Being and Becoming an Exemplary Nurse - an Authentic Journey

Abstract

The aims of this study were to illuminate the joint constructions of exemplary nurses and their lived experiences of being and becoming one. Inherent in being ‘exemplary’ was the notion of ‘becoming’, which involved the integration of knowledge and experiences through reflecting on the day-to-day of ‘being a nurse’. Being exemplary was not about perfection but learning from every experience and integrating these into becoming. To elucidate these phenomena, I developed a creative qualitative and participatory method informed by Guba and Lincoln’s Constructivist, and van Manen’s Human Science Approaches, underpinned by Glaser’s Emergent Philosophy. Ten exemplary nurses were recruited and interviewed three times. They also provided supplementary data such as photos, poetry and writings. This interview data was transcribed and imported into the computer programme QSR NVivo. This programme allowed for management of the raw data and facilitated coding and categorising, while remaining grounded in the whole text and its meanings. Analysis occurred through first and second level categorising and the use of writing as method. Writing became a way of knowing – assisting discovery and allowing reflection on the data in order to connect the categories and themes together in a coherent and workable whole. The above method led to the following emergent findings. The pivotal construct was Authentic Being, through living a reflective life, surrounded by the major constructs of Love of Nursing, Making a Difference, Critical Friends, Walking the Talk and Backpack patients. These constructs directed a specific and comprehensive review of both the philosophical and nursing literature. This review was not used to expand or enlarge the findings but to enlighten, illuminate and clarify. Significant philosophical ideas were extended, developed and synthesised with the findings. Noteworthy was the expansion of Heidegger’s notion of B/being: where capitalisation denotes essence and lower case symbolises the verb – to be. The use of B/being represents the merging of a person’s essence and being into one. The notion of B/being and B/becoming through time – specifically human-lived-time was also important. B/being and B/becoming exemplary was an authentic embodiment of being self with being with others – a true holistic B/being-in-the-world. The purposeful review of significant nursing theorists and the general nursing literature demonstrated that this study’s participants had attributes and skills comparable to those described and ‘called’ for. In addition, this study’s participants often went further than these descriptions, and demonstrated and exemplified a true holistic B/being – where they were more than the sum of their parts and integrated all aspects of themselves through critical reflection in order to B/be and B/become. Through synthesis of this knowledge a definition of B/being and B/being an Exemplary Nurse was developed - Exemplary nurses authentically embody being themselves – with being with others – they are B/being-in-the-world. Situated in human-lived-time they use experiences carried in their backpacks to actively ‘Be’ who they want to ‘Become’. At the spiralling intersection between past and future they use their love of nursing and critical friends to make a difference for those they care for and to walk the talk with their colleagues. The new knowledge that emerged from this research has profound implications for everyday nursing practice, undergraduate and post graduate nursing education, and for Charge Nurses and Senior Nurses, who are of vital importance as role models, mentors and critical friends. The results are significant and are important for nurses and the nursing profession and contribute to, and, advance nursing knowledge.