The Caring Relationship in Hospice Care: An analysis based on the ethics of the caring conversation

Abstract

Good nursing is more than exercising a specific set of skills. It involves the personal identity of the nurse. The aim of this article is to answer two questions: (1) what kind of person should the hospice nurse be? and (2) how should the hospice nurse engage in caring conversations? To answer these questions we analyse a nurse’s story that is intended to be a profile of an exemplary hospice nurse. This story was constructed from an analysis of five semistructured interviews with hospice nurses, based on the ‘ethics of the caring conversation’, which is inspired by the ethical perspective of Paul Ricoeur. The research questions concentrate on the norms of respect, responsibility and reciprocity, which are integral parts of the ‘ethics of the caring conversation’.

Keywords

caring conversation ethics hospice nurse palliative care Paul Ricoeur

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References

Bensing J , Van Dulmen S , Tates K. Communication in context: new directions in communication research . Patient Educ Counsel 2003; 50: 27-32 .

Larson DG , Tobin DR. End-of-life conversations. Evolving practice and theory . JAMA 2000; 284: 1573-1578 .

Wallace PR. Improving palliative care through effective communication . Int J Palliat Nurs 2001; 7: 86-90 .

Richardson J. Health promotion in palliative care: the patients’ perception of therapeutic interaction with the palliative nurse in the primary care setting . J Adv Nurs 2002; 40: 432-440

Olthuis G , Dekkers W. Quality of life considered as well-being. Views from philosophy and palliative care practice . Theor Med Bioethics (in press).

Costello J. Nursing older dying patients: findings from an ethnographic study of death and dying in elderly care wards . J Adv Nurs 2001; 35: 59-68 .

The AM. Palliative care and communication. Experiences in the clinic. Buckingham: Open University Press , 2002.

Kayser-Jones J. The experience of dying: an ethnographic nursing home study . Gerontologist 2002; 42(special issue III): 11-19 .

Georges JJ , Grypdonck M , Dierckx de Casterlé B. Being a palliative care nurse in an academic hospital: a qualitative study about nurses’ perceptions of palliative nursing . J Clin Nurs 2002; 11: 785-793 .

10.

Ragan SL , Wittenberg E , Hall HT. The communication of palliative care for the elderly cancer patient . Health Commun 2003; 15: 219-226 .

11.

de Haes H , Koedoot N. Patient centered decision making in palliative cancer treatment: a world of paradoxes . Patient Educ Counsel 2003; 50: 43-49 .

12.

Botelho RJ. A negotiation model for the doctor-patient relationship . Fam Pract 1992; 9: 210-218 .

13.

Toop L. Patient centred primary care . BMJ 1998; 316: 1882-1883 .

14.

Little P , Everitt H , Williamson I et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations . BMJ 2001; 323: 908-911 .

15.

Fredriksson L , Eriksson K. The ethics of the caring conversation . Nurs Ethics 2003; 10: 138-148 .

16.

Fredriksson L. Modes of relating in a caring conversation: a research synthesis on presence, touch and listening . J Adv Nurs 1999; 30: 1167-1176 .

17.

Ricoeur P. Oneself as another. Chicago, IL: University of Chicago Press , 1994: 172-172.

18.

Reagan CE. Personal identity. In: Cohen RA , Marsh JL eds. Ricoeur as another. Albany: State University of New York Press , 2002: 3-31.

19.

World Health Organization . Palliative care. (n.d.) Retrieved 16 August, 2004, from: http://www.who.int/cancer/palliative/en/

20.

MacIntyre A. After virtue. A study in moral theory, second edition. London: Duckworth , 1990.

21.

Ricoeur P. Het probleem van de grondslagen van de moraal. (The problem of the foundations of morality.) Kampen: Kok Agora, 1995: 33.

22.

Hermans HJM , Kempen HJG. Body, mind and culture: the dialogical nature of mediated action . Cult Psychol 1995; 1: 103-114 .

23.

Olthuis G , Dekkers W. Professional competence and palliative care: an ethical perspective . J Palliat Care 2003; 19: 192-197 .

24.

Peters V. Kwalitan 5.0. Gebruikershandleiding.(Kwalitan 5.0. Manual.) Nijmegen: Department of Methods, Radboud University Nijmegen, 2000.

25.

Miles MB , Huberman AM. Qualitative data analysis: an expanded sourcebook. Thousand Oaks: SAGE , 1994.