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The concept of presence evolved from the philosophical roots of several disciplines (McKivergin and Daubenmire, 1994). It relates to the essence of nursing practice and is commensurate with nursing theories of care. McKivergin and Daubenmire argue that the provision of compassionate care requires a sensitivity to the many dimensions of the self and invoke the theory of presence, first introduced into nursing literature in 1976 by Paterson and Zderad, as a route to understanding therapeutic relationships that entail ‘being with’ as well as ‘doing with’. Presence entails personal and professional dimensions: the personal uniqueness that each nurse brings to the nurse-patient encounter, and the professional context of that encounter, which is goal-directed.
In the belief that the process of being present can be consciously explored, experienced, evoked, taught and learned, McKivergin and Daubenmire operationalise the process at different levels of practice and identify related types of contact and skills needed for the practice of presence in nursing: physical, psychological and therapeutic presence.
As a nurse moves through these levels of presence, the nature of contact moves from ‘being there’ to ‘being with’ to ‘relating to the patient as whole being to whole being’. Cingel (2011) extends these notions by arguing that ‘being there’ is a conscious choice and not a coincidence; the nurse notices the need for presence. Presence is intentional.
Sources:
Cingel, M. van der (2011) Compassion in care: A qualitative study of older people with a chronic disease and nurses. Nursing Ethics 18(5): 672-685
McKivergin, M. J. and Daubenmire, M. J. (1994) The healing process of presence. Journal of Holistic Nursing, 12(1): 65-81
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