Abstract

Caring in the family health experience may be intricately intertwined with the meanings discovered through interactions between the family and the nurse. The purpose of this study was to explore the phenomenon of family-nurse co-construction of meaning in the family health experience in the pediatric intensive care unit within a framework of existentialism and symbolic interactionism. A hermeneutic phenomenologic method described by Van Marten was used to explore the lived experience of co-construction as described by a convenience sample of four family-nurse dyads, four families of critically ill children and the four nurses assigned to their care who were participating in a larger study . Data were derived from semi-structured interviews regarding significant interactions throughout the child's illness and subsequent significant interactions of families with other nurses and nurses with other families. Trustworthiness of the study was addressed through prolonged dwelling within the study setting; consulting with experts in family health, nursing theory and qualitative methods; and creating a thick description of the interaction between nurses and families. ;Co-construction of meaning in the family health experience was found to have two-dimensions: interdependent and independent. Both families and nurses described being like family as an essential component of the interdependent experience. Families recognized vulnerability of the child and family and nurses realized constantly living in the family's storm of vulnerability. Independent dimensions for families were journeying through troubled waters of learning the meaning of the illness event and sensing family comfort through the nurse's care. Nurses described independent dimensions of journeying through troubled waters learning to care for families and living with another's fear, sensing empathy for families and ways to interpret situations to enhance comfort. ;Caring, based on the understanding of the co-construction phenomenon, is enhanced through actions the nurse performs on behalf of and with the family while attending to the family's unique situation. Caring actions by nurses in participation with families hold abundant potential for enhancing the family health experience and honor the ethic of caring as central to nursing. Implications for knowledge development, research, and practice are suggested