scholarly journals The balancing act of organizing professionals and managers: An ethnographic account of nursing role development and unfolding nurse-manager relationships

2020 ◽  
Author(s):  
Jannine van Schothorst-van Roekel ◽  
Anne Marie J W M Weggelaar-Jansen ◽  
Antoinette A de Bont ◽  
Iris Wallenburg
Keyword(s):  
Development Process ◽  
Daily Practice ◽  
Professional Role ◽  
Ethnographic Study ◽  
Nurse Manager ◽  
Role Development ◽  
Nursing Role ◽  
It Impacts ◽  
Professional Authority ◽  
Nursing Professional

Abstract Scholars describe organizing professionalism as ‘the intertwinement of professional and organizational logics in one professional role’. Organizing professionalism bridges the gap between the often-described conflicting relationship between professionals and managers. However, the ways in which professionals shape this organizing role in daily practice, and how it impacts on their relationship with managers has gained little attention. This ethnographic study reveals how nurses shape and differentiate themselves in organizing roles. We show that developing a new nurse organizing role is a balancing act as it involves resolving various tensions concerning professional authority, task prioritization, alignment of both intra- and interprofessional interests, and internal versus external requirements. Managers play an important yet ambiguous role in this development process as they both cooperate with nurses in aligning organizational and nursing professional aims, and sometimes hamper the development of an independent organizing nursing role due to conflicting organizational concerns.

scholarly journals Nurses in the lead: a qualitative study on the development of distinct nursing roles in daily nursing practice

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jannine van Schothorst–van Roekel ◽  
Anne Marie J.W.M. Weggelaar-Jansen ◽  
Carina C.G.J.M. Hilders ◽  
Antoinette A. De Bont ◽  
Iris Wallenburg
Keyword(s):  
Qualitative Study ◽  
Healthcare Delivery ◽  
Organizational Capacity ◽  
Daily Practice ◽  
Role Development ◽  
Developmental Approach ◽  
Nursing Role ◽  
Healthcare Needs ◽  
Small Change ◽  
Nursing Roles

Abstract Background Transitions in healthcare delivery, such as the rapidly growing numbers of older people and increasing social and healthcare needs, combined with nursing shortages has sparked renewed interest in differentiations in nursing staff and skill mix. Policy attempts to implement new competency frameworks and job profiles often fails for not serving existing nursing practices. This study is aimed to understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice. Methods A qualitative study was conducted in four wards (neurology, oncology, pneumatology and surgery) of a Dutch teaching hospital. Various ethnographic methods were used: shadowing nurses in daily practice (65h), observations and participation in relevant meetings (n=56), informal conversations (up to 15 h), 22 semi-structured interviews and member-checking with four focus groups (19 nurses in total). Data was analyzed using thematic analysis. Results Hospital nurses developed new role distinctions in a series of small-change experiments, based on action and appraisal. Our findings show that: (1) this developmental approach incorporated the nurses’ invisible work; (2) nurses’ roles evolved through the accumulation of small changes that included embedding the new routines in organizational structures; (3) the experimental approach supported the professionalization of nurses, enabling them to translate national legislation into hospital policies and supporting the nurses’ (bottom-up) evolution of practices. The new roles required the special knowledge and skills of Bachelor-trained nurses to support healthcare quality improvement and connect the patients’ needs to organizational capacity. Conclusions Conducting small-change experiments, anchored by action and appraisal rather than by design, clarified the distinctions between vocational and Bachelor-trained nurses. The process stimulated personal leadership and boosted the responsibility nurses feel for their own development and the nursing profession in general. This study indicates that experimental nursing role development provides opportunities for nursing professionalization and gives nurses, managers and policymakers the opportunity of a ‘two-way-window’ in nursing role development, aligning policy initiatives with daily nursing practices.

