Making meaning of nursing practices in acute care

Abstract

Purpose – The purpose of this paper is to consider how meaning may be made of nursing practices by contrasting the rationalistic approach commonly used in the nursing literature with Bourdieu’s theory of practice. Design/methodology/approach – The data under consideration is an account of ten to 15 minutes of a larger ethnographic study of nursing practices which asks the question: how do nurses accomplish nursing within and between patients’ needs for care in the acute hospital setting? The five main sources of data were: observations of and conversations with nurse participants, as well as hospital documentation (including facility protocols and patients’ notes) and the observer’s field diary. These were woven together to provide an account of one nurse with one patient for a few moments of her day. Findings – Although this paper makes no attempt to speak to the rest of her workload, in these few minutes the nurse accomplishes multiple moments of nursing practice. Further, while the rationalistic approach presents the nurse as a highly skilled practitioner, Bourdieu’s theory of practice not only illuminates the nurse’s role as pivotal in the acute hospital setting but is also able to address the dialectical nature of the relationship between nurses’ practices and the dynamics of the context. Originality/value – The use of Bourdieu’s theory of practice makes possible the study of how nurses nurse “within and between” to illuminate the everyday practices of nurses.

Revisiting “Intelligent Nursing”: Olga Petrovskaya in conversation with Mary Ellen Purkis and Kristin Bjornsdottir

“…It certainly takes me back to your 2006 paper with which we started our conversation (Purkis & Bjornsdottir, ). Recently, Australian nurse researchers Sarah Lake, Trudy Rudge, and Sandra West cited your 2006 paper in their ethnographic study of nursing practice in Australia (Lake, Rudge, & West, ). I suggest we talk next about these two papers.…”

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OP: In their paper, “Making Meaning of Nursing Practices in Acute Care,” Lake et al () describe moments from a day of a nurse named Glenda. She interacts with one of her patients, Ross, a man with diabetes and infected wound on his foot.

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“…The researchers are inspired by how “Glenda moved fluidly between intravenous antibiotics, insulin, breakfast, documentation, the doctors’ round and wound care accomplishing multiple moments of nursing practice” (p. 66). In general, I think Lake et al’s () analysis is a good example of what you envisioned as the New Nursing Studies: an ethnographic description focused on nursing practices; the move away from a conception of the nurse as a rational actor whose actions can be explained by intentions and cognitive decisions alone; an attempt to capture the dynamism and non‐linearity of events; and attention to humans and things. Would you agree?MEP: Yes.OP: Mary Ellen, I noticed some key similarities between your article (Purkis & Bjornsdottir, ) and that by Lake et al ().…”

Perspectivas e dilemas da enfermagem na p�s-modernidade: dialogando com Zygmunt Bauman

“…Até mesmo as costumeiras explicações literárias da enfermagem, como assentada na arte cognitiva e no raciocínio lógico amplamente qualificado e científico, parecem insuficientes, já que regularmente decisões são tomadas em esferas de conhecimento destacadas e que não admitem cooperação. Impreterivelmente, as práticas de enfermagem devem possuir um significado muito mais de "teoria na prática" do que no racionalismo extremo (27) . Baseados no dialogismo da "Teoria da prática" de Pierre Bourdieu em momentos matutinos de uma enfermaria, em artigo recente, percebeu-se que o sentido das ações de enfermeiros através da lente de Bourdieu, são basicamente os de jogadores em uma partida, organizando médicos, pacientes e gerenciando o desenrolar do trabalho diário em um contexto limitado, por vezes (27) .…”

“…Impreterivelmente, as práticas de enfermagem devem possuir um significado muito mais de "teoria na prática" do que no racionalismo extremo (27) . Baseados no dialogismo da "Teoria da prática" de Pierre Bourdieu em momentos matutinos de uma enfermaria, em artigo recente, percebeu-se que o sentido das ações de enfermeiros através da lente de Bourdieu, são basicamente os de jogadores em uma partida, organizando médicos, pacientes e gerenciando o desenrolar do trabalho diário em um contexto limitado, por vezes (27) . Colaborando com a questão do racionalismo exacerbado, a dificuldade em enxergar a realidade dos pacientes e acercar-se do locus no qual trabalha é um dos dilemas das profissões da saúde, ainda sim, a identidade da categoria de enfermagem deve estar fixada na contramão de modelos excludentes.…”