This ethnographic study is a descriptive analysis of the interactive behaviors of a group of nurses caring for a population of clients considered typical in a hospital-based discrete hospice unit. As in most hospital-based hospices, this population includes both terminally ill clients and clients expected to regain their health. Questions guiding this research related to the transition of role of hospice nurses and examined the relationships among the nurses' interactional behaviors, values, and philosophies.

Techniques of data collection included participant observation, informal interviews, demographic questionnaires, and examination of supporting documents. The extensive field notes generated by the data collection were analyzed systematically using a constant comparative method of qualitative analysis in combination with a typological analysis. The typology of symbolic interactionism was utilized.

Three questions guided the data collection and analysis. The first question asked in what ways the interactive behaviors of hospice nurses with terminally ill clients differed from the interactive behaviors of these nurses with acutely ill clients. Analysis of the data revealed no differences in the ways the participant nurses interacted with acutely ill and terminally ill clients.

The second question considered the relationship between the interactive behaviors of hospice nurses and their expressed personal values and nursing philosophies. Observed interactive behaviors of the participant hospice nurses were congruent with their expressed personal values and nursing philosophies.

The third question examined the relationship between the observed and reported interactive behaviors of hospice nurses. There was some degree of congruence between the instrumental interactive behaviors and the orally expressed behaviors of the hospice nurses. Written self-reports of their interactive behaviors, however, did not accurately reflect all that the nurses were observed to do. The participant nurses neglected to report, in writing, psychospiritual domain interactions with their clients.

An explanation for these findings was found within the framework of nursing as caring in combination with the nurses' cognitive and affective preparation for their hospice work. Humanistic caring was found to be the unifying focus of care for acutely ill and terminally ill clients, as well as the core of shared values and nursing philosophies.