Reframing the meaning of life and professional values: A theoretical framework of facilitating professional care for terminally ill patients

Professional values reflect nurses' understanding of how to deliver professional care, which might influence nurses' attitudes and caring behaviors during end-of-life care. However, limited research has been conducted to explore nurses' experiences of professional development during end-of-life care, and theoretical explanations are scarce about how nurses enact their professional values during the caring process. This study explored the social process of professional values involved in end-of-life care in the Chinese cultural context by adopting a constructivist grounded theory approach. Twenty semi-structured in-depth interviews with 15 nurses from three hospitals in southeastern China were conducted. A theoretical framework emerged when focusing on the social process of "reframing the meaning of life and professional values" to facilitate professional care for terminally ill patients. Three main categories were sequentially identified as "recognizing the dilemmas when caring for terminally ill patients," "applying strategies to deal with values conflict," and "reconstructing values." This theoretical framework may be applied as a practical framework for equipping nurses with effective strategies to cultivate professional values, including the provision of adequate end-of-life knowledge, and a supportive workplace environment.

Compassion and care at the end of life: oncology nurses' experiences in South-East Iran

BACKGROUND

End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life.

AIM

The aim of this study was to explore nurses' experiences of caring for dying patients in Iran.

METHODS

A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons.

FINDINGS

Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives.

CONCLUSION

Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.

DEATH CONCERN AND DEATH OBSESSION IN IRANIAN NURSES

The goal of the present study was to examine whether nurses had increased death concern and death obsession compared to non-nursing staff. A Death Concern Scale and a Death Obsession Scale, translated into Persian, were administered to 56 female Iranian nurses (55% in their 30s) and compared to 56 female hospital staff members (45% in their 30s). The two groups did not differ significantly in their scores on either scale. It is, therefore, recommended that death education programs in hospitals be given to all staff, nursing and non-nursing.

I am only a nurse: a biographical narrative study of a nurse's self-understanding and its implication for practice

BACKGROUND

The personal is a vital part of professional nursing practice. From a psycho-social perspective, nurses produce and reproduce conceptions of the Self through experience. A literature search on nurses' self-understanding in a psycho-social perspective yields no results. Hence, the aim of this study was to investigate personal and professional experiences that may have formed the self-understanding of a nurse, and how this self-understanding may have influenced her professional practice.

METHODS

Using a single case approach, I conducted a Biographical Narrative Interview with a 50-year-old experienced Norwegian nurse. I asked the nurse to tell me the story of her life and how her work has affected her and possibly changed the way she saw herself. The overall aim of the interpretation was to understand the historically situated subjectivity in terms of the nurse's personal, social and professional constraints and chosen options.

RESULTS

The nurse's narrative of her life story made it possible to trace a common theme throughout her experiences, the experience of being "only a nurse". The nurse experienced a low status, as well as a downgrade in the competence needed to deliver quality care in professional relationships. She felt it difficult to identify with the experience of being on the bottom of the social ladder and to identify with the female, mothering ideal connected to nursing. She desired a better position, and wanted to identify with strong women. In contrast to reality, her self-understanding influenced her relationship with her patients, her professional pride and her further professional development.

CONCLUSIONS

This study shows that the professional practice of a nurse was informed by her self-understanding. This study suggests that the individual nurse must be given the opportunity to explore her professional vulnerability based on the assumption that it is both personally and socially constituted. This study indicates that the exploration of a nurse's self-understanding is one way to contribute to professional development.

The nursing discipline and self-realization

BACKGROUND

It is obvious from literature within the nursing discipline that nursing is related to moral or moral-philosophical related ideas which are other-oriented. The socio-cultural process of change in modern society implies that more self-oriented ideas have been found to be significant.

AIM

The overall aim of this article is to highlight self-oriented moral or moral-philosophical related ideas as an important part of the nursing discipline. This is achieved by (a) exploring self-realization as a significant self-oriented moral or moral-philosophical related idea based on a philosophical anthropological perspective, (b) demonstrating how moral or moral-philosophical related ideas are expressed by nurses, (c) discussing the relevance of self-realization for the nursing discipline, and (d) pointing out possible consequences for the future development of the discipline of nursing.

RESEARCH DESIGN

This theoretical study draws empirical examples from interviews.

PARTICIPANTS AND RESEARCH CONTEXT

Data consisted of interviews with 13 nurses with varying work experience within the primary and secondary somatic and psychiatric health service, from inside as well as outside institutions.

ETHICAL CONSIDERATIONS

The empirical study was approved by the Norwegian Social Science Data Services. Information was given and consent was obtained from the study participants.

FINDINGS

Findings are presented in two themes: (a) other-oriented ideas and (b) self-oriented ideas. More concretely, the findings show that nurses hope to make life as good as possible for the patient and they have a wish to improve themselves as human beings, to become better persons.

DISCUSSION

The relevance of self-realization for the nursing discipline is discussed along two lines, first, by connecting nurses' self-understanding to a horizon of identity and second, by considering what self-realization could offer.

CONCLUSION

It is of ultimate concern for the nursing discipline to highlight self-realization connected to the positive view of freedom understood as an exercise-concept. Further identifying and articulating the contribution of self-realization to nurses and nursing practice is of particular importance.