Nursing as healing work

Nurse-patient interaction is a resource for hope, meaning in life and self-transcendence in nursing home patients

BACKGROUND

Spiritual dimensions such as hope, meaning in life and self-transcendence have been found to be predictors of successful ageing, life satisfaction and well-being in older individuals. Connectedness and communicating with others have been seen to facilitate hope, meaning in life and self-transcendence among nursing home patients.

AIMS

This study aimed to investigate the associations between hope, meaning in life, self-transcendence and nurse-patient interaction in a nursing home population.

DESIGN AND METHODS

A cross-sectional design was employed, collecting data in 44 different Norwegian nursing homes (NHs) from 250 patients who met the inclusion criteria. Approval by all regulatory institutions dealing with research issues in Norway and the Management Unit at the 44 NHs was obtained. A sample of 202 cognitively intact nursing home patients responded to the Herth Hope Index, the Purpose in Life test, the Self-Transcendence Scale and the Nurse-Patient Interaction Scale. A structural equation model (SEM) of the hypothesized relationships between the constructs was tested.

RESULTS

The SEM model fit well with the present data. Significant direct relationships of nurse-patient interaction on hope, meaning in life and self-transcendence were displayed. Meaning and the interconnectedness dimension of hope appeared to be particularly dynamic resources, revealing significant influences on all the constructs in the SEM model tested.

CONCLUSION

Nurse-patient interaction influences hope, meaning in life and self-transcendence in cognitively intact nursing home patients and might be an important resource in relation to patients' health and global well-being. Thus, care providers are above all fundamental for nursing home patients. Advancing caregivers' interacting and communicating skills might facilitate patients' health and global well-being and inspire professional caregivers as they perform their daily care practices. More research of the effectiveness of such strategies is greatly needed.

LIMITATIONS

The SEM model tested comprised 20 variables, indicating a desirable sample size of n = 200, while the present effective sample was n = 187. Also, cross-sectional data do not allow making conclusion on the causality.

Teaching on the spiritual dimension in care: the perceived impact on undergraduate nursing students

The aim of the study unit, delivered in 2004-2005, to a cohort group of nursing students (n=65), who undertook the Diploma in Health Science, was to increase students' awareness about the spiritual dimension in nursing care so as to enable them to implement holistic care. The aim of this paper is to reveal the perceived impact of the study unit on students' life. This was derived from a written self-reflection account, which was submitted on voluntary basis, additional to the written assignment. The majority of students (97%, n=63) performed this written exercise which seems to demonstrate the students' interest in this study unit. Excerpts from students' written personal reflection indicate the personal, academic and professional impact of the study unit on nursing students. The positive feedback from students sheds light on the importance of teaching undergraduate students on the spiritual dimension in care. This implies that such a study unit is to be integrated within the curriculum of nursing education for the benefit of the nurses themselves and to enable delivery of holistic care.

Nursing competencies for spiritual care

AIM AND OBJECTIVES

The aim of this paper is to reveal the main nursing competencies for spiritual care, which emerged from data collecting from qualified nurses in Malta.

BACKGROUND

For nurses to deliver spiritual care, they must be competent to provide care on a physical, mental, social and spiritual level. As spiritual care may be influenced by culture, this study explored the competencies for spiritual care from the Maltese nurses' perspective.

METHODS

A descriptive exploratory study investigated nurses' competencies in the delivery of spiritual care to patients with myocardial infarction. Data were collected by means of an open-ended questionnaire on qualified nurses (n=77) followed by an in-depth interview on a stratified random sample (n=14) of nurses from the same respondents.

RESULTS

The four main nursing competencies identified were associated with the role of the nurse as a professional and as an individual person; delivery of spiritual care by the nursing process; nurses' communication with patients, inter-disciplinary team and clinical/educational organizations and safeguarding ethical issues in care.

CONCLUSION

This study demonstrated the complexity of spiritual care, which requires nurses to increase their awareness of the uniqueness of each individual patient with regard to the connection between mind, body and spirit; the assessment of the spiritual status of patients during illness and the implementation of holistic care as recommended by the Nursing Code of Ethics.

RELEVANCE TO CLINICAL PRACTICE

These findings will enable nurses to consider the importance of spiritual care, which may allow them to help empower patients find meaning and purpose during times of illness. More emphasis should be put on spiritual care in the pre- and postregistration education. Further research to translate these main competencies into specific competencies will guide spiritual care.

Taking the Eagleʼs View

Watson's conceptual model of a caring-healing transpersonal understanding of nursing was used to underpin a hermeneutic phenomenological study of the extraordinary and transformational experiences of nurse healers. The 5 essential themes uncovered from the analysis of interviews with 11 nurse healers--Belonging & Connecting, Opening to Spirit, Summoning, Wounding & Healing Journey, and Living as a Healer--are set out, along with the overarching theme "Walking Two Worlds." Foundational understandings of Watson's model as they relate to the findings, and theoretical aspects, are discussed, and potential contributions of this study to the ongoing evolution of Watson's conceptual model are articulated.

Healing Ourselves, Healing Others

Although not used in most nursing texts and journals, the term "nurse healer" is common in holistic nursing literature. Nurses who identify themselves as healers have tapped into a source of strength and confidence that adds creativity and vitality to their nursing work. In this qualitative study, the researcher asks 11 relatively "holistically naïve" medical-surgical nurses if they would label themselves as healers. Their responses reveal an inherent understanding of the multidimensionality of the healing process and the importance of relationships and therapeutic presence to the healing role.

Transformative change of self: the unique focus of (adolescent) mental health nursing?

In mental health nursing, inadequate nursing practice research has resulted in a deficit of knowledge concerning the nurse-client relationship; an area seen as the heart of practice. In turn, the specialty has experienced difficulty in identifying its unique domain of practice. Findings from a hermeneutic study into adolescent mental health nursing explicated its practice knowledge. These findings include: (i) 'engaging in therapeutic relationships'; (ii) 'guiding the potential for change'; and (iii) 'facilitating positive outcomes'. A higher order finding was named 'fostering a functional self'. These findings are discussed. Findings point to the nature, purpose and processes of the nurse-client relationship, and to outcomes from that relationship. It is suggested they also represent a beginning understanding of the specialty's unique contribution to nursing; that mental health nursing fosters transformative change of self.

Exploring the therapeutic potential of friendliness and friendship in nurse-client relationships

Friendliness and friendship, within the nurse-client relationship, are explored. Friendliness is superficial and includes nurses' smiling, joking, a warm tone of voice and interest in clients, while friendship is a deeper more affective involvement between client and nurse. The therapeutic outcomes of friendliness and friendship are significant. When nurses are friendly, client feelings of disease, strangeness and alienation are replaced by feelings of comfort, belonging and involvement. Friendship between nurse and client has similar outcomes but is a deeper experience that is simultaneously rewarding and sustaining for both. The therapeutic potential of friendliness and friendship suggests: (1) focused research would assist nursings' understanding of these concepts, and (2) determine their implications to nurse education and practice.