HEALTH PROFESSIONS AND NURSING STUDENTS: FACING A CONTEMPORARY DILEMMA BETWEEN A FOCUS ON COMPASSION OR TECHNICAL ASSISTANCE. TRANSFORMATIVE LEARNING AS A HYPOTHESIS TO COPE TO THE DE-IDEALIZATION TRAINING PATH

Introduction According with WHO (2003) chronic diseases are increasing worldwide. Moreover, scientific progress of engineering and informatics applied to medicine has introduced many changes in health operators’ daily work, now characterized by technical and informatic devices for therapeutic and diagnostic targets in the critical settings. According to this, there are a sort of dichotomic aspect of health work, fluctuating between the human care and the technical cure (Williams et al., 2009). The caring of a chronic patient that needs psico-social support and human understanding requests compassion and ability to face suffering and death. In the other side, the cure of a critical patient requests the acquisition and continuous update of many technical and informatic skills, as well as to be efficient and rational in the emergency situations. But both kind of patients, sometimes, request both kind of assistance. Study Design These considerations lead to understand if this dualism characterizes only health professionals or the health students too. So, we conducted a qualitative observational study that has involved a significant group of nursing students of the Padua University. Semi-structured interviews were realized between June to September 2015, involving freshmen and near to degree students. Dialogues were recorded, unwound and analysed using a test analysis software (Atlas.ti). Results We interviewed 43 freshmen and 32 near-graduated. The analysis of dialogues let to identify the presence among students of a dualism resulting more dichotomic among the younger than the older students. Among freshman, especially females are oriented to a sympathetic assistance, instead almost of all men have a technical and rational approach to the profession. The difference between young and older students may be linked to the quality of experiences lived throughout the three years; when, during the stages, a student faces to some negative aspects of his future profession, many of his anticipations about nurse’s rule could be destroyed: students who have an altruistic approach could not be ready to understand their older colleagues’ cynicism. Whereas, students who have a rational approach could not be able to face patient’s request of human compassion. Some students react to this empasse activating one or more psychological mechanisms of defense (denial, avoidance, etc.) Some others choose not to defense themselves, and to try to come to terms with reality, with different consequences. Conclusion and implication for practice It is known that a rational or, in opposition, a contemplative thinking singularly taken is not enough to cope to the task of assisting a chronic or dying patient. As Heidegger (1966) says only the use of a union of these two kind of thinking lets humanity to face life challenges. These students, as well as, many health professionals, need to be supported in an unavoidable and never-ending path of de-idealization that leads them to understand and accept the fatigue of a professional role that must unify rational and human, efficiency and compassion in caring for a patient that is, nevertheless, a person. The path of de-idealization (Kay, 1990) is faceable by the development of a transformative learning itinerary. Accordingly, teacher and tutor have to support students in these paths, and, above all, first university has to face these matters finding the adequate strategies to implement among teachers and tutors the transformative learning teaching methods.