L'opinion publique et les conflits de classes

Res Publica ◽  
1975 ◽  
Vol 17 (4) ◽  
pp. 563-588
Author(s):  
Nicole Delruelle
Keyword(s):  
Public Opinion ◽  
Relative Deprivation ◽  
Professional Role ◽  
Class Conflict ◽  
Opinion Poll ◽  
The Public ◽  
Authority Structure ◽  
Professional Authority

This article tries to confront the answers to certain questions in the opinion poll with the analysis (as proposed by Dahrendorf) of class conflict in our types of societies.It is wrong to say that people have modified the image they have of society, or that they would not consider it in terms of division and conflict any langer : conflicts are rather well perceived by public-opinion ; their aggravation is felt by many.According to the results of the poll, public opinion holds it that positions in the professional authority structure tend to be no longer identical with positions in the authority structure in society as a whole. This distinction goes together with a diminution of the importance of the professional role.  While quite well perceiving authority conflicts, the public seems to try to keep at some «distance» from these conflicts.According to their electorate's structure, political «families» express images of society either rather in terms of division and coercion (being associated with a larger dissatisfaction, with feelings of relative deprivation), or more in terms of integration (being associated with more satisfaction).

scholarly journals 'Team capital’ in quality improvement teams: findings from an ethnographic study of front-line quality improvement in the NHS

2020 ◽  
Vol 9 (2) ◽  
pp. e000948
Author(s):  
Catherine Montgomery ◽  
Stephen Parkin ◽  
Alison Chisholm ◽  
Louise Locock
Keyword(s):  
Quality Improvement ◽  
Patient Experience ◽  
Daily Practice ◽  
Healthcare Systems ◽  
Ethnographic Study ◽  
Front Line ◽  
Multiple Resources ◽  
Informal Knowledge ◽  
Organisation Management ◽  
Improve Patient

BackgroundTeamwork is important in the design and delivery of initiatives in complex healthcare systems but the specifics of quality improvement (QI) teams are not well studied.ObjectiveTo explain the functioning of front-line healthcare teams working on patient-centred QI using Bourdieu’s sociological construct of capital.MethodsOne medical ward from each of six NHS Trusts in England participated in the study, purposively selected for a range of performance levels on patient experience metrics. Three ethnographers conducted focused ethnography for 1 year, using interviews and observations to explore the organisation, management and delivery of patient-centred QI projects by the six front-line teams. Data were analysed using Bourdieu’s typology of the four forms of capital: economic, social, symbolic and cultural.ResultsWhile all teams implemented some QI activities to improve patient experience, progress was greater where teams included staff from a broad range of disciplines and levels of seniority. Teams containing both clinical and non-clinical staff, including staff on lower grades such as healthcare assistants and clerks, engaged more confidently with patient experience data than unidisciplinary teams, and implemented a more ambitious set of projects. We explain these findings in terms of ‘team capital’.ConclusionTeams that chose to restrict membership to particular disciplines appeared to limit their capital, whereas more varied teams were able to draw on multiple resources, skills, networks and alliances to overcome challenges. Staff of varying levels of seniority also shared and valued a broader range of insights into patient experience, including informal knowledge from daily practice. The construct of ‘team capital’ has the potential to enrich understanding of the mechanism of teamwork in QI work.

Consumer perception of the professional nursing role: development and testing of a scale

2000 ◽  
Vol 7 (3) ◽  
pp. 32-39 ◽  
Author(s):  
Sharon K. Judkins ◽  
Wendy J. Barr ◽  
Dolores Clark
Keyword(s):  
Consumer Perception ◽  
Role Development ◽  
Nursing Role ◽  
Professional Nursing

scholarly journals The daily digital practice as a form of self-care: Using photography for everyday well-being

2018 ◽  
Vol 23 (6) ◽  
pp. 621-638
Author(s):  
Liz Brewster ◽  
Andrew M Cox
Keyword(s):  
Practice Theory ◽  
Self Care ◽  
Daily Practice ◽  
Well Being ◽  
Ethnographic Study ◽  
Digital Communities ◽  
Individual Trait ◽  
Theory Framework

