The Meaning of Establishing and Maintaining a Caring Relationship in the Prehospital Context as Experienced by Specialist Ambulance Nurses

AIMS AND OBJECTIVE: The aim of the study was to explore the meaning attributed by specialist ambulance nurses to the process of establishing and maintaining a caring relationship in the prehospital context. BACKGROUND: Previous studies suggest that some patients may feel overlooked or not taken seriously in encounters with the ambulance service. Even brief caring relationships in prehospital care can support well-being, strengthen patients' own resources, and help preserve dignity. However, less is known about how these relationships are experienced and interpreted by specialist ambulance nurses. METHODS: Eleven specialist ambulance nurses were interviewed digitally in Sweden. Data were analysed using a phenomenological-hermeneutic method, developed by Lindseth and Norberg based on Ricoeur's epistemology, with the aim of interpreting the meaning of the lived experiences expressed in the interviews. RESULTS: Specialist ambulance nurses' main concern was to achieve concordance, that is, a situation involving acceptance of the circumstances, consensus and concurrence in a state of harmony, leading to a caring ambulance clinician-patient encounter built on mutual trust and understanding. However, the participants also reported disruptive encounters with patients and their significant others involving resistance to the circumstances, disagreement, disbelief and a sense of frustration, resulting in a prehospital encounter built on mutual bias and misunderstanding. CONCLUSION: Caring relationships in the prehospital context are shaped by concordance and disruption, fostering relational connectedness or experiences of abandonment. Just care requires specialist ambulance nurses to recognise and challenge inherent biases, as otherwise health promotion may be overshadowed by the power to refuse care.