Date of Award

12-1-1994

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Teaching & Learning

Abstract

Caring is identified as a central and defining feature of professional nursing. Yet, there is little explicit emphasis on the philosophy and substance of caring in the traditional nursing program. Rather, caring is subsumed by the pressing need to stay current with expanding definitions of nursing competence and increased knowledge required by licensing boards. The purpose of this phenomenological investigation was to better understand the lived experiences of caring and knowing as expressed by senior nursing students near completion of the nursing program. Eighteen sen ior nursing students, within one month of graduation, participated in this interview study in which they were asked to describe themselves in the nursing role and to focus on particular interactions they have experienced with patients.

Descriptions of caring behaviors identified by students included listening empathy, helping, being with, not rushing, being competent, genuineness, physical comforting, touch, communication, teaching, seeing or creating positive results, and patient advocacy.

Most students described the progression from fear and anxiety in the initial days of patient care to more security in their nursing practice by the time of this study. Some students spoke with greater richness and more detail about their caring interactions with patents. These "green thumb" caring qualities expressed by roughly half of the students included: reverence for the patient, making a difference by maintaining hopeful possibility and a commitment to the patient's well-being, personal involvement, and participating in a reciprocal relationship with the patient.

Students who did not express caring occasions in as much detail and did not have recollections of patients in which they were able to articulate interpersonal care were, in most cases, found to express insecurity of either a personal nature or insecurity in the concepts and procedures involved in professional nursing. A minor theme among this group of nursing students was a pre-occupation with procedures, pathophysiology, and technology.

Implications for improving nursing student self-confidence, self-esteem, and carmg behaviors are presented. In summary, these implications are for more reflective teaching and learning in nursing education, modeling of caring behaviors by faculty, both in their interactions with students and with patients, empowering student nurses in their developing nursing practice, providing more clinical time in which students have experience with, and responsibility for, patient care, and using teaching methods which provide students the opportunity to understand the human experiences of caring and suffering through literature and the arts.

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