A phenomenological study of the Nurse's presence with persons experiencing suffering

Pettigrew, Jan McCrary
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As nurses daily confront the suffering of others, they carry within themselves an immeasurable source of comfort, that of presence. During times of suffering, crisis, tragedy, or grief, support is often defined as "being there." The invitation is to come alongside and be allowed to hear words that come out of brokenness, to see and share the woundedness of another, and at times, to gently touch and bind up those wounds. Because the cost of exposing one's suffering is extremely high, presence is always approached and experienced as a gift and a privilege.

Using a phenomenological approach, the study questioned: What are the essential elements of the lived-experience of the nurse's presence as experienced by family members or friends of a terminally-ill cancer patient?

A purposive sample of six family members of cancer patients participated in unstructured interviews after the death of the patient and recalled their experiences of the nurse's presence. The descriptions were analyzed using an adaptation of Colaizzi's (1978) procedure.

Findings revealed that the experience of the nurse's presence evolved around a time of crisis related to a deterioration in the patient's status. Presence was recognized through deliberate nursing behavior and care that demonstrated verbal affirmation, good listening and non-verbal communication skills, clinical competency, spiritual care, a sense of action beyond the ordinary, and attitudes that reflected unrestricted availability, compassion, valuing of personhood, and staying power.

Presence was identified as an intersubjective and reciprocal experience that is intangibly discerned and characterized by the nurse's vulnerability and personal investment of self. Presence was commonly referred to as "being there" and was considered a privilege to be entered into only upon the invitation or permission of the one suffering. Presence was hindered by emotional distancing and fears of emotional dependency and over-extension.

Outcomes of presence included an inspiriting experience that was both memorable in impact and made a discernable difference at the time. Presence increased coping strength, trust, self-esteem, a sense of relatedness, and a sense of being heard, while decreasing a sense of isolation and influencing perception of a healthy death experience.

Patient suffering, Presence and support, Concept of presence