title: Lamentation and loss: expressions of caring by contemporary surgical nurses.
abstract: OBJECTIVE
  This paper is a report of a phenomenological study of caring from the perspective of nurses working on surgical wards.
  
  
  BACKGROUND
  While care and caring are complex foundational nursing concepts which have received considerable and ongoing attention from theorists, researchers and clinicians, there has been little research into caring on surgical units.
  
  
  METHODS
  A convenience sample of ten nurses working on surgical units in a public teaching hospital in Canada was interviewed using van Manen's phenomenological approach. Data were collected during 2001 using semi-structured interviews.
  
  
  RESULTS
  The major theme of lamentation and loss was identified from the data. Participants revealed a dichotomous tension between what caring should be and what actually occurs. This tension was pervasive and generated lament - an expression of grief and mourning for the loss of caring. The essential structures supporting this theme included lack of time, lack of caring support, tasking, increased acuity, lack of continuity of care, emotional divestment and not caring for each other. Loss and sadness were articulated and participants lamented and grieved about the loss of care in contemporary practice.
  
  
  CONCLUSIONS
  The forces and influences described by participants undermined caring in the new practice milieu. If this is a glimpse of the future, then the values of the nursing profession may be under siege. Caring as the central core, the essence or unifying concept of nursing may be subject to marginalization in contemporary practice.
authors.affiliation: Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada. carol_ens@umanitoba.ca
authors.forename: Carol
authors.initials: C
authors.lastname: Enns
authors.forename: David
authors.initials: D
authors.lastname: Gregory
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology; D003142:Communication; D004645:Empathy; D004993:Ethics, Nursing; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology / Q000592:standards