The care encounter: Pondering caring, honest communication and control

Abstract

The proposition presented in this paper is that caring, underpinned by beneficence and non-maleficence, assumes that nurses will make determinations about another's best interests and act accordingly. With some emphasis on high-level (nursing home) aged care, it is the author's contention that nurses give priority to communication that controls the care encounter rather than acting in another's best interests. This view is supported in the literature, which suggests that nurses perceive honesty and information-sharing as less important in caring than do patients, and nurses' perception that telling another the truth is harmful and, therefore, contravenes the duties of beneficence and non-maleficence.

Encounters in Swedish nursing homes: a hermeneutic study of residents’ experiences

“…Being nobody in our study could also mean not being listened to as a resident, experiencing that nurses did not listen or consider different actions based upon the residents’ own will. In a review Tuckett (2004) stated that nurses in the care of older people perceive honesty and information‐sharing as less important in caring. Instead nurses are often intent on having control over the situation rather than acting in the best interest of the patients.…”

Nurse-patient interaction and communication: A systematic literature review

“…Alternatively, the closely related model of systemic constructivism was used (Darmann 2002;Flaskerud 1986). Both define interaction as a mutual process of in- RCT Brown 1997;Carlson 1972;Castledine 2004;Darmann 2002;Davies 1994;Flaskerud 1986;Fry 1994;Gastmans 1998;Harding 1987;Klein 2005;Lein and Wills 2007;Lomax 1997;Moreira et al 1997;Nordby 2006Nordby , 2007Sarvimäki 1988;Scheiner and Knipfer 2006;Smith-Stoner 1999;Sumner 2001;van Maanen 2002;Watson 2005;Williams et al 2005b Non-research literature Caris-Verhallen et al 1999b;Chatwin 2008;Cossette et al 2006;Daubenmire et al 1978;Jones 2003;Mallett 1999;Oliver and Redfern1991 Proposed/developed methods Canales 1997;Caris-Verhallen et al 1997;Mathews 1983;May 1990;O'Kelly 1998;Routasalo 1999;Shattell 2004;Tacke 1999;Tuckett 2005;Turnock 1991;Walther 2003;Williams 2001 Qualitative reviews …”

“…Communication constitutes an important part of the quality of nursing care and predominantly influences patient and resident satisfaction; it is a core element of nursing care, a fundamentally required nursing skill (CarisVerhallen et al 1999a;Dean et al 1982;Gastmans 1998;Hansebo and Kihlgren 2002;Hewison 1995b;Jones 2003;Rundell 1991;Tuckett 2005;Williams and Gossett 2001;Williams et al 2005a).…”

“…Like communication, relationships are unique situations (Anderson 1979) and are mutually constructed whereby the professional nurse-patient relationship is responsive and intersubjective (Aranda and Street 1999). It is this interpersonal relationship that makes the difference between nursing and caring (Tuckett 2005). The nursepatient relationship is said to be of importance for patient participation in nursing care (Millard et al 2006).…”

On paternalism, autonomy and best interests: Telling the (competent) aged‐care resident what they want to know

“…This paper is derived from the review of literature from a recent qualitative study on truth‐telling, conducted in the largest, privately operated, aged‐care organisation operating in Queensland, Australia 7 . The theoretical framework and attendant research methods and analysis have been briefly discussed elsewhere in this journal 8 …”