Nursing students' experiences of *being and *presence: A hermeneutic approach

The profession of nursing is both an art and a science. Although nursing practice intertwines the art and science of nursing, nursing education focuses on the scientific behavioral outcomes of learning content knowledge and nursing skills. The behaviorist scientific curricula of most nursing schools are not congruent with nursing practice. Therefore, the outcomes of nursing education do not pedagogically match the objectives of nursing practice. Nursing educators do not know how nursing students learn to intertwine art and science, the being of nursing. The purpose of this study was to understand how student nurses make meaning of experiences of being in nurse/patient interactions. This study was conceptualized using Heidegger's philosophy of being and Vygotsky's social constructivist theory of learning. Heidegger's philosophy describes being as a process or activity of existing. Vygotsky's theory describes the learner as a constructor of knowledge who actively searches for meaning in transactional, socially-constructed situations.;The participants were 28 sophomore nursing students, enrolled in a basic fundamentals course, and in the first year of clinical experiences with patients in acute care settings. The participants self-selected experiences to ejournal by answering six open-ended questions concerning their thoughts and feelings of being in nurse/patient interactions. The data were analyzed using an interpretive process true to hermeneutic phenomenology. Five themes were identified: fear of interacting with patients; developing confidence; becoming self aware; connecting with knowledge; and connecting with patients. A possible sixth theme was experiencing sacred space.;The relevance of the research is the understanding of the process of learning as uncovered in the students' experiences. Four conclusions were drawn from the study: student nurses intertwine the art and science of nursing in nurse/patient interactions; nursing education must be restructured to include a balance of the art and science of nursing; reflection and/or journal writing is a valuable way to enhance learning; and student nurses are developing identity simultaneously as a nurse and as a person. Nurse educators could therefore enhance optimum cognitive and psychological learning in the clinical and classroom environments.