The silent demand in the diagnostic phase

Patients' experience of going through the diagnostic phase in hospital is apt to be overlooked by nurses and physicians; most of their inner preparative work for receiving the diagnosis is hidden because of the vulnerability of the situation. This paper discusses findings from a grounded theory study, of 18 in-depth interviews of 15 patients going through medical investigation at a gastric ward in a Norwegian university hospital. The interviews were conducted in 2002-2003. The generated 'Preparative Waiting Theory', which accounts for how patients in the diagnostic phase work to prepare themselves for receiving a diagnosis, is discussed in relation to the Danish theologian and philosopher Løgstrup's writings about the ethical demand and life utterances of trust, openness and the untouchable zone. The ethical demand from patients going through medical investigations is silent and radical, and thus challenging for nurses and physicians to judge how to best fulfil. Examples from the interviews are used to illustrate patients' vulnerability as they prepare to face the conclusion about their case. To the extent trust develops between patients and nurses/physicians, patients can reveal what is at stake in their lives without feeling exposed or embarrassed. Because of the power nurses and physicians have in the healthcare system, and because of laws, morals and conventions guiding practice, we have a professional responsibility to develop a culture that fosters the ability and willingness to take care of our patients.