine registered nurses, and transcripts were analyzed using constant comparison methods resulting in codes and themes by three investigators. The experience of nurses caring for women and infants during fetal loss and termination of pregnancy occurs throughout a continuum before, during, and after work. The experience is one of the layers, starting with emotions, sadness, and remorse in the center, followed by layers of attitude (respect and comfort) and action (communication). The foundation for these layers is teamwork, faith, and coping, surrounded by a box of uncomfortableness and distress. Nurses care for both the woman and infant during the termination of pregnancy and fetal loss, treating each with respect and comfort by communicating in both words and physical presence. Support between nurses with similar experiences provides a strong foundation that buffers the uncomfortable and distressing experience.
- Go to article: Persons who Dependent Upon Technologies for Care: Lived Experience of Being Cared for Following Lower Limb Amputation
Persons who Dependent Upon Technologies for Care: Lived Experience of Being Cared for Following Lower Limb Amputation
The purpose of this study was to describe the experience of persons who were being cared for while dependent upon technologies for human care. Eight participants who met the inclusion criteria were interviewed. Following van Manen’s (1990) hermeneutic phenomenological approach, 4 thematic experiential descriptions were revealed. The lived experience of being cared for is an expression of independence in finding meaning and acceptance, while being mindful of recovery with existing technological use of configured space. Understanding the meaning of being cared for with technologies enhances human caring in community living. Engaging in understanding shared lived experiences of persons being cared for with technologies is expected.
When discussing caring quality and good care there has been a lack of a conceptual frame of reference and of models representing a caring quality perspective. Starting from Aristotle’s idea of quality, and by the aid of abduction and Peirce’s view of ‘the maybes’, we wish to point out the possibility of assuring quality in an original and deeper sense. Based on Aristotle’s thinking, the concept of quality can be molded in terms of three different depths of meaning that we here refer to as primary, secondary, and tertiary. The idea of the heuristic model is that it should liberate thought and encourage reflection starting from the idea of quality. Our basic assumption is that caring represents quality in a profound sense if, and only if, the primary substance permeates the substance at secondary and tertiary levels. The heuristic model starts from the category of the possible and opens up a dialectic based on ontology or primary quality. A heuristic model gives free scope to realize the good and discover the things that are likely to counteract the good. Starting from the primary substance, one can ask what good care is in relation to the basic motive of caring science in terms of our way of defining the basic motive as caritas. Good care in accordance with this means implementing all acts of caring through love and mercy. Good care cannot be defined in terms of external criteria, but it is each nurse’s own honest attitude to the basic motive that is the determining factor.
Relations of caring are contrasted with the treatment transactions that typify managed care. This contrast reflects a social tension between 2 core narratives of survivorship: the narrative of extensive responsibility and the narrative of limited liability. The potential and the difficulties of the former narrative are discussed. Clinical examples show the potential for clinicians to validate and enhance their patients’ sense of the responsibilities that attend survivorship. Care as remora-lization provides a model of how society’s moral quotient—the relationship between the time spent in relations of care and the time spent in transactions—can be raised.
- Go to article: Nurses’ Experiences of Violations of Their Own Dignity in Psychiatric Inpatient Settings
Dignity is a core concept in nursing care. This study highlights dignity as an important ethical concern in psychiatric inpatient settings since both caregivers and patients must struggle with being in situations where their dignity can be violated. Our findings show that caregivers violate nurses’ dignity by violating acts and patients’ actions violate nurses’ dignity. The new understanding shows that nurses in psychiatric inpatient settings are highly exposed to patient’s outward behavior. Unfortunately, other caregivers violate nurses’ dignity, as patients are dependent which makes their existence uncertain. Findings are interpreted and discussed in the light of caring theory of human dignity.
- Go to article: Patients’ Communication with Nurses: Relational Communication and Preferred Nurse Behaviors
Communication between a nurse and a patient is a shared process that forms the basis for the professional relationship that is foundational for enhancing patient care and affecting patient outcomes. Both hermeneutical and descriptive methodologies were used to examine nurse-patient communication dimensions and identify patient-preferred nurse behaviors. Patients in three age groups participated in an interview and survey questionnaire. Use of the Nurse-Patient Communication Assessment Tool recognized a one-dimension model of patient-nurse relational communication comprised of calm, comfortable, caring, interested, sincere, accepting, and respectful. Responses to the Health Communication Interview questionnaire identified preferred behaviors patients want and expect from nurses as caring, warm/friendly, professional, competent, empathy, listens, and honest/sincere.
- Go to article: Supporting Students' Understanding of Caring Science as a Meaningful Basis for Practice
Caring science has been described as abstract, difficult to apply, or unscientific common sense. An alternative view is that caring science knowledge does not pose a greater challenge because it is abstract, but because it challenges caregivers' existence. No matter how nursing faculty perceive these challenges, it is crucial to create a context where students are supported in the integration of theoretical knowledge. This article addresses teachers' responsibility for creating a caring learning environment. It further proposes how reflections on perspectives and concepts can be linked to experiential learning to contribute to students' embodied understanding of caring science.