Relational care: learning to look beyond intentionality to the 'non-intentional' in a caring relationship.
ABSTRACT This paper considers the implications for nursing practice of what the continental philosopher Emmanuel Levinas described as the 'non-intentional'. The place of the non-intentional emerges from a critique of Buber's conception of the 'I-Thou' and the 'I-It' relations, and is revealed to a person in the moments prior to the grasping of conscious understanding. A specific incident that took place between a nurse and a person diagnosed with dementia is described and then used to illustrate an exploration of the 'I-Thou' relation and then the non-intentional. The nurse practitioner's pre-understandings of the term dementia are shown to have hindered the emergence of an 'I-Thou' relation and the possibility of a non-intentional glimpse of the otherness of the other. It is suggested here that the plausible associations that become synonymous with a diagnosis like dementia detract from attentiveness to another 'person'. The more tangible an understanding of another person becomes, the less likely it is that a person can really experience the other as separate to their perception of them. The implications for practitioner education and learning in relation to the non-intentional are considered, in particular the need to reflect on the immediacy of the feelings experienced in a relationship. The non-intentional highlights how 'I', as a nurse practitioner, can exclude the other by imposing an understanding on what is seen and experienced in relation to another person. The 'I' prioritizes intentional understanding and so obscures the importance of the spontaneous response to the tear in the eye of the other, which is the basis for Levinas's conception of the non-intentional. The spontaneity of the non-intentional is what Levinas believed confirmed the separateness and autonomy of the other and consequently should be the basis for a therapeutic nursing relationship with a patient.
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ABSTRACT: Health care leaders in the 21st century face challenges that stem from issues concerning quality care in a cost efficient environment while maintaining customer satisfaction. Technology has played a vital part in offering more advanced diagnostic and surgical equipment. The proliferation of technology has resulted in documentation at the patient’s bedside with computers-on-wheels, workstations-on-wheels, and electronic handheld devices. The problem iterated in the study is that the technological age challenges nurses to maintain a caring and healing environment as computers are brought to the bedside and used as a method of documentation by nurses. The quantitative ex post facto study examined patient satisfaction scores from 1990 to 2011. The purpose was to determine if the nurses transition from paper documentation to partial paper documentation and computer documentation at the nurse’s station to complete computer documentation at the bedside impacted patient satisfaction. Descriptive, inferential, parametric, and nonparametric testing were used to test the hypothesis. The findings from the study suggested that patient satisfaction increased with complete computer documentation. The results of the study could be instrumental in assisting health care leaders to find solutions to improve patient satisfaction. The recommendation for future research is to conduct a satisfaction survey with the use of an instrument that consist of items that are designed specifically to measure patient satisfaction with nursing care when computers are used for documentation at the patient bedside.09/2012, Degree: Doctorate in Heath Administration, Supervisor: Marlene Mahle-Gordon
Article: A concept analysis of otherness.[Show abstract] [Hide abstract]
ABSTRACT: Otherness is an important concept in understanding the health provider-patient relationship and in creating insights into how to be more present with patients and families. This is an analysis of the concept of Otherness that leads to a definition of the construct.Holistic nursing practice 03/2012; 26(2):87-91. · 0.34 Impact Factor