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Nursing Ethics, Vol. 13, No. 6, 622-632 (2006)
DOI: 10.1177/0969733006069697

The Dialectic Tension Between ‘Being’ and ‘Not Being’ a Good Nurse

Lisbeth Fagerström

Swedish Polytechnic, Sweden

The aim of this hermeneutic study was to gain a broader understanding of nurses’ workload and what characterizes a nurse’s experience in terms of the various levels of intensity of nursing care. Twenty-nine nurses participated in seven focus groups. The interpretation process took place in six different phases and the three laws of dialectics were used as interpretation rules. An optimal nursing care intensity level can be understood as a situation characterized by the balance between the intensity of care needed by patients and the external and internal factors of the current nursing care situation. The nurses’ work situation can be understood as a dialectic struggle between ‘being’ and ‘not being’ a good nurse; this can be said to be the underlying root metaphor. Nursing care can be understood as consisting of ‘complex and meaningful caring situations’. Dialectics can be used as a fruitful method of revealing the complexity of clinical reality.

Key Words: dialectics • focus group • hermeneutics • nursing care intensity • patient classification system • workload

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