title: Nursing praxis, compassionate caring and interpersonal relations: an observational study.
abstract: BACKGROUND
  The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature.
  
  
  METHODS
  Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience.
  
  
  RESULTS
  The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care.
  
  
  CONCLUSIONS
  The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised.
authors.affiliation: Faculty of Health University of Technology, Sydney, Australia. margaret.fry@uts.edu.au
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
authors.forename: Casimir
authors.initials: C
authors.lastname: MacGregor
authors.forename: Kate
authors.initials: K
authors.lastname: Ruperto
authors.forename: Kate
authors.initials: K
authors.lastname: Jarrett
authors.forename: Janet
authors.initials: J
authors.lastname: Wheeler
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Fong
authors.forename: Wendy
authors.initials: W
authors.lastname: Fetchet
mesh_terms: D004644:Emotions; D004645:Empathy; D006801:Humans; D007398:Interpersonal Relations; D007697:Kinesics; D009517:New South Wales; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology; D009730:Nursing Assessment; D019555:Physician-Nurse Relations