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University of Technology Sydney. Faculty of Health. 𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: Busyness within modern health care has often been defined as time constraints and increased workload, leading to individualised perceptions of stress. To date, no published studies have sought to explore busyness as a construct within therapeutic relationships in a paediatric acute care setting or how cultural dimensions of paediatric nursing fosters perceptions of busyness within everyday care practices. 𝗔𝗶𝗺: To explore a notion of busyness within the context of paediatric acute care and how this influences the therapeutic relationship between paediatric nurses and families. 𝗠𝗲𝘁𝗵𝗼𝗱: Ethnography was the research design selected for the study. Semi-structured interviews with 10 paediatric nurses and 10 parents, and 40 hours of non-participant observations were conducted. Brewer’s (2000) framework for ethnographic analysis and interpretation was utilised and findings were presented as a realist tale. 𝗙𝗶𝗻𝗱𝗶𝗻𝗴𝘀: Seven themes emerged, which detailed cultural dimensions of busyness that influenced paediatric acute care. Perceptions of busyness challenged teamwork and re-shaped therapeutic relationships between paediatric nurses and families. During perceived busyness task focused care became the dominant culture and hindered family centred care. Instead, challenges emerged that required role negotiation, balancing expectations and re-forming of collaborative partnerships. The emotional cost of busyness created a sense of personal conflict that surfaced within nurses and care activities. Similarly, parents were challenged during times of busyness, leading to feelings of frustration and powerlessness. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: This ethnography has identified a culture of care that was influenced by busyness. Roles within therapeutic relationships, paediatric nurse and parental expectations and collaborative partnerships were re-shaped by busyness. The findings highlighted the importance of family centred care to paediatric nurses and gave social understandings and insights into the complexities of the paediatric nurse – parent partnerships, which assisted to define dimensions of the therapeutic relationship. Importantly, the ethnography has brought to the surface how paediatric nurses and parents negotiated and balanced their partnership to achieve a desired therapeutic relationship. This ethnography has addressed a significant research gap and provided new insights into nursing, paediatric nursing practice, education and research. |
