The use of the Ethnograph program to identify the perceptions of nursing staff following the introduction of primary nursing in an acute medical ward for elderly people.

Interviews with a small group of nurses working in a primary nursing ward were content analysed using the Ethnograph computer program. In response to some very general questions about their views of primary nursing, the respondents talked at some length about their improved knowledge of patients, about better communication, about their relationships with patients and relatives and about personal responsibility. They did not talk spontaneously about controlling their own practice, decision-making, autonomy or accountability. Such terms did not form part of their vocabulary in describing their work though these issues were raised obliquely in the conversations. The value of the change in the way of organizing the delivery of nursing care was seen more in terms of its potential for developing therapeutic relationships rather than in terms of personal professional development. Increased knowledge of and responsibility for specific patients coupled with the greater continuity of care they were able to provide, gave them greater job satisfaction than they had previously experienced.