Nebulous Intentioning – Acute hospital nurses' struggle to deliver core nursing care. (29th September 2020)

• Record Type: Journal Article
• Authors: Lane, Aoife; Landers, Margaret; Andrews, Tom
• Is Part Of: Journal of advanced nursing. Volume 76:Number 12(2020)
• Page Start: 3537
• Page End: 3547
• Publication Date: 2020-09-29
• Subjects: accommodating -- conforming -- connecting -- coordinating -- intuiting -- nursing -- prioritizing -- vigilance; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14546
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aim: To explore the influences on nursing practice in acute hospital care. Design: A Classic Grounded Theory study. Methods: Data collection (2013–2015) was through interviews and non‐participant observations. Analysis was undertaken using constant comparative data analysis and theoretical sampling. Memo writing was used as an aid to understanding and conceptualizing data during analysis. Theoretical coding served to integrate emerging concepts. Results: This theory explains core nursing as a nebulous intention, an idea which acute care nurses retain throughout each shift, that they will nurse their patients fully when they have the opportunity. It reveals this as the resolution of their main problem which is the constant deferral of core nursing care. This study explains its two sub‐core categories, accommodating and integrity eroding. Conclusion: The theory highlights nurses' attitudes towards their role, demonstrated by deferring it to accommodate the work of others, but offers a new perspective on the significant contribution nurses make to the safe and cohesive transition of patients through the acute healthcare system. Impact: The theory adds a new understanding of the unique contribution nurses make to patient health and safety in acute care environments. It also provides insight into nurses' attitudes towards their own professional work. It explains the consequences of attitudes which undermine core nursing when it competes for priority with accommodating. Accommodating indicates a greater workload for nurses than has been previously understood in explaining the activities, additional to core nursing care, which nurses undertake to contribute safety and cohesion to the patient's acute care journey. These new insights suggest a role for managers in recognizing accommodating in decisions about staffing and resources and for educators in improving the profession's regard for its theoretical underpinnings and for its self‐image. 摘要: 目的: 探讨急症医院护理对护理实践的影响。 设计: 典型扎根理论研究。 方法: 通过访谈和非参与者观察的方式收集数据(2013‐2015年)。采用持续性比较数据分析和理论抽样方法, 对相关数据进行分析。在分析过程中使用备忘录, 帮助理解和概念化数据。此外, 采用理论编码法, 用于整合新提出的概念。 结果: 根据这一理论, 核心护理为潜在意图, 具体而言, 急性护理护士在每次轮班过程中都会想, 如果有机会, 他们将对患者进行充分护理。这表明, 上述措施是解决其核心护理服务持续延迟的主要方法。研究过程中, 对两个子核心范畴进行解释和分析:即适应和完整侵蚀。 结论: 这一理论强调护士对其角色的态度, 一般情况下, 护士推迟工作以适应其他人员, 但同样, 护士使用急性医疗系统, 从而确保患者安全, 并提高其内部凝聚力。 影响: 通过这个理论, 人们强化对护士的认识, 充分了解护士在急性护理环境中对患者健康和安全的独特贡献。此外, 人们可以通过这个理论深入了解护士对自身专业工作的态度。这一理论对在适应竞争优先权时破坏核心护理的后果进行解释。提供住宿表示护士的工作量较之前解释活动内容时更大, 除核心护理工作外, 护士还应为患者提供安全的急性护理服务, 并应保证其内部凝聚力。上述新见解表明, 管理者已经认识到人员配置和资源决策方面的灵活性, 并认为教育工作者需要提高对其理论基础和自我形象的重视。