Title: How nurses handle care of palliative patients – with focus on reflection and the use of professional assessment.
The focus of this study is to investigate how nurses handle care and treatment of palliative patients in hospitals, including how they reflect on this phenomenon and use the of professional assessment in the care.
The thesis is based on three qualitative interviews with nurses, who take care of palliative patients in a hospital. The empirical data has been analyzed using Lindset and Nordbergs phenomenological, hermeneutical analysis method. Herein the findings are divided into four main discourses: anxiety of physical contact, ”by the book”, lack of clarification of reflection and professional practice.
The first three sub analyzes contain the individual dimension, where we explore the nurses’ individual experiences with palliative patients. The last sub analysis contains the group perspective, where we analyze the professional practice, to understand the social impact of the nurses’ experiences with this phenomenon.
Through analysis we found that the nurses use professional assessment in dif- ferent ways in their care and treatment for the palliative patient. With this statement we must assume that the nurses use reflection when they handle the care and treatment for the palliative patient, because it is at part of the theory “professional assessment”. Also, we found that the nurses were challenged to make these reflections linguistically and hereby to be using discourse in the care of palliative patients. This is also supported by Jack Mezirow’ theory “transformative learning” and Donald Schön’ theory “the reflective practitioner”. The conclusion was that the nurses did not make these reflections linguistically in the social professional practice.
Discussing Patricia Benner’ competence theory, we understood that the chal- lenges with making reflection linguistically through the interview, might be because of the many years of experiences the nurses have in palliative care. These many years of experiences make the nurses able to handle care and treatment with a plan of action in any situation.
These findings make us wonder how the competent nurses contribute to a common professional culture where there is focus and opportunities for improve- ments and development. This leads us to a learning design that contains a pedagogical reflection tool, which aim is to make the nurses reflect on their care and treatment of the palliative patients and therefore challenge their habits.
In our opinion, this study contributes with attention on nurses’ use of reflection in care and treatment of the patients and how it contributes to improvements and development in the common professional practice.