Harvey Clare, Thompson Shona, Pearson Maria, Willis Eileen, Toffoli Luisa
School of Nursing, Eastern Institute of Technology, Napier, Hawkes Bay, New Zealand.
Flinders University, Adelaide, South Australia, Australia.
Nurs Inq. 2017 Jul;24(3). doi: 10.1111/nin.12180. Epub 2017 Jan 18.
This article draws on the free-text commentaries from trans-Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self-effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.
本文借鉴了跨塔斯曼研究中的自由文本评论,这些研究使用MISSCARE问卷来探究护士漏做护理的原因。在本文中,我们探讨了这样一种观点:护士坚持一种自我贬低的护理方式,以患者护理和职业责任为代价,用他们所谓的护理艺术来阐述他们对护理和漏做护理的说法。我们运用历史对话以及范式分析,来研究为什么护士允许自己继续在那些将他们的专业/个人自我置于一边的环境中工作,试图在使完成护理成为一项不可能任务的限制条件下提供护理。研究结果表明,在新公共管理环境中试图提供护理的护士面临着矛盾和冲突。这体现在护理作为一门艺术与护理作为一个财务目标之间的紧张关系中,同时也体现在护理在两种相互矛盾的范式中被概念化的方式所产生的内在价值观冲突中。