The perioperative dialogue : coherence in a continuous whole

Abstract

The traditional way of working in Swedish perioperative care, from the nurse anaesthetist’ and theatre nurse’s perspective, means that they will meet the patient at only one occasion, where they often are unprepared for the character of a patient’s worries or particular wishes. When the same nurse meets  the patient at three different occasions in a perioperative dialogue, i.e. a pre-, intra-, and postoperative conversation, the nurse has an opportunity to receive better knowledge about the goals of the patient. Aim The overall aim for the project was to identify expressions for health and well-being, which became evident through patients’ as well as nurse anaesthetists and theatre nurses’ experiences from the perioperative dialogue.  Methodology: The research is based on two studies where semi-structured interviews were carried out, with 18 patients and 20 nurses. Data from the interviews were analysed according to grounded theory. Results The results showed, that by using the perioperative dialogue, a continuity of care is created, both from a patient and nurse perspective. The continuity of the patient’s relationship with the nurse, and the nurse’s relationship with the patient, forms a coherent whole. When the nurse creates a caring relationship and involves the patient into the activities surrounding the surgery, the situation becomes more understandable, manageable and meaningful to the patient. Health and well-being for patients is promoted when nurses give them time and make them part of what is going to happen. Health and well-being for the nurses is promoted when they are allowed to care for the patient throughout the perioperative process. In the perioperative dialogue, the patient, in his or her relationship with the nurse, is guaranteed the responsibility of his or her own recovery and the movement towards health and wholeness. In the relationship with the patient, the nurse becomes responsible for creating a whole, a coherent whole. Conclusions The perioperative dialogue promotes the process of becoming in health and well-being through continuity of care and the sense of coherence, both for the patient and the nurse