Warchol Nathalie
Cadre de Santé Centre hospitalier de Meaux.
Rech Soins Infirm. 2007 Dec(91):76-96.
Nursing consultation is an innovative system even if this way of taking responsibilities has been proposed as early as 1970 by stomal therapy nurses. Its current development is in close relation with the demographic situation, the progress of professional skills, and economic constraints. This work wonders about professional autonomy in the practice of nursing consultation, an aspect which has been little studied until now. This question is examined through the concepts of autonomy and responsibility. More precisely, in relation to the attributes of the concept of autonomy which are: to decide for oneself, to control one's environment, in a state of awareness, to manage one's dependencies. Thirteen semi-directing discussions have been conducted in five hospitals by nurses who practise consultation in different specializations. The remarks of these professionals are analysed by themes according to the attributes of the concept of autonomy. It turns out that, from the professional point of view, nursing consultation offers certain autonomy. As a matter of fact, the nurse, alone in front of the patient, takes initiatives, makes decisions, makes choices and assumes them. In case of difficulty, she does not hesitate to appeal to resource people. This practice requires a perfect knowledge of oneself and of institutional rules. It also requires some skills developed in the concerned specialization. Through the discourse of "consulting" nurses, each attribute of the central concept of autonomy is represented. Nursing consultation, through this study, concretely expresses the notions of autonomy and of responsibility inherent in its context of activity.
护理咨询是一种创新体系,尽管早在1970年造口治疗护士就提出了这种承担责任的方式。其当前的发展与人口状况、专业技能的进步以及经济限制密切相关。这项工作探讨了护理咨询实践中的职业自主性,这是一个迄今为止很少被研究的方面。这个问题通过自主性和责任的概念来审视。更确切地说,与自主性概念的属性相关,这些属性是:为自己做决定、控制自己的环境、处于意识状态、管理自己的依赖关系。五家医院的护士针对不同专业开展了13次半指导性讨论,这些护士从事咨询工作。根据自主性概念的属性,按主题对这些专业人员的言论进行分析。结果表明,从专业角度来看,护理咨询提供了一定的自主性。事实上,护士独自面对患者时会采取主动、做出决定、进行选择并承担责任。遇到困难时,她会毫不犹豫地向资源人员求助。这种实践需要对自己和机构规则有透彻的了解。它还需要在相关专业中培养的一些技能。通过“咨询”护士的话语,自主性核心概念的每个属性都得到了体现。通过这项研究,护理咨询具体表达了其活动背景中固有的自主性和责任概念。