Nurses' perspectives of self-awareness in nursing practice: A descriptive qualitative study

Affiliations.

  • 1 Faculty of Nursing, Memorial University of Newfoundland, St. John's, Canada.
  • 2 Shifa College of Nursing, Islamabad, Pakistan.
  • 3 Al-Shifa Eye Trust Hospital, Rawalpindi, Pakistan.
  • 4 College of Nursing, Isra University, Islamabad, Pakistan.
  • PMID: 31837204
  • DOI: 10.1111/nhs.12671

Self-awareness is essential for nurses for improving nurse-patient relationship and patient care. There are many theories about self-awareness, but scant research explores nurses' perspectives regarding self-awareness and its significance for themselves and patient care. This study explores nurses' perspectives regarding self-awareness in nursing, the importance of self-awareness for nurses, and its influence on patient care. We used a descriptive qualitative design. Face-to-face semistructured interviews were conducted, from October to December 2018, with a purposive sample of 13 nurses at two hospitals in Pakistan. Thematic analysis was used for data analysis. Five themes and 13 subthemes were generated. The themes included the meaning of self-awareness: a personal, professional, and conscientious attribute, significance of self-awareness for nurses, self-aware nurses and its impact on patient care, behaviors, and actions signifying self-awareness, and what is needed to enhance self-awareness. Self-awareness can increase nurses' confidence in managing challenging situations and providing culturally competent care to patients from various cultural and religious orientations.

Keywords: nurse-patient relationship; nursing practice; qualitative research; self-awareness; self-knowledge.

© 2019 John Wiley & Sons Australia, Ltd.

  • Interviews as Topic / methods
  • Nurses / psychology*
  • Qualitative Research
  • Self-Assessment*

American Association of Colleges of Nursing - Home

Self-Awareness

Caring, the basis of good nursing, depends on you knowing more about who you are.  We cannot help others unless we have a clear idea about who we are and what we value. For the nurse to be able to use the self therapeutically, understanding the self is required.

Self-awareness is the ability to, and process of consciously looking at oneself objectively and to identify and process information important to one’s well-being.  Development of self is affected by biological, psychological, social, and cultural factors.  Awareness of self includes the ability to recognize and evaluate the effects of internal and external stimuli.  These stimuli include behavior, needs, motives, attitudes, values, feelings, perceptions, assumptions, thoughts, beliefs, and interactions with one’s environment.  

The purpose of engaging in self-awareness is understanding the personal inner world and the interpersonal outer world. The insight and understanding achieved through self-awareness enable management of feelings, thoughts, and actions in order to protect and improve oneself. More succinctly, “Self-awareness is a multidimensional, introspective process used to become aware of, scrutinize, and understand one’s thoughts, feelings, convictions and values on an ongoing basis with the use of this understanding to consciously and authentically guide behavior” (Eckroth-Bucher, 2010).

The ongoing process of self-awareness can be organized as follows:

  • Intrapersonal: focuses on exploring the nurses’ personal self and examining personal thoughts
  • Relational: allows oneself to analyze oneself in relation to other people and connect personal thoughts and feelings with that of others
  • Extra-personal: continuously expands beyond personal self and focuses on the analysis of the environment
  • Contextual: focuses on intrapersonal, interpersonal and extra-personal analysis within a given context or situation
  • A cognitive activity

Possessing a clear sense of self-awareness will help nurses engage professionally with a diverse patient population and modify behavior as needed. The self-aware nurse is able to:

  • Better assess one’s ability to provide care and assess patient needs
  • Pivot when needed in evolving situations
  • Prevent situations from getting out of control
  • Maintain self-esteem and self-efficacy
  • Be confident in difficult situations
  • Build strong skills in the area of resilience, decision-making, and communication
  • Improve interpersonal and professional relationships

Strategies for increasing self-awareness include:

  • Reflective journaling (diary)
  • Reflective practice
  • Using portfolios
  • Seeking feedback from others
  • Noticing (paying attention to one’s feelings, thoughts, and actions; developing greater understanding of those feelings; seeking feedback and appraisal from others; and then comparing personal beliefs with others)
  • Introspection (cognitive exploration of internal self and feedback)

Reflections:

Questions and exercises to consider with classmates and/or colleagues:

  • What do you believe are the biological, psychological, social, and cultural factors that influence self-awareness?
  • How would you describe the difference between the personal inner world and the interpersonal outer world?
  • How might you structure reflective journaling as a means of increasing self-awareness?
  • What are some additional strategies for increasing self-awareness?

