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'Being With' or 'Doing for': Fractured Caring in Chinese Community Nursing
1Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
Objective:
To examine how Chinese community nurses experience and navigate the dual imperatives of population-focused public health services and individualised clinical care.
Design:
Narrative inquiry using participant-generated drawings and interviews, interpreted through Swanson's theory of caring.
Sample:
Fourteen female registered nurses from five community health centres in Shenzhen, China, recruited via a WeChat-based pool.
Measurements:
Narrative analysis of transcripts and drawings, examining plot, agency, affective stance, and metaphor/symbol. Coding proceeded before Swanson's caring processes were introduced as an interpretive lens.
Results:
Three navigational practices. EMERGED: relational triage (prioritising the proximate patient), systemic compliance (prioritising metrics and protocols), and fragmented agency (paralysis and withdrawal when both imperatives collide). These form a typology of (im)balancing caring, revealing a fracture between relational depth ('being with', 'knowing') and procedural completion ('doing for') reoriented towards system metrics.
Conclusions:
(Im)balancing caring is constitutive labour generated by systemic architecture, not individual adaptation. The study's theoretical contribution is to show how 'doing for' is co-opted from patient-centred to system-centred ends. Sustaining community nursing requires recognising this skilled negotiation, supporting reflective forums, and integrating relational indicators into performance systems.