Angel Sanne, Vatne Solfrid
Section of Nursing, Institute of Public Health, Aarhus University, Aarhus, Denmark.
Department for Health and Social Care, Molde University College, Molde, Norway.
J Clin Nurs. 2017 May;26(9-10):1428-1437. doi: 10.1111/jocn.13583. Epub 2017 Feb 16.
To examine the mutual vulnerability of patients and nurses, anticipating that an enhanced understanding of the phenomenon may help reduce vulnerability.
Patient vulnerability is a key issue in nursing, aimed at protecting the patient from harm. In the literature, vulnerability is described both from a risk perspective and a subjective perspective. This implies that the objective dimension of patient vulnerability does not necessarily reflect the patient's own perception of being vulnerable. However, external judgment may influence internal perception. Adding to this complexity, attention has also been drawn to the vulnerability of the nurse.
A definition deduced from central literature on vulnerability captures the complexity of objective versus subjective vulnerability. Based on the perspective of vulnerability in general, vulnerability in healthcare services shows how dependency may increase patient vulnerability. Further, despite education, training and supportive settings, patients may increase nurse vulnerability. The core of this mutuality is explored in the light of Martin Heidegger's philosophy of being.
The patient's need for help from the nurse opens the patient to engage in supportive and/or harmful encounters. Thus, dependency adds to the vulnerability related to health issues. The nurse's vulnerability lies in her engagement in caring for the patient. If failing to provide proper care, the nurse's existence as 'a good nurse' is threatened. This is exacerbated if the patient turns against the nurse. Therefore, the core of vulnerability seems to lie in the fact that the patient and the nurse are both striving to be the persons they want to be, and the persons they have not yet become.
Recognition of the mutual vulnerability in the patient-nurse relationship calls for collective acknowledgement of the demanding nature of caring relationships, for support and for a strengthening of professional skills.
探讨患者与护士的相互脆弱性，预期对该现象的深入理解可能有助于降低脆弱性。
患者脆弱性是护理中的关键问题，旨在保护患者免受伤害。在文献中，脆弱性既从风险角度又从主观角度进行描述。这意味着患者脆弱性的客观维度不一定反映患者自身对脆弱的感知。然而，外部判断可能会影响内部感知。除此之外，护士的脆弱性也受到了关注。
从关于脆弱性的核心文献中推导出来的定义抓住了客观与主观脆弱性的复杂性。基于一般脆弱性的视角，医疗服务中的脆弱性表明了依赖性如何可能增加患者的脆弱性。此外，尽管有教育、培训和支持性环境，患者仍可能增加护士的脆弱性。这种相互性的核心依据马丁·海德格尔的存在哲学进行探讨。
患者对护士帮助的需求使患者容易遭遇支持性和/或有害的接触。因此，依赖性增加了与健康问题相关的脆弱性。护士的脆弱性在于她从事患者护理工作。如果未能提供适当护理，护士作为“好护士”的存在就会受到威胁。如果患者转而反对护士，这种情况会加剧。因此，脆弱性的核心似乎在于患者和护士都在努力成为他们想要成为的人，以及他们尚未成为的人。
认识到患者 - 护士关系中的相互脆弱性要求集体承认护理关系的苛刻性质，要求提供支持并加强专业技能。
