scholarly journals How Community Nurses Manage Ethical Conflicts: A Grounded Theory Study

2019 ◽  
Vol 6 ◽  
pp. 233339361989495
Author(s):  
Caroline Porr ◽  
Alice Gaudine ◽  
Kevin Woo ◽  
Joanne Smith-Young ◽  
Candace Green
Keyword(s):  
Grounded Theory ◽  
Moral Agency ◽  
Moral Problem ◽  
Main Concern ◽  
Community Settings ◽  
Moral Uncertainty ◽  
Moral Residue ◽  
Ethical Conflicts ◽  
Self Talk ◽  
Glaserian Grounded Theory

Research is limited on how nurses in community settings manage ethical conflicts. To address this gap, we conducted a study to uncover the process of behaviors enacted by community nurses when experiencing ethical conflicts. Guided by Glaserian grounded theory, we developed a theoretical model (Moral Compassing) that enables us to explain the process how 24 community nurses managed challenging ethical situations. We discovered that the main concern with which nurses wrestle is moral uncertainty (“Should I be addressing what I think is a moral problem?”). Moral Compassing comprises processes that resolve this main concern by providing community nurses with the means to attain the moral agency necessary to decide to act or to decide not to act. The processes are undergoing a visceral reaction, self-talk, seeking validation, and mobilizing support for action or inaction. We also discovered that community nurses may experience continuing distress that we labeled moral residue.

Managing Digital Identities: A Grounded Theory of Mental Health Professionals’ Participation in Online Social Networking

2021 ◽  
pp. 104438942110144
Author(s):  
Kara S. Lopez ◽  
Susan P. Robbins
Keyword(s):  
Mental Health ◽  
Grounded Theory ◽  
Social Networking ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Social Process ◽  
Main Concern ◽  
Research Interviews ◽  
Glaserian Grounded Theory ◽  
Digital Identities

Despite the meteoric rise of social media, little is known about how clinical social workers and other mental health professionals respond to this new form of communication. This study used classic (Glaserian) grounded theory methodology to explore the experiences and concerns of mental health professionals on social networking websites such as Facebook, Twitter, and LinkedIn. The main concern that emerged out of research interviews with 26 mental health professionals was a loss of control over others’ perceptions and the loss of ability to compartmentalize the different parts of identities associated with personal and professional selves. Participants resolved these concerns through the author-identified basic social process of “managing digital identities.” This study highlights practice implications for professionals as they manage online identity.

Harmonizing hope: A grounded theory study of the experience of hope of registered nurses who provide palliative care in community settings

2011 ◽  
Vol 9 (3) ◽  
pp. 281-294 ◽  
Author(s):  
Kelly Penz ◽  
Wendy Duggleby
Keyword(s):  
Palliative Care ◽  
Grounded Theory ◽  
Registered Nurses ◽  
Care Delivery ◽  
Quality Care ◽  
Work Life ◽  
Main Concern ◽  
Theory Approach ◽  
Community Settings ◽  
Life Challenges

AbstractObjective:The purpose of this study was to explore the hope experience of registered nurses (RNs) who provide palliative care services in community settings. The specific aims of the study were to (1) describe their hope experience, (2) develop a reflexive understanding of the processes of their hope, and (3) construct a substantive theory of hope of palliative care RNs.Methods:Using constructivist grounded theory methodology, purposeful theoretical sampling was used to enroll 14 practicing community palliative care RNs in the study. Twenty-seven open-ended telephone interviews were conducted and nine daily journal entries on hope were copied. Interviews and journals were transcribed verbatim and analyzed using Charmaz's grounded theory approach.Results:Participants described their hope as a positive state of being involving a perseverant and realistic understanding of future possibilities. Their hope sustained and motivated them, and helped them to strive to provide high-quality care. The main concern for participants was keeping their hope when faced with work life challenges and contrasting viewpoints (i.e., when their hopes differed from the hopes of others around them). They dealt with this through harmonizing their hope by the processes of “looking both ways,” “connecting with others,” “seeing the bigger picture,” and “trying to make a difference.” Their experience of hope was defined within the social context of their work and lives.Significance of results:The results of this study suggest that hope is very important to palliative care RNs, in that it helps them to persevere and sustains them when faced with work life challenges in their practice. This study also highlights the need for continued research in this area as there appears to be a lack of evidence on the meaning of hope for healthcare professionals, and, in particular, understanding hope in the context of palliative and end-of-life care delivery.

