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与患者同行并为患者服务:急症护理中护士工作实践所蕴含的知识。

With and for the Patient: The Knowledges Embodied in Nurses' Practices-of-Work in Acute Care.

作者信息

Lake Sarah, Rudge Trudy

机构信息

Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, New South Wales, Australia.

出版信息

Nurs Inq. 2025 Apr;32(2):e70006. doi: 10.1111/nin.70006.

Abstract

While understanding of what nurses do is most commonly framed as using clinical decision-making in completing a range of tasks to meet the care needs of patients, other perspectives show nurses as experiential carers and/or utilising a body of professional knowledge to do this. Taking data from an ethnographic study framed in Bourdieu's theory of practice, this paper aims to extend understanding of how nurses in acute care accomplish nursing-in-practice by utilising reconnaissance, a conceptualisation of nursing practice knowledges, as a vocabulary to further analyse these data. In this new way of thinking about what nurses do, nursing-as-it-happens is shown to be not about nurses making decisions as such, but about how nurses use contextualised knowledge to activate practices that respond to what needs to be done for patient care in the context of each practice situation. Focusing attention on what nurses accomplish in their daily practices-of-work reveals nurse agency as working with and for the patient. This enables recognition of how nurses working with multiple patients on a shift can make adjustments to their practices in light of unfolding situations and, when necessary, bring each of those patients as persons to the centre of their practice.

摘要

虽然对护士工作的理解通常被界定为在完成一系列任务时运用临床决策以满足患者的护理需求,但其他观点则将护士视为经验丰富的护理人员和/或运用专业知识体系来开展工作。本文采用布迪厄实践理论框架下的一项人种志研究数据,旨在通过运用“侦察”这一护理实践知识的概念化表述作为一种词汇来进一步分析这些数据,从而扩展对急症护理护士如何在实践中完成护理工作的理解。在这种思考护士工作的新方式中,实际发生的护理工作并非仅仅关乎护士做出决策,而是关乎护士如何运用情境化知识来激活实践,以回应在每种实践情境下为患者护理所需做的事情。将注意力集中在护士在日常工作实践中所完成的事情上,揭示了护士的能动性在于与患者合作并为患者服务。这使得人们能够认识到,当班时照顾多名患者的护士如何能够根据不断变化的情况调整其做法,并在必要时将每一位患者作为个体置于其护理实践的中心。

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