Relational Engagement as the Heart of Continuity of Care in Education
by © 2013 ~ June Kaminski, MSN PhD(c)
Presented at Xi Eta Chapter, Sigma Theta Tau International 18th Annual Ethel Johns Forum - Minding the Gap: Continuity of Care on February 2nd, 2013, St. Paul's Hospital, Vancouver, BC.
Relational engagement is a way of knowing that emerges as a nurse develops partnerships with diverse clients in a variety of different contexts. Each client is unique, requiring nurses to be able to quickly attune to the client's state of being, at all levels - physical, mental, emotional, and spiritual.
Since the beginning of nursing, presence and caring have been identified as fundamental attributes of professional nursing care and are aspects of relational engagement. Presence implies that nurses are attuned to the unique individual they are working with; they apply relational engagement and other ways of knowing, including critical inquiry, to establish a core connection with the client.
Caring goes beyond applying nursing skills, showing respect, and attending to a client's needs. Caring implies that the nurse uses her or his entire being to mutually engage with clients in true partnership, open to client choices, needs, preferences, goals and decisions. Despite the harried pace of the common healthcare context, it is important that nurses cultivate a cultural construction of health challenges from the client's perspective. An important part of this cultivation is the assurance of caring, demonstrated by authentic mutual, caring presence.
Caring presence is a state of being most readily observed through the bodily, sentient, enunciated caring behaviours demonstrated by nurses who ensure that they take the time to form a relationship with their clients. Inherent to caring presence is an attitude of sensitivity, a sense of life, and attentive and alert mindfulness: the ability to be and to act in the here and now, being totally present for the client. Nurses demonstrate caring presence by 'being there' for clients showing a willingness to relate to their experience; 'being with' to enable the feeling of comfort, and 'being in tune' while mutually creating the future and assuring seamless continuity of care.
This presentation focused on the cultivation of relational engagement in nursing education to prepare graduates who support and engage in continuity of care. To work effectively as a nurse, complex skills, abilities and knowledge are crucial. Nursing is a science that depends on clear thinking, keen observation, critical inquiry skills, and intense knowledge about the human being, both in wellness and sickness. However the science of nursing is not enough to meet the diverse needs of clients. Both the science and the art of nursing must be mastered for true therapeutic use of self with all clients. This depends on relational engagement as a way of knowing that informs nurses as they provide optimal care and establish effective nurse-client partnerships.