What matters in nursing - exploration of core concepts in clinical practice

What matters in nursing – exploration of core concepts in clinical practice
Background
The research network Nursing of the Future seeks
to develop a coherent knowledgebase for nursing
in the 21st century.
As society changes so does nursing. Changes in
demographics, expanding technological
development, and more outpatient treatment
increases the complexity of nursing. Nursing is
influenced by the logics of Neoliberalism and New
Public Management and its focus on checklists,
standardization and guidelines. Meanwhile,
patients request involvement, holism and care. A
strong research based anchoring of the
knowledgebase of nursing can therefore be seen
as a necessity to meet the challenges of an ever
evolving healthcare system and the subsequent
evolving needs of future patients and relatives.
Aim
To explore how clinical nurses talk about and
describe nursing and nursing care.
This with the aim of identifying core concepts, that
can describe the essence of nursing and nursing
care and thereby assist in developing a coherent
knowledge base for nursing in the 21st century.
Method
Three group interviews were conducted in two
clinical settings. The interviews were analyzed
using Kvale & Brinkman’s method of analysis as
well as collaborative data analysis involving clinical
nurses. Lastly, possible core concept were
identified.
Results
We identified three paradoxes in clinical nursing
that point toward parts of the core of nursing.
Relational time versus system time, seeing the
patient versus algorithms and clinical assessment
versus clinical guidelines.
Conclusion and implication for caring in a
changing world
This study identified three paradoxes in clinical
nursing that exemplify two opposing positions. On
one side, what Delmar describes as the good, the
wise and the right nursing and on the other side,
New Public Management and its logics.
To meet the care need of patients and relatives in a
changing world, the knowledge base of nursing has
to root itself in a caring philosophy which centers
on the person ‘behind the patient’.