Abstract:
The focus of this study was on understanding the caring nature of the nurse-client relationship as reflected in a story of nursing practice. The story was examined and understood using an interpretive approach which emerged over time and reflected the exploratory and intuitive nature of the work.
The processes of reflection, immersion and crystallisation were used to generate an exploratory theoretical work on caring. The method was called 'The Hermeneutic Wave' because it focused on interpreting and understanding textual reflection of experience, and reflected the ebb and flow nature of the processes of interpretation used. These tidal processes involved moving out of the story to conceptualise what was occurring within the story from a general perspective, and then re-layering the conceptualisations back over the story to examine congruity and differences, and to uncover understanding and meaning of practice. These processes were repeated until 'The Moment of Caring: A Manuscript for Reflection on Caring Moments in Nursing Practice' emerged.
The manuscript consists of four phases; Phase One - Readiness to Co-participate, where the nurse and client fulfil expected health related roles and their relationship is characterised as one of apartness where they are relating in regard to their distinct roles; Phase Two - In Relationship, where the nurse and client are in the process of moving from a relationship characterised by apartness to that of oneness where they relate as person-to-person; Phase Three - 'The Moment of Caring', where the nurse and client transcend relating from a position of apartness and relate as one; and Phase Four - Redefining Wholeness, where the nurse's and client's understanding of their shared experience results in growth in their beings, and where their relationship moves from oneness to apartness in response to this growth.
The manuscript 'The Moment of Caring' provides nurses with a framework for reflection in as well as on nursing practice, offers an emerging exploratory approach to the development of theory from practice, and contributes to the growing body of knowledge of caring within nursing practice in New Zealand and internationally.
