A Heideggerian analysis of good care in an acute hospital setting: Insights from healthcare workers, patients and families.
Jan DewarCatherine M CookElizabeth SmytheDeborah SpencePublished in: Nursing inquiry (2023)
This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research investigated accounts of good care provided by nursing, medical, allied and auxiliary staff. The Heideggerian phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, communicative nature of care. The study involved interviews with 17 participants: 3 previous patients, 3 family members and 11 staff. Data were analysed iteratively, dwelling with stories and writing and rewriting to surface the phenomenality of good care. The data set highlighted the following essential constituents: authentic care: caring encompassing solicitude (fürsorge); impromptu care: caring beyond role category; sustained care: caring beyond specialist parameters; attuned care: caring encompassing family and culture; and insightful care: caring beyond assessment and diagnosis. The findings are clinically significant because they indicate the importance of nurse leaders and educators harnessing the potential capacity of all healthcare workers to participate in good care. Healthcare workers reported that participating in or witnessing good care was uplifting and added meaning to their work, contributing to a sense of shared humanity.
Keyphrases
- healthcare
- palliative care
- quality improvement
- affordable care act
- mental health
- chronic kidney disease
- primary care
- hepatitis b virus
- newly diagnosed
- risk assessment
- electronic health record
- health insurance
- liver failure
- acute respiratory distress syndrome
- end stage renal disease
- advanced cancer
- health information
- chronic pain
- mechanical ventilation
- artificial intelligence