Interest in the connection between involvement in digital communities and well-being has increased as these communities become more commonplace. Specific models of interaction that affect well-being have emerged; here, we examine one of those models, termed ‘digital daily practice’. Digital daily practices involve a commitment to doing one thing – exercise, photography and writing – every day and sharing it online. Participants in these practices agree that they provide an unexpected benefit of improving well-being. This article makes an in-depth examination of one digital daily practice, photo-a-day, using a practice theory framework to understand the affordances it offers for well-being. We engage with the literature on well-being and self-care, critiquing its presentation of well-being as an individual trait. We present data from an ethnographic study including interviews and observations to highlight how photo-a-day as a practice functions as self-care and how communities are formed around it. Photo-a-day is not a simple and uncomplicated practice; rather it is the complex affordances and variance within the practice that relate it to well-being. We conclude that this practice has multi-faceted benefits for improving well-being.

scholarly journals Barreiras do processo de construção do enfermeiro-líder: uma etnoenfermagem

2018 ◽  
Vol 12 (5) ◽  
pp. 1381
Author(s):  
Liliane Alves Pereira ◽  
Carolina Domingues Hirsch ◽  
Rosemary Silva Silveira ◽  
Jamila Geri Tomaschewski-Barlem ◽  
Claudia Denise Schallenberger ◽  
...  
Keyword(s):  
Personal Characteristics ◽  
Institutional Culture ◽  
Daily Practice ◽  
Nursing Leadership ◽  
Ethnographic Study ◽  
Leadership Ethics ◽  
Nurse Leader ◽  
Building Process ◽  
Work Shifts ◽  
Process Method

RESUMOObjetivo: compreender as barreiras no processo de construção do enfermeiro-líder. Método: estudo qualitativo, fundamentado nos pressupostos da etnoenfermagem, tendo, como sujeitos, 22 profissionais da equipe de Enfermagem que compõem três turnos de trabalho. A análise dos dados respeitou o preconizado pela etnoenfermagem, que propõe que as informações sejam analisadas em quatro fases utilizando-se de critérios específicos e congruentes com o paradigma qualitativo e apresentando os resultados após cada fase. Resultados: foram agrupados nas categorias Características pessoais e Cultura Institucional. Conclusão: as principais barreiras na construção do exercício da liderança pelo enfermeiro devem ser reconhecidas para serem superadas no cotidiano do exercício profissional, pois tanto as características pessoais, quanto a cultura institucional devem ser transpostas com conhecimento e criatividade. Descritores: Enfermagem; Liderança; Ética, Metodologia de pesquisa em enfermagem; Cultura Organizacional; Saúde.ABSTRACT Objective: to understand the barriers in the nurse-leader building process. Method: a qualitative study, based on the presuppositions of the ethnographic study, having, as the subjects, 22 professionals of the Nursing team that compose three work shifts. The data analysis respected what was recommended by the ethnographic survey, which proposes that the information be analyzed in four phases using specific and congruent criteria with the qualitative paradigm and presenting the results after each phase. Results: were grouped in two categories: Personal characteristics and Institutional Culture. Conclusion: the main barriers in the construction of leadership by the nurse must be recognized to be overcome in the daily practice, since both personal characteristics and institutional culture must be transposed with knowledge and creativity. Descriptors: Nursing; Leadership; Ethics; Methodology of nursing research; Organizational culture; Health. RESUMEN Objetivo: comprender las barreras en el proceso de construcción del enfermero líder. Método: estudio cualitativo, fundamentado en los presupuestos de la etnoenfermería, teniendo, como sujetos, 22 profesionales del equipo de Enfermería que compone tres turnos de trabajo.  El análisis de los datos respetó el preconizado por la etnoenfermería, que propone que las informaciones sean analizadas en cuatro fases, utilizando criterios específicos y congruentes con el paradigma cualitativo, presentando los resultados después de cada fase. Resultados: se agruparon en las categorías:1) Características personales y 2) Cultura Institucional. Conclusión: las principales barreras en la construcción del ejercicio del liderazgo por el enfermero deben ser reconocidas para ser superadas en el cotidiano del ejercicio profesional, pues tanto las características personales, en cuanto a la cultura institucional deben ser transpuestas con conocimiento y creatividad. Descriptores: Liderazgo; Ética, Metodología de investigación en Enfermería; Cultura de la Organización; Salud.

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