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Nebulous intentioning – Acute hospital nurses’ struggle to deliver core nursing care
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Date
2020-09-29
Authors
Lane, Aoife
Landers, Margaret
Andrews, Tom
Journal Title
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Publisher
John Wiley & Sons Ltd.
Published Version
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.
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Keywords
Accommodating , Conforming , Connecting , Coordinating , Intuiting , Nursing , Prioritizing , Vigilance
Citation
Lane, A., Landers, M. and Andrews, T. (2020) 'Nebulous intentioning – Acute hospital nurses’ struggle to deliver core nursing care', Journal of Advanced Nursing. doi: 10.1111/jan.14546
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© 2020, John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Lane, A., Landers, M. and Andrews, T. (2020) 'Nebulous intentioning – Acute hospital nurses’ struggle to deliver core nursing care', Journal of Advanced Nursing. doi: 10.1111/jan.14546, which has been published in final form at https://doi.org/10.1111/jan.14546. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.