Table 3

Comparative exemplar quotes from a national convenience sample of physicians and non-medical professionals about themes related to presence (n=40, interviews conducted in 2017–2018)

ThemePhysician QuotesNon-Medical Professional Quotes
Purposeful intention to connect
Intention to connectYou want to open (communication)… You want to have people feel freedom that they can talk to you about personal things (MD1)I think that's the goal of presence… to obtain a connection, but you may or may not get it (EPA enforcement agent)
AttentionI think just really being there, and being already listening to them …So, I don't look at the computer. I just really try to look at them (MD1)I like ‘attending’ better than ‘presence’ because it suggests that there's a relationship (LCSW)
FocusI guess it's just a complete focus on the patient at that time and at that moment, and really trying to give your undivided attention to that (MD3)Staying focused on the moment, looking somebody in the eye (Journalist)
ListeningI think I've learnt to just sit and listen and be present for when patients share their story about what's going on with them, and what's of interest to them, and really just giving them the space to talk about that and overcoming the urge to interrupt or direct the conversation (MD8)Listening and responding to them. …one of the most difficult parts of interviewing somebody is truly listening… So, being present is truly listening (Journalist)
Focusing on the client/patient storyThe interview often with me is… that really intense connected moment where I'm really trying to understand their level of suffering, what this means to them, the significance of their story and how that impacts their life (MD2)Most of the times it's about hearing someone's story and about why they did something, and where it led them, and who they are now. And so those experiences change me often …because I was present for (the story) (Documentary filmmaker)
Not being alone…so (a patient) didn't feel like she was completely alone in that, I assessed that the best way to make her feel safe was for me to disclose my vulnerability as well (MD2)We haven't been alone to each other, we haven't been alone to what's greater than ourselves (Chaplain)
Removing distractionsWell, so I kind of say that your baggage is packed. So, it isn't spilling into the office visit or the phone call or whatever it is (MD7)It means kind of the opposite of distraction. It's kind of focus(ing) on your conversation and interaction with a person in real time and having a true sense of focus on it (EPA enforcement agent)
Conscious navigation of time
Returning to the presentIt is almost like a meditation where we're taught to focus on our breathing and focus, but naturally our mind wanders, and you want to check that email (MD3)… the executive director of our organisation…, he always uses this mantra where he says, ’Now. Here. This’, to stay present. And so, when I remember to do that, it has been helpful (Restorative justice lawyer)
Taking breaksI take breaks, actually. I think that's been a big thing. I am no longer interested and I'm no longer capable, because of that, of this way of working where you're constantly doing something (MD5)Yeah, get a good sleep, making sure that (I've) eaten, making sure there's breaks, and that I have stuff with me to keep my energy going, like (chocolate) and water and stuff, whatever I need that day (Documentary filmmaker)
Quiet/ silence/ slowing downI'm not in as much of a rush to get to the right answer. I'm more comfortable with the silence, with the space, with the level of certainty that comes with primary care, and understanding that I don't have to have the answer right this instant (MD8)I think silence is a big part of presence, and I think just taking a minute to notice, to get where the person is from, really how are you today (Psychology professor)
Management of the physical environment
Occupying the same space as a client/patientI certainly pull the chair up close to talk to people trying to find that right distance, not too close, but certainly not across the room. Just trying to be in that space with the patient (MD1)Presence is a felt sense that I have of … being seated inside myself in my body and being present in the room, sitting in the room and aware of everything that's in the room (LCSW)
Setting boundariesI'll be very persistent (about staying on topic). Like, 'Uh, no, we're not going there. We're staying here'. That's …related to boundary setting …trying to control things so that there can be connection, so that something can happen, so that there's time to actually engage… (MD5)…Setting boundaries… (is) 'here’s what I'm going to do and here's what you're going to do. Is that okay with you?' …Asking permission (Recreational therapist)
Technology/ managing competing prioritiesAnd so, maybe part of presence is also letting them know, ‘okay, I'm looking at the ER visit, because you're telling me about that’ (MD3)So, you close the laptop and you get away from the table and you don't look at your notes and you connect (Psychology professor)