Relationships Among Nursing Presence, Openness, and Fatigue in Acute Care Nurses


The purpose of this study was to examine the extent to which fatigue and openness predict nursing presence in bedside nurses in inpatient acute care settings.

Background and significance

Florence Nightingale first described establishing a physical presence or "being" and providing compassionate care or "doing" as the phenomenon of nursing presence. (Watson, 1998; Boeck, 2014; Dossey, 2000). Nursing presence has been explored in nursing throughout the past several decades but the impact of nursing fatigue and degree of openness on the development of nursing presence has not been studied.

Theoretical/Conceptual framework

Kostovich’s Model of Nursing Presence, which describes the nurse –patient relationship guided this study. The focus of this study was to explore the portion of the model that depicts the ability of the nurse, as a focused observer within the nurse-patient interaction, to be open and be present with the patient. Being a focused observer, allows the nurse to listen and assess and consequently take knowledge-based action on the patient’s behalf. A better understanding of the factors impacting the nurse’s ability to be present will expand the body of knowledge specific to understanding nursing presence.


A cross-sectional sample of nurses (N=177) employed in acute care settings completed an online survey consisting of the Presence of Nursing Scale-RN version, The Big Five Inventory Openness subscale, The Fatigue Assessment Scale and the PROMIS Sleep-related Impairment Short-form.


Regression Analysis revealed fatigue is inversely correlated with the “being with” subscale (r= -.331, p=r= -.215, p=Openness was positively correlated with “being with” (r=.386, p=.001) and “doing for” (r=.275, p=.001) subscales. Pearson correlation analysis indicated fatigue and openness were inversely correlated (r= -.200, p=0.01)


Results demonstrate that nurses with increased fatigue have a lesser capacity to be emotionally present and to do for the patient. Nurses with higher levels of openness have a greater capacity to be emotionally present and perform those tasks needed for a patient. These findings suggest optimizing openness traits and minimizing fatigue may increase nursing presence and promote positive outcomes related to nursing presence.



Relationships Among Nursing Presence, Openness, and Fatigue in Acute Care Nurses