Advancing the status of nursing: reconstructing professional nursing identity through patient safety work
| Autor: | Trond Kongsvik, Erna Håland, Frode Heldal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
education Resistance (psychoanalysis) Audit Care Nursing Staff Hospital Health informatics Nurse's Role Health administration 03 medical and health sciences Patient safety 0302 clinical medicine Nursing Hospital Administration Audit systems Health care Medicine Humans 030212 general & internal medicine Qualitative Research Social Identification business.industry Norway 030503 health policy & services Health Policy Nursing research Public health lcsh:Public aspects of medicine lcsh:RA1-1270 Professional nursing identity humanities 0305 other medical science business Research Article Program Evaluation |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 19, Iss 1, Pp 1-12 (2019) |
| ISSN: | 1472-6963 |
| Popis: | Background Recent decades have seen increased attention to patient safety in health care. This is often in the form of programmes aiming to change professional behaviours. Health professionals in hospitals have traditionally resented such initiatives because patient safety programmes often take a managerialist form that may be interpreted as a challenge to professional identity. Research, however, has mostly paid attention to the role of physicians. This study aims to highlight how such programmes may affect professional nursing identity. Methods We qualitatively investigated the implementation of a patient safety programme in Norway, paying attention to changes in nurses’ practices and values. Based on purposive sampling, two group interviews, four individual interviews and five hours of observational studies were conducted in a hospital department, involving ten nurses and three informants from the hospital management. Interviews were conducted in offices at the hospital, and observations were performed in situ. All the interviews lasted from one to one and a half hours, and were recorded and transcribed ad verbatim. Data was analysed according to ad-hoc meaning generation. Results The following analytical categories were developed: reconstructing trust, reconstructing work, reconstructing values and reconstructing professional status. The patient safety programme involved a shift in patient safety-related decisions, from being based on professional judgement to being more system based. Some of the patient safety work that previously had been invisible and tacit became more visible. The patient safety programme involved activities that were more in accordance with the ‘cure’ discourse than traditional ‘care’ work within nursing. As a result, this implied a heightened perceived professional status among the nurses. The safety programme was – contrary to the ‘normal’ resistance against audit systems – well received because of the raised perceived professional status among the nurses. Conclusions Reconstructing trust, work, values and status, and even the profession itself, is being reconstructed through the work involved in implementing the procedures from the safety programme. Professional knowledge and identity are being challenged and changed, and what counts as good, professional nursing of high quality is being reconstructed. © The Author(s). 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink