Abstract

Presence is a key phenomenon to the nurse-patient relationship. Placing presence within the context of caring offers a way for connection between the nurse and patient that enables the patient to verbalize suffering and interpret it in a meaningful way. Little or no research has been reported in the literature to date, however, which examines the experience of caring presence from the perspective of both nurse practitioner and patient in a relationship or the impact of managed care on caring presence. Guided by Jean Watson's theory of transpersonal caring and the actual caring occasion, this is the first phenomenological-hermeneutic study that integrated the phenomenon of caring presence, which heretofore have been explored as separate phenomena. In addition, this study described the experience of caring presence within the context of a shared nurse practitioner-patient relationship over time from the perspectives of both nurse and patient. ;From several levels of reflection on the text of conversations with five nurse practitioners and ten of their patients, the unity of meaning of the experience of caring presence was recognized as a journey toward a mutual goal. The variation in modes of being of caring presence were reflected in the following themes: mutual trust and sharing, transcending connectedness, and metaphysical experience. Understanding the experience of caring presence from the perspectives of those involved in the relationship will serve as a springboard for further dialogue and study of caring presence as an ontology for nursing. Research related to caring presence within the nurse practitioner-patient relationship in the context of a managed care outpatient system provides another basis in which to develop nursing knowledge to guide practice within the human and technological interface; it may serve as a source of information for other practice disciplines