Mirroring the human circumstance: An interpretive phenomenological study of student encounters in critical care

Abstract

This study explores the lived experiences of senior baccalaureate students during their clinical encounters with patients in critical care. The entering question was, "What is it like for senior baccalaureate students to experience the clinical setting of critical care nursing as they are accompanied by their teacher?" The text was constructed from the students' written stories, reflections, group dialogue, and drawings of critically ill patients. Additionally, the researcher's journal reflections and dialogue comprised portions of the text. The research is grounded in interpretive phenomenology. The philosophical grounding for this interpretive phenomenological study draws on the works of Gadamer, Heidegger, and Levinas. The methodological structure of the research was guided by van Manen's (1990) six research activities. Attention was directed to pedagogic events and situations that arose in the critical care setting. Through phenomenological reflection and hermeneutic analysis, meanings and understandings were revealed about the students' encounters with patients. Inherent in the meaning of these encounters are new possibilities for understanding students' experiences in critical care and what those experiences reveal about living in the modern epoch. Predominant themes about encountering patients amidst technology, vulnerability and shared vulnerability, sacred moments, and bearing witness to suffering were revealed through the students' lived experiences. Learning to care for patients involved students' recognizing the mystery and sacredness of personhood and being able to doubt their knowing in this highly technical practice setting. Critical care is a place that mirrors the human circumstance and calls into question what we think we know about our own inevitable finitude. When students are given opportunities for writing and dialogue about their critical care encounters, they are able to establish a sacred interconnectedness with their patients. Implications include the integration of ethical nursing concerns into nursing curricula. Allowing students to authentically recognize the patient as the profound mystery of the human circumstance helps them to experience a unity with their patient. This unity comes from knowing oneself and one's connection and unity to another. Additionally, the use of narrative pedagogy helps students feel "cared about" and teaches them to "care for" their patients.