Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students

Background: Nurse communication of patient needs at discharge is critical to ongoing care, but system-level demands often prohibit comprehensive discharge conversations. Caregivers of discharged patients frequently report feeling underprepared to meet patient needs. Meaningful interpersonal encounte...

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Main Authors: Marie C. Haverfield, Sara Nayeem, Meaghan Sterk, Stacy Demertzis, Deborah Szeto, Robin Whitney
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Nursing Studies Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666142X25000475
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author Marie C. Haverfield
Sara Nayeem
Meaghan Sterk
Stacy Demertzis
Deborah Szeto
Robin Whitney
author_facet Marie C. Haverfield
Sara Nayeem
Meaghan Sterk
Stacy Demertzis
Deborah Szeto
Robin Whitney
author_sort Marie C. Haverfield
collection DOAJ
description Background: Nurse communication of patient needs at discharge is critical to ongoing care, but system-level demands often prohibit comprehensive discharge conversations. Caregivers of discharged patients frequently report feeling underprepared to meet patient needs. Meaningful interpersonal encounters, or presence, are known to enhance clinical interactions amidst system-level demands, which could help improve caregiver preparedness and patient care. Purpose: To explore and synthesize examples of nurse presence during discharge conversations through Presence Circles (structured focus groups) to provide recommendations for enhancing high-quality information at discharge. Methods: In a secondary analysis of data from a larger study based on the Nurse Presence Framework, nursing students (N = 14) from a Northern California school were asked to participate in two Nurse Presence Circles. Audio recordings from 10 Presence Circles were transcribed and analysis was conducted according to the five practices of the Nurse Presence framework: Prepare with Intention, Listen Intently and Completely, Agree on What Matters Most, Connect with the Story, and Evolve System-Level Change. Results: Within each of the five nurse presence practices, strategies and challenges were collapsed into broader themes that served as recommendations for enhancing the exchange of high-quality information at discharge. Conclusions: Presence Circles offered a useful space to share strategies and identify system changes that could advance the exchange of high-quality information at discharge. We have provided a synthesis of recommendations for nurses, particularly those new to discharge conversations or early in their nursing career, demonstrating the need to engage nursing students about discharge conversations and introduce considerations related to health care systems and policy to better support the discharge conversation experience.
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spelling doaj-art-0c283fad97424682867579263b0df8cb2025-08-20T03:45:45ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810033810.1016/j.ijnsa.2025.100338Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing studentsMarie C. Haverfield0Sara Nayeem1Meaghan Sterk2Stacy Demertzis3Deborah Szeto4Robin Whitney5Department of Communication Studies, San José State University, Hugh Gillis Hall (HGH), 220 E. San Fernando Street, San Jose, CA 95112, United States; Corresponding author at: Department of Communication Studies, San José State University, Hugh Gillis Hall (HGH), 220 E. San Fernando Street, San Jose, CA 95112, United States.Department of Biology, San José State University, One Washington Square, San Jose, CA 95112, United StatesDepartment of Communication Studies, San José State University, Hugh Gillis Hall (HGH), 220 E. San Fernando Street, San Jose, CA 95112, United StatesDepartment of Public Health and Recreation, San José State University, Spartan Complex 211, San Jose, CA 95192, United StatesThe Valley Foundation School of Nursing, San José State University, CA, Health Building 420, San Jose, CA 95192, United StatesThe Valley Foundation School of Nursing, San José State University, CA, Health Building 420, San Jose, CA 95192, United StatesBackground: Nurse communication of patient needs at discharge is critical to ongoing care, but system-level demands often prohibit comprehensive discharge conversations. Caregivers of discharged patients frequently report feeling underprepared to meet patient needs. Meaningful interpersonal encounters, or presence, are known to enhance clinical interactions amidst system-level demands, which could help improve caregiver preparedness and patient care. Purpose: To explore and synthesize examples of nurse presence during discharge conversations through Presence Circles (structured focus groups) to provide recommendations for enhancing high-quality information at discharge. Methods: In a secondary analysis of data from a larger study based on the Nurse Presence Framework, nursing students (N = 14) from a Northern California school were asked to participate in two Nurse Presence Circles. Audio recordings from 10 Presence Circles were transcribed and analysis was conducted according to the five practices of the Nurse Presence framework: Prepare with Intention, Listen Intently and Completely, Agree on What Matters Most, Connect with the Story, and Evolve System-Level Change. Results: Within each of the five nurse presence practices, strategies and challenges were collapsed into broader themes that served as recommendations for enhancing the exchange of high-quality information at discharge. Conclusions: Presence Circles offered a useful space to share strategies and identify system changes that could advance the exchange of high-quality information at discharge. We have provided a synthesis of recommendations for nurses, particularly those new to discharge conversations or early in their nursing career, demonstrating the need to engage nursing students about discharge conversations and introduce considerations related to health care systems and policy to better support the discharge conversation experience.http://www.sciencedirect.com/science/article/pii/S2666142X25000475CommunicationCaregiversNursingInpatient
spellingShingle Marie C. Haverfield
Sara Nayeem
Meaghan Sterk
Stacy Demertzis
Deborah Szeto
Robin Whitney
Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
International Journal of Nursing Studies Advances
Communication
Caregivers
Nursing
Inpatient
title Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
title_full Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
title_fullStr Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
title_full_unstemmed Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
title_short Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students
title_sort using presence circles to identify strategies to enhance nurse presence at discharge a focus group study with nursing students
topic Communication
Caregivers
Nursing
Inpatient
url http://www.sciencedirect.com/science/article/pii/S2666142X25000475
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