Donna Frost

Nature of professional artistry 181 6 The nurse’s way of being and doing make the creation of a sheltered, shared space possible. Although some nurses have a knack for this, it is none the less a skilled process requiring attention and responsiveness to the emotions, concerns and way of being of the patient. Paradoxically, it requires ‘seeing the other’ and even ‘knowing the other’ in that period before the other is known. The space cannot be created or entered into without the co-operation or perhaps permission of the patient. So in the beginning the nurse has to let something of himself be known to the patient. For example, the nurse shows himself willing and available, shows that this is the place he wants to be at this moment. He is fully present. He shows himself interested, attentive, focused. “I want to get to know them [the patient], understand their situation, what is important for them right now. I want them to feel safe, to know that I understand. Let them know I care.” (FloortjeRNI-CRC- 20121212 -p 4 ) When the patient speaks or in another way communicates their experiences or feelings or questions these are valued and accepted by the nurse: he listens and responds so that the patient is both ‘seen’ and ‘heard’. The nurse is in the driving seat in that he is facilitating the creation of a sheltered space, yet he moves with the patient, with their story, questions, experiences and emotions. “It’s all about creating connections: humour, touch, eye contact, waiting, listening, noticing emotions and reactions. I follow their lead if at all possible. I don’t just listen to what the patient says, but look behind their words.” (DylanNPI-CRC- 20140204 -p 7 ) When observing each other in practice situations we saw, heard and experienced particular ways of doing that are indicative of this pattern of engagement. We saw, for example, a physical orientation toward the patient; sometimes a removal of or bridging over of physical barriers (for example a desk) between the nurse and patient; taking a chair or stool and sitting next to the bed; eye contact; generally stillness except for nodding or moving the body forward in rhythm with the conversation; open posture; a tendency towards gentleness of reactions and expressions including smiles; smiles that reach the eyes; waiting – not jumping in; noticing the patient or resident even when walking past in the corridor and acknowledging them with a nod, a smile or a gesture such as a ‘thumbs up’. We heard ‘hmm mmm’ and other encouraging sounds; silences in which the contact