A Phenomenological Study of Nurses Philosophy of Nursing Care.

Abstract

Abstract: Introduction: Nursing and its philosophy is the main under consideration phenomenon of present research. Nursing is a human sciences, and it has been descripted as an applied or practical field. It is expected from nurses that, they act according to professional values that they have learned in the education period. Presence of an inner philosophy and attitude is necessary to do any act. Also, the benefit in values is necessary in order to develop the sense of professional obligation and social responsibility, and apart from the work unit of nursing on work area, the activity and development of the nursing is effective as a profession. The reviewed texts are indicative of the limitation of research about meanings and origin of nurses' behaviors and the relations between the meanings of behavior and existing values in it with "I" (Individual). It is also, indicative of limitation research about finding the value collection of them. Therefore, the aim of present study is to find meanings, the origin of appearance, development of beliefs and nurses' values in nursing care of patients, also the quality of the generation of resulting and important beliefs and their continuance on the line of different possibilities. In order to achieve above aim, this study is going to answer these questions: 1) what are the meanings and causes of nurses' behaviors in nursing care? 2) What are the nursing paradigms in description of nurses' experiences? Method and Material: Interpretative phenomenology, especially, Heidegger's hermeneutics was as a field to perform this study. It is the method Heidegger use it in order to find new possibilities in the available conditions. In other words, separated man and a person from conditions is not imaginable and real. Phenomenology is a special philosophical method that wants to find out the meaning and essence of "subject" (itself) before the pollution of it by preconceptions and presuppositions. And the meaning of Hermeneutic is philosophical interpretation or to find the hidden and interpretative meanings. At first 10 participants were interviewed by purposeful sampling. The type of interview was deep and unstructured. After the primary analyses and extraction of common themes, another 5 persons of employed nurses in Tehran, Kermanshah, Urmia, and Khoy were interviewed. All of the interviews were transcribed and were analyzed. The analysis of information was carried out hermeneutically using the Diekelmann seven –stage method. Findings: The analyses of the findings lead to extraction of 50 common themes. And on the basis of them, 10 main themes and 3 connecting patterns and one acceptable philosophical model which were indicative of themes belonging were extracted. Respectively, the patterns and main themes (in the parenthesis) are considerate: 1) the patterns of "adaptation with managerial issues, organizational, individual and professional values for the achievement of nursing human care" (the management as a provider of the condition of care –supportive and preventive behaviors of the manager –management based on values). 2) The pattern of "Clarifying of the value. Expectations and meaning of caring emphasizing on the attitudes of politicians, doctors. Nurses, patients, community and organization culture for the achievement of good care and good nurse" (nursing and caring from the nurses' view –nurses' belief about doctor, expectations from nursing -nurses' belief about politician and organizational holders expectations from nurse –nurses' belief about patients expectations and society from nursing.). 3) The pattern of "exploring meaning of self –possessed and identity", (emphasizing on the context and situation of the work, individual personality, empathy and belief in God and conscience). And at the end, philosophical model is by the name of nursing philosophy in the fulfilment of human care. That is resultant of related to each other effects of trial patterns. Conclusion: In this study with due attention to participants viewpoint, allocated meaning to paradigms of person, health, situation and nursing and also some of the reasons which nurses presented for showing their care as a nurse, such as interest, relaxation of conscience, God satisfaction, fear of results, hope of spiritual rewards, satisfying their individual needs, superior satisfaction, feeling of responsibility have been presented. On the basis of the findings of this study, some suggestions have been presented at the end of dissertation for next researches that can be used as an appropriate guidance in order to collect the educational and supportive programs for employed nurses in clinical settings and help them to change their thought and achieve the dignity and appropriate altitude.