Testing established nursing theories and letting go of our ‘egos’ as nurses are essential to meet the challenge of decolonising nursing. At an inner-city rehabilitation hospital in the USA, patient goals and the attainment of these goals are discussed at inter-professional rounds and at different points during the delivery of therapies and nursing care. In 2016, the hospital’s nursing department chose Imogene King’s Theory of Goal Attainment as the foundational model for professional practice. Developed in the seventies, the patient and the nurse must mutually enter a level of interaction called transaction to advance goal setting and achieve attainment. With today’s advancement of Person-Centred Care as grounding principles of inter-professional collaborative practice between patients, families and staff, there was the need to revisit elements of King’s theoretical framework. Specifically, unveil gaps between epistemological and practise congruency.
A research study was conducted to explore these concepts through the lived experience lens of hospital patients. This research study aimed to uncover in-depth and unique meanings of the research question: what are patients’ understanding of goal and goal attainment? The researchers commenced purposive sampling reflecting the ethnic mix of the rehabilitation hospital after IRB approval. Face-to-face audio-recorded interviews were conducted, guided by semi-structured questions and prompts. The study used Martin Heidegger’s philosophical ontology and hermeneutics as the methodology and foundation for the research study, which fostered the use of one’s self to understand patients’ disclosures of goal and goal attainment and the need for transaction.
The research study informs the need to revisit King’s traditional model and assertion of a transactional ‘nurse-patient’ relationship. In particular, challenge nursing’s ego of knowing what is suitable for the patient and to have confidence in the patient and their family’s ability to set their unique goals and sustain attainment.