‘Being With’ or ‘Doing for’: Fractured Caring in Chinese Community Nursing

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.