Donna Frost

Discussion and conclusions 251 8 concerned, for example the patient or family member, and the situation, and to take appropriate action. The patterns of engagement have not been described and grouped together in this way elsewhere in the literature, either within or outside nursing, and are therefore a unique contribution of this study. This investigation demonstrates how nurses practising with professional artistry are able to create, nurture and work within a sheltered and shared space with the patient or other person. The literature around professional artistry does not tend to emphasize this aspect of engagement when discussing professional artistry in clinical practice, although Finfgeld-Connett ( 2006 , 2008 b) explores specifically the relationship between nursing presence, the art of nursing and caring. Other sources do link the idea of ‘presence’ with the art of nursing (Bournes & Naef, 2006 ; Iseminger, Levitt & Kirk, 2009 ; Robinson, 2014 ), although without examining the concept in relation to professional artistry specifically. Descriptions of presence and being present (Easter, 2000 ; Öhman & Söderberg, 2004 ; de Freitas, 2008 ; Newman, 2008 ; Turpin, 2014 ), are congruent with this aspect of the CCCI findings concerning the nature of professional artistry. Zyblock ( 2010 ) notes, for example, that connecting with people in this way pays attention to their lived experience and Easter ( 2000 ) describes presence as the “gift of one’s self in human interactions” (p. 362 ). Godkin ( 2001 ) also describes a connection with the patient’s experience as an important aspect of nursing presence. In the present research, being ‘seen’ and taken seriously by the nurse are central to patient descriptions within this pattern of engagement (creation of a sheltered, shared space) as is the notion of the nurse sharing something of themselves in the encounter as well. Paying attention to the creation and holding of safe spaces and establishing trust is discussed explicitly with respect to facilitating group activities (eg. Predeger, 1995 , 1996 ; Heron and Lahood, 2008 ; Dewing et al., 2014 ), and within leadership (eg. Senge et al., 2005 ; Sell, 2017 ) or coaching relationships (eg. Titchen, 2001 a; 2001 b; Titchen and Hammond, 2017 ; Titchen and Kinsella, 2019 ). Certainly the literature around establishing and maintaining therapeutic relationships in healthcare (eg. Ersser, 1997 ; Williams & Irurita, 2004 ; Freshwater, Esterhuizen & Horton-Deutsch, 2008 ; Stirling, 2015 ) pays attention to this as well. A common emphasis in the literature and in the present findings is the importance of the professional, the nurse in this case, paying genuine attention to the other and to their experience, and creating the conditions in which the other feels safe to show themselves, to share their story, and to allow themselves to be accompanied on the next steps of the journey. This pattern of engagement enabled furthermore the creation of shared understandings between the patient, or family member, and the nurse.