Listening to the patient's self-reported testimony: the authentic hermeneutical witness to the compassionate nurse?

Aim: This paper considers whether the patient's self-reported testimony of nursing care provides an authentic basis for nursing knowledge. An international nursing and philosophical literature gives international relevance.

Background: United Kingdom reports detail patients' complaints about nursing care. Many are personal self-reported testimonies published in the media, but discounted by the nursing profession.

Design: Discussion paper.

Data Sources: Data sources 1873-2012 include policy documents, nursing studies involving grounded theory, phenomenology and narrative inquiry, nursing textbooks 1882-1971 and the interpretive paradigms of Glaser and Strauss, Heidegger, Ricoeur and Gadamer.

Discussion: Nursing researchers use qualitative methodologies to understand the patient's experience of nursing. Three exemplars reveal epistemological and ontological problems. Epistemologically, researchers are controlling data, their selection and interpretation. Ontologically, the researcher's present horizon dominates because no consideration is given to the historical horizon and context where the tradition of nursing developed and defined the nurse. Arguably, patients' expectations of compassionate nurses bear witness to this past horizon.

Implications For Nursing: Patients' self-reported testimonies should be taken seriously as an evidence base for understanding and improving nursing care. Nursing researchers using qualitative methods should be transparent about their pre-judgements. Connections with the past horizon of nursing history should be made to cast light on the present horizon.

Conclusion: Patients' self-reported testimonies are more congruent with methods of narrative inquiry than data solicited and filtered by the interviewer's undeclared pre-judgement. They bear witness to the horizon of the past and the meaning and purpose of nursing, its values and ethos.