Trafford Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
School of Health Sciences, The University of Manchester, Manchester, UK.
Nurs Inq. 2022 Oct;29(4):e12486. doi: 10.1111/nin.12486. Epub 2022 Mar 9.
The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009-2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid-Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high-profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re-evaluated in the current Covid-19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy-in to strategy documents.
本当代历史研究旨在通过话语分析，分析英格兰国民保健制度信托机构在 2009 年至 2013 年期间制定的护理策略文件。2013 年，弗朗西斯爵士发布了关于米德尔塞克斯郡国民保健制度基金会信托基金的报告。该报告强调了一家重视财务效率而不是患者护理的信托机构的全面组织失败。然而，随后的分析却过于强调护士的失误。当时的护理策略文件为国民保健制度信托机构指明了未来的方向，为每个护理人员队伍规定了具体的价值框架。然而，所选择的价值观经常相互冲突，将护理价值观与管理比喻相对立。有人认为，这些文件对国民保健制度更广泛的关注和护理方面的高调失败做出了回应，尤其是弗朗西斯报告，虽然口头上支持员工参与，但仍保持着企业重点。护理价值观被牢牢地置于管理主义话语中，在当前的 COVID-19 大流行中，这种话语需要重新评估。该研究的更广泛影响表明，在护理教育中讨论价值冲突可能是有益的，而真正的地方战略制定方法可能会促进员工对战略文件的认同。
