Endpiece: Extending ‘presencing’ in the context of enhancing patient wellbeing in nursing care

Abstract

Drawing on a single narrative of the experience of an expert nurse engaging with a patient who is approaching the end of life, this paper examines how critical moments in the crucial site of engagement were discursively and collaboratively managed. The discussion makes salient the holistic understanding of the interactional context, this understanding being captured in the construct of ‘presencing’ as key to contributing to the accounting for nursing expertise. Presencing is embedded firmly here in communication and nursing discourse, which in turn is key to nursing practice. Emphasis must then be placed on the preparation to which novice nurses are exposed, and foremost is communication within the nursing curriculum for students preparing for practice and also within postgraduate in-service programs. Presencing of itself is not necessarily “taught” formally, but is often modeled, as are many other professional behaviours, in the practice of expert nurses. However a firm grounding in the understanding of discourse practices will equip the nurse to have a better awareness of the nature of presencing since we argue that used strategically, it is firmly grounded in discourse. Central to nursing and discourse practices demonstrated by the expert nurse, is her sensitivity to, and understanding of the patient’s needs and exemplified in the appropriate use of presencing.