Articles of interest
05th July 2021
Book in Focus
Reflecting on Presence in Nursing
A Guide for Practice and Research
Edited by Emmerentia Du Plessis
This book is a guide to remind nurses to slow down, and be intentional, when providing nursing care. It offers a collection of wisdom to help them think about connecting, attuning, finding meaning and joy, and being relational in their nursing care.
Divided into three parts, this edited collection takes the reader on a journey of understanding what presence is, and why it is important. We share real-life stories of presence and the difference it makes. In the second part of the book, we deepen our journey by focusing on research methods. This section can be used as a point of reference when researching this difficult-to-conceptualise phenomenon. Lastly, we offer a concluding chapter, reflecting on our journey and the way forward.
In the foreword, Professor Charlene Downing writes that this book “is the birthing of caring presence in South Africa and the international arena of nursing, caring and caring presence.” She further states that readers are guided from novice to applicant and that the collaborative and reflective approach in the book creates a philosophical framework for presence.
Professor Maria Grypdonck states that this edited collection “gives words to the presence that is so often manifested and experienced in nursing care. It conceptualises the presence that often remains unarticulated in nursing practice. It increases our understanding of the phenomenon. It provides hints and guides for researching the phenomenon so that our understanding of it, and its adequate practice may increase.”
One of the collaborators, Lillian Kalimashe, summarises her impressions in the following way: “Ever wondered what makes you, as a healthcare practitioner, be willing to give a listening ear to a person in need? To avail yourself to helping the person, even though you have never met them before? Well, the answers you will find in this book. The book will take you through a journey of understanding yourself as “human”, not just as a healthcare practitioner. It will reassure you that there’s absolutely nothing wrong in you wanting to help, in you exposing yourself to another to help and somehow being able to understand circumstances in which others find themselves. The root of all healthcare practitioner-patient interactions is the “human-human”, “I-You” relationship. This book will break down this unique interaction, and will let you see yourself through caring eyes and also reassure you that it’s okay to be human in caring for the other.”
Presence is a whole lot of things we are not aware of; it is of greater impact to humans as carers than we give it credit for, but the book will bring all that to light. Presence allows both the patient and nurse to benefit from their interaction. The humanistic approach on which the interaction is based brings out the similarity of being human into the shared relationship, before sharing the patient-nurse space. Presence in health care communicates, “I may not know how you require me to care for you, but if you communicate it to me, I promise to pay attention and hear. Allow me into your space and I promise I will not judge, but I will embrace and respect your individuality.”
The book shares experiences, ideas and guidance for “presence” and, most importantly, takes you through some of the research-based knowledge on presence for evidence-based practice. Presence is an art of practising the science of health care.
The words of another collaborator, Rudo Ramalisa-Budeli, are equally inspiring, as she focuses on ways to cultivate presence in nursing: “Today nursing care is based on decision making, planning and delivering, technological expertise, and profit-making healthcare facilities. This has replaced the real essence of the profession, which is to care and to be present when the patient is experiencing discomfort. This presence moves away from just being available to being there for the purpose of being there. There are various ways for nurses to cultivate presence. One way is through mindfulness meditation. This solitary practice has been associated with various benefits, including being aware of internal and external experiences, feelings, and thoughts. Nurse theorists recommend that nurses engage in self-care practices for efficiency in care provision. In addition, mindfulness can prove to be useful as the practice unifies the mind, body, spirit, and heart, allowing the nurse to be truly present to the here and now. This will further influence healthcare delivery to patients as the care provided will be superior and unique to the care receiver.”
Kathleen Froneman, also a collaborator in this edited collection, shares her thoughts and gives us a glimpse into what to expect when reading our book: “Presence and reflective practices are a “way of being”. They are about “being with” and “being there” for the other. Nurse educators fulfil this vital role in facilitating presence through reflective practices to nursing students that will contribute to producing competent reflective practitioners who will be present with their patients. Many think that presence is a difficult and complex concept to grasp because of its variety of uses and definitions appearing in the literature. Presence is a behaviour, a “way of being”, such as a smile, listening to someone, an appropriate touch, accepting the other as a human being, showing respect, demonstrating honesty, and being sincere. Nursing as a profession is characterised by care and compassion. Presence is about caring for another and demonstrating compassion to them. As a nurse educator, I embrace the need to show care and compassion to my nursing students. My dream is that my presence in the lives of my students will be imprinted on their hearts and last a lifetime. I ought to invest in their present actions and behaviours so they will feel safe, inspired, and confident, and know that they are important. This book will assist you in understanding presence, how it can be discovered and internalised, and the use of various authentic examples and previous research on presence. It will make a difference in the lives of all professions personally, as well as professionally.”
Jan den Bakker, a collaborator in writing Chapter 5, about relational leadership, provides a short introduction to this important chapter: “The ideas about what management is, are fixed, accepted and often undisputable. Mainstream management is about rational intervening in organisations to achieve performance indicators and goals. In this chapter, we argue that there is more. There is also purpose, based on a deep understanding of what care is about. And there is messy complexity. There are no easy answers. So instead of giving answers, management is about searching together, asking questions and making sense of what’s is happening. It is a relational activity. Accepting presence as a valuable concept is also about accepting management as a relational activity. You can still do a lot of things. But what you do is foremost relational interfering and not managerial intervening. What you can do to contribute to good care is presented in this chapter.”
Jan concludes, and, in these words, summarises the heart of our book. However, besides doing, the bigger question under the surface is always: who am I, or who do I want to be? Consequently, this is about taking moral responsibility for one’s actions.
Emmerentia du Plessis works as a Professor at the School of Nursing Science of North-West University, South Africa. She conducts research on presence in nursing, and provides supervision to post-graduate students. She has published numerous articles and book chapters on the topic of presence, as well as issues such as communication skills, psychiatric nursing and nursing education. She also offers a community counselling service, and initiated several social media platforms to create awareness about presence in nursing.
Reflecting on Presence in Nursing: A Guide for Practice and Research is available now in Hardback at a 25% discount. Enter PROMO25 at the checkout to redeem.