As I listen to nurses talk about their caring experiences I hear a lot about the impact of their work environments on their experiences.
The question in my mind is how can nurse leaders help nurses transform their caring experiences?
By caring experiences, I mean those experiences that bring meaning and renewal to each nurse.
We all agree that our work environment is riddled with work issues— staffing, assignments, resources, etc.
But I also know that our battles about work demands and working conditions are partially fueled by our confusion about caring expectations and pressures.
The nature of nursing is unique, complex, complicated, etc.
I am studying again Halldorsdottir’s research on patients’ experiential views of the nurse-patient relationship (1991). The results revealed a continuum of stages. It provides a useful structure for evaluating caring.
Halldorsdottir’s continuum spans from uncaring to caring.
- Biocidic: life destroying; nurse causes distress, despair, vulnerability
- Biostatic: life restraining; nurse is insensitive or indifferent
- Biopassive: life neutral; nurse is apathetic and detached, “just a job”
- Bioactive: life sustaining; nurse is kind, responsive, concerned
- Biogenic: life giving and life receiving for both nurses and patient; authentic connection that restores sense of wellbeing, potentiates learning and healing.
(Halldorsdottir, 1991;Watson, 2012, p.45)
What I hear from the stories that nurses share are the extremes of their biocidic experiences in their work environments and their biogenic experiences with their patients they’ve been able to carve out.
The discussions from there revolve around, How do we get to more caring in our work? This is the big question.
Yes, this journey is multi-layered.
From what I see is, just acknowledging that there are multiple layers of caring and related complexities breaks barriers, triggers thinking, opens doors, exposes vulnerabilities, reveals common ground and offers moments of peace and healing for nurses and leaders alike.
Nurse leaders have to consider the many steps required to transform a culture of caring.
Setting up opportunities to have ongoing dialogues around Halldorsdottir’s concrete caring framework is a start.