Non-caring encounters at an emergency care unit -: a life-world hermeneutic analysis of an efficiency-driven organization

The aim of this study was to analyse and describe non-caring encounters at an emergency care unit (ECU). The research approach was life-world hermeneutics, and the research question was: what are the conditions leading to noncaring encounters at an ECU? Nine nurses and nine patients were interviewed. The interpretative analysis reveals an adaptation to organisational demands for efficiency, on the part of both nurses and patients. This form of adaptation seems to constitute a precondition for a well-functioning ECU. Furthermore, a comparison with a study of the intersubjective aspects of caring for aggressive patients reveals unexpected similarities: the carets are absent in both contexts. In nursing education and ECU-practice caring competence must thus include capacity to be present when patients express their needs worries and questions about care. (C) 2003 Elsevier Science Ltd. All rights reserved.