ABSTRACT
Data sets from three individual studies on nursing judgment were reviewed from a wider perspective. This yielded meanings and phenomena not readily identified in the individual studies, and it was tentatively labeled presence. A hermeneutic study using 10 transcripts from each data set asked: What are the common features of the context of nursing judgment? and, What are the features of the nurses' connection with the patient that contribute to nursing judgment? The analysis yielded six features of nursing presence: uniqueness, connecting with the patient's experience, sensing, going beyond the scientific data, knowing (what will work and when to act), and being with the patient. These features of nursing presence are logical distinctions and serve as ways to grasp the idea of nursing presence.
Subject(s)
Holistic Nursing/methods , Judgment , Nurse-Patient Relations , Nursing Assessment/methods , Nursing Process , Cues , Gestalt Theory , Humans , Intuition , Models, Nursing , Nursing Methodology ResearchABSTRACT
Nursing presence emerged in the nursing literature in the 1960s as a coherent and consistent philosophical term based in the existentialism of Gabriel Marcel and Martin Heidegger, and the religious philosophy of Martin Buber. Since the mid-1980s, however, the precision in definition has deteriorated and presence has accrued multiple meanings, resulting in a weakened sense of the concept. After delineating the etymological and philosophical foundations of nursing presence, the concept is defined. The existential nature of nursing presence is explored and arguments for the indispensability of nursing presence are offered to counter the claims of bottom-line thinking. A definition is offered of nursing presence as an intersubjective encounter between a nurse and a patient in which the nurse encounters the patient as a unique human being in a unique situation and chooses to "spend" herself on his behalf.
Subject(s)
Existentialism , Models, Nursing , Nurse-Patient Relations , Humans , Knowledge , Philosophy, Nursing , Religion and PsychologySubject(s)
History of Nursing , Religious Missions/history , History, 19th Century , Humans , Japan , United StatesABSTRACT
The purpose of this phenomenological study was to discover the process by which psychiatric nurses make judgments as they care for persons who exhibit impaired judgment. Data were collected from six experienced psychiatric nurses in a private room and were audiotaped. These data were analyzed using Spiegelberg's (1976) phenomenological method. The data yielded an overarching theme: all the nurses presented judgment as a personal responsibility. Within this overarching theme, were four major themes: (1) closeness to the clinical data; (2) critical reflection; (3) respect for one's knowledge and ignorance; and (4) existential nature of judgment. Categories within theme (1) closeness to the clinical data were nurse as knower and focus on the patient; within theme (2), critical reflection were experience and understanding; within theme (3), respect for one's knowledge and ignorance were self-consciousness and expectation of self; and within theme (4), existential nature of judgment were alone facing the unknown and "Eureka! I've got it!" Essentially, judgment occurred privately within the mind of the nurse, making it both the creation and responsibility of the nurse. For these nurses judgment was the pivotal event in nursing inquiry beginning in the desire to know, proceeding through understanding and presentation of a nursing problem and then determining the question, "What is it?" in a "Eureka!" moment. With this experience of "I've got it!" the nurse crossed from the unknown to the known. Judgment which began in the desire to know began again with a new question.
Subject(s)
Judgment , Mental Disorders/nursing , Psychiatric Nursing , Decision Making , Humans , Interviews as Topic , Mental Disorders/psychology , Problem SolvingSubject(s)
Military Nursing , Catholicism , History, 19th Century , Ireland , Religion and Medicine , Turkey , WarfareABSTRACT
Recently, nursing has turned more of its attention to judgment and has given it a high priority for study. A significant part of that study asks: What is judgment? How is it made? Why is it important? The ancient Greeks discovered reason and then created enduring art that demonstrates it. Three nurses are excerpted from this literature to evoke and explain how judgment is made. Euryclea, Cilissa, and Medea's nurse also illustrate the personal commitment in judgment. Human beings depend on the nurse's judgment. They depend on the nurse as knower. Nurses are obliged to move from doubt and opinion towards knowledge and certitude. Judgment is the nurse's key to that knowledge.
