definition of caring in nursing scholarly articles

This article reviews the definitions of the PCC concept and the paths of healthcare systems to implement this approach, while focusing on nursing and nursing education. We propose that on a universal level, caring, regardless of context, is coloured by humanism and the most important prerequisite for caring, is to recognise and acknowledge the person behind the patient. Polit DF, Beck CT. Assessment of the essentials of care, i.e. Nursing has come a long way since the 1860s and the ‘Nightingale Training School and Home for Nurses’ at St Thomas’s Hospital in London. DOI: 10.3912/OJIN.Vol21No01PPT02Keywords: wisdom, knowledge, informatics, concept analysis, antecedents of wisdom, characteristics of wisdom, wisdom-in-actionWhere is the wisdom we have lost in knowledge? Thomas Stearns Eliot (1969, p. 147)Few could i… (pause) … Then you also have to remind the physician properly, which I usually do. The term integrative refers to practice that includes two or more disciplines or distinct approaches to care. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. This study showed that nurses conceive caring as person-centredness, which can be regarded as a good prerequisite for implementing person-centred care (PCC) in hospital settings. The nurses described caring as nursing interventions as continuously mediating customised information about treatment, medication and the current situation to and between the patient and the next of kin. 2006;12(6):359–65. But nursing has changed…” (p. 523). doi: 10.1046/j.1365-2648.2002.02112.x [31] provided constructive routines to facilitate and safeguard the transition to PCC and to ensure that it can be practised systematically and consistently. Only articles related to primary care cases were included. They strived to explore and reach an understanding of the person’s individual illness narration and the impact of the illness on everyday life and to do so with sensitivity and based on the person’s overall situation. The nurses in our study conceived that the starting point for caring is the perspective of the person behind the label ‘patient’ and their descriptions mirrored the intention to reinforce the patient, i.e. as a cardiac nurse). [19], which indicated that staffing hospital surgical wards with nurses with a degree and not making them care for more than six patients at a time, would lead to a significant reduction in preventable hospital deaths. Nursing Journal with highest impact factor offers Open Access option to meet the needs of authors and maximize article visibility. California: Sage Publications; 1994. p. 300–316.51. The results show that nurses conceived caring as undertaking nursing interventions, hence caring aimed at improving the patient’s symptoms, enhancing their well-being, promoting health and meeting the patient’s need for essential care and information while at the same time consistently putting the patient’s interests first. Showing respect for the person’s decisions or opinions, especially when they were not in accordance with the opinion of the professionals, was regarded as being essential to caring. 2019 Jan/Feb;44(1):27-32. doi: 10.1097/NMC.0000000000000494. Another explanation could be published reports and studies that indicate that the healthcare system is failing to offer safe, good-quality healthcare [20-22]. 2007;45(12):1195–204. Patient participation in nursing care: an interpretation by Swedish registered nurses. J Adv Nurs. Findings: Holistic describes “whole person care” often acknowledging body–mind–spirit. Watson J. Lancet. Nursing home residents do not relinquish human rights just because they need care. Unfortunately, in another study by Aiken et al. 2001;36(2):188–98. Scand J Caring Sci. Br J Nurs. Part of By using this website, you agree to our Nursing competency has been extensively addressed in the literature in terms of safety and quality of nursing care . One participant stated: It’s important that you know the technical aspect so that we can observe and see that: No this is pretty unstable, so you can sound the alarm and maybe change your mind and initiate various measures earlier than you possibly planned. In fact, professional competency in nurses is defined as a combination of skills, knowledge, attitudes, values and abilities that bring about effective or high performance in occupational and professional positions [ 6 ]. Our results reflect a hierarchical relationship between the four descriptive categories, the outcome space (Figure 1), interpreted to represent the nurses’ collective understanding of caring. Int J Nurs Stud. Healthcare in the western world is facing significant challenges, for example changing patterns of disease, aging population, numerous people living with chronic illnesses and long-term treatments, and a mobile healthcare workforce [18]. If there’s a lot to do, as always, (pause) it might actually be the case that caring is neglected sometimes, because then it’s just what’s most urgent that you prioritise all the time and unfortunately a lack of staff is a hindrance. Nursing and Care is an peer-reviewed journal for the rapid publication of innovative research covering all aspects of Nursing and Health Care. 1984;11(6):46–50. Lancet. Intensive Crit Care Nurs. Cite this article. This stood out as being the core of their conception of caring and the main supporting feature of caring as safeguarding the patient’s best interests and caring as nursing interventions. Get the latest research from NIH: https://www.nih.gov/coronavirus. Andersson EK, Borglin G, Sjöström-Strand A, Willman A. In: Morse JM, editor. The role of nursing in imparting quality medical treatment to ailing patients cannot be undermined. In the third step, through careful scrutiny, a comparison of the preliminary descriptive categories was made to establish the borders between them. The patient will start talking with me about how it’s been, explain their situation and when you’ve listened to the patient talk, that’s when you get to talk… it’s important that you let the patient be in control, that it’s he or she who knows their illness and their condition the best, so that they can tell you what it’s really like… you listen actively to what the patient has to say and then interpose with information during the conversation; it can be like that, it’s common that it’s like that, during the conversation… it is the patient who is (pause) the specialist regarding his body and his illness and then I need to listen actively and provide information based on this. The final group of participants comprised of 21 nurses, 20 women and one man. [20]). Caring Science and nursing offers a deeper, moral, philosophical, knowledgeable value-based approach relevant to sustaining the dignity of humanity worldwide as well as the profession of nursing (Clarke, Watson & Brewer, 2009). 