Swansea University, Swansea SA3 3BB, UK.
Nurs Inq. 2009 Dec;16(4):355-65. doi: 10.1111/j.1440-1800.2009.00452.x.
The introduction of nurse-led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call-centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call-centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional 'hands-on' models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries.
引入护士主导的电话热线，让患者能够获得信息和建议，这为护士的实践带来了一种新的方式。本研究聚焦于 NHSD 护士如何构建护理身份，并在呼叫中心环境中塑造他们的工作。实证研究结果来自于一项研究，该研究调查了 NHSD 对专业护理问题的影响，这是对英国南威尔士 NHSD 服务进行更广泛评估的一部分。数据来自对发送给三个 NHSD 站点护士的问卷中包含的自由文本问题的回应。进一步的数据来自与 NHSD 护士举行的焦点小组。护士们为自己作为护士的身份辩护，而不是作为呼叫中心工作人员。护士们的话语与护理的传统价值观紧密一致，包括整体和富有同理心的实践，这些实践已经随着护士们跨越不同地点而发展。我们认为，护士们在 NHSD 中围绕着先前经验的重要性构建护理身份，并声称实践整体护理。然而，为了满足 NHSD 工作的需求，新技能的发展和旧技能的适应，挑战了传统的“动手”实践模式的规范性观念，并表明可能朝着基于知识、分析和沟通技能的护理认知模式发展，这反映了专业身份和边界的变革性和动态性质。
