Date of Graduation

2012

Document Type

Dissertation

Degree Name

Doctor of Education (Ed.D.)

Department/Program

Leadership Studies

First Advisor

Ellen Herda

Second Advisor

Patricia Mitchell

Third Advisor

Betty Taylor

Abstract

Research Topic

Presence, although it involves action at times, is a humanitarian quality of relating that is ethically generated and has real-world implications for both patient and nurse. It is an interpersonal process characterized by sensitivity, holism, intimacy, vulnerability, and adaptation to unique circumstances that results in enhanced mental wellbeing for nurses and patients, and improved physical wellbeing for patients. Knowing and being with are foundational to being present.

Theory and Protocol

This research is grounded in critical hermeneutics and follows an interpretive approach to field research and data analysis (Herda 1999). This orientation places the researcher and participants in a collaborative relationship that exemplifies the power of conversation and the importance of language to unveil new understandings about our world.

Research Categories

Three critical hermeneutic concepts, drawn from the work of Paul Ricoeur and Hans- Georg Gadamer, provided the categories for this research. The concepts were narrative identity, play, and solicitude. These categories served as the boundaries for both data collection and analysis: Narrative identity informs the nurse about herself, the patient, and provides context for the development of possibilities. Play describes the nature of the interaction between nurse and patient. Solicitude describes the ethical foundation of the relationship that the nurse has with the patient and also with her or himself.

Findings

Being present with a patient requires the ability to be open to possibilities in the moment, along with a strong ethical commitment. The ability of a nurse to be present with a patient requires self-knowledge, knowledge of the process of healing, and the ability to fully engage in the shared experience with the patient. The ability to be present with a patient can be fostered through self-care practices, meditation, other healing practices, and the provision of an environment that is conducive to nursing presence

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