Breaking the boundaries between nursing and sociology: a critical realist ethnography of the theory-practice gap.

This paper is a response to the challenges laid down by Hannah Cooke in a paper in the Journal of Advanced Nursing entitled "Boundary work in the nursing curriculum: the case of sociology' (Cooke 1993a). In her paper, Cooke noted that the outlook of nursing and sociology are inimicable because nursing's concentration on individuals is at variance with sociology's concern with wider social issues. We argue that it is possible for nursing research to give due attention to social structures without losing its focus on individuals. One methodology that could facilitate this broadening of nursing's epistemological boundaries is critical realist ethnography, which works under the assumption that the relationship between social structures and individual actors involves a two-way process, in that while the enablements and constraints imposed by structures influence individual actions, those actions in turn either maintain or transform social structures. To demonstrate how such a methodology could be applied in nursing research, we work through a case study concerning the theory-practice gap, arguing that the gap is neither the result of clinicians' ignorance of nor antipathy to theory, but is largely generated by the lack of resources enjoyed by nurses, which in turn is a reflection of the social structure of capitalism within which nurses operate.