Encounters with "bad nursing" : a phenomenological exploration of nurses' experiences with substandard practice

Although excellence and expertise in nursing practice have been extensively studied, inferior or substandard practice has been rarely researched. This descriptive, phenomenological study explores the lived experience of encountering substandard practice in a fellow nurse. Five registered nurses were interviewed using a broad, open-ended question, and the transcripts were analyzed using a seven-step method described by Colaizzi, to identify common themes and shared meanings. Participants described these events as difficult, anguishing, and highly contextualized. Common themes included an emphasis on persistent, non-technical practice deficits, and the crucial roles of unit culture, personal values, and prior work experiences in establishing expectations. Barriers to taking action included the reluctance to confront peers, the absence of collegiality between nurses, ambiguities of responsibilities between staff and management, and conflicts between interpersonal and professional models of relationships. Understanding these experiences will provide a more authentic basis for efforts at reform and improvement of practice.Digitized from a paper copy provided by the Arizona Health Sciences Library