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Advancing Nursing Practice with a Unit‐based Clinical Expert
Author(s) -
Hanneman Sandra K.
Publication year - 1996
Publication title -
image: the journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 0743-5150
DOI - 10.1111/j.1547-5069.1996.tb00383.x
Subject(s) - nursing , grounded theory , sample (material) , context (archaeology) , unit (ring theory) , psychology , clinical practice , metaphor , nursing practice , qualitative research , medicine , sociology , paleontology , social science , chemistry , linguistics , mathematics education , philosophy , chromatography , biology
Objective: To explore patterns in the practice of nursing and patient outcomes. Design: Qualitative field research. Population, Sample, Setting: Populations were critical care nurses and critically ill adult patients in the 10‐bed medical critical care unit of a 900‐bed teaching hospital. A convenience‐purposive sample of 27 nurses and 31 patients was studied in 1985. Methods: Six months of participant observation, unstructured interviews, and the constant comparison method of grounded theory. Findings: Markedly different patterns were found in expert and nonexpert practice. The substantive theory of conversion helped explain how the majority of nonexpert nurses advanced their practice. The metaphor of catalyzed conversion captures how a unit‐based expert nurse serves as a catalyst to advance the practice of nonexperts. Presence, defined as the way of being within a given clinical context, differentiated nurses. Conclusions: (a) Expert and nonexpert practices are substantively different, (b) Expert and nonexpert practice results in different patient outcomes, (c) Conversion helps explain changes in nonexpert practice. Clinical Implications: A unit‐based expert nurse can increase patient‐focused care.