Counselling as part of the nursing fabric: where is the evidence? A phenomenological study using ‘reflection on actions’ as a tool for framing the ‘live

Anecdotal claims are often made that counselling has become part of the nursing fabric. While there is a plethora of literary comments on the subject, there is hardly any concrete evidence to demonstrate how nurses use counselling skills as part of their work. ‘Evidence-based care’ requires nurses to produce evidence or research in order to enhance nursing care. This study is an attempt to illuminate the counselling phenomenon as it applies to present-day nursing. Guided reflection-on-actions was used as a tool for framing the ‘lived counselling experience’ of six qualified nurses who have recently completed a counselling and health module as part of a BSc in Health Studies. The findings suggest the existence of a paradigm shift in the direction of a closer alignment between counselling skills as applied by nurses and counselling as a healing culture. It supports the notion that there is a distinction between using counselling skills and counselling practice per se. It also concludes that within the context of nursing, what patients require is exploration and/or resolution of focal problems and not ‘personality fine-tuning’ as might be the case in counselling in general. When called upon to ‘dispense counselling skills’, nurses are adept at combining this with other nursing activities being performed at the time.