Nurse patient interactions: what do patients have to say?

A qualitative, hermeneutic inquiry was undertaken for the purpose of understanding the meaning of nurse-patient interactions from the perspective of the patient. A philosophical stance of hermeneutics was used to guide data collection and interpretation. The nursing theory of Modeling and Role-Modeling (Erickson, Tomlin, & Swain, 1983) provided a framework for beginning to understand the patient’s world. The participant’s perception and interpretation of all interactions was accepted as the salient reality. Convenience methods were used to identify potential informants. Members of the researcher’s dissertation committee, friends, students, and family members approached potential informants for permission to be referred to the researcher. This method provided 14 diverse informants. Four men and 10 women participated in unstructured, in-depth interviews. Interview times ranged from 20 minutes to 3 hours. All interviews were transcribed verbatim and reviewed for accuracy. Categories were developed using microanalytic coding of the transcribed data. As new categories emerged, reanalysis and recoding occurred. Data were handled using the NUD·IST software program. Use of this program simplified coding and recoding. The stories shared by these informants provided a data base for understanding the meaning of nurse-patient interactions to patients. When a nurse validated the personhood of a patient through words or actions, the patient viewed the interaction as beneficial. When a nurse objectified or invalidated the personhood of a patient through words or actions, the patient viewed the interaction as nonbeneficial. Additionally, informants addressed the notion that they were cooperative when interactions were viewed as beneficial and actively, intentionally uncooperative when interactions were viewed as nonbeneficial. Building upon these data, the author extrapolated a framework for nurses to use in their interactions with patients. This framework includes the need to have a basic understanding of personhood, the need to understand that patients are people, too, and the benefit of enacting either participatory or collaborative patient care. The primary conclusion of this study is that “patients just want to be treated like real people who really matter!” A framework for nurses to implement interactions that facilitate this process has been provided.