Understanding the Evolving Meaning of Care among Nurses Working in High Pressure Clinical Environments

Awaluddin Awaluddin; Hardin Hardin

doi:10.55927/fjst.v4i12.342

Authors

Awaluddin Awaluddin Sekolah Tinggi Ilmu Kesehatan Kamus Arunika
Hardin Hardin Sekolah Tinggi Ilmu Kesehatan Kamus Arunika

DOI:

https://doi.org/10.55927/fjst.v4i12.342

Keywords:

Evolving Meaning, Care, Nurses, High Pressure, Clinical Environments

Abstract

This study explores how nurses reinterpret and reconstruct the meaning of caring within high-pressure critical care environments in South Sulawesi. Using an Interpretative Phenomenological Analysis approach, semi-structured interviews were conducted with eight nurses working in ICU, emergency, and critical care units. The analysis reveals a shift in the meaning of caring from an empathic–idealistic orientation toward a more pragmatic, standardized, and safety-focused practice, while maintaining core humanistic values. This transformation is shaped by clinical stress intensity, time constraints, organizational demands, and emotional experiences in managing critical cases. The findings highlight caring as a dynamic construct influenced by nurses’ reflections and working conditions, and provide implications for workload management, psychosocial support, and nursing education to sustain care quality in high-pressure settings.

References

Anderson, L. (2022). Revisiting caring theory in high-pressure clinical settings: A contemporary perspective. Journal of Advanced Nursing, 78(4), 1551–1563.

Atkinson, P. (2021). Selecting participants in qualitative health research: A focused methodological guide. Qualitative Health Research, 31(9), 1704–1716.

Baldwin, C. (2021). Theory-experience alignment in qualitative nursing research. Nursing Inquiry, 28(3), e12415.

Cunningham, J., Evans, C., & Mathers, N. (2020). Ensuring credibility in qualitative nursing studies through methodological triangulation. Nurse Researcher, 27(2), 20–28.

Devereux, A. (2023). Emotional load and clinical intensity among ICU nurses: A global review. Intensive and Critical Care Nursing, 74, 103348.

Eatough, V., & Shaw, R. (2020). Interpretative phenomenological analysis in health psychology. Health Psychology Review, 14(2), 242–255.

Eatough, V., & Shaw, R. (2021). Developing IPA for complex emotional phenomena. Qualitative Research in Psychology, 18(3), 424–440.

Ferguson, L. (2024). Organizational support and emotional supervision in sustaining caring values. Journal of Nursing Management, 32(1), 45–56.

Gibson, M. (2023). Chronic stress and the erosion of emotional sensitivity in nursing care. Journal of Clinical Nursing, 32(5–6), 1180–1191.

Goh, Y. L., & Clarke, A. (2021). Burnout and meaning-making among frontline nurses: A phenomenological review. International Journal of Nursing Studies, 115, 103861.

Hamilton, R. (2021). Transition care burden and administrative complexity in critical care units. Journal of Nursing Scholarship, 53(2), 224–233.

Harrington, M. (2023). Meaning making in the health professions: Emotional and interpretive processes. Social Science & Medicine, 314, 115516.

Hefferon, K. (2020). Emotional complexity and IPA: Implications for nursing research. Qualitative Health Research, 30(8), 1277–1289.

Holloway, K. (2022). Work stress and care prioritization in emergency nursing practice. Journal of Emergency Nursing, 48(6), 684–692.

Hollowell, J., Rivera, D., & Mason, L. (2020). Sample saturation in phenomenological nursing studies. Nursing Research, 69(4), 302–310.

Huang, T., & Chang, S. (2021). Emotional labor and identity conflict in high-pressure nursing. Journal of Nursing Management, 29(7), 1821–1832.

Jacobs, D. (2023). Hermeneutic dialogue in IPA research processes. Qualitative Inquiry, 29(5), 523–537.

Kramer, M. (2020). Understanding caring as adaptive professionalism under stress. Nursing Philosophy, 21(1), e12271.

Langridge, D. (2022). Phenomenology in contemporary nursing research: Beyond numerical reduction. Journal of Qualitative Studies on Health & Well-being, 17(1), 2104173.

Lee, J., & Kim, H. (2021). Emotional fragmentation and care meaning under stress. Asian Nursing Research, 15(4), 210–218.

Lee, S., Park, H., & Yoon, J. (2023). Technical precision as caring in critical units: A cross-national study. Intensive Care Medicine, 49(3), 384–395.

Lopez, A. (2021). Caring in high-risk environments: Structural efficiency and patient safety. Journal of Nursing Care Quality, 36(4), 295–304.

Martinez, P. (2021). Balancing ideal caring and service efficiency in developing-country hospitals. International Nursing Review, 68(2), 214–223.

Molina, G., & Duarte, L. (2020). Shifts in empathy and care meaning under prolonged clinical stress. Journal of Clinical Nursing, 29(21–22), 4194–4207.

Morgan, D. (2023). Dialogical interviewing in phenomenological nursing studies. Qualitative Health Research, 33(1), 45–58.

Morales, J. (2023). Pragmatic caring in contemporary clinical practice. Journal of Nursing Scholarship, 55(1), 67–77.

Nguyen, A. (2022). Rapid decision-making and caring shifts in emergency departments. Journal of Emergency Medicine, 63(4), 512–520.

Ortega, L., Santos, G., & Perez, J. (2024). NVivo-supported coding transparency in IPA. Qualitative Research Journal, 24(1), 55–70.

Park, S., & Song, J. (2022). Professional identity formation in nursing: Interplay of values and environment. Nurse Education Today, 118, 105510.

Petersen, K. (2021). Reinterpretation of caring values in stressful clinical environments. Journal of Holistic Nursing, 39(3), 248–259.

Powell, A. (2022). Ethical compliance and confidentiality in qualitative nursing research. Nursing Ethics, 29(6), 1567–1580.

Rahman, S., Yusuf, A., & Chong, Y. (2022). Empathy and emotional experiences among Southeast Asian nurses. Journal of Transcultural Nursing, 33(2), 140–151.

Reid, K., & Flowers, P. (2022). IPA insights into health-care worker pressure and meaning-making. Health Psychology Review, 16(1), 58–74.

Rodriguez, M., & Nolan, P. (2023). Organizational support and caring expression under stress. Journal of Nursing Management, 31(2), 412–423.

Sankar, P., & Kumar, S. (2022). Patient safety culture as an expression of caring. Safety in Health, 8(1), 19.

Sharma, N. (2022). Cultural dynamics and caring interpretation among Asian nurses. Journal of Asian Nursing Research, 16(1), 35–44.

Smith, J. A. (2020). Foundations of interpretative phenomenological analysis. Qualitative Research in Psychology, 17(2), 176–194.

Smith, J. A., Flowers, P., & Larkin, M. (2021). Interpretative phenomenological analysis: Theory, method, and research (2nd ed.). SAGE Publications.

Smith, L., & Rhodes, R. (2022). Nursing in high-pressure environments: Changing care interpretations. Journal of Clinical Nursing, 31(9–10), 1284–1296.

Turner, J. (2024). IPA for uncovering emotional meaning in clinical staff. Qualitative Health Research, 34(2), 190–204.

Watson, J. (2021). Human caring theory in modern health care. Journal of Human Caring, 25(1), 25–40.

Watson, S., & Brewer, K. (2021). Professional identity and caring practice under organizational pressure. Nursing Inquiry, 28(2), e12389.

Wong, M., Chan, C., & Lee, T. (2021). Clinical stress and resilience among Southeast Asian nurses. Journal of Nursing Management, 29(3), 402–413.