This qualitative study critically examined nurses' perception of nursing qua nursing in an American Nurses Credentialing Center Magnet® re-designated healthcare system in Albany NY. Watson's Theory of Human Caring is used by many Magnet® hospitals, including the site for this study, to inform and guide nursing practice. Watson's Theory supports concepts and practices of integral health, holism, caring, healing, and the education and integration of complementary health care modalities as independent therapeutic nursing interventions. This study aimed to understand the nurse's emancipatory experience, comportment and self-agency as she/he participated in a theory guided practice; and illuminate the nurses' acquisition, understanding and utilization of knowledge and power as required for engaging independent therapeutic nursing interventions in the unitary-transformative health paradigm.
Eight nurses from the Oncology Unit self-selected to participate without recidivism from August to October 2012. The study was conducted in two parts: 1) A questionnaire was developed by the researcher to collect demographic and educational data from participants including: age, ethnicity, level of academic education, years of experience in nursing and in specialty, education to nursing theory, including education specifically to Watson's Theory of Human Caring and to holistic nursing and Complementary and Alternative Modalities (CAM), and CAM use in practice and self-care; and 2) Kim's (1999, 2007, 2010) Critical Narrative Inquiry Method was used to collect and analyze narrative data in three phases: 1) descriptive 2) reflective; and 3) critical-emancipatory. Written and audio data from in-person interviews were transcribed and analyzed by the researcher. Data was validated by participants and used to answer four research questions: 1) What are the emancipatory experiences of nurses in a Magnet® re-designated healthcare system that promotes Human Caring Theory; 2) What are the patterns that facilitate nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet® re-designated healthcare system; 3) What are the patterns that create barriers to nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet ® re-designated healthcare system; and 4) How does the organization support nurses control over their nursing practice within this one ANCC Magnet ® re-designated healthcare system? Findings gleaned from the patterns that occurred most frequently in the narrative data included: 1) Nurses used Human Caring and Integral Nursing theoretical concepts to inform and conduct their practice; even though they reported limited education to the theories. Elements of the theories that manifested in their practice and self-care included: advocating, educating, counseling, creating a caring-healing environment by honoring the patient and family's space and wishes, approaching patients and families non-judgmentally with an open mind and loving kindness, using complementary modalities of humor, prayer, intention, authentic presence, music, imagery, touch, and obtaining complementary therapy, palliative and spiritual care consults for patients; 2) Facilitators to practice included: the support of their manager, colleagues and team members, optimal staffing patterns, resource nurses and competent, self-motivated care technicians and support staff; and 3) Nurses in the study confirmed their Magnet® healthcare system values: a) Supportive and participative nursing management; b) Advanced education by providing tuition reimbursement and flexible scheduling; c) Participation in and use of the most current nursing research in their practice; and d) A strong nursing mentoring culture, where nurses empower each other to provide ethical care and advocate for patients' and nurses' rights. Opportunities for nursing education and leadership include: 1) The need to revise academic and continuing education curricula to adopt integral theory guided practice at all levels; 2) The need for advanced practice nurses to translate conceptual models into practice and help nurses to articulate the value and power of nursing to impact integral health and healing.
Suggested Keywords: nursing, holistic, integral, human caring, theory guided practice, emancipatory praxis, critical narrative inquiry, ANCC Magnet®.
|Commitee:||Brewer, Barbara B., Kelman, Glenda B.|
|School:||Sage Graduate School|
|Department:||School of Health Sciences|
|School Location:||United States -- New York|
|Source:||DAI-B 74/12(E), Dissertation Abstracts International|
|Subjects:||Philosophy, Pedagogy, Nursing|
|Keywords:||Ancc magnet, Critical narrative inquiry, Emancipatory praxis, Human caring, Integral health, Theory guided practice|
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