2014;51(4):523–25. (pause) It’s really important that you listen to what they’re wondering about, how they feel it has affected their situation and family and listen out for what it is they want to know… that you are sensitive to and really find out how it has affected this particular person and not generalise. Diya L. Koen, Sermeus W, Lesaffre E. The relationship between in-hospital mortality, readmission into the intensive care nursing unit and/or operating theatre and nurse staffing levels. There is substantial evidence in the literature of an association between contextual aspects of caring, e.g. Sjöström B, Dahlgren LO. One participant stated: … lack of staff. Paternalism in nursing and healthcare: central issues and their relation to theory. Nurses’ decision-making and problem-solving in caring need to be founded on solid evidence as only then, according to Cronenwett et al. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, et al. It must be hard to listen to a patient expressing concern about this, since this will stir these feelings in me, instead of being able to listen to what they’re saying. Caring was also conceived as pharmacological intervention, i.e. Teamwork is also known to improve patient planning, is clinically more efficient and supports a person-centred care [36]. The first author conducted the interviews between March and May 2013. In the 1970s, Watson [3] suggested that caring is the basic ontological substance of nursing and is interpersonal. In a metasynthesis, Finfgeld-Connett [14] describes caring as a context-specific, interpersonal process signified, among other things, by intimate relationships and interpersonal sensitivity. Intensive Crit Care Nurs. warfarin) or cardiac rehabilitation. Testing nursing interventions. : Little, Brown; 1979. 22 That is, within care and family processes. By acknowledging caring as person-centredness, caring as safeguarding the patient’s best interests, caring as nursing interventions and caring as contextually intertwined, caring could open up the possibility of influencing the patient’s experiences and well-being in different ways. HHS Int J Nurs Pract. Cochrane Database Systematic Review. The two CCUs are divided into two parts – one emergency care part (six-seven single rooms) and one step-down/rehabilitation part (6–11 rooms with 16–19 beds) with telemetry facilities. It was also considered important to be open, perceptive, reflective and creative when formulating individual caring solutions. Holistic nursing defines a disciplinary practice specialty. However, it was also stated that important enablers of caring were cooperation with other nurses in charge, encouragement as well as reassurance from colleagues and managers and these were described by the nurses as important features of caring as contextually intertwined. Collaborative care seems to be of vital importance in times characterised by an intensified workload and strained healthcare finances, often resulting in inadequate nursing staff (cf. Seven of the nurses shifted between the emergency and step down/rehabilitation part of the CCU, one worked only with secondary prevention and cardiac rehabilitation and the remaining 13 shifted between both parts of the CCU and nurse-led follow-up outpatient clinics (heart failure, arrhythmia and anticoagulation therapy e.g. The nurses stated that this meant being truly present, readily available and conveying a sense of comfort. 2002;40(2):149–57. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth’s description of phenomenography. Nurse educators can utilize these caring processes to teach nursing students by cultivating meaningful, healing relationships. Cookies policy. J Clin Nurs. Just as it takes a team to properly complete the MDS and develop a meaningful care plan, it takes the whole nursing team to achieve positive outcomes for all residents. Co; 1952/1988. Caring is a value and an attitude that manifests itself in the form of a concrete act. In a linguistic dictionary, the term is a synonym of “well-being”, and is defined as aid and solace in moments of affliction.15, 16 Comfort has always been a central concern and concept in nursing and it is particularly important in the definition of the nature of nursing knowledge, the discipline, and the profession. Concepts of caring and caring as a concept. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The nurses stated that the patient was ‘the expert on her/his body and illness’ and emphasised the importance of involving the next of kin in caring. So it’s the seriously ill patients that I help with everything if that should be the case (pause) make conversation when I’m in there changing diapers but for me it’s important that they’re clean and not in any pain. Nurses therefore need to integrate evidence into their daily nursing practice in order to ensure research can be used for the benefit of all patients. The aim of this study was to describe registered nurses’ conceptions of caring. PubMed  [34] suggest that the act of ‘standing by’ the patient is of importance and means that the nurse is attentive, present and prepared to assist the patient in all situations, whilst at the same time giving the patient the freedom of choice to decide the extent to which they want to participate. Caring has been identified as an essential aspect of nursing … Hence, a continual process of iteration between a focus on the whole and the parts was used to check on the interpretation until the descriptive categories that emerged from the data were found to be mutually exclusive. 