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When expressions make impressions-Nurses' narratives about meeting severely ill patients in home nursing care: A phenomenological-hermeneutic approach to understanding
Centre of Care Research, Mid-Norway, Steinkjer, Norway; Department of Nursing, Sweden University, Sundsvall, Sweden.
Centre of Care Research, Steinkjer, Mid-Norway; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
Centre of Care Research, Steinkjer, Mid-Norway; Department of Nursing, Mid-Sweden University, Sundsvall, Sweden; Department of Health Sciences, Nord-Trøndelag University College, Namsos, Norway.
2013 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1, article id 21880Article in journal (Refereed) Published
Abstract [en]

Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses’ lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs’ lived experience of patients’ expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: “Sensing vulnerability” and “Empathizing with.” The second theme, Being satisfied, entails the subthemes, “Feeling exceptional” and “Being trusted.” The third theme, Being frustrated, contains the subthemes, “Being disappointed” and “Being angry.” The fourth and final theme, Being ambivalent, includes one subtheme: “Being generous or reserved.” Patients’ expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role.

Place, publisher, year, edition, pages
Informa Healthcare , 2013. Vol. 8, no 1, article id 21880
Keywords [en]
Nurse–patient interactions, emotional dimension, touch, home nursing care, palliative care, professional identity, phenomenological-hermeneutic approach
National Category
Nursing
Identifiers
URN: urn:nbn:se:hig:diva-25020DOI: 10.3402/qhw.v8i0.21880ISI: 000325898000001PubMedID: 24138930Scopus ID: 2-s2.0-84886686756OAI: oai:DiVA.org:hig-25020DiVA, id: diva2:1134829
Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2018-03-13Bibliographically approved

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