The Ethics of Relational Stance in Family Nursing: Resisting the View of “Nurse as Expert”

Abstract

Nurses make choices about how to situate themselves in relation to the people they encounter in clinical practice. In this article, the notion of resisting the view of the “nurse as expert” is offered as a caution against some of the ways that professional values and practices of experts can influence relational skills in clinical nursing practice with families. These ideas are based on a hermeneutic research project that explored the advanced clinical practice of nurses engaged in therapeutic conversations with families experiencing ischemic heart disease. Exemplars from the research project illustrate relational practices that can counterbalance expert professional views by explicitly acknowledging the expertise and knowledge of those persons and families encountered in practice. These practices include offering commendations, coevolving a description using the family’s language, exploring the illness story and the medical story, asking questions that invite reflection, and initiating conversations about family members’ preferences.