The Caring Relationships Created by Nurse Practitioners and the Ones Nursed: Implications for Practice

Joan D. Thomas, PhD, RN, BC; Linda P. Finch, PhD, RN; Savina O. Schoenhofer, PhD, RN; Ann Green, PhD, RN, BC, A/G/FNP


Topics in Advanced Practice Nursing eJournal. 2004;4(4) 

In This Article

Abstract and Introduction

Context: Nurse practitioners (NPs) are called to embrace caring as the focus of their own being and nursing identity. What distinguishes the care of NPs is 2-fold. First, it is their willingness to talk with the ones being nursed, listening very carefully and paying attention to details. Second, with that detailed information, NPs are then able to tailor treatment regimens to match preferences and lifestyles at the same time that they provide teaching and health promotion. NPs are beginning to examine theories that describe the practice of their profession.
Objective: The objective of this phenomenological study is to uncover the caring experienced in the NP-nursed relationship. Implications for advanced practice nursing are discussed. The study is based on the theory of Nursing as Caring, developed by Boykin and Schoenhofer.[1]
Design: The design was Schoenhofer's Nursing as Caring research praxis approach.[2]
Setting: All key informants were interviewed in their respective outpatient settings.
Patients: The 14 key informants were composed of 7 dyads, each consisting of an NP and the one being nursed.
Main Outcome Measures: Attributes of the caring between the NPs and the ones nursed composed the main outcome measures.
Results: The themes emerging from the dialogue data were love, respect, trust, mutuality, spiritual expression, and enhanced personhood.
Conclusion: From the results of the study, 3 major implications for advanced practice nursing emerged. Spirituality proved to be a significant factor in the caring between the NP and the nursed. The caring created in the relationships resulted in the enhanced personhood of NPs. The caring emanating from the NP enhanced the personhood of the ones nursed beyond immediate physical needs. Conclusions from the study also suggest avenues for additional research as well as a potential influence on the education of NPs.

Caring is the central and unifying focus of the nursing profession.[3] Caring characterizes an essential human need and is the foundation of professional nursing. A full understanding of caring and the ways it manifests assists nurses to provide quality healthcare.[4] Caring is more than being physically present; the nurse's caring is directly related to the satisfaction and sense of well-being of the patient (the one who is nursed).[5] Nursing is based on the understanding that nursing involves the nurturing of ""persons living, caring, and growing in caring (p. 12).[1]"

Moreover, advanced practice nurses, specifically nurse practitioners (NPs), are called to embrace caring, not simply as a task or professional obligation, but as the focus of their own being and nursing identity.[6] A distinctiveness of NP practice resides in the tendency to dialogue with, and really come to know, their patients (the nursed) and then tailor treatment regimens, including appropriate teaching and health-promotion activities that match patient preferences and lifestyles.[7]

NPs are beginning to examine nursing theories for their application to their professional practice. The testing of theory is imperative to the growth of NP discipline.[8] However, there has been little theoretically based research that examines the caring occurring between the NP and the nursed.[5] Therefore, the purpose of this phenomenological study was to discover the caring experienced in the NP-nursed relationship and examine the implications for advanced practice nursing. The study is based on the theory of Nursing as Caring, developed by Boykin and Schoenhofer.[1]


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