Allen Davina
Nursing, Health and Social Care Research Centre, School of Nursing and Midwifery Studies, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff CF24 0AB, Wales, UK.
Nurs Inq. 2004 Dec;11(4):271-83. doi: 10.1111/j.1440-1800.2004.00234.x.
This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future.
本文考察了1993年至2003年间发表的英文护理工作实地研究，作为基于实证重新制定护理使命的第一步。十年的人种学研究表明，与当代那些宣扬以个体化、无中介的关爱关系为中心的护理工作形象的理论相反，在现实生活实践中，护理的核心贡献是充当医疗保健调解人。利用文献中的证据描述了构成这一中介角色的八组活动。护理文化与理想与工作环境的结构及限制之间的不匹配，是从业者不满情绪的长期根源。有人认为，该行业追求以情感亲密为中心的整体患者护理议程几乎没有什么好处，而侧重于医疗保健调解人功能的替代性职业使命可能会带来更人道的医疗服务和更可行的职业未来。
