The Phenomenology of Knowing the Patient

Abstract

Nurses' discourse about knowing the patient emerged as a recurring theme in an interpretive phenomenological study of the development of expertise in critical care nursing. The purpose of this article is to present analyses related to the meaning of knowing the patient, and its role in everyday nursing practice. Informants in the study were 130 nurses who practiced in adult, pediatric and newborn intensive care units of eight hospitals in three metropolitan areas. The data were group interviews in which nurses gave narrative accounts of exemplars from their practice; in addition, a sub-sample of 48 nurses were observed in their practice and participated in intensive personal history interviews. Knowing the patient means both knowing the patient's typical pattern of responses and knowing the patient as a person. Knowing the patient is central to skilled clinical judgment, requires involvement, and sets up the possibility for patient advocacy and for learning about patient populations.

Strategies Used by Critical Care Nurses to Identify, Interrupt, and Correct Medical Errors

“…21 Furthermore, "knowing the patient" has been espoused as integral to achieving beneficial outcomes for patients. 18,19 Since this concept includes knowing a patient's experiences and response patterns, knowing the patient may result in better informed decision making. 18 The identification of knowing the patient as a strategy for error recovery has important implications for interventions aimed at improving relationships, communication, and collaboration among nurses, patients, families, and providers.…”

“…The nurses in this study described several error recovery strategies, including surveillance and knowing the patient, which have been recognized as integral to patients' outcomes. [17][18][19][20] Surveillance, in relation to promoting and maintaining patient safety, is defined as the purposeful, ongoing collection and analysis of information about patients and their environment. 20 Nursing surveillance is a key factor in recognizing the development of complications, whereas lack of surveillance leads to "failure to rescue."…”

Le sens de la vocation d’infirmière en oncologie : s’investir pour aider vraiment

“…Apprendre à connaître le patient, comme l'indiquent Tanner, Benner, Chesla et Gordon (1993), c'est le connaître non seulement en sachant comment il risque de réagir, mais aussi en sachant qui il est en tant que personne. La défense des droits des patients, comme l'ont décrit Bu et Jezewski (2007), est « un processus ou une stratégie qui consiste en une série de mesures précises visant à pré-server, à représenter ou à protéger les droits des patients, leur meilleur intérêt et leurs valeurs dans le système de soins de santé » (p. 104, traduction).…”

The meaning of being an oncology nurse: Investing to make a difference

“…These oncology nurses got to know and develop relationships with their patients and families over time, sometimes over several years, as patients are often admitted to hospital on several occasions, for example, for diagnostic testing, treatments and or for the management of complications. Getting to know patients, as Tanner, Benner, Chesla, and Gordon (1993) suggest, includes knowing them not only by expected patterns of response but as individual people. Nurses understand the depth and complexities of their patients through their involvement and engagement in the nurse-patient relationship (Whittmore, 2000) and gain additional insight into their needs (Wu & Volker, 2009) which can help to guide nursing decision making and judgments (Benner & Tanner, 1987).…”