A dialogue with excellence.
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Biomedical subjects
Publications and source records attributed to P Benner.
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A Heideggerian phenomenological approach to explanation, prediction, and understanding in the study of health, illness, and disease is presented. The extremes of objectification and subjectivism as barriers to understanding illness and suffering are explored. It is argued that meaning terms are essential when studying practical activity and relational issues, and that a privileged position is not gained by developing structural analyses or power terms that get behind or beyond meaning. Hermeneutics, or interpretive methodology, is a holistic strategy because it seeks to study the person in the situation rather than isolating person variables and situation variables and then trying to put them back together. Paradigm cases, exemplars, and thematic analysis are described as interpretive and presentational strategies.
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Systemic lupus erythematosus with renal involvement is associated with excessive pregnancy wastage as well as substantial maternal risk. The same may be said of borderline renal function after renal transplantation. We treated a patient who had both problems and who carried a pregnancy to term successfully.
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In this two-part article, the authors present strategies for clinical knowledge development, for documenting, conserving and enhancing the unique knowledge of the experienced clinician. In Part 1, they examine differences between practical and theoretical knowledge and discuss the implications for enhancing the practical knowledge nurses gain through clinical experience. Part 2, which will appear in the next issue of JONA, will examine clinical knowledge development as a means for enriching jobs, retaining experienced nurses, and improving patient care.
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When expert nurses are freed to practice nursing in the way they know is good, with others who care about positive patient outcomes, in a supportive environment, they will want to stay in that work setting and that setting will attract others of like mind. How to begin? With storytelling.
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