Caring connections: a practical way to both show and teach caring in nursing

摘要

Hospital care is changing, - dominated by the dollar and technology and the patient is taking second place. Nursing, traditionally known as being a caring profession, is not exempt from the changes and the traditional entrance interview to find caring students has been replaced by a computerised system. Graduates from university programs are being branded as non-caring. This research sought to find practical ways in which nurses showed caring to patients, and to develop a framework which could be used to teach and cultivate caring attributes in undergraduate students. A broad sweep of the past was taken to show how, dominated by disease and the necessity to take care of the suffering and infirm, nursing has been inextricably linked to the inability of science to cure. The discussion on the impact of the Therapeutic Revolution and a health care system, dominated by the dollar, places nursing and caring in perspective. Some philosophical, religious and psychological notions of caring were briefly explored. A participative paradigm underpins this research which uses a collaborative inquiry cyclical and reflective process of three phases. In Phase I a group of Graduate Registered Nurses reflected on the enacted/strategies/skills that were used to show caring to patients. Six key enactments were elicited from the total of 64 reflections that were submitted. Phase II constructed a framework that could be used to teach caring, which was then critiqued by an expert group of educators. Phase III returned to Phases I and II and used a process of reflection-on-reflection and a new emergent meaning of caring in nursing ensued. As a result of this reflection-on-reflection, a reconfiguration of the framework resulted in the development of the Care Connections model.