The phenomenon of presence has recently become more recognized in nursing; however, it has not yet been clearly described. This qualitative study describes presence through identification of antecedents, defining attributes and consequences of the phenomenon as related by practicing nurses. The guiding conceptual framework is provided by the researcher's concept analysis of presence, and symbolic interactionism serves as the sensitizing framework (Blumer, 1960). Fifteen subjects were interviewed, and the data were analyzed using latent content analysis.

The antecedents to presence are a patient who is in need and who develops trust in the nurse. The nurse has a sense of mission, a desire to help the patient, altruism, and an affinity for the patient. The nurse also demonstrates a personal instinct, insight and intuition about the patient's situation. The will and strength to be vulnerable to the patient's situation are also necessary antecedents as the nurse uses herself as a reference point in care decisions. Finally, the nurse is mature and self-confident.

Defining attributes to the experience of presence include initial physical closeness between nurse and patient with the development of a metaphysical connection and exchange between the nurse and patient. The nurse enters the experience of the patient's needs as companion and uses a broad range of skills to facilitate the patient's experience. These experiences create a significant effect on the patient; however, there is great variability in the characteristics of the experiences.

As a consequence of presence all aspects of the patient's experience progress in a positive manner--whether that is improved psycho-social-spiritual functioning, improved physical functioning, or death. The patient desires more contact with the nurse and the nurse continues to be available. Nurses having experienced presence with a patient learn more about the patient, tend to function as a surrogate for the patient, and experience significant emotions. Personal and professional development is promoted for the nurse as she feels affirmed in her role and manner of practice. Criticism of the nurse's use of presence by other health care providers is a possibility.