"Multi-Beings" : a theoretical discourse on the caring relationship between nurses and patients

Background and Objectives: A wide range of requirements influence nurses and people in need of care in shaping their relationship. However, current literature focuses on singular aspects and lacks a comprehensive approach. This theoretical discourse aims to gain a deeper understanding of the nurses’ and patients’ role, thereby considering the broader context and its effects on the caring relationship. Design and Methods: Kenneth Gergen's concept of multi-beings is used for this purpose. It is based on the idea of reality as a social construction in which individuals derive their understanding of the world from social interactions. Accordingly, Gergen considers the individual as being shaped by a multitude of past relationships and interactions. These leave traces, including in the form of experiences and habits. The diverse potentials or facets are in turn brought into current social interactions, which illustrates the ‘multi-being’ and the relational character of the individual. Results: The nurses’ multi-being is based on the different levels of training (unskilled, one to several years, academic) and work experience, their values and own attitude towards the profession. Patients are shaped by their respective illnesses, a changing social environment and their need for care. For both, the individual contexts (e.g. migration and cultural background) represent further facets. As both are individual multi-beings consisting of countless facets, this shows the heterogeneity of the individual and thus the uniqueness of the encounter. The nursing relationship is therefore a dynamic process that results from the relationships and interactions that each of them has had individually and with each other in the past. Nurses experience discrepancies between expected professional behaviour, their own professional identity and actual care practice within their multi-being. Thus, they are caught between the expectations placed on them by patients, their own idea of the relationship, legal requirements and guidelines and the relationship that is actually possible. Conclusions: Transferring Gergen’s concept of multi-beings to the nursing context illustrates the complexity within which both parties act and shape their relationship together. Nurses should be supported to take a step back and explore factors contributing to their own or the patients' multi-being that may have a confluence in the relationship. This can lead to a deeper reflection of shaping the relationship.