Helpful Resource

Increase Your Self Awareness with One Simple Fix Tasha Eurich, TedTalk

Recommended Readings

Eckroth-Bucher, M. (2010). Self-awareness: a review and analysis of a basic nursing concept.  Advances in Nursing Science , 33(4), 297-309.  doi: 10.1097/ANS.0b013e3181fb2e4c.

Han Soolgi, & Kim Sungjae. (2016). An integrative literature review on self-awareness education/training programs in the nursing area.  Perspectives in Nursing Science , 13(2), 59.

Rasheed, S. P., Younas, A. A., & Sundus, A. (2018). Self‐awareness in nursing: A scoping review.  Journal of Clinical Nursing , 28(5-6), 762-774. doi:10.1111/jocn.14708

Rasheed, S. P., Sundus, A., Younas, A., Fakhar, J., & Inayat, S. (2021). Development and testing of a measure of self-awareness among nurses.  Western Journal of Nursing Research , 43(1), 36–44.

Younas, A., Rasheed, S.P., Sundus, A. & Inayat, S. (2019). Nurses' perspectives of self-awareness in nursing practice: A descriptive qualitative study.  Nursing & Health Sciences , 22(2), 398-405. https://doi.org/10.1111/nhs.12671

Self-Awareness of Nursing Analysis Essay

To become a professional nurse, one is to objectively their strengths and weaknesses in terms of providing care and interacting with professionals and patients daily. Such a phenomenon of recognizing one’s emotions and behavioral patterns is known as self-awareness (Grand Canyon University, 2018). When analyzing personal strengths, I can point out a high level of empathy. Indeed, after years of interacting with patients in general hospitals and rehabilitation facilities, I have learned that compassion comes a long way in providing quality care, as people need medical professionals to empathize with them to trust the treatment plans.

Another strength is the ability to take responsibility for my actions. Even when following someone’s advice or recommendations, I take full accountability for the decisions made, as I am the last person to justify a decision, and being influenced by others does not equal the responsibility divided between everyone taking part in the process. Finally, good communication skills are also one of my positive professional aspects, as I find it easy to find common ground with colleagues and patients through active listening and respect. However, to improve these aspects, it is vital not to become too invested in communication and compassion, as it may potentially affect my objective reasoning when working with patients.

As far as the weaknesses are concerned, the first major drawback would be the lack of autonomy. While I can take responsibility for my actions, it is difficult for me to decide without external assistance, as I often feel self-conscious and seek guidance from others. To improve this area, it would be beneficial for me to start believing in my professional intuition before making a decision instead of making sure I was right after hearing the same answer from other professionals. Another weakness is inflexibility, as I find it challenging to adapt quickly to a new environment to the extent required by the clinical setting. One way to combat this is to develop my skill sets to feel more confident when faced with a challenge. Finally, my behavior frequently lacks patience, which may lead to the patient outcomes being poorer than expected. A way to combat this issue would be to develop a habit of long-term perception of every decision made, as limited analysis of the decision’s implications may rush people into making immediate choices without seeing the options.

Grand Canyon University. (2018). Nursing leadership & management: Leading and serving [E-book]. Web.

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  5. Self-awareness in nursing: A scoping review

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  6. Self Awareness By Definition Nursing Essay

    Self Awareness By Definition Nursing Essay. Effective communication is a prerequisite skill in nursing. Miller and Nicholson defined communication as a way of exchanging information from a source to a receiver, which often stimulates a behavioural response. This is a way in which ideas and feelings are shared in an attempt to establish a ...

  7. Nurses' perspectives of self-awareness in nursing practice: A ...

    This study explores nurses' perspectives regarding self-awareness in nursing, the importance of self-awareness for nurses, and its influence on patient care. We used a descriptive qualitative design. Face-to-face semistructured interviews were conducted, from October to December 2018, with a purposive sample of 13 nurses at two hospitals in ...

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  9. Nurses' perspectives of self‐awareness in nursing practice: A

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