Search

Truth is an enormously complex concept. For any person at any point in time, the truth is relative to their beliefs, perspective and context. This article explores some concepts relating to truth under three broad headings. First, the potentially competing truths that patients and professionals have, and the contexts in which they interact. Second, the ways in which culture, language and approaches to knowledge may construct truth. Finally, the concepts of ‘being with’ patients and spirituality are suggested as essential to working with patients as they navigate truth.

This article details a study that was undertaken in order to give voice and thereby increase understanding of the less articulated knowledge used in practice by palliative care nurses. An additional aim was to explore perceived influences on the development of these nurses. A hermeneutic approach was used to explore the lived experiences of seven nurses who had worked in the field for more than 2years. The themes that emerged from analysis of the data were: knowing the bigger picture, time (movement and measure), ethical dimensions, knowing and minding yourself, the ‘just’ and ‘simply’ of practice, the embodiment of being with, unseen tutors. Recommendations relating to the need for further research, practice setting and palliative education are suggested from the findings of the study.

The concept of ‘being with’ was an essential part of the hospice philosophy developed by Cicely Saunders, and one that she believed was a key element in the care of the dying. In Saunders’ philosophy, ‘being with’ is a specific moment of engagement between a health professional and a patient whereby the patient has the opportunity to examine and express their thoughts and feelings relating to their imminent death. This study examined how ‘being with’ was implemented as a part of ordinary day-to-day practice in a hospice in Scotland. The study was based on the principles of ethnomethodology, which aims to reveal embedded and taken-for-granted rules and behaviours that determine practice. The data collection and analysis revealed that the nursing practice was constructed in such a way that ‘being with’, as Saunders understood it, could not be initiated either by a member of the nursing staff or by the patients. By adopting the philosophical framework of Heidegger, the study offers an understanding of how the nursing staff had developed ‘being with’ as provision of comfort in order to protect both themselves and the patients from engaging with painful emotions associated with facing death.