scholarly journals GROUNDED THEORY METHODOLOGY IN THE CONTEXT OF SOCIAL INNOVATIONS FOR RURAL DEVELOPMENT RESEARCH

2018 ◽  
Author(s):  
Rasa PRANSKŪNIENĖ
Keyword(s):  
Grounded Theory ◽  
Rural Development ◽  
Scientific Literature ◽  
Main Concern ◽  
Development Research ◽  
Grounded Theory Methodology ◽  
Research Participants ◽  
Social Innovations ◽  
The World

Although the Grounded Theory (GT) methodology has been developed for over 50 years and is one of the most popular methodologies in the world, it is not often used in rural development research. In order to update the possibilities of applying GT in rural development research, this article is based on the analysis of scientific literature and presents the evolution of the development of GT methodology and the possibilities of its application in rural development research. The classic GT strategy is discussed in more detail, as methodology which provides the possibility to researcher to look at the phenomenon from inside without formulating the hypothesis, i.e., to “emerge” the theory, which reveals the main concern and explains how it is resolved, by conceptualizing the authentic experiences of research participants. The article aims to explain that classic GT is a “full package” approach, discusses its coding process; reveales the principles of the emerging classic GT. The GT methodology is discussed as the paradigm that can help researchers discover new insights and develop new theories, explaining the processes of social innovations for rural development.

Distressful Situations, Non-Supportive Work Climate, Threats to Professional and Private Integrity

2020 ◽  
pp. 54-79 ◽  
Author(s):  
Elisabet Tiselius ◽  
Elisabet Hägglund ◽  
Pernilla Pergert
Keyword(s):  
Health Care ◽  
Grounded Theory ◽  
Working Conditions ◽  
Language Barriers ◽  
Work Climate ◽  
Interview Study ◽  
Equal Access ◽  
Main Concern

This chapter describes situations of distress and the working climate of healthcare interpreters in Sweden. A questionnaire focused on distressful situations was administered to interpreters with experience in healthcare interpreting. The results indicated that distress in healthcare interpreting could be traced back to ethically and emotionally challenging interpreting situations and working conditions, and a lack of respect for the interpreters' work. An interview study using Grounded Theory showed that interpreters' main concern was the threat to professional and private integrity. Despite the fact that in general the interpreting profession in Sweden may seem professionalized, interpreters struggle with dilemmas connected to less professionalized activities. Our study was conducted in Sweden, but we argue that the results can be generalized to other countries. Although differently organized in different countries, health care interpreters experience similar dilemmas. Equal access to equitable care can be effectively hindered by language barriers.

Moral Professional Personhood: ethical reflections during initial clinical encounters in nursing education

2004 ◽  
Vol 11 (2) ◽  
pp. 122-137 ◽  
Author(s):  
Chryssoula Lemonidou ◽  
Elizabeth Papathanassoglou ◽  
Margarita Giannakopoulou ◽  
Elisabeth Patiraki ◽  
Danai Papadatou
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Lived Experience ◽  
Moral Agency ◽  
Personal Values ◽  
Moral Awareness ◽  
Written Narratives ◽  
Clinical Encounters ◽  
Ethical Conflicts ◽  
Ethical Reflections

Moral agency is an important constituent of the nursing role. We explored issues of ethical development in Greek nursing students during clinical practice at the beginning of their studies. Specifically, we aimed to explore students’ lived experience of ethics, and their perceptions and understanding of encountered ethical conflicts through phenomenological analysis of written narratives. The process of developing an awareness of personal values through empathizing with patients was identified as the core theme of the students’ experience. Six more common themes were identified. Development of the students’ moral awareness was conceptualized as a set of stages, commencing with empathizing with patients and nurses, moving on to taking a moral stand and, finally, concluding by becoming aware of their personal values and showing evidence of an emerging professional moral personhood. The notions of empathy, caring and emotion were in evidence throughout the students’ experience. Implications for practice and nurse education are discussed.

