'Being With' or 'Doing for': Fractured Caring in Chinese Community Nursing.

OBJECTIVE

To examine how Chinese community nurses experience and navigate the dual imperatives of population-focused public health services and individualised clinical care.

DESIGN

Narrative inquiry using participant-generated drawings and interviews, interpreted through Swanson's theory of caring.

SAMPLE: Fourteen female registered nurses from five community health centres in Shenzhen, China, recruited via a WeChat-based pool.

MEASUREMENTS: Narrative analysis of transcripts and drawings, examining plot, agency, affective stance, and metaphor/symbol. Coding proceeded before Swanson's caring processes were introduced as an interpretive lens.

RESULTS

Three navigational practices. EMERGED: relational triage (prioritising the proximate patient), systemic compliance (prioritising metrics and protocols), and fragmented agency (paralysis and withdrawal when both imperatives collide). These form a typology of (im)balancing caring, revealing a fracture between relational depth ('being with', 'knowing') and procedural completion ('doing for') reoriented towards system metrics.

CONCLUSIONS

(Im)balancing caring is constitutive labour generated by systemic architecture, not individual adaptation. The study's theoretical contribution is to show how 'doing for' is co-opted from patient-centred to system-centred ends. Sustaining community nursing requires recognising this skilled negotiation, supporting reflective forums, and integrating relational indicators into performance systems.