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Admitting hospital patients: a qualitative study of an everyday nursing task

Jones, Aled 2007. Admitting hospital patients: a qualitative study of an everyday nursing task. Nursing Inquiry 14 (3) , pp. 212-223. 10.1111/j.1440-1800.2007.00370.x

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Abstract

In recent years new modes of nursing work have been introduced globally in response to radical changes in healthcare policies, technology and new ideologies of citizenship. These transformations have redefined orthodox nurse–patient relationships and further complicated the division of labour within health-care. One distinctive feature of the work of registered nurses has been their initial assessment of patients being admitted to hospital, and it is of interest that this area of nursing practice remains central to the registered nurse's role at a time where other areas of practice have been relinquished to other occupational groups. This qualitative study, drawing on conversation analysis and ethnographic techniques, explores this area of everyday nursing work. Initial nursing assessments have attracted considerable interest in the nursing literature, where it is clearly stated that assessments should be patient centred and seen as the important first step on the road to a therapeutic nurse–patient relationship. Results from this study lead to the conclusion that the actual nursing practice of patient assessment on admission to hospital is at odds with the recommendations of the literature and that a more routinised, bureaucratic form of work is devised by nurses as a means of expediting the process of admission. In this paper I explore the work of nurses when initially assessing the health and social care needs of adults undergoing admission into hospital. While there has been a small body of work that has explored this particular area of nursing work, few have taken the opportunity offered by qualitative methods to explore in detail the way frontline nurses and patients accomplish initial assessments. The article aims to contribute to the understanding of everyday nursing work by describing the ways in which initial nursing assessments are rooted in social relations and routine practices. My premise in this article is that descriptions in nursing literature of mundane work such as patient assessment are often idealised towards what ‘should happen’ and biased to highlight the individual nurse's judgemental, interpretive work. Consequently, these descriptions often overlook how mundane nursing work may be shaped by external routines of everyday practice, which operate to organise the individual nurse's working day, rather than reflecting some idealised version of nursing practice. An attempt will be made to rectify this bias whilst acknowledging the fact that nurses’ work is not easily understood, nor is it easy to research (Melia 1979; Lawler 1991). In acknowledgement of this frequent reference will be made to qualitative data collected in the UK during doctoral studies to support any of the points made.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > RT Nursing
Uncontrolled Keywords: conversation analysis; ethnography; patient admission; routine nursing work; service delivery
Publisher: Wiley
ISSN: 1320-7881
Last Modified: 10 Jan 2018 07:45
URI: http://orca.cf.ac.uk/id/eprint/13532

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