1997;26(6):1189–92. The nurses conceived caring as maintaining and strengthening the patient’s sense of dignity and being a person. 2003;16(4):288–96. In a Scandinavian context, with a start in the 1980s, Eriksson [4] suggested that, in theory, caring, the innermost core of nursing, comes about in a relationship between the patient and the care provider and that caring implies alleviation of suffering. This is similar to the nursing care provided in other settings [67, 68]. It’s always the critical things, people who are very seriously ill. Those are the sorts of things that are prioritised all the time. Nevertheless, it was considered representative of the nursing profession, since, in Sweden, only approximately 11% of nurses are male. 2005;14(1):35–42. In our study the nurses described how they found themselves forced on a daily basis to focus on measurable medical tasks and to learn how to control their frustration when they were required to leave the essentials of care unaddressed. Although we know that caring occurs in a complex healthcare environment, caring must be enacted in such a way that it is possible to observe, measure and replicate successful caring to the benefit of all patients. Manage cookies/Do not sell my data we use in the preference centre. 2004;13(4):422–29. Nurs Res. Caring as safeguarding the patient’s best interests was described as becoming involved at an early stage in the patient’s discharge plans. The concept of caring has also been studied empirically with qualitative designs [10,11], and it is explored in quantitative designs [12,13]. That you ensure that it’s done on their… I can feel that it’s a form of mistreatment not to do as they, as the patient wants it. Similar results are shown in several recent studies across the globe [45-47]. One participant stated: I think that it’s important that I as a nurse (pause) Well, sometimes the decision is made before the physician has seen the patients and I think: Hey, this is a person we’re talking about, have you seen her? It therefore seems reasonable that continuous in-service training should be a natural part of the nurse’s day-to-day work. Regardless, and perhaps somewhat controversially, it could be the right time to suggest that it is no longer sufficient to explain caring as a unique nurse-patient relationship. Modern-day nursing, which takes place within a healthcare system that is undergoing wide-reaching reforms due to huge economic restrictions worldwide (cf. Systematic review and meta-analysis. ERIC/ECTJ Annual Review. Partnership: an analysis of the concept within the nurse-client relationship. The caring art of nursing is demonstrated perfectly in Dr. Jean Watson's presentation on the Theory of Human Caring/Caring Science to honor Nurses Week. The person’s experiences, feelings and preferences were considered to be vital aspects of caring. Nolte E, McKee M. Caring for people with chronic conditions: a health system perspective. (pause) In a way it’s knowledge of people (pause) knowledge of human nature, that you’re able to read another person and dare to (pause) be open to what they say and dare to accept that. The theoretical development in nursing accelerated during the 1970s to 1990s, mainly in the U.S., but nursing theorists who focused on caring in nursing were few. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people. Nursing Interventions Classification (NIC). George's death--understood through Swanson's theory of caring. https://doi.org/10.1186/s12912-015-0067-9, DOI: https://doi.org/10.1186/s12912-015-0067-9. 2005;50(6):641–50. Our findings imply that nurses’ conceptions of caring have evolved during the last decade. … It’s also very important that you know those bits and that you observe it, observe the equipment, what the patient says and how the patient is feeling, the patient’s overall condition. Coronary care takes place mainly within secondary care (hospitals), where the nurses often work in a team with enrolled nurses (two years’ college education and no regulation) and a physician. Search across a wide variety of disciplines and sources: articles, theses, books, abstracts and court opinions. An evolutionary concept analysis of caring. Did you make sure she understood what you were saying? NIH Try to ask open questions to get more comprehensive answers. Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. Organised inpatient (stroke unit) care for stroke. 2012;68(5):1073–81. Adv Nurs Sci. The conceptions may vary from one person to another, and within the same person as different aspects of the phenomenon are conceived depending on the entirety in relation to a given context. Swanson's (1991) middle range theory of caring has traditionally been used to define the care of patients and family members. Subscribe today! How is the patient doing now? Caring: dealing with a difficult concept. A nursing intervention is defined in the literature as ‘any treatment, based on clinical judgement and knowledge, that a nurse performs to enhance patient or client outcomes’ ([39] p. 2). CAS  This indicates that caring was not perceived as a passive intervention occurring in isolation but rather as a dynamic contextual intervention occurring in intricate interplay in the relationship with patients, colleagues and the context in which caring takes place (Figure 1). In the descriptive category caring as safeguarding the patient’s best interests, the nurses conceived caring as carefully guiding the patient through teamwork with other allied healthcare professionals.

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