A Stratification of the Embodied Knowledge of Nursing Care Experience in Hospice Wards

Friday, 26 July 2013: 8:30 AM

Chang-Hsiung Tsai, PhD, MA, BA
Department of Life-and-Death Studies, Nanhua University, Dalin, Chiayi, Taiwan
Shu-Ling Tsai, RN, MA, BS
Department of Nursing, Chang-Gung University of Science & Technology, Puzi, Taiwan
Hsiu-Huei Lee, BA.
Hospice, Buddhist Dalin Tzu-Chi Hospital, Dalin, Chiayi, Taiwan

Learning Objective 1: The learner will be able to see how hospice care experience in nursing can be understood in terms of a stratification of embodied knowledge.

Learning Objective 2: The learner will be able to perceive the importance of embodied knowledge both in hospice clinical teaching and school education.

Purpose: This study focuses on the distilling of embodied knowledge of nurses’ caring experience in hospice wards. A stratification of a four-leveled nursing terminal care experience paralleled to Benner’s model of nursing knowledge will be identified and laid out for examination and interpretation. Though, based on the previous model, this study goes further in that it does not only provide an understanding of how hospice nurses acquire their embodied caring knowledge progressively, but also discloses the very nature of nursing care during the terminal stage; i.e., living with dying.

Methods: In this qualitative study, 12 nurse participants from three hospitals in Taiwan were recruited through purposive sampling for semi-structured depth-interviews. The years of their hospice care experience range from 3 to 20, possibly representative of the different stages from advanced beginner to expert in Benner’s model. The texts were then analyzed by the hermeneutic phenomenological method. A reciprocally interpretive circle between units of meaning, sub-themes and main themes was conducted.

Results: A four-leveled embodied knowledge of terminal care based on hospice nurses' subjective experience were stratified from the bottom up as follows. 1. learning without knowing, 2. digging out the sure, 3. one step short of penetrating, 4. going with the life flow.

Conclusion: Hospice nurses’ caring experiences are invaluable. However, given that the caring experiences are subjective in nature, they cannot be properly communicated, learned and taught if they are not first rendered into the form of knowledge. In this study, what has been portrayed is a progressive model of terminal care knowledge in terms of nursing clinical experience. It helps establish an embodied knowledge basis from which both hospice clinical teaching and school education for better nursing can be benefited.