Primary nursing: autonomy or autocracy?

There has been an almost exponential increase in the number of clinical areas using primary nursing as a mode for delivering nursing care Concurrently, the amount of written material pertaining to primary nursing has grown In this paper, a small sample of this literature is reviewed Most of the literature can be seen as either descriptive or as evaluative research Many of the papers reviewed have methodological weaknesses, also the findings are equivocal about the advantages and the nature of primary nursing A major problem appears to be that the basic tenets, beliefs and values of primary nursing have not been systematically investigated, thus attempts to evaluate primary nursing without such a philosophical analysis may be misdirected This paper argues that such an analysis (a) is now necessary, (b) requires a qualitative research approach to generate theory, and (c) that a grounded theory methodology is the most appropriate way to do this A preliminary field study is briefly described and the generated data discussed