THE SOCIAL CONSTRUCTION OF THE DEFINITION OF NURSING (INTERPRETIVE, PROFESSIONAL)

This study presents an ethnographic perspective of a nursing unit, focused on the creation of the definition of nursing. Participant observation was used as the main data gathering resource. Analysis of documents and a questionnaire supplemented data collection. The purposes of this study were to (1) discover the process by which the definition of nursing became known to the staff members on a selected unit and, (2) describe the unit\u27s definition of nursing and how it was practiced. The motivation for this research was a search for a way for the nurse manager to understand how nursing comes to be known on a nursing unit, so the manager would be in a stronger position to support a collaborative process for the development of a new vision of professional nursing. The definition of nursing discovered was a complex mixture of the old and new cultures discussed in nursing literature today. The traditional culture of nursing was dominated by the language and values of medicine and bureaucracy. The medical perspective dominated the way the nurses viewed and cared for their patients. The assessment forms, teaching curriculums, language and ritual of shift report and patient progress notes all reinforced the medical pathology. The departmental structure and lack of problem solving between specialties served to exhaust the nursing resources in time consuming systems and routines (e.g. medication and laboratory systems). The emphasis on rules and task assignments by way of policies, memos and job descriptions, focused nursing care in such a way that there was little room to be creative and use autonomous nursing judgment. The behaviors in the new culture in nursing was characterized by an emphasis on professional development. There was a beginning by nurses to identify domains that were unique for nursing. The new standards for documenting care provided the method and process for nurses to begin to use a new exclusive framework for assessing their patients and planning their care. The new culture\u27s nurses were beginning to recognize and use the power within themselves to establish new values and directions. Implications for nursing education, management and further research were discussed