Giving voice to the less articulated knowledge of palliative nursing: an interpretative study

Abstract

This article details a study that was undertaken in order to give voice and thereby increase understanding of the less articulated knowledge used in practice by palliative care nurses. An additional aim was to explore perceived influences on the development of these nurses. A hermeneutic approach was used to explore the lived experiences of seven nurses who had worked in the field for more than 2 years. The themes that emerged from analysis of the data were: knowing the bigger picture, time (movement and measure), ethical dimensions, knowing and minding yourself, the 'just' and 'simply' of practice, the embodiment of being with unseen tutors. Recommendations relating to the need for further research, practice setting and palliative education are suggested from the findings of the study.

Conceptualizing Compassion as Recognizing, Relating and (Re)acting: A Qualitative Study of Compassionate Communication at Hospice

“…Susan ascribed her actions to an intuitive recognition of her patient's ''communication.'' A number of scholars have studied intuition in healthcare in general (King & Appleton, 1997) and argued that hospice/palliative care practitioners, in particular, are more intuitive due to the holistic and personal nature of work (Dunniece & Slevin, 2002). Many of our participants discussed the value of intuition and indicated that it was a much-prized communication skill.…”

Alleviating existential distress of cancer patients: can relational ethics guide clinicians?

“…According to Davies & Oberle (1990) characteristics of valuing are inherent in respecting the worth of all humans, as well as the particular individual. Accordingly, ethical codes of conduct exist to recognize and guide attitudes of dignity and choice for patients, but clinicians experience moral ambiguity in 'particular' cues that signal muted changes of deterioration or suffering, possibly unbeknownst to others (family, friends and other clinicians) (Rittman et al 1997;Dunniece & Slevin 2002;Mok & Chiu 2004 (McCaughan & Parahoo 2000). Additionally, personal experiences of cancer profoundly influenced their continuing beliefs towards cancer and its treatment (McCaughan & Parahoo 2000).…”

“…Patients experiencing this kind of stress sometimes refer to it as existential distress. God) or to others, to preserve individual personhood and dignity (Byok 1997;Chochinov et al 2002;Dunniece & Slevin 2002;Kaut 2002;Kabel & Roberts 2003). Suffering is emotionally and psychologically reported to be concerned with fears of death [dread of non-being (Kierkegaard)], with ambiguity of freedom (lacking external ways to constitute one's destiny), with isolation (the unbridgeable gulf between self and all else) and with the question of meaning [the possibility of a cosmos without meaning (Yalom 1980)].…”

“…physical or natural), to a higher power (e.g. God) or to others, to preserve individual personhood and dignity (Byok 1997;Chochinov et al 2002;Dunniece & Slevin 2002;Kaut 2002;Kabel & Roberts 2003).…”

Esthetic abilities: a way to describe abilities of expert nurses in palliative home care

“…A number of personal qualities (Mok & Chiu 2004), or abilities, are mentioned in literature concerning the creation of relations in nursing, for example: creativity (De Vries 2001), intuition (Benner 1984) empathy and self‐knowledge (Benner 1984, Dunniece & Slevin 2002). Alligood (1991) claims that emphatic ability can be strengthened by stimulating the creative potential of the nurses.…”