scholarly journals Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

2021 ◽  
Author(s):  
◽  
Patrea Rose Andersen
Keyword(s):  
Grounded Theory ◽  
Comparative Analysis ◽  
Nursing Students ◽  
Competency Assessment ◽  
Theory Approach ◽  
Validity And Reliability ◽  
Nursing Assessment ◽  
Assessment Of Competence ◽  
Glaserian Grounded Theory ◽  
Constant Comparative Analysis

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency  assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Ethical Issues in the Supportive Care of Patients With Advanced Kidney Disease

2020 ◽  
pp. 239-247
Author(s):  
Catherine R. Butler ◽  
Alvin H. Moss
Keyword(s):  
Kidney Disease ◽  
Moral Status ◽  
Ethical Issues ◽  
Moral Uncertainty ◽  
Quality Of Patient Care ◽  
Ethical Conflicts ◽  
Underlying Causes ◽  
The Individual ◽  
Social And Cultural Factors

Although the benefits of standard dialysis therapy for many older adults with complex comorbid conditions is equivocal, there continues to be substantial moral uncertainty in the practice of withholding and withdrawing dialysis treatment. This chapter reviews several ethical conundrums in palliative care of patients with advanced kidney disease, including uncertainty about the moral status of withholding dialysis and pursuing medical management without dialysis, challenges in decision-making when patients lack capacity to participate, and ethically relevant social and cultural factors influencing practice. Better understanding of the underlying causes of these conundrums reveals opportunities to improve quality of patient care at the individual and system levels by incorporating palliative practices. The chapter also suggests strategies for clinicians to identify and facilitate resolution of ethical conflicts around end-of-life care for patients with advanced kidney disease in clinical practice.

A grounded theory of humanistic nursing in acute care work environments

2016 ◽  
Vol 24 (8) ◽  
pp. 908-921 ◽  
Author(s):  
Mojgan Khademi ◽  
Eesa Mohammadi ◽  
Zohreh Vanaki
Keyword(s):  
Grounded Theory ◽  
Acute Care ◽  
Outcome Measurement ◽  
Essential Elements ◽  
Professional Values ◽  
Teaching Hospitals ◽  
Main Concern ◽  
Technological Advancement ◽  
Positive Interaction ◽  
Classic Grounded Theory

Background: Humanistic nursing practice which is dominated by technological advancement, outcome measurement, reduced resources, and staff shortages is challenging in the present work environment. Objective: To examine the main concern in humanistic nursing area and how the way it is solved and resolved by Iranian nurses in acute care setting. Research design: Data were collected from interviews and observations in 2009–2011 and analyzed using classic grounded theory. Memos were written during the analysis, and they were sorted once theoretical saturation occurred. Participants and research context: In total, 22 nurses, 18 patients, and 12 families from two teaching hospitals in Tehran were selected by purposeful and theoretical sampling. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals. Results: The main concern for the nurses is the violation of their rights. They overcome this concern when there is a synergy of situation–education/learning, that is, a positive interaction between education and learning of values and sensitivity of the situation or existence of care promotion elements. They turn to professional values and seeking and meeting others’ needs, resulting in “success and accomplishment” of nurse/nursing manager and patient/family. Conclusion: This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses’ professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses’ rights are violated.

scholarly journals Resisting, Reaching Out and Re-imagining to Independence: LPN’s Transitioning towards BNs and Beyond

2013 ◽  
Vol 10 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Sherri Melrose ◽  
Paul M. Wishart
Keyword(s):  
Higher Education ◽  
Grounded Theory ◽  
University Students ◽  
Research Program ◽  
Vocational Training ◽  
Main Concern ◽  
Institutions Of Higher Education ◽  
Nursing Role ◽  
The Core ◽  
Core Variable

AbstractLittle is known about the process of how nurses transition between vocational training and institutions of higher education. Understanding this process provides educators with the knowledge to support new groups of university students making this transition. Grounded theory (GT) was used to explore and understand this process. Three studies from a 7-year research program were used as data. The analysis led to the generation of a GT illuminating the process of students transitioning from post-LPN to BN. This GT illustrates how students overcome difficulties encountered moving to a more complex nursing role. The students’ main concern was a lack of independence. The core variable, which resolves this main concern, and which emerged from the analysis of the data is developing independence. There are three sub-core variables, resisting, reaching out and re-imagining which support this core variable of developing independence.

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