Creating Clinical Spaces of Presence: A Phenomenological Study of Nurse Managers' Ward Rounds in Japan.

AIM(S): To explore and describe nurse managers' everyday practices during ward rounds in Japanese hospital settings, focusing on how perception guides practice within unfolding clinical situations.

BACKGROUND

Although nurse managers increasingly assume administrative responsibilities, they continue to maintain a clinical presence through ward rounds. Little is known about how nurse managers engage with unfolding situations and how such engagement shapes practice.

METHOD(S): A phenomenologically informed qualitative design drawing on Merleau-Ponty's theory of perception was employed. Repeated participant observations and interviews were conducted with five nurse managers. Data from all five participants were included in the initial analysis, with the final in-depth phenomenological analysis focusing on three participants for whom the relationship between perception and practice could be analytically traced across the observational and interview data.

RESULTS

Four themes were identified: Creating Clinical Spaces of Presence, Responding Through the Body, Reflecting in the Moment, and Demonstrating Managerial Presence. Across these themes, the ward rounds examined were understood as situated and relational practices in which perception, embodied responsiveness, reflection, and managerial responsibility were intertwined.

CONCLUSION(S): The findings suggest that, in the cases examined, ward rounds may involve more than routine surveillance, encompassing ongoing relational responsiveness and the enactment of managerial responsibility within everyday care. These practices suggest that nurse managers may sustain the relational world of the ward through their engagement with patients and clinical situations.

IMPLICATIONS FOR NURSING MANAGEMENT: Professional development for nurse managers may benefit from supporting perceptual sensitivity, embodied responsiveness, and reflective capacity during ward rounds, in addition to decision-making and coordination.