Nurses between care and reification: A theory of inner conflicts
Stefanie SchnieringBackground
A key pillar of the nursing profession is to care for and to bear responsibility for people experiencing illness, support needs or older age. Many nurses experience inner conflicts between their commitment to deliver the best possible care, their own needs, employers’ interests and structural conditions within which they work.
Research aim
This study explores nurses’ experience of inner conflicts around their roles and the patterns of interpretation and action nurses follow to manage those conflicts.
Research design
Based on grounded theory methodology, this study analyses episodic narrative interviews. It creates a typology of nurses’ dealings with their inner conflicts, drawing on elements of critical theory, especially with the terms recognition and reification taken from Honneth.
Participants and research context
Participants were home care staff working largely with people living alone with dementia, due to the significantly increased potential for inner conflict around care in this setting. I interviewed 16 nursing professionals with a range of qualifications, all of whom delivered care for clients’ day-to-day needs in Germany.
Ethical considerations
The study adhered to the guidelines of the Declaration of Helsinki and German Society for Nursing Science. The study did not require formal ethical review under the institutional regulations. All participants provided informed consent.
Findings
Facing inner conflicts, participants reported experiencing a sense of being torn between their personal involvement with their clients and their tendency to reify them, that is, to treat them as objects. I identified four distinct types of interpretive and practical responses to this sense of diremption.
Conclusions
The prevailing conditions of professional nursing care enable reification and alienation to permeate nurse-client relationships to an extent that ultimately frustrates any attempt of individual nurses to resolve their intractable inner conflicts. Systemic and societal changes are necessary to find a lasting solution to these incompatibilities.