Bearing witness to distress as breathlessness : a hermeneutic phenomenological study
This Hermeneutic Phenomenology (HP) study seeks to identify the experiences of Community Respiratory Nurses Specialists (CRNSs) when supporting people with breathlessness by asking the question “What are the experiences of community respiratory nurses when supporting people with breathlessness?” A purposive sample of 12 CRNSs undertook in-depth interviews via video platform to explore their experiences of supporting people with breathlessness. Analysis of the data was achieved by crafting stories from the transcripts, addressing Heidegger's notions of being-toward-death, thrownness, machination, being-with, leaping in and leaping ahead as solicitude and the state of the uncanny and then attuning to the mood of the interviews. This unconcealed the complexity of care by illuminating both the challenge and burden of bearing witness to distress as breathlessness as well as the phenomenon of fulfilment. This study brings new understanding of bearing witness to distress, aligning to emotional labour. This has historically been considered a burden for nurses because understanding has been politically driven. Second wave feminism, the work of Isabel Menzies and later Nicky James and the professionalisation of nurses have all contributed to acceptance of this position. Yet this HP study, examining lived experience of bearing witness to distress as breathlessness reveals that when the antecedents of space to process, connection with patients and teamwork are in place, this can be an opportunity for fulfilment for nurses. I suggest that in reframing emotional labour as emotional connection, a focus on fulfilment could be embedded in clinical practice, nurse education and management when examining the role of nurses across the profession. This could lead to better patient care as well as improved recruitment and retention of nurses. Further research to explore fulfilment as an outcome of implementation of these antecedents could further develop this notion.
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