Caring in the Nursing Practice of Mid-Career Generalist Nurses at an Acute Regional Support Hospital

Aim and Objectives: This study aimed to elucidate the current state of caring in nursing practice in Japan by mid-career generalist nurses following the implementation of a community-based integrated care system at an acute regional support hospital. Background: With the promotion of functional specialization of medical care throughout Japan, the mean length of hospital stay at acute regional support hospitals is decreasing. Understanding the current state of caring (consideration and concern) for patients by mid-career generalist nurses who promote nursing practice to discharge or transfer patients in short-term hospitalizations is important as it will help determine the impact on caring in Japan. Design: Qualitative descriptive study Methods: We conducted semi-structured interviews with six mid-career generalist nurses working at acute care hospitals in Japan. Narratives about caring (consideration and concern) for patients were recorded verbatim and were qualitatively analyzed using a qualitative inductive approach. Results: We determined five categories of caring (consideration and concern) by mid-career generalist nurses in Japanese acute care hospitals: respect for individual patients and protection of their safety, accurate observation of symptoms, working on the strengths of the patient, working on the strengths of the family, and having a good understanding of the role of an acute care hospital nurse. Conclusions: Assuming that respect for patients and the protection of their safety are the basis for mid-career generalist nurses at acute care hospitals, we found that with a good understanding of the role of acute care hospitals, mid-career generalist nurses have been entrusted with intervention for families and nursing care after discharge. We also found that concern for each terminal phase patient arises during the course of care, which is difficult to share. Caring (consideration and concern), which is the core of nursing care, arises through situations and relationships. In the event of hospital transfers or transitions to home care from short-term hospital stays, sharing information with the local individual in charge is an issue, and the continuity of caring in nursing practice should be examined from the perspective of the patients’ and nurses’